Dysfunctional attitudes and episodes of major depression: Predictive validity and temporal stability in never-depressed, depressed, and recovered women

In a large, community-based sample of women (N = 750), the authors examined the nature of associations between dysfunctional attitudes and depression. Dysfunctional attitudes were evaluated both as a vulnerability factor for depression and as a consequence of depression. A link was found between past depression and baseline elevations in dysfunctional attitudes that was independent of current subsyndromal symptoms, but intensification of dysfunctional attitudes following prospectively evaluated episodes of depression (depressive "scarring") was not observed. Although baseline dysfunctional attitudes predicted an episode of major depression over 3 years of prospective study, this prediction, considered alone or in interaction with negative life events, was redundant with that offered by history of past depression. Further, no significant prediction was evident for the Dysfunctional Attitude Scale (A. N. Weissman & A. T. Beck, 1978) when the formerly depressed and never-depressed cohorts were considered separately. Implications for cognitive theories are discussed.     

The almost untreatable narcissistic patient

Clinical experience in the Personality Disorders Institute at Weill Cornell Medical College suggests that patients with borderline personality organization and a narcissistic personality disorder have a more serious prognosis than all other personality disorders functioning at the borderline level, and that those who in addition present significant antisocial behavior have an even worse prognosis (Clarkin, Yeomans, and Kernberg 1999; Stone 1990). This negative trend culminates in a group of practically untreatable patients with antisocial personality disorder, who represent the most severe cases of pathological narcissism. There are also patients with severe narcissistic personality disorder, functioning at an overt borderline level with significant antisocial features, but not presenting an antisocial personality disorder proper, who at times respond to treatment, while others do not. These patients are explored here, with a focus on particular psychotherapeutic techniques that have proven helpful, as well as on the limits of these technical approaches.     

College students' motivations for money and subjective well-being

Previous research indicates that, while making money is important to college students, it is negatively correlated with subjective well-being. This study asked 157 undergraduate business and psychology students about the importance of making money, their motives for doing so, and several dimensions of subjective well-being: satisfaction with life, self-actualization, and mood/affect. Making money remains very important to college students. Being motivated to make money was not globally related to subjective well-being, but wanting to make money to help others, to feel secure, and to feel proud of oneself were predictive of happiness or subjective well-being. Motives such as comparing oneself favorably to others, spending impulsively, and overcoming self-doubt were not correlated with subjective well-being. Business students appeared more motivated to make money than other students and also to have more negative affect.     

Memento ... life imitates art: the request for an ethics consultation

This was a troublesome case, without complete consensus about the right thing to do. It seemed there were arguments on both sides: those who thought that the goal of comfort care without treatment was most consistent with his wishes, versus those who thought the additional testing and treatment might have produced a net benefit in spite of the burdens. Ultimately, the patient was placed in a facility with a do-not-resuscitate (DNR) order in effect and a plan for comfort care. He may live a few months or more. We all hope that whatever time he has is spent free of pain and symptoms, and that he is able to live a life of quality consistent with his wishes. The main story line is consistent with actual events; however, there have been changes in terms of gender, disease, and relationships that have been included to protect the anonymity of the patient.     

Clinical perspectives on the combination of D-cycloserine and cognitive-behavioral therapy for the treatment of anxiety disorders

In a particular success for translational research agendas, characterization of the neuronal circuits underlying fear extinction, and basic research in animal extinction paradigms, has led to intervention studies examining the use of D-cycloserine (DCS) to enhance therapeutic learning from exposure-based cognitive-behavioral therapy (CBT). In this article, we review these intervention studies, and discuss DCS augmentation of CBT relative to more traditional combination-treatment strategies in the treatment of anxiety disorders. We offer an accounting, based on evidence for internal context effects, of current limitations in the combination of antidepressant or benzodiazepine medications with CBT and discuss the advantages of isolated-dosing strategies with DCS relative to these limitations. This strategy is contrasted with the chronic-dosing applications of DCS for schizophrenia and Alzheimer's disease, and future directions for isolated-dosing strategies are discussed.     

Inferior Frontal Regions Underlie the Perception of Phonetic Category Invariance

ABSTRACT— The problem of mapping differing sensory stimuli onto a common category is fundamental to human cognition. Listeners perceive stable phonetic categories despite many sources of acoustic variability. What are the neural mechanisms that underlie this perceptual stability? In this functional magnetic resonance imaging study, a short-interval habituation paradigm was used to investigate neural sensitivity to acoustic changes within and between phonetic categories. A region in the left inferior frontal sulcus showed a pattern of activation consistent with phonetic invariance: insensitivity to acoustic changes within a phonetic category and sensitivity to changes between phonetic categories. Left superior temporal regions, in contrast, showed graded sensitivity to both within- and between-category changes. These results suggest that perceptual insensitivity to changes within a phonetic category may arise from decision-related mechanisms in the left prefrontal cortex and add to a growing body of literature suggesting that the inferior prefrontal cortex plays a domain-general role in computing category representations.     

Navigating through abstract decision spaces: Evaluating the role of state generalization in a dynamic decision-making task

Research on dynamic decision-making tasks, in which the payoffs associated with each choice vary with participants’ recent choice history, shows that humans have difficulty making long-term optimal choices in the presence of attractive immediate rewards. However, a number of recent studies have shown that simple cues providing information about the underlying state of the task environment may facilitate optimal responding. In this study, we examined the mechanism by which this state knowledge influences choice behavior. We examined the possibility that participants use state information in conjunction with changing payoffs to extrapolate payoffs in future states. We found support for this hypothesis in an experiment in which generalizations based on this state information worked to the benefit or detriment of task performance, depending on the task’s payoff structure.     

The race that precedes coactivation: development of multisensory facilitation in children

Rationale: The facilitating effect of multisensory integration on motor responses in adults is much larger than predicted by race‐models and is in accordance with the idea of coactivation. However, the development of multisensory facilitation of endogenously driven motor processes and its relationship to the development of complex cognitive skills in school‐age children is largely unexplored. Method: Twenty adults and 95 children where allocated into six age groups: 6, 7, 8, 9, 10–11 and adults. Participants’ motor reaction times (MRTs) and accuracy in response to the detection of auditory, visual and audiovisual stimuli were recorded. Children's reading accuracy and nonverbal IQ were also assessed. Results: In general, MRTs of children were significantly slower with greater variability than those of adults. Although the average level of multisensory facilitation was similar for all age groups, mean cumulative density functions (CDFs) showed that multisensory facilitation in 6 and 10–11‐year‐olds is within the predictive limits of race‐models. Where coactivation was seen in the CDF of individual children it was not as strong or as consistent as that in adults. The degree of multisensory facilitation did not correlate with age, reading accuracy or IQ. Conclusion: The average level of multisensory facilitation to endogenously driven motor responses does not change gradually with age nor is it related to intelligence or reading accuracy. In general, multisensory integration remains immature until 10–11 years of age and lies within the predicted confines of race‐models.     

The encounter with God in myth and madness

Background

It is well known how often psychiatric patients report religious experiences. These are especially frequent in schizophrenic and epileptic patients as the subject of their delusions. The question we pose is: are there differences between this kind of religious experiences and those we find in religious texts or in the mythological tradition?

Results

An overview on famous mythological narratives, such as The Aeneid, allows us to establish that the divinities become recognizable to the human being at the moment of their departure. Thus, Aeneas does not recognise his mother, Venus, when she appears to him in the middle of the forest at the coast of Africa. A dialogue between the two takes place, and only at the end of the encounter, when she is going away and already with her back to Aeneas, she shows her son the signs of her divinity: the rose-flush emanating from her neck, her hair perfume and the majesty of her gait. Something analogous can be observed in the encounter of Moses with Yahweh on Mount Sinai. Moses asks God: "Show me your glory, I beg you". And God replies, among other things: "you shall see the back of me, but my face is not to be seen". In the same sense, the Emmaus disciples do not recognise Jesus till the moment of his disappearance ("but he had vanished from their sight"), and Saul of Tars falls off his horse just in the moment when he feels the divine presence. In short, the direct encounter with the divinity seems not to occur in the realm of myth or in religious tradition. The realm of madness is exactly the opposite. Our research on religious experiences in schizophrenic and epileptic patients leads us to conclude that God appears to them face to face, and the patient describes God the father, Jesus or the Virgin Mary in intimate detail, always in an everyday setting. So, the divinity is seen in the garden, or in the bedroom, or maybe above the wardrobe, without any of its majesty. The nearness to God also tends to be so extreme that even an identification of patient and God can occur. That light emanating from the world of the divine ceases to be perceived by them.

Conclusion

While in mythological narratives God appears to the human being at the moment of His departure or showing His back, psychiatric patients with religious delusions experience the divinity in a direct way, face to face. Given the deformation of the divine occurring on the edge of madness we can better understand the mysterious words from Yahweh to Moses in Exodus: "for man cannot see me and live".     

The Relationship Between Religious Coping Style and Anxiety over Breast Cancer in African American Women

In this study, we investigated the relationship between religious coping style and anxiety related to breast cancer and the use of mammography in a sample of African American women. We also assessed the relationship of breast cancer anxiety to related variables such as church affiliation and attendance, church teachings on health, and acceptance of those teachings.