Anticipatory nausea and vomiting among cancer patients: A Review

Abstract

Anticipatory nausea and vomiting (ANV), as a side-effect of cancer chemotherapy, is a well recognized phenomenon. The literature is reviewed for data on: prevalence rates, factors contributing to onset and psychological treatments used to attempt a remission in the symptoms. From the available evidence it appears that ANV is a substantial problem with one major review indicating an average combined prevalence of 32%. Although explicable using a conditioning model it has a complex aetiology with emotional and cognitive elements, as well as specific pharmacological factors, playing a role in onset. ANV appears to be responsive to psychologically-based treatment methods, with a good outcome overall. However, more process evaluation is needed in order to understand aetiologic and treatment mechanisms and to determine how best to treat cases of ANV with different aetiologies. It is considered that procedures for identifying and referring patients with ANV should be routinely incorporated into the care of cancer patients receiving repeated cycles of chemotherapy.     

Inattention,working memory,and academic achievement in adolescents referred for attention deficit/hyperactivity disorder (ADHD)

This study investigated the role of inattention and working memory in predicting academic achievement in 145 adolescents aged 13 to 18 referred for attention deficit/hyperactivity disorder (ADHD). Path analysis was used to examine whether auditory-verbal and visual-spatial working memory would mediate the relationships between classroom inattention symptoms and achievement outcomes. Results provide support for the mediational model. Behavioral inattention significantly predicted both auditory-verbal and visual-spatial working memory performance. Auditory-verbal working memory was strongly associated with adolescents' achievement in reading and mathematics, while visual-spatial working memory was only associated with achievement in mathematics. The path from inattention symptoms to reading was partially mediated by the working memory variables, but the path from inattention to mathematics was not mediated by working memory. The proposed model demonstrated a good fit to the data and explained a substantial amount of variance in the adolescents' achievement outcomes. These findings imply that working memory is a risk factor for academic failure for adolescents with attentional problems.     

Working in the Metaphor Commentary on Paper by Stephen Seligman

This paper expands on Seligman's ideas about mentalization and the challenges of working with patients who cannot mentalize. Seligman's clinical presentation demonstrates that much valuable analytic work takes place without explicit reference to the transference. Drawing on Britton's notion of the triangular internal space that allows for reflective thought, we propose that analytic interest in an external object, discovered through the relationship and meaningful to both patient and analyst, helps create the same kind of space. The difference-within-sameness of shared contemplation can increase receptivity to divergent perspectives. Likewise, the “third object” can become a therapeutic metaphor, open to various meanings without being limited to any one interpretation. We trace how Seligman and his patient use a series of third objects in their work together. In this process, the patient moves from a transitional relationship of minimal differentiation to an increasingly secure sense of her own separateness, beginning to accept, and even enjoy, having a motivated mind of her own. Finally, we discuss how Ferro's concept of the analytic field offers a theoretical rationale for the effectiveness of this process.     

Student autonomy and course value: The unique and cumulative roles of various teacher practices

High school students (N = 278) in 30 classrooms with ten teachers (grades 9 through 12) reported on teacher practices in a single course, autonomy need satisfaction, and value for that course. Using hierarchical linear modeling, results indicated that student perceptions of teachers providing choices and engaging in perspective-taking to a greater extent uniquely related to greater autonomy need satisfaction. Subsequent analyses suggested that students’ autonomy need satisfaction was greatest when they perceived that teachers also identified the importance and usefulness of coursework and considered students’ interests and opinions in course activities. Provision of choice and perspective-taking related to greater course value through autonomy need satisfaction, while identifying the importance and usefulness of course activities had only direct positive effects on course value. The pattern of total, direct, and indirect effects was slightly different depending on the component of course value. Results underscore the importance of including provision of choice in conceptualizations of teacher autonomy support.     

Handling and self-handling: An object relations perspective on leisure exercise

This paper considers participation in exercise activities as a form of ‘self-handling’. The focus is on individual exercise rather than on activities, such as those involved in some sports and martial arts, which involve pair or group interaction.

The author suggests that the way in which physical activity is used, abused, or avoided in adult life is linked to the quality of primary relationships and in particular to childhood experiences of handling (Winnicott 1962a, 1970). She suggests that exercise evokes ‘memories-in-feeling’ (Klein 1957) of early experiences of handling and is thus essentially object related. A number of different psychic functions of exercise are considered in relation both to theory, particularly Winnicottian theory, and to clinical material.

As we are all aware, not everything a client does in the external world is raised for consideration in the context of the therapeutic relationship. The author reflects on the need to consider the meaning of the client's introduction of the subject of exercise into the therapeutic discourse, as well as the meaning of the physical activity itself.     

Soul pain and the therapeutic use of ritual

Abstract

This paper will explore the relationship between ritual and transformation. It will show how a therapist and a monk work together to create sacred spaces in which individuals can experience transformation of and through their personal histories, linking their past, present and future to address their soul pain through ritual.

It is illustrated with case studies which will demonstrate the phases of ritual work which are collectively important as part of the psycho-dynamic therapeutic process.     

Migration: Vocational perspectives on a complex and diverse transition

This paper outlines the origins of this special issue: a UK Economic and Social Research Council supported seminar series on ‘Careers and Migration’. The series elucidated a number of salient (though under-researched) issues: migration as a diverse and complex process; the loss, recovery and reconstruction of career capital as central in the migration experience; insecurity, security and their dynamic interplay; the salience of relationships with family, compatriots and communities in migrants' career development; and the appropriateness of creative approaches in researching migrants' careers. The seven articles, written by interdisciplinary authorial teams (sometimes working in different occupational sectors) contribute to our understandings of these pressing concerns.     

The Cognitive Reflection Test as a predictor of performance on heuristics-and-biases tasks

The Cognitive Reflection Test (CRT; Frederick, 2005) is designed to measure the tendency to override a prepotent response alternative that is incorrect and to engage in further reflection that leads to the correct response. In this study, we showed that the CRT is a more potent predictor of performance on a wide sample of tasks from the heuristics-and-biases literature than measures of cognitive ability, thinking dispositions, and executive functioning. Although the CRT has a substantial correlation with cognitive ability, a series of regression analyses indicated that the CRT was a unique predictor of performance on heuristics-and-biases tasks. It accounted for substantial additional variance after the other measures of individual differences had been statistically controlled. We conjecture that this is because neither intelligence tests nor measures of executive functioning assess the tendency toward miserly processing in the way that the CRT does. We argue that the CRT is a particularly potent measure of the tendency toward miserly processing because it is a performance measure rather than a self-report measure.