A modest proposal: (re)defining unconscious fantasy

The author argues that unconscious fantasy, properly defined, necessarily represents the three-dimensional intersection of wishful thinking (fantasy), veridical perception of the environment (reality), and the naive cognition of childhood. It is proposed that, although attachment theory developed out of the intent to capture the unalloyed reality of dyadic experience, that experience is inextricably entangled with the other two components, wishes and naive cognition, and furthermore, that the behavior of children in the attachment paradigm can only be accounted for by positing the existence of underlying unconscious fantasies. In making these arguments, the author also addresses the development of unconscious fantasies and their relationship to compromise formations and trauma.     

Evidence-based treatment of stuttering: V. The art of clinical practice and the future of clinical research

This epilogue summarizes and expands on some of the many points raised in Parts I through IV, emphasizing that evidence-based practice is not in conflict with the "art" of clinical practice but may actually be synonymous. An evidence-based practice framework is also used to suggest some future directions for clinical research in stuttering. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1) describe the similarities between evidence-based practice and the art of clinical practice, (2) explain how evidence-based practice provides a structure for future stuttering research, and (3) evaluate the importance of an evidence-based approach to stuttering treatment.     

Modulation of tremor amplitude during deep brain stimulation at different frequencies

Rest tremor was quantified in the index finger tip of 16 patients with Parkinson's disease (PD) receiving deep brain stimulation (DBS) of the ventro-intermediate nucleus (Vim) of the thalamus, the subthalamic nucleus (STN), or the internal part of the globus pallidus (GPi) while being off L-dopa for 12h. Clinically, without DBS, tremor amplitude varied from absent to high. Tremor was recorded continuously for about 5 min under three conditions of DBS repeated twice, namely, effective frequency (E), ineffective frequency (I), and no DBS (O). No changes in tremor were observed across conditions in subjects with little or no tremor. However, in subjects with moderate to large amplitude tremor, DBS decreased tremor amplitude to near normal values within a few seconds. Generally, transitions were progressive and occurred with a varying time delay. Occasionally, tremor escaped from control regardless of the stimulation condition considered. In some cases tremor amplitude in one condition appeared to depend on the preceding condition. Finally, the results were reproducible on two consecutive days. We conclude that tremor control with DBS follows specific dynamical rules, which must be compatible with the hypotheses proposed regarding the underlying mechanisms of DBS.     

Day treatment of patients with personality disorders: experiences from a Norwegian treatment research network

This study sought to investigate the following research questions: Are time-limited day treatment programs for patients with personality disorder (PD) effective outside resourceful university settings, and what are the overall treatment results when the program is implemented on a larger scale? Do all categories and subtypes of PDs respond favorably to such treatment? How intensive should such day treatment programs be? All patients (n = 1,244) were consecutively admitted to eight different treatment programs in the Norwegian Network of Psychotherapeutic Day Hospitals from 1993 to 2000. Altogether, 1,010 patients were diagnosed with PD. Avoidant, borderline, not otherwise specified (NOS), and paranoid PD were the most common conditions. SCID-II and MINI were used as diagnostic instruments. Outcome measures included GAF Global Assessment of Functioning, (GAF; American Psychiatric Association, 1994), SCL-90R, CIP, Quality of Life, work functioning and parasuicidal behavior, measured at admittance, discharge and 1-year follow up. The attrition rate was 24%. The number of dropouts did not improve over time. As a group, completers with PD improved significantly on all outcome variables from admittance to discharge and improvement was maintained or increased at follow up. Treatment results were best for borderline PD, cluster C patients, PD NOS and No PD, and poorer for cluster A patients. Units with a high treatment dosage did not experience better outcomes than those with a low treatment dosage (10 hours per week). Results from the University unit were not better than those from units at local hospitals or mental health centers.     

When parallel processing in visual word recognition is not enough: new evidence from naming

Low-frequency irregular words are named more slowly and are more error prone than low-frequency regular words (the regularity effect). Rastle and Coltheart (1999) reported that this irregularity cost is modulated by the serial position of the irregular grapheme-phoneme correspondence, such that words with early irregularities exhibit a larger cost than words with late ones. They argued that these data implicate rule-based serial processing, and they also reported a successful simulation with a model that has a rule-based serial component—the DRC model of reading aloud (Coltheart, Rastle, Perry, Langdon, & Ziegler, 2001). However, Zorzi (2000) also simulated these data with a model that operates solely in parallel. Furthermore, Kwantes and Mewhort (1999) simulated these data with a serial processing model that has no rules for converting orthography to phonology. The human data reported by Rastle and Coltheart therefore neither require a serial processing account, nor successfully discriminate among a number of computational models of reading aloud. New data are presented wherein an interaction between the effects of regularity and serial position of irregularity is again reported for human readers. The DRC model simulated this interaction; no other implemented computational model does so. The present results are thus consistent with rule-based serial processing in reading aloud.     

Implicit memory in schizotypal subjects and normal controls: effects of a secondary task on sequence learning

Using a serial reaction-time task, the implicit memory performances of 29 high scoring (schizotypes) and 24 low scoring subjects (controls) on the German version of the 1997 Schizotypal Personality Questionnaire by Klein, Andresen, and Jahn were compared. To test the hypothesis that schizotypes show a differential deficit, subjects participated either in a single task condition of the serial reaction-time task or in a dual task condition of a secondary tone-counting task. Neither under single task conditions nor under dual task conditions did schizotypes show any impairment of implicit memory compared with controls. In addition, a separate analysis of the response latencies for the unique and ambiguous transitions of the repeated sequence did not indicate any differences between the two groups. These findings support and augment the results reported by Ferraro and Okerlund (1995).     

New mothers and their babies: attachment in the face of maternal life-threatening illness

Life-threatening illness in the mothers of babies or young children is rare. Its impact is discussed in this paper, which focuses on attachment theory as a foundation for work in this area. A single case study is used to illustrate the potential conflicts and dilemmas for professionals caring for babies and their families in this situation.     

Studying Sexual Harassment in the Laboratory: Are Egalitarian Women at Higher Risk?

A laboratory experiment is reported in whichmale participants in Northern Italy (N = 120 universitystudents) were given the opportunity to sendpornographic material to a female interaction partner(“computer harassmentparadigm”). The allegedgender-role orientation of the female (traditional vs.egalitarian) and the construal of the interaction aseither intergroup or interpersonal were variedsystematically. Results show that participants molest femaleinteraction partners more when they express egalitarianrather than traditional gender-role attitudes; this isparticularly true for males with a high propensity to harass (high scores on likelihood of sexualharassment scale, Pryor, 1987), with sexist attitudes,with a strong identification as “males,” andfor low self-monitors. Also, males with a highpropensity to harass were more likely to harass theirinteraction partner when they perceived the situation asa male-female inter-group setting (rather than asinterpersonal). Results are interpreted as supporting a social identity account ofmisogyny.     

Bayesian estimation and testing of structural equation models

The Gibbs sampler can be used to obtain samples of arbitrary size from the posterior distribution over the parameters of a structural equation model (SEM) given covariance data and a prior distribution over the parameters. Point estimates, standard deviations and interval estimates for the parameters can be computed from these samples. If the prior distribution over the parameters is uninformative, the posterior is proportional to the likelihood, and asymptotically the inferences based on the Gibbs sample are the same as those based on the maximum likelihood solution, for example, output from LISREL or EQS. In small samples, however, the likelihood surface is not Gaussian and in some cases contains local maxima. Nevertheless, the Gibbs sample comes from the correct posterior distribution over the parameters regardless of the sample size and the shape of the likelihood surface. With an informative prior distribution over the parameters, the posterior can be used to make inferences about the parameters underidentified models, as we illustrate on a simple errors-in-variables model.We thank David Spiegelhalter for suggesting applying the Gibbs sampler to structural equation models to the first author at a 1994 workshop in Wiesbaden. We thank Ulf Böckenholt, Chris Meek, Marijtje van Duijn, Clark Glymour, Ivo Molenaar, Steve Klepper, Thomas Richardson, Teddy Seidenfeld, and Tom Snijders for helpful discussions, mathematical advice, and critiques of earlier drafts of this paper.