Development of a Health Related Quality of Life Measure for Adolescents and Young Adults Following Invasive Meningococcal Disease

This study describes the key areas that matter to adolescent survivors of Invasive Meningococcal Disease (IMD). Satisfaction with Life After Meningitis is a brief multidimensional measure of health related quality of life that is reliable and correlates with criterion variables in a theoretically meaningful way. To develop a Health Related Quality of Life (HRQoL) measure for adolescent and young adult survivors of (IMD) we used a cross-sectional study and focus groups. The study was conducted in two phases. In Phase 1 a pool of potential items were generated based on the following: a review of existing measures, focus groups with IMD survivors, and an expert group consultation. Phase 2 involved administration of the questionnaire to a sample of adolescent and young adult IMD survivors. Factor analysis suggested a correlated four factor solution: Wellbeing, Positive about Future, Social Support, and Confidence. These factors were significantly correlated in a theoretically predictable way with scores from the Beck Depression Inventory (correlations ranged from ?0.77 to ?0.81) and the eight domains of the SF-36 Health Survey (correlations ranged from 0.32 to 0.79). The reliability of all subscales was high ranging from 0.85 to 0.92. The Satisfaction with Life After Meningitis (SLAM) questionnaire is a HRQoL self-report measure that produces reliable scores and is appropriate for use with young survivors of IMD. There is also evidence of concurrent validity with existing measures of physical and psychological well-being.     

THE BIRTH OF PSYCHOANALYSIS FROM THE SPIRIT OF TECHNIQUE1

The author aims to demonstrate, through a textual analysis of Freud's work, how the creation of psychoanalysis as a plausible set of understandings of the human mind has a methodological origin that has sometimes been overlooked: in the Greek concept of techne. Freud, an acknowledged pupil of Brentano, was well versed in Aristotelian rhetoric, and selected this instrument of investigation, dependent on language, from the outset of his efforts to describe, understand and treat the world of the unconscious mind. Working in the tradition of techne Freud actually rehabilitated ‘guessing’ (zu erraten) ‐ although it became a largely overlooked concept in Freud's work ‐ and so sought to place conjectural reason as the definitive form of knowledge for the investigation and treatment of the mind. This explains why the 1895 ‘Project’ could not succeed and why technique became irreplaceable as the via regia in ‘The Interpretation of Dreams’. Its model is founded in Aristotelian rhetoric, whose conception of language was first rediscovered by Nietzsche and was used therapeutically by Freud. Freud's view is apparent in his 1923 definition of psychoanalysis which is compared to the current IPA definition, a definition which, the author suggests, gives a misleading prominence to ‘theory’ and which shows how far a questionable rationality has removed conjectural reason from the field, to its detriment. From this point of view it is argued that the ‘precious conjunction’ (Freud) between investigation and treatment has been abandoned, and the concept of historical truth and its significance for psychoanalysis obscured.     

The effect of inpatient cognitive-behavioral therapy for eating disorders on temperament and character

Personality traits seem to have an important role in the development, clinical expression, course, and treatment response in eating disorders (EDs). We investigated the effects of an inpatient cognitive-behavioral treatment (CBT) on the measures of temperament and character (Temperament and Character Inventory (TCI)) in 149 consecutive patients with EDs. Baseline assessment included anthropometry, the Eating Disorder Examination (EDE), the Beck Depression Inventory (BDI), and the TCI. Treatment was based on the transdiagnostic cognitive behavior theory and treatment of ED, adapted for an inpatient setting. Treatment effects were tested by paired ANOVA, adjusted for covariates. No effects were found on Novelty Seeking, Reward Dependence, and Cooperativeness. Harm Avoidance (F=18.17, p<0.001), Persistence (F=7.71, p=0.006), Self-Directedness (F=27.55, p<0.001), and Self Transcendence (F=16.38, p<0.001) significantly changed after treatment. Changes in TCI scores were wholly dependent on the changes in BDI and EDE, and independent of ED diagnosis and behavior and of BMI changes. We conclude that in ED, a few scales of both temperament and character are significantly modified by CBT, in relation to changes in psychopathology and depression, independently of nutrition. These results are relevant for future studies based on TCI.     

Self-attributed body-shadows modulate tactile attention

Our body-shadows are special stimuli in the visual world. They often have anatomical resemblance with our own body-parts and move as our body moves, with spatio-temporal correlation. Here, we show that self-attributed body-shadows cue attention to the body-part they refer to, rather than the location they occupy. Using speeded spatial discrimination for tactile or visual targets at the hands, or for visual targets delivered near the hand-shadows, we demonstrate that mere viewing of task-irrelevant shadows can selectively facilitate tactile discrimination at the body-part casting the shadow (Experiment 1). In addition, such facilitation only develops through time for cast-shadows that have no resemblance with the body-part, but move in spatio-temporal correlation with it (Experiment 2). Conversely, facilitation fades away rapidly for shadow-like images that resemble the stimulated body-part, but are in fact static pictures (Experiment 3). Thus, recognising oneself as the owner of a shadow affects distribution of tactile attention.     

The Sequential Combination of Pharmacotherapy and Psychotherapy in Mood Disorders

The aim of this review was to consider the literature concerned with a sequential use of pharmacotherapy and psychotherapy in mood disorders. Review of the clinical trials where treatment components were used in a sequential order were identified by using MEDLINE, a manual search of the literature and the Index Medicus. In unipolar recurrent depression, the sequential use of pharmacotherapy and psychotherapy was found to improve relapse rate. In bipolar disorder, the use of psychotherapeutic strategies in patients who were already assuming mood stabilizers was also found to yield clinical benefits. The sequential model has the potential for improving the logic and timing of interventions. A conceptual shift in current assessment methods (staging) is needed.     

A longitudinal examination of early communicative development: Evidence from a parent‐report questionnaire

The present research employed a longitudinal design to assess the verbal and non‐verbal communicative abilities of a sample of 104 children, using two different parent‐report instruments: the Questionnaire for Communication and Early Language (QCEL) development at 12, 16, and 20 months, and the Italian adaptation of the MacArthur–Bates Communicative Development Inventories: Words and Gestures at 23 months. The results supported and extended previous data about the validity of the QCEL, by showing that: (1) both verbal and non‐verbal variables predicted the level of language development at 23 months; (2) children classified as at‐risk with the QCEL had reduced vocabulary size and a lower number of sentences at 23 months; (3) early individual differences in the use of words and gestures were associated with later differences in linguistic abilities. It is concluded that the longitudinal use of the QCEL questionnaire can provide useful information about language development.