Convex and Concave,Part I: Images of Emptiness in Women

The American Journal of Psychoanalysis -     

Executive function deficits in autism spectrum disorders and attention-deficit/hyperactivity disorder: examining profiles across domains and ages

Deficits in 'executive function' (EF) are characteristic of several clinical disorders, most notably Autism Spectrum Disorders (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). In this study, age- and IQ-matched groups with ASD, ADHD, or typical development (TD) were compared on a battery of EF tasks tapping three core domains: response selection/inhibition, flexibility, and planning/working memory. Relations between EF, age and everyday difficulties (rated by parents and teachers) were also examined. Both clinical groups showed significant EF impairments compared with TD peers. The ADHD group showed greater inhibitory problems on a Go-no-Go task, while the ASD group was significantly worse on response selection/monitoring in a cognitive estimates task. Age-related improvements were clearer in ASD and TD than in ADHD. At older (but not younger) ages, the ASD group outperformed the ADHD group, performing as well as the TD group on many EF measures. EF scores were related to specific aspects of communicative and social adaptation, and negatively correlated with hyperactivity in ASD and TD. Within the present groups, the overall findings suggested less severe and persistent EF deficits in ASD (including Asperger Syndrome) than in ADHD.     

The reliability and validity of the panic disorder self-report: a new diagnostic screening measure of panic disorder

This study examined the Panic Disorder Self-Report (PDSR), a new self-report diagnostic measure of panic disorder based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994). PDSR diagnoses were compared with structured interview diagnoses of individuals with generalized anxiety disorder, social phobia, and panic disorder and nonanxious controls. Receiver operating characteristic analyses revealed that the PDSR showed 100% specificity and 89% sensitivity. The PDSR also demonstrated retest reliability, convergent and discriminant validity, and kappa agreement of .93 with a structured interview. Finally, the PDSR demonstrated clinical validity. Students who were identified as having panic disorder using the PDSR did not have significantly different scores on the Panic Disorder Severity Scale--Self-Report form (P. R. Houck, D. A. Speigel, M. K. Shear, & P. Rucci, 2002) than a panic disordered community sample. However, both groups had significantly higher scores than students identified as not meeting criteria for panic disorder.     

Fragment memories mark the end of childhood amnesia

Adults described and dated two kinds of first remembrances: a personal event memory (the recollection of a personal episode that had occurred at some time in some place) and a memory fragment (an isolated memory moment having no event context and remembered, perhaps, as an image, a behavior, or an emotion). First fragment memories were judged to have originated substantially earlier in life than first event memories--approximately 3 1/3 years of age for first fragment memories versus roughly 4 years of age for first event memories. We conclude that the end of childhood amnesia is marked not by our earliest episodic memories, but by the earliest remembered fragments of childhood experiences.     

Inference revision processing in adults with and without aphasia

Processing abilities in aphasia, and the nature of processing breakdowns, were the focuses of this investigation. Individuals with either fluent or nonfluent aphasia, plus a control group, participated in a cross-modal lexical priming task designed to elicit priming effects when activation of inference interpretations occurred. Comprehension of inferences was measured by responses to four types of questions that related to the inferences. Results indicated that both the control group, as well as the nonfluent aphasia group, activated the intended meaning of the stimuli whereas the fluent aphasics did not. Comprehension of the inferences was best demonstrated by control participants, nonfluent aphasic participants, and fluent aphasic participants, in that order.     

A Beautiful Mind

It is often difficult to discern the line between creativity and madness. This presents a particular hazard for the analyst, whose failure to recognize real potential can result in undermining the individual's developmental strivings. This dilemma is explored through a case illustration of a woman whose creativity was undermined by a lack of recognition. To vivify the dilemma, the author invites the reader to look through her eyes into the lens offered by the film A Beautiful Mind, which portrays the struggles of Nobel Prize-winning mathematician John Nash to maintain his sanity while also testing the limits of his mind and imagination. These illustrations encourage us to consider the dilemma of the gifted individual when excessive tension arises between absorption in one's medium versus needs for recognition.     

Family predictors of disease management over one year in Latino and European American patients with type 2 diabetes

Family context is thought to influence chronic disease management but few studies have longitudinally examined these relationships. Research on families and chronic illness has focused almost exclusively on European American families. In this prospective study we tested a multidimensional model of family influence on disease management in type 2 diabetes in a bi-ethnic sample of European Americans and Latinos. Specifically, we tested how baseline family characteristics (structure, world view, and emotion management) predicted change in disease management over one year in 104 European American and 57 Latino patients with type 2 diabetes. We found that emotion management predicted change in disease management in both groups of patients as hypothesized, while family world view predicted change in both ethnic groups but in the predicted direction only for European Americans. Examining family context within ethnic groups is required to elucidate unique cultural patterns. Attending to culturally unique interpretations of constructs and measures is warranted. The import of family emotion management, specifically conflict resolution, in disease management deserves further study to support clinical intervention development. Examining multiple domains of family life and multidimensional health outcomes strengthens our capacity to develop theory about family contexts and individual health.     

Exploring the influence of personality on depressive symptoms and self-esteem across a significant life transition

This study investigates the influence of personality on adjustment to a particular life transition, community relocation. Participants were 285 women (average age=69.5) who were interviewed once before they moved, and then multiple times after the move. Within the context of this multiwave design, personality traits were used to predict changes in depressive symptoms (DS) and self-esteem (SE) across the move. Neuroticism and Openness to Experience predicted increases in DS over time, whereas Extraversion and Openness predicted increases in SE. Stressful reactions to the move and sense of mastery about the move partially mediated these effects. The study documents the dynamic influence of personality on positive and negative aspects of adjustment and investigates differing routes through which such effects occur.     

Examining the locus of age effects on complex span tasks

To investigate the locus of age effects on complex span tasks, the authors evaluated the contributions of working memory functions and processing speed. Age differences were found in measures of storage capacity, language processing speed, and lower level speed. Statistically controlling for each of these in hierarchical regressions substantially reduced, but did not eliminate, the complex span age effect. Accounting for lower level speed and storage, however, removed essentially the entire age effect, suggesting that both functions play important and independent roles. Additional evidence for the role of storage capacity was the absence of complex span age differences with span size calibrated to individual word span performance. Explanations for age differences based on inhibition and concurrent task performamce were not supported.