The termination phase of combined therapy

Three different kinds of termination are described and discussed. In combined therapy the group can help to resolve and clarify the meanings of moves to terminate therapy. The role of the therapist's countertransferences in this stage of the work is important to consider, and here, too, the group is an important part of the work. The author sees termination as an important part of the treatment process. In combined therapy it may be more complex but it also allows for a fuller exploration of the relevant issues.     

The Psychosocial Impact of Undergoing Prophylactic Total Gastrectomy (PTG) to Manage the Risk of Hereditary Diffuse Gastric Cancer (HDGC)

Individuals identified as at high risk of developing Hereditary Diffuse Gastric Cancer (HDGC) are advised to undergo prophylactic surgery - have their stomach removed - in their early twenties. Research with (older) cancer patients who undergo gastrectomy for curative reasons suggests that gastric resection has a number of physical and psychosocial sequelae. Because it is difficult to extrapolate the findings of studies of older cancer patients to younger healthy patients who are considering prophylactic total gastrectomy (PTG), the aim of this qualitative interview study was to determine the psychosocial implications of undergoing prophylactic surgery to manage genetic risk. Fourteen men and 13 women from the UK’s Familial Gastric Cancer study who had undergone PTG were invited to participate in qualitative interviews. Most reported that undergoing surgery and convalescence was easier than anticipated. There was evidence that age affected experiences of PTG, with younger patients tending to report faster recovery times and more transient aftereffects. All saw the benefits of risk reduction as outweighing the costs of surgery. Surgery was described as having a range of physical impacts (disrupted appetite, weight loss, fatigue, GI symptoms) that had related psychological, social and economic implications. Those considering PTG need to be aware that its impact on quality of life is difficult to predict and negative sequelae may be ongoing for some individuals.     

The effect of similarity between elemental stimuli and compounds in olfactory patterning discriminations

We studied the ability of honeybees to discriminate between single odorants and binary olfactory mixtures. We analyzed the effect of the number of common elements between these two stimulus classes on olfactory discrimination. We used olfactory conditioning of the honeybees' proboscis extension reflex (PER), a paradigm in which odors can be associated with a reinforcement of sucrose solution. Bees were asked to discriminate reinforced from nonreinforced olfactory stimuli. They were trained with two elemental odors (A and B) versus a binary olfactory mixture. The mixture was either AB (group 2CE, two common elements), AC (group 1CE, one common element A), or CD (group 0CE, no common element). Three groups followed a positive patterning schedule (mixture reinforced and elements nonreinforced: groups 2CE+, 1CE+, and 0CE+) and three other groups a negative patterning schedule (mixture nonreinforced and elements reinforced: groups 2CE-, 1CE-, and 0CE-). We showed that a reduction of similarity (number of common elements) between elemental odors and compounds enhanced the ability to discriminate elements from compounds and that the kind of compound processing used by the bees supports theories that assume nonelemental compound processing (i.e., that exclude the mere summation of the elemental associative strengths upon compound presentation).     

Characteristics of auditory agnosia in a child with severe traumatic brain injury: a case report

We present a case that is unusual in many respects from other documented incidences of auditory agnosia, including the mechanism of injury, age of the individual, and location of neurological insult. The clinical presentation is one of disturbance in the perception of spoken language, music, pitch, emotional prosody, and temporal auditory processing in the absence of significant deficits in the comprehension of written language, expressive language production, or peripheral auditory function. Furthermore, the patient demonstrates relatively preserved function in other aspects of audition such as sound localization, voice recognition, and perception of animal noises and environmental sounds. This case study demonstrates that auditory agnosia is possible following traumatic brain injury in a child, and illustrates the necessity of assessment with a wide variety of auditory stimuli to fully characterize auditory agnosia in a single individual.     

Large-scale ensemble averaging of ambulatory impedance cardiograms

Impedance cardiography has been used increasingly to measure human physiological responses to emotional and mentally engaging stimuli. The validity of large-scale ensemble averaging of ambulatory impedance cardiograms was evaluated for preejection period (PEP), interbeat interval, and dZ/dt_(min) amplitude. We tested whether the average of “classical” 60-sec ensemble averages across periods with fixed activity, posture, physical load, social situation, and location could be accurately estimated from a single large-scale ensemble average spanning these entire periods. Impedance and electrocardiograms were recorded for about 24-h from 21 subjects. Recordings were scored by seven raters, using both methods for each subject. Good agreement (average intraclass correlation coefficient was .91) between both ensemble averaging methods was found for all three cardiac function measures. The results indicate that for unambiguous ambulatory impedance cardiograms, large-scale ensemble averaging is valid, which makes measuring prolonged changes in cardiac sympathetic activity by measuring ambulatory PEP feasible even in large epidemiological samples.     

Divergent effects of different positive emotions on moral judgment

Positive emotions are often treated as relatively similar in their cognitive-behavioral effects, and as having unambiguously beneficial consequences. For example, Valdesolo and DeSteno (2006) reported that a humorous video made people more prone to choose a utilitarian solution to a moral dilemma. They attributed this finding to increased positive affect. To determine whether such results actually stem in general from positive affect or from other more specific properties of humor, we conducted an experiment with moral dilemmas presented during an interleaved emotion-induction procedure involving mirth and another positive emotion, elevation. Mirth increased permissiveness for deontological violations, whereas elevation had the opposite effect. Furthermore, affective valence had no apparent independent influence on these judgments. Our results suggest that mirth and elevation have distinct cognitive consequences whose properties reflect their respective social functions, not their shared positive valence.     

The other way around: does health predict perceived support?

The aim in this study was to identify predictors of perceived social support before and after cataract surgery. We hypothesized that physical (comorbidity and visual acuity) and mental (depressive symptoms) health indicators would be directly and indirectly (through actually received support) associated with perceived support. One hundred and thirty-six cataract patients (69% women; mean age = 71.6 years) completed questionnaires before and after cataract surgery. Results showed that received support partially mediated the association between depressive symptoms and perceived support. However, mental and physical health variables were also directly associated with perceived support. We conclude that health status might feedback to perceptions of available support.