Understanding suicidal behaviour in young people referred to specialist CAMHS: a qualitative psychoanalytic clinical research project

A qualitative psychoanalytic clinical research project using a post-Kleinian contemporary approach was undertaken by a team of seven qualified and experienced child psychotherapists working in community Tier 3 Child and Adolescent Mental Health Services (CAMHS). A number of referred young people who deliberately harmed themselves or attempted suicide, who fulfilled the inclusion criteria and consented to participate, were offered an extended individual and family assessment. Grounded Theory analysis of the qualitative data led to the formulation of the Truth Danger Theory. Typical situations in which suicidal behaviour occurred were identified, including intergenerational confusion, neglect, physical and/or sexual abuse within the family, Oedipal conflict, maternal depression and families in which there was a chronically ill sibling. We found that there was a marked disparity between the young person's experience of relationships in the family and the family's own account of their situation, a fractured reality. This can be reflected in an incongruence in the young person's presentation, which may be misleading when assessing risk. The young person feels him/herself to be in a dead end from which there seems to be no escape. Self-harm, for some, contains this impossible dilemma (albeit pathologically) but when it does not, suicide may seem the only option. The Truth Danger Theory provides explanations and predictions for suicidal behaviour and has implications for clinical practice.     

Learning to say goodbye. An essay on Philip Pullman's The Amber Spyglass Volume 3 of His Dark Materials

This paper discusses the third volume of Pullman's remarkable trilogy. The two main child characters, Lyra and Will, are now entering adolescence, and the novel explores their intense and ambivalent feelings towards the parents and the variously protective or hostile parental figures who surround them. The novel devises remarkable imaginary worlds – for example the land of the mulefa, and the underworld visited by Will and Lyra – through which to explore issues of considerable intellectual and emotional depth. The ‘realism’ to which Pullman is committed is apparent in the conclusion of the book, where the two child characters, who have fallen in love with one another, have to accept the necessity of separation.     

The relationship between the perception of axes of symmetry and spatial memory during early childhood

Early in development, there is a transition in spatial working memory (SWM). When remembering a location in a homogeneous space (e.g., in a sandbox), young children are biased toward the midline symmetry axis of the space. Over development, a transition occurs that leads to older children being biased away from midline. The dynamic field theory (DFT) explains this transition in biases as being caused by a change in the precision of neural interaction in SWM and improvements in the perception of midline. According to the DFT, young children perceive midline, but there is a quantitative improvement in the perception of midline over development. In the experiment reported here, children and adults needed to determine on which half of a large monitor a target was located. In support of the DFT, even the youngest children performed above chance at most locations, but performance also improved gradually with age.     

Emotion and recognition memory: the discrimination of negative information as an adaptive process

We studied the effect of emotion generated by IAPS (International Affective Picture System) pictures on incidental recognition of these pictures for short retention periods (15 min). Memorization distraction tasks and reaction time tasks were used together with short exposure times (2 seconds per picture) in order to prevent a high recognition rate that would impede testing for the effect of emotion on discrimination parameters (A′) and response bias (B′′D) (ceiling effect). We used 80 pictures representing the medium and high levels of two-dimensional emotional space. The results showed greater discrimination and a more conservative response style to unpleasant and medium arousal level pictures. These pictures produced higher confidence and lower response times in the recognition phase. The results can be explained by the negative content of the pictures and activation level effects on attentional processing and memory, and can be interpreted as a phenomenon that is evolutionarily adaptive.     

How do you see me? Coming out in counselling

Recent large-scale survey research has raised serious concerns in both the counselling community and the mass media about the ways in which counsellors work with lesbian, gay and bisexual (LGB) clients. The current questionnaire-based research focused on client experiences of their own, and their counsellor's, self-disclosures of sexuality. Most clients did not require counsellor disclosure. However, failure of the counsellor to disclose could result in problems and assumptions being made by the client. We conclude that LGB awareness is improving, but there is still much need for training in this area to challenge limiting assumptions by some counsellors and to avoid the need for clients to educate them.     

The problem of empirical redundancy of constructs in organizational research: An empirical investigation

Construct empirical redundancy may be a major problem in organizational research today. In this paper, we explain and empirically illustrate a method for investigating this potential problem. We applied the method to examine the empirical redundancy of job satisfaction (JS) and organizational commitment (OC), two well-established organizational constructs. Analysis based on responses from a sample of 292 employees collected at two occasions showed that: (a) the construct-level correlation between JS and OC was very high (.91) and (b) both JS and OC are similarly related to positive affectivity and negative affectivity. These results suggest that the constructs may be empirically indistinguishable, despite their well-established conceptual distinction. These findings illustrate the problem of empirical redundancy of organizational constructs and provide a basis for a possible movement towards parsimony in the realm of constructs that could open the way to more rapid advances in knowledge in organizational research.     

Early Institutionalization: Neurobiological Consequences and Genetic Modifiers

Children raised in the profound deprivation associated with institutionalization are at elevated risk for negative outcomes across a host of social and cognitive domains. This risk appears to be mitigated by early foster care or adoption into a family setting. Although pervasive developmental problems have been noted in a substantial proportion of previously institutionalized children, marked variation exists in the nature and severity of these deficits. Increasing evidence suggests that institutional deprivation impacts the developing brain, potentially underlying the wide range of outcomes with which it is associated. In the current review we examine the neural consequences of institutionalization and genetic factors associated with differences in outcome in an effort to characterize the consequences of early deprivation at a neurobiological level. Although the effects of institutional deprivation have been studied for more than 50 years much remains unanswered regarding the pathways through which institutionalization impacts child development. Through a more complete and nuanced assessment of the neural correlates of exposure and recovery as well as a better understanding of the individual factors involved we will be better able to delineate the impact of early adversity in the setting of severe social deprivation.     

Commentary on “Life as a Pregnant Genetic Counselor”

The genetic counseling role is complex. There are frequently challenges raised for the genetic counselor both personally with the client and through factors external to the genetic counselor such as the clinical setting. The pregnant genetic counselor working in a prenantal diagnosis center may be confronted by her own countertransference towards the client or by the client’s tranference. The processes of transference and countrtransference need to be clearly understood, identified and dealt with in a sensitive self aware manner to facilitate the role of communicating empathically and giving genetic information to facilitate informed client decision making. Regular professional supervision and debriefing for the genetic counselor are essential to develop professional boundaries and to develop self awareness.