Gifts,talismans and tokens in analysis: symbolic enactments or sinister acts?

Analysis is nuanced with many non-verbal cues and interactions. This is vividly illustrated when gifts are presented to the analyst. Their physical presence transcends the symbolic frame of analysis because, although their meaning may be metaphorical, their presence is real. Unlike other material objects and pictures, the gift may seem to invite the analyst to receive it personally. It may apparently demand some form of action. A gift may be consciously given as a token, or it may be magically invested as a talisman. On the surface, it might appear to be an expression of love; it may be a communication of a wish for acceptance; but it may have more 'sinister', unconscious intent. It may embody the wish to expel unwanted affect, ward off evil or control the analyst. Therefore disposal, that is the resolution and settling of the object, is significant. The case with which this paper is illustrated traces the meaning of a series of gifts in a single analysis. It is hoped that this will enhance a wider understanding of this common analytic phenomenon.     

Influences of APOE ε4 and expertise on performance of older pilots

Little is known about how APOE ε4-related differences in cognitive performance translate to real-life performance, where training and experience may help to sustain performance. We investigated the influences of APOE ε4 status, expertise (FAA pilot proficiency ratings), and their interaction on longitudinal flight simulator performance. Over a 2-year period, 139 pilots aged 42-69 years were tested annually. APOE ε4 carriers had lower memory performance than noncarriers (p = .019). APOE interacted with Expertise (p = .036), such that the beneficial influence of expertise (p = .013) on longitudinal flight simulator performance was more pronounced for ε4 carriers. Results suggest that relevant training and activity may help sustain middle-aged and older adults' real-world performance, especially among APOE ε4 carriers.     

A single exposure to the American flag shifts support toward Republicanism up to 8 months later

There is scant evidence that incidental cues in the environment significantly alter people's political judgments and behavior in a durable way. We report that a brief exposure to the American flag led to a shift toward Republican beliefs, attitudes, and voting behavior among both Republican and Democratic participants, despite their overwhelming belief that exposure to the flag would not influence their behavior. In Experiment 1, which was conducted online during the 2008 U.S. presidential election, a single exposure to an American flag resulted in a significant increase in participants' Republican voting intentions, voting behavior, political beliefs, and implicit and explicit attitudes, with some effects lasting 8 months after the exposure to the prime. In Experiment 2, we replicated the findings more than a year into the current Democratic presidential term. These results constitute the first evidence that nonconscious priming effects from exposure to a national flag can bias the citizenry toward one political party and can have considerable durability.     

Rewarding performance feedback alters reported time of action

Past studies have shown that the perceived time of actions is retrospectively influenced by post-action events. The current study examined whether rewarding performance feedback (even when false) altered the reported time of action. In Experiment 1, participants performed a speeded button press task and received monetary reward for a presumed “fast,” or a monetary punishment for a presumed “slow” response. Rewarded trials resulted in the false perception that the response action occurred earlier than punished trials. In Experiments 2 and 3, the need for a speeded response and reward were independently manipulated in order to decouple the cognitive and reward components in the feedback signal. When tested independently, neither variable affected the judged time of action. We conclude that meaningful feedback (fast or slow) is only used when made salient by reward, to modulate the judged time of an action.     

A REPLICATION AND EXTENSION OF THE ANTISYMMETRY EFFECT IN PIGEONS

Pigeons trained on successive AB symbolic matching show emergent BA antisymmetry if they are also trained on successive AA oddity and BB identity ( Urcuioli, 2008 , Experiment 4). In other words, when tested on BA probe trials following training, they respond more to the comparisons on the reverse of the nonreinforced AB baseline trials than on the reverse of the reinforced AB baseline trials (the opposite of an associative symmetry pattern). The present experiment replicated this finding. In addition, it showed that antisymmetry also emerged after baseline training on successive AB symbolic matching, AA identity, and BB oddity, consistent with the prediction from Urcuioli's (2008) theory of pigeons' stimulus‐class formation. Together, these results provide further empirical support for that theory including the proposition that the functional stimuli in pigeons' successive matching consist of the nominal stimuli plus their ordinal positions within a trial.     

Application of a CBPR Framework to Inform a Multi-level Tobacco Cessation Intervention in Public Housing Neighborhoods

African American women in urban, high poverty neighborhoods have high rates of smoking, difficulties with quitting, and disproportionate tobacco-related health disparities. Prior research utilizing conventional "outsider driven" interventions targeted to individuals has failed to show effective cessation outcomes. This paper describes the application of a community-based participatory research (CBPR) framework to inform a culturally situated, ecological based, multi-level tobacco cessation intervention in public housing neighborhoods. The CBPR framework encompasses problem identification, planning and feasibility/pilot testing, implementation, evaluation, and dissemination. There have been multiple partners in this process including public housing residents, housing authority administrators, community health workers, tenant associations, and academic investigators. The advisory process has evolved from an initial small steering group to our current institutional community advisory boards. Our decade-long CBPR journey produced design innovations, promising preliminary outcomes, and a full-scaled implementation study in two states. Challenges include sustaining engagement with evolving study partners, maintaining equity and power in the partnerships, and long-term sustainability of the intervention. Implications include applicability of the framework with other CBPR partnerships, especially scaling up evolutionary grassroots involvement to multi-regional partnerships.     

Integration: Opportunities and Challenges for Family Therapists in Primary Care

Integration of behavioral and physical health is becoming critical for the overburdened primary care system. Policy changes are needed to accommodate integration nationally. Locally, medical and behavioral health providers are working together to create models that better fit their patients?? comprehensive needs while respecting the clinical, operational, and financial constraints of the current system. Family therapists trained to work in medical settings have an opportunity to emerge as clinical, research, and administrative leaders in this context. However, a paradigm shift is crucial to adapting their systemic orientation to interactions between individual patients, providers, staff, and healthcare and support systems. This article provides family therapists with: (1) an overview of the basic structure and barriers of integration, (2) suggestions on how to deliver quality care despite barriers at the local level, and (3) examples of key advocacy efforts representing possible entryways on a larger scale.     

Comparison of deck- and trial-based approaches to advantageous decision making on the Iowa Gambling Task

We compared the original deck-based model of advantageous decision making assessed with the Iowa Gambling Task (IGT) with a trial-based approach across behavioral and physiological outcomes in 33 younger adults (15 men, 18 women; 22.2 ± 3.7 years of age). One administration of the IGT with simultaneous measurement of skin conductance responses (SCRs) was performed and the two methods applied: (a) the original approach of subtracting disadvantageous picks of Decks A and B from advantageous picks of Decks C and D and (b) a trial-based approach focused on the financial outcome for each deck leading up to the trial in question. When directly compared, the deck-based approach resulted in a more advantageous behavioral profile than did the trial-based approach. Analysis of SCR data revealed no significant differences between methods for physiological measurements of SCR fluctuations or anticipatory responses to disadvantageous picks. Post hoc investigation of the trial-based method revealed Deck B contributed to both advantageous and disadvantageous decision making for the majority of participants. When divided by blocks of 20, the number of advantageous to disadvantageous choices reversed as the task progressed despite the total number of picks from Deck B remaining high. SCR fluctuations for Deck B, although not significantly different from the other decks, did show a sharp decline after the first block of 20 and remained below levels for Decks C and D toward the end of the task, suggesting that participants may have gained knowledge of the frequency of loss for this deck.     

Generalizability of evidence-based assessment recommendations for pediatric bipolar disorder

Bipolar disorder is frequently clinically diagnosed in youths who do not actually satisfy Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; DSM-IV-TR; American Psychiatric Association, 1994) criteria, yet cases that would satisfy full DSM-IV-TR criteria are often undetected clinically. Evidence-based assessment methods that incorporate Bayesian reasoning have demonstrated improved diagnostic accuracy and consistency; however, their clinical utility is largely unexplored. The present study examines the effectiveness of promising evidence-based decision-making strategies compared with the clinical gold standard. Participants were 562 youths, ages 5 to 17 and predominantly African American, drawn from a community mental health clinic. Research diagnoses combined a semistructured interview with youths' psychiatric, developmental, and family mental health histories. Independent Bayesian estimates that relied on published risk estimates from other samples discriminated bipolar diagnoses (area under curve = .75, p < .00005). The Bayes and confidence ratings correlated at rs = .30. Agreement about an evidence-based assessment intervention threshold model (wait/assess/treat) was κ = .24, p < .05. No potential moderators of agreement between the Bayesian estimates and confidence ratings, including type of bipolar illness, were significant. Bayesian risk estimates were highly correlated with logistic regression estimates using optimal sample weights (r = .81, p < .0005). Clinical and Bayesian approaches agree in terms of overall concordance and deciding next clinical action, even when Bayesian predictions are based on published estimates from clinically and demographically different samples. Evidence-based assessment methods may be useful in settings in which gold standard assessments cannot be routinely used, and they may help decrease rates of overdiagnosis while promoting earlier identification of true cases.