The influence of depression symptoms on exploratory decision-making

People with symptoms of depression show impairments in decision-making. One explanation is that they have difficulty maintaining rich representations of the task environment. We test this hypothesis in the context of exploratory choice. We analyze depressive and non-depressive participants’ exploration strategies by comparing their choices to two computational models: (1) an “Ideal Actor” model that reflectively updates beliefs and plans ahead, employing a rich representation of the environment and (2) a “Naïve Reinforcement Learning” (RL) model that updates beliefs reflexively utilizing a minimal task representation. Relative to non-depressive participants, we find that depressive participants’ choices are better described by the simple RL model. Further, depressive participants were more exploratory than non-depressives in their decision-making. Depressive symptoms appear to influence basic mechanisms supporting choice behavior by reducing use of rich task representations and hindering performance during exploratory decision-making.     

Language difficulties in children adopted internationally: Neuropsychological and functional neural correlates

Children who have experienced deprivation as a result of orphanage care during early development are at increased risk for a number of cognitive, emotional, and social difficulties (MacLean, 2003). This study examined the neuropsychological and behavioral profile of internationally adopted children with language difficulties, one of the most common cognitive challenges (Behen et al., 2008). In addition to neuropsychological testing, fMRI was utilized to examine activation patterns during expressive fluency and receptive language tasks. In comparison to internationally adopted children without language difficulties and nonadopted controls, participants with language difficulty had worse performance on tasks of verbal memory and reasoning, academic skills, and working memory. Behaviorally, all internationally adopted participants, regardless of language ability, had more parent-reported hyperactivity and impulsivity compared with controls. The fMRI tasks revealed reduced activation in traditional language areas in participants with language difficulty. The impact of early adverse experience on later development is discussed.     

Omnipotence in the transference and in the countertransference

The concept of omnipotence refers to a primitive fantasy, a mechanism of defense, and a pathological psychic structure. Omnipotence and its derivative defensive operation, omnipotent control, are highly prevalent in borderline personality organization. Three clinical vignettes illustrate these mechanisms in the treatment of patients with borderline, narcissistic, and obsessive personality disorders, respectively. These vignettes illustrate the transference developments when omnipotence and omnipotence control are dominant, and the therapeutic approach to these conditions.     

Identifying persons feigning limitations in their competence to proceed in the legal process

Accurate assessment of the response styles criminal defendants adopt when undergoing evaluations of their competence to proceed with the legal process is critical because some feign limitations in their abilities in an attempt to delay or avoid prosecution. This study examined the utility of the Inventory of Legal Knowledge (ILK) to identify persons motivated to feign competence related limitations. That the ILK has good potential as a screening tool is indicated by findings that the measure (1) has adequate test–retest reliability and (2) classified correctly the large majority of participants in two samples (i.e., college students and psychiatric patients) who completed the measure under “honest” or “fake bad” conditions. Copyright © 2010 John Wiley & Sons, Ltd.     

Self‐Control Moderates Decision‐Making Behavior When Minimizing Losses versus Maximizing Gains

We examined (1) whether people would be more responsive to the delayed consequences of their decisions when attempting to minimize losses than when attempting to maximize gains in a history‐dependent decision‐making task and (2) how trait self‐control would moderate such an effect. In two experiments, participants performed a dynamic decision‐making task where they chose one of two options on each trial. The increasing option always gave a smaller immediate reward but caused future rewards for both options to increase. The decreasing option always gave a larger immediate reward but caused future rewards for both options to decrease. In Experiment 1 where the two options had equivalent expected value in the long run, participants were more prone to select the increasing option, which yielded larger benefits on future trials, in the loss‐minimization condition than in the gain‐maximization condition. Trait self‐control moderated the effect of losses by enhancing the effect for low self‐control participants while attenuating it for high self‐control participants. In Experiment 2 where selecting the increasing option was suboptimal, low self‐control participants still attempted to reduce losses on future trials by selecting the increasing option more often than high self‐control participants. These results suggest that decision makers value delayed consequences of their actions more in a losses domain relative to a gains domain and low self‐control individuals are more susceptible to such an effect. Copyright © 2014 John Wiley & Sons, Ltd.     

Transference-Focused Psychotherapy for Borderline Adolescents: A Neurobiologically Informed Psychodynamic Psychotherapy

In this article we first contextualize and then outline a model of TFP adapted for working with adolescents with Borderline Personality Disorders. We discuss how to take the normal developmental challenges of adolescence, such as separation-individuation in consideration, and how to support this in the context of the therapeutic work, while at the same time stimulating curiosity through clarification and confronting the adolescent with self-defeating and destructive patterns and dangerous behavior. Furthermore, we give examples of working with split–off parts of self and other representations through clarification to increase self-awareness and confrontations with contradictions within the adolescents communication and nonverbal behavior, with the aim of facilitating the integration of identity.     

The Development of a Personal View of the Psychoanalytic Field

This paper summarizes the development of my professional identity as psychoanalyst and psychiatrist. It describes the influences on my dedication to the study of severe personality disorders, namely, the training experiences I had under the guidance of Ignacio Matte-Blanco, in Chile; the research team of Jerome Franck at Johns Hopkins; the work in the Psychotherapy Research Project of the Menninger Foundation under Robert Wallerstein, my personal working relationship in New York, with Edith Jacobson, Margaret Mahler, the introduction to British Psychoanalysis by John Sutherland, and to French analysis in sabbatical times in Paris. I conclude by a brief overview of my theoretical orientation, combining ego psychological, object relations, and Kleinian approaches in the development of a synthesis that inspired my present research on the psychoanalytic psychotherapy of severe personality disorders.     

Cortisol,stress, and attentional bias toward threat

Abstract

Attentional bias toward threatening stimuli is a central characteristic of anxiety and acute stress. Recent small-scale studies have provided divergent perspectives on the association between the stress hormone cortisol and attentional bias toward threat cues. In a larger sample size than previous studies, we examined this association by investigating the impact of cortisol on attentional bias in two studies using a psychological stressor (N=35) and a physical stressor (N=65), respectively. Attentional bias and salivary cortisol were measured prior to and following the administration of a stressful task designed to increase cortisol levels. Results across these studies were equivocal relative to the association between baseline cortisol and baseline attentional bias. In addition, the association between acute change in cortisol and change in attentional bias appeared to differ as a function of the presence or absence of psychological stress. There was a trend toward a stronger negative association between acute cortisol change and attentional bias change among women relative to men. These results imply that the association between cortisol and attentional bias may be moderated by additional factors, such as gender or presence of stress.