Catch 22: the inflammatory nature of insight

I will describe a man I saw in psychoanalytic psychotherapy with a history of serious drug abuse and violent psychotic episodes. At the start of therapy my patient had little capacity to tolerate the anxiety, depression or the inevitable frustrations involved in facing reality. Over time and with the support of the therapy he was able to increase his capacity for self observation noticing the way he withdrew from the world of shared reality into psychotic states of mind in order to avoid painful feelings of rage, humiliation and shame. In the book ‘Catch 22?, Joseph Heller described the paradox of pilots who wish to claim insanity in order to avoid fatal flying missions, while the authorities maintain that in claiming insanity to avoid suicidal missions the individual demonstrates a sane awareness of the insanity of the missions! This insight is deemed to be evidence of the individual’s sanity and consequently their plea of insanity is denied. In this paper, I will show how Mr. A’s developing capacity for reflective functioning lead to a ‘Catch 22’ as the insight he needed as part of the process of recovery threatened to overwhelm him with depressing realities about the extent of his illness.     

Is There Still Time?

In this article we intend to discuss the psychoanalysis of elderly patients and, also, to review certain prejudices that are based upon the psychoanalytic technique and theory.     

Personality and Cognitive Ability as Predictors of Typical and Maximum Managerial Performance

Despite long-established distinctions between typical and maximum performance variables on both the predictor and criterion side, little previous research has directly addressed the extent to which these distinctions translate into differential predictor-criterion relationships. Using a sample of candidates for managerial positions, we examined relations of predictors conceptually linked to typical (i.e., broad, narrow, and compound personality traits) and maximum (i.e., broad and narrow cognitive abilities) performance with corresponding criterion measures (N = 84–873). Supervisory ratings of managerial performance served as the typical performance criterion, whereas maximum performance was assessed via an assessment center. Confirmatory factor analyses supported the distinction between typical and maximum performance. Results also confirmed our hypothesis that cognitive abilities are more strongly correlated with maximum performance than with typical performance and largely supported the expectation of the opposite pattern with personality traits as predictors.     

The Perceptions of Terminated Ministers Scale—Revised

The Perceptions of Terminated Ministers Scale—Revised (PTM-R), a 15-item measure of perceptions of termination appropriate to members of clergy, was developed for use among researchers studying how clergypersons perceive the effects of forced termination events. To examine the reliability and validity of the measure, three samples of clergy were assessed using the PTM and PTM-R. The three samples used Barfoot et al.’s (2005) working definition of forced pastoral exits. Their definition does not distinguish between being fired or forced to resign. Each participant was asked to specify whether they were fired or forced to resign. Recently, Tanner et al. (2012) offered a new definition of forced termination: “Forced termination is the result of a process of involuntary removal of paid and non-paid clergy-persons that results from a period of traumatic and demeaning psychological and emotional abuse” (p. 14). Data analysis among all three samples supports the reliability and validity of the scale and commends it for further use among clergy who have experienced forced termination.     

The relation between achievement goal and expectancy-value theories in predicting achievement-related outcomes: A test of four theoretical conceptions

Although achievement goal and expectancy-value theories are both dominant in the achievement motivation literature, the relation between goals and expectancy-value variables in predicting achievement-related behaviors remains unclear. The present study evaluated the empirical validity of four contrasting theoretical conceptions which posit that (1) goals and expectancy-value variables are independent predictors of achievement-related outcomes (2) goals predict expectancy-values, (3) goals mediate the relation between expectancies and task-values, and (4) goals partially mediate the relation between expectancy-values and achievement outcomes, in predicting course performance, career intentions and academic aspirations. Path models evaluating these conceptions were tested separately in mathematics and language arts domains among 697 6th and 8th grade students. Results supported the fourth theoretical approach suggesting that expectancy-value variables predict achievement-related outcomes both directly and indirectly through achievement goals. These findings provide insight about the relation between expectancy-value and achievement goal theories and highlight their complementary role in predicting achievement behaviors.     

Little Jeremy's Struggle with Autism,Schizophrenia and Parano a

Since its formulation by Bleuler in 1911, the generalisation of the term ''autism'', mainly due to its use by Kanner in 1943 and its remake by authors of Kleinian inspiration, implies problems which mislead us, blurring our perception and understanding of clinical realities. Our psychoanalytical possibilities can be enlarged by a clear knowledge of the history of psychoanalysis, a dynamic approach to psychiatric classification and to problems related to our conception of the setting. On the basis of a case history the author shows how a child and its family worked through major autistic symptoms and proposes new approaches to some psychoanalytical concepts.     

Two sides of the same coin? On the history and phenomenology of chronic fatigue and burnout

Background: Burnout and chronic fatigue syndrome (CFS) are two fatigue syndromes which have developed largely independently from each other, yet whose similarities in symptoms can be a source of confusion. We aim to explore the phenomenology of burnout and CFS in a historical context as this may provide some insight into the links and relationship between these conditions. Method: A narrative review based on literature in the fields of history, social science and medicine. Results: The origins of CFS lie within medicine, whereas burnout developed in a psychological setting. As well as symptoms, burnout and CFS also share similar themes such as an overload process triggering illness onset, the need for restoration of depleted energy, external causal attributions and the characteristics of people suffering from these illnesses. However, these themes are expressed in either psychological or medical terms according to the historical background. Conclusion: Despite their similarities, there have been few direct comparisons of the two concepts. Culture, illness perceptions and accountability are important issues in both conditions and could contribute to their differences. Comparing burnout and CFS within one sample frame, thus looking beyond the psychology/medicine divide, could be a useful first step towards understanding their relationship.     

The Catholic Church,moral doctrine,and HIV prevention in Recife,Brazil: Negotiating the contradictions between religious belief and the realities of everyday life

Religious beliefs have had a key role in shaping local responses to HIV and AIDS. As the world's largest Catholic country, Brazil is no exception. Yet little research has been conducted to document how religious doctrine is enacted in practice among its lay leaders and followers. In this article, we present ethnographic research from Recife, Brazil, conducted to understand the way in which religious doctrines are interpreted at a local level. Contextualised within the sociology of contemporary Brazilian Catholicism, we draw on interviews with clergy members, lay leaders, and parishioners to discuss how the Catholic Church's vision of sexuality translates into everyday lives of its followers. We explore the disjuncture between the Catholic ideals of fidelity and delaying sex until marriage with the everyday reality of the Church's followers, highlighting the role that gender plays in defining sexual roles and expectations. We conclude by posing questions for future research and HIV prevention strategies considering the formal institutional response of the Brazilian Catholic Church to AIDS on the one hand, and the social and cultural contexts in which Catholics live their daily lives on the other.     

Probabilities on Sentences in an Expressive Logic

Automated reasoning about uncertain knowledge has many applications. One difficulty when developing such systems is the lack of a completely satisfactory integration of logic and probability. We address this problem directly. Expressive languages like higher-order logic are ideally suited for representing and reasoning about structured knowledge. Uncertain knowledge can be modeled by using graded probabilities rather than binary truth values. The main technical problem studied in this paper is the following: Given a set of sentences, each having some probability of being true, what probability should be ascribed to other (query) sentences? A natural wish-list, among others, is that the probability distribution (i) is consistent with the knowledge base, (ii) allows for a consistent inference procedure and in particular (iii) reduces to deductive logic in the limit of probabilities being 0 and 1, (iv) allows (Bayesian) inductive reasoning and (v) learning in the limit and in particular (vi) allows confirmation of universally quantified hypotheses/sentences. We translate this wish-list into technical requirements for a prior probability and show that probabilities satisfying all our criteria exist. We also give explicit constructions and several general characterizations of probabilities that satisfy some or all of the criteria and various (counter)examples. We also derive necessary and sufficient conditions for extending beliefs about finitely many sentences to suitable probabilities over all sentences, and in particular least dogmatic or least biased ones. We conclude with a brief outlook on how the developed theory might be used and approximated in autonomous reasoning agents. Our theory is a step towards a globally consistent and empirically satisfactory unification of probability and logic.     

The Portuguese version of Addenbrooke’s Cognitive Examination–Revised (ACE-R) in the diagnosis of subcortical vascular dementia and Alzheimer’s disease

The aim of this study was to investigate the accuracy of the Portuguese version of Addenbrooke’s Cognitive Examination–Revised (ACE-R) in detecting and differentiating early stage subcortical vascular dementia (SVD) from early stage Alzheimer’s disease (AD). Ninety-two subjects (18 SVD patients, 36 AD patients, and 38 healthy controls) were assessed using the ACE-R. Between-group’s differences were evaluated using the Quade’s rank analysis of covariance. The diagnostic accuracy and discriminatory ability of the ACE-R were examined via receiver operating characteristic (ROC) analysis. The ACE-R was able to successfully discriminate between patients and healthy subjects. The mean ACE-R total scores differed between SVD and AD patients; there were also significant differences in attention and orientation and in memory measures between the groups. An optimal cut-off of 72/73 was found for the detection of AD (sensitivity: 97%; specificity: 92%) and SVD (sensitivity: 100%; specificity: 92%).