Comparison of outcome in men and women after treatment in psychiatric security hospitals in Germany

Previous research has shown that forensic psychiatric treatment reduces reoffending, rehospitalization and premature mortality. Treatment outcome varies with diagnosis, but little is known about the influence of sex, psychosocial adjustment and aftercare. To assess these variables, we interviewed male and female patients discharged from three psychiatric security hospitals in Germany in the years 2010–2017. Participants were interviewed at discharge (n = 609) and 1 year later (n = 366) about reoffending, readmissions, substance use and psychosocial adjustment. Among patients with substance use disorder (SUD), 14% reoffended, 20% were re-hospitalized and 60% maintained abstinence. Among patients with severe mental disorder, 5% reoffended and 13% were re-hospitalized. Significant sex differences were found in offenders with SUD. The results suggest that sociodemographic and disorder-related risk factors are associated with treatment success and that female patients with SUD might need a specific treatment approach. Sex-specific aspects, diagnosis and psychosocial adjustment should be considered in forensic psychiatric treatment and risk assessment.     

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.     

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.     

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.     

Twist Structures and Nelson Conuclei

Studia Logica - Motivated by Kalman residuated lattices, Nelson residuated lattices and Nelson paraconsistent residuated lattices, we provide a natural common generalization of them. Nelson...     

Is interoceptive awareness really altered in somatoform disorders? Testing competing theories with two paradigms of heartbeat perception

Alterations in the perception of body signals (i.e., interoceptive awareness [IA]) are considered crucial for the development and maintenance of somatoform disorders (SFDs). However, competing theories come to different conclusions about whether IA is increased or decreased in SFDs. The present study investigated IA in 23 patients with SFDs (as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and in 27 healthy controls. IA was reliably assessed with two well-established heartbeat perception paradigms (heartbeat discrimination task and mental tracking task). The results of both paradigms showed no evidence for increased IA in patients with SFDs. Correlational analyses revealed that having a higher number of somatoform symptoms was significantly linked to lower (rather than higher) IA in SFDs. These findings are in line with recent cognitive approaches to SFDs that stress the importance of biased schema-guided processing of interoceptive information. (PsycINFO Database Record (c) 2012 APA, all rights reserved).