Psychological Follow-up of Presymptomatic Genetic Testing for Spinocerebellar Ataxia Type 2 (SCA2) in Cuba

Presymptomatic testing for spinocerebellar ataxia type 2 (SCA2) in Cuba started five years ago. We have now investigated the psychological impact of test results on 150 individuals at 50% risk for SCA2. In a prospective study, psychological instruments were used to evaluate depression, anxiety and family functioning (1) before testing and (2) one year after disclosure of the test result. One year after, anxiety and depression levels decreased both in carriers and non-carriers, but anxiety decreased significantly more in carriers. Pathological levels of anxiety were seen mostly in members of dysfunctional families, but decreased more in them than in other consultands. Presymptomatic testing thus seems to have been especially beneficial for these testees, possibly due to a greater gain from the psychosocial support received. It would be pertinent to evaluate now the impact of other psychosocial variables and perform longer-term longitudinal studies.     

Developmental changes in mother-infant face-to-face communication: birth to 3 months

This study documented the growth of the earliest form of face-to-face communication in 16 mother-infant dyads, videotaped weekly during a naturalistic face-to-face interaction, between 1 and 14 weeks, in 2 conditions: with the infant in the mother's arms and with the infant semi-reclined on a sofa. Results showed a curvilinear development of early face-to-face communication, with a significant increase occurring between Week 4 and Week 9 depending on the dyad. After 2 months, trajectories diverged into 2 groups: I whose duration of face-to-face communication continued to increase and I whose duration peaked and then began to decrease. After the 1st month, the duration of face-to-face communication was significantly longer when the infant was on the sofa rather than in the mother's arms. In the latter condition, during the 3rd month, girls spent a significantly longer time than boys in face-to-face communication. These findings suggest that context (infant being held vs. not being held) interacts with the infant's age and sex in affecting mother-infant communication.     

Cognitive changes following subthalamic nucleus stimulation in two patients with Parkinson disease

The limits of a drug therapy in severe forms of Parkinson disease have led to refining neurosurgery on the basal ganglia. Deep brain stimulation of the subthalamic nucleus has been recognized as one of the most promising techniques to decrease "off" motor symptoms and motor fluctuations, allowing a reduction of drug therapy and limiting side effects of the drugs. There is still open debate on the possible consequences of chronic subthalamic stimulation in other ways, apart from motor symptoms, of general cognitive performance. We examined and followed two patients with Parkinson disease for 9 mo. after surgery for deep stimulation, studying their cognitive performances. There is a general amelioration of cognitive performances, in particular as far as linguistic capabilities is concerned. We discuss the possible significance of these results, reminding strenuously that only two patients were involved, so the potential for generalization is seriously limited.     

El contexto de descubrimiento y la psicología de la ciencia

Resumen

Desde que el neopositivista Reichenbach planteó la división, en el análisis de la ciencia, entre contexto de descubrimiento y contexto de justificación se empieza a considerar el primero como una tarea que incumbe a los psicólogos. Aquí se revisan las explicaciones de la psicología actual sobre el descubrimiento científico que se incluyen dentro de ese nuevo enfoque científico propugnado por los postpopperianos, donde convergen el análisis histórico, sociológico y psicológico. Se reseñan las aportaciones más relevantes para la explicación de la creatividad científica: el estudio cognitivo de casos de Gruber, el análisis temático de Holton, la concepción del genio científico de Simonton así como las obras «programáticas» definidoras de los contenidos y métodos de esta «ciencia de la ciencia» como las de Tweney et alt., Miller o Giere.     

La interpretación asociativa del proceso creador

Resumen

Este trabajo es una revisión de las aportaciones a la psicología de la creatividad, que proceden de las interpretaciones asociativas del proceso creador.

Las referencias introspectivas de los individuos excepcionalmente creadores en el ámbito científico, literario o artístico han servido de argumento a los teóricos del proceso asociativo, por ello se hace una referencia a estos trabajos en la primera parte del artículo, para, posteriormente, centrar la revisión en el análisis de la teoría asociativa de Mednick, como la más elaborada y sistemática de cuantas aportaciones se han hecho a la definición del pensamiento creador como un proceso asociativo. Se ofrecen datos del propio grupo de Mednick sobre argumentos empíricos de validación de la teoría y se plantean las limitaciones de la validez de la misma en relación con el instrumento de evaluación de la aptitud creadora en términos asociativos: el «Remote Associated Test».     

The cognitive regulation of emotions: The role of success versus failure experience and coping dispositions

Attention deployment and generating specific types of cognitions are central cognitive mechanisms of emotion regulation. Two groups of hypotheses make contradicting predictions about the emotion-cognition relationship. The moodcongruency hypothesis expects the emergence of mood-congruent cognitions (i.e., negative mood leads to negative and positive mood to positive cognitions). Similarly, a substantial body of research suggests that negative mood induces selffocus, whereas positive mood elicits an external focus of attention. The moodrepair hypothesis, on the other hand, assumes that persons in a negative mood state summon thoughts incongruent with that state and divert attention away from the self. However, the temporal sequence of cognitions assessed as well as coping dispositions, such as vigilance and cognitive avoidance, may moderate these relationships. Positive and negative emotional states were elicited by exposing the participants to the experience of success or failure in a demanding cognitive task. Cognitions that were present after emotion induction were assessed by means of a thought-listing procedure. For the total sample, results clearly confirmed the moodcongruency hypothesis. Thought order was a critical factor only for changes in self-focus. Thought valence (positive, neutral, negative) as well as self-focus were substantially influenced by coping dispositions.     

Cerebellum and processing of negative facial emotions: Cerebellar transcranial DC stimulation specifically enhances the emotional recognition of facial anger and sadness

Some evidence suggests that the cerebellum participates in the complex network processing emotional facial expression. To evaluate the role of the cerebellum in recognising facial expressions we delivered transcranial direct current stimulation (tDCS) over the cerebellum and prefrontal cortex. A facial emotion recognition task was administered to 21 healthy subjects before and after cerebellar tDCS; we also tested subjects with a visual attention task and a visual analogue scale (VAS) for mood. Anodal and cathodal cerebellar tDCS both significantly enhanced sensory processing in response to negative facial expressions (anodal tDCS, p=.0021; cathodal tDCS, p=.018), but left positive emotion and neutral facial expressions unchanged (p>.05). tDCS over the right prefrontal cortex left facial expressions of both negative and positive emotion unchanged. These findings suggest that the cerebellum is specifically involved in processing facial expressions of negative emotion.     

The mental pain of the psychoanalyst: A personal view

Abstract

Mental pain is a common concern of psychoanalysts in their professional life. Combining her clinical experience with previous contributions by others, the author presents a personal overview of the patient-triggered mental pain of the analyst. Countertransference is considered to be the major source of the analyst's work-derived mental pain. This type of mental pain is not to be avoided or discarded by the analyst. Rather, the analyst will benefit from tolerating and even welcoming professional mental pain: in most cases, mental pain will bring with it rich clinical material that, upon interpretation, will help him or her to offer previously intolerable contents back to the patient in a transformed version that now becomes acceptable. The analyst's mental pain may emerge in his dreams; clinical examples of this phenomenon are presented. It is suggested that there is an increased chance of the analyst undergoing mental pain when treating patients suffering from severe psychopathology, and a clinical case is reported to illustrate this assertion. The author proposes that a lifelong effort is to be expected from analysts in terms of enhancing their threshold of tolerance to professional mental pain. In situations of mental pain, analysts must be particularly aware of the need to modulate their interpretations before transmitting them to the patient. The capacity of analysts to transform their mental pain (Ta, according to Bion) will depend on the plasticity of their container functions, the quality of their transformation abilities and, in particular, their threshold of tolerance to mental pain.     

Perversion on the other side of the couch

Abstract

Taking as his starting point the fact that, according to Freudian theory, perversion is inherent to the human being, the author focuses upon an aspect of perversion that has been little discussed: perversion on the other side of the couch, and thereby questions of how, in psychoanalytic theoretical and clinical practice, perverted drive motions may be presented. Such a phenomenon takes various forms: actually being enacted with patients; using psychoanalytic theory as a normative rule; the individual choice of profession and so forth. To exemplify his point of view, the author presents four different expressions of sexuality in Freudian theory: genital sexuality, perverted sexuality, the sexuality of the Ideals and narcissistic sexuality. After differentiating these four sexual expressions, the author shows how each of them may generate perversion in both clinical and theoretical psychoanalysis.

Ceccarelli P Perversion auf der anderen Seite der Couch

Indem er als Ausgangspunkt die Tatsache nimmt, daß entsprechend der Freudianischen Theorie Perversion dem menschlichen Sein inhärent ist, fokussiert der Autor auf einen Aspekt der Perversion, der wenig diskutiert wurde: Perversion auf der anderen Seite der Couch und damit Fragen, wie in der psychoanalytischen und klinischen Praxis pervertierte Triebbewegungen dargestellt werden können. Ein solches Phänomen zeigt sich in verschiedenartigen Formen: tatsächlich mit Patienten in Szene gesetzt; im Gebrauch psychoanalytischer Theorie als einer normativen Regel; die individuelle Wahl des Berufs und so weiter. Um seinen Standpunkt zu exempifizieren, stellt der Autor vier verschiedene Ausdrücke von Sexualität in der Freudianischen Theorie dar: genitale Sexualität; perverse Sexiualität; die Sexualität der Ideale; und narzißtische Sexualität. Nach einer Differenzierung dieser vier Ausdrücke für Sexualität zeigt der Autor, wie jeder von ihnen Perversion in klinischer und theoretischer Psychoanalyse generieren kann.

Ceccarelli P. Perversión del otro lado del diván.

Tomando como punto de partida el hecho de que de acuerdo a la teoría Freudiana la perversión es inherente al ser humano, el autor se enfoca en un aspecto de la perversión que ha sido muy poco discutido: la perversión del otro lado del diván, se pregunta cómo en la práctica psicoanalítica clínica y teórica, algunos impulsos pervertidos pueden estar presentes. Un fenómeno así puede tomar diversas formas: pasos al acto con pacientes, usar la teoría psicoanalítica como regla normativa, la elección individual de profesión y así. Para ejemplificar su punto de vista, el autor presenta cuatro diferentes expresiones de la sexualidad en la teoría freudiana: la sexualidad genital, sexualidad pervertida, la sexualidad de los Ideales, y la sexualidad narcisista. Además de diferenciar estas cuatro expresiones sexuales, el autor demuestra como cada una de estas formas puede generar perversión en el psicoanálisis clínico y teórico.     

Distinction between mental pain and psychic suffering as separate entities in the patient's experience

Abstract

Mental pain and psychic suffering are herein defined as two separate concepts in psychoanalysis. The concept of mental pain lies at the core of psychoanalysis; it was introduced by Freud and was further elaborated by a number of investigators, mostly by Bion. Mental pain refers to a pain that the patient reports as being impossible to describe in words, and lacking any associations, whereas psychic suffering can be both named and described by the patient. Mental pain is derived from non-tolerance on the part of the psychic apparatus when it is harmed by very painful emotions. In contrast to psychic suffering, mental pain resists elaboration and transformation by dream-work. How to address and transform the patient's mental pain is a major challenge facing the analyst in his clinical work because mental pain may halt or slow the progression of the analytical process. To overcome this hindrance, the work of the analyst is focused on helping patients to modify their mental pain into psychic suffering, that is, to reactivate in the patient the chain of transformations that generates thought. The analyst is also challanged with the mental pain of the patients because he has himself to tolerate the mental patient induced by counter transference. Suggestions for the analyst on how to deal with the mental pain of the patient during psychoanalytic therapy are proposed.