Cognitive and affective correlates of decisional balance regarding screening mammography in older women

Participation in screening mammography remains suboptimal. This research aimed to improve understanding of ways to facilitate screening mammography attendance. One hundred and forty-two women from Gold Coast, Australia, aged 50-75, participated in the study. Social cognitive variables were assessed as potential predictors of mammography attendance. Most participants (79%) were maintaining regular screening mammography. Greater knowledge of breast cancer was the strongest predictor of decisional balance in favor of attending screening. Women who had relapsed from screening had significantly lower breast cancer worry than those contemplating attending for the first time. The results were consistent with previous research and point to factors screening services could consider to increase uptake.     

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent among adolescents enrolled in behavioral health services but remains undertreated, and the first-line treatment option, stimulant medication, is underutilized. To address this gap, this article introduces the Medication Integration Protocol (MIP): ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about integrating medication interventions into primary care; managing medication priorities for adolescents with multiple diagnoses, including substance use problems; and the compatibility of MIP with everyday practice conditions.     

Beyond the representation field

Abstract

This article outlines the importance of representation and several Freudian concepts such as Vorstellung, Trieb, and word and object representations. The author refers to the division of the analytical process into two main fields: the field of representation, and the field of the Real, which is characterized by impossibility. He then states that this field is the proper field of psychoanalysis. The author presents two clinical vignettes in an attempt to demonstrate the significance of the analytical act as a tool to deal with such extreme psychic situations.     

In dialogue with Daniel Stern: A review and discussion of The Present Moment in Psychotherapy and Everyday Life

Abstract

Daniel Stern's concepts of “present moment” and “now moment,” with impending kairos, are described. In the latter, the patient demands the authentic presence of the analyst. If the analyst can open himself to the patient, he proposes that this will result in more profound changes in the patient's implicit knowing than verbal interpretations in the narrative domain would lead to. The value of intersubjectively relating and dwelling more in the phenomenal than in the narrative dimension is highlighted. A similarity to the works of the existential psychoanalyst Harold Kelman is shown. The author agrees with, but also problematises, a tendency to favour the implicit, devaluing verbal understanding and interpretation, which may result in the patient not seeing the primitive levels in his inner life. For this purpose, works from D. W. Winnicott, Jessica Benjamin and Christopher Bollas, as well as others, are used. The author concludes that object relations and intersubjective theory need to complement each other that further, there is a need to give words to the middle-ground between the phenomenal and narrative dimensions.     

Primary shame,mortal wound and tragic circularity: Some new reflections on shame and shame conflicts

Invited to contribute some thoughts on recent developments in psychoanalytic thinking about shame, the author starts off with Aristotle's prescient analysis of shame and then focuses on accumulating experiences in the psychoanalytic treatment of patients with severe neuroses, in particular the close relationship of severe traumatization and chronic states of shame, and how this is reflected in shelfdestructive repetitions. Reminiscent of what we know from tragedy and the tragic dimension of human existence, this repetition compulsion shows a built‐in circularity. These circular dynamics have at their core struggles with deep woundedness that can variably be conceived of as primary pain, primary shame and primary anxiety. Consequently, throughout the experiences with these patients goes the absoluteness both of their conscience and of their ideal, what we know as the “archaic superego:”     

Using the Theory of Gender and Power to Examine Experiences of Partner Violence,Sexual Negotiation,and Risk of HIV/AIDS Among Economically Disadvantaged Women in Southern India

This article uses the Theory of Gender and Power to examine women's vulnerability to HIV/AIDS in order to: understand the vulnerability of female sex workers/poor women due to poverty and lack of educational resources; explore women's vulnerability in the context of client/partner violence, alcohol use, male partner's high-risk behaviors, and women's lack of control in their intimate relationships; and explore the role of traditional heterosexual gender norms in the outcomes of sexual negotiation. Ethnographic data were collected from 32 women and 38 men in India as part of an ongoing National Institute of Mental Health study. Results highlighted women's vulnerability to HIV/AIDS stemming from partner violence, alcohol use, poverty, dangers of sex work environments, and tacit acceptance of cultural/gender norms.