Out of nothingness: rhythm and the making of words

Abstract: This contribution describes some aspects of the work with a four‐year‐old autistic child who was treated for many years with four times weekly sessions of psychotherapy. The fluctuations between the symbolic and non‐symbolic use of external objects are described, as well as the ever changing quality of the child's object relations. The rhythmical element in the analysand‐analyst interplay is of great importance: the construction of the temporal shapes (Alvarez) and the modulation of presence and absence are relevant as regards the progressive capacity to name aspects of external reality and subjective experience. From a theoretical point of view, the contributions of both the post‐Jungian, including Michael Fordham, and the post‐Kleinian traditions are outlined. The notions of pre‐conception (Bion) and of archetype (Jung) are immensely helpful in working with autistic children as they actually help the analyst in assuming that some proto‐trace of representational potential is always present in the individual.     

Multidimensional Latent Markov Models in a Developmental Study of Inhibitory Control and Attentional Flexibility in Early Childhood

We demonstrate the use of a multidimensional extension of the latent Markov model to analyse data from studies with repeated binary responses in developmental psychology. In particular, we consider an experiment based on a battery of tests which was administered to pre-school children, at three time periods, in order to measure their inhibitory control (IC) and attentional flexibility (AF) abilities. Our model represents these abilities by two latent traits which are associated to each state of a latent Markov chain. The conditional distribution of the test outcomes given the latent process depends on these abilities through a multidimensional one-parameter or two-parameter logistic parameterisation. We outline an EM algorithm for likelihood inference on the model parameters; we also focus on likelihood ratio testing of hypotheses on the dimensionality of the model and on the transition matrices of the latent process. Through the approach based on the proposed model, we find evidence that supports that IC and AF can be conceptualised as distinct constructs. Furthermore, we outline developmental aspects of participants’ performance on these abilities based on inspection of the estimated transition matrices.     

Psychiatry Residents' Attitudes on Ethics and Professionalism: Multisite Survey Results

Recent studies show that psychiatry residents express a relatively greater need for ethics curricula than their colleagues in other specialties. Such studies have been limited in their generalizability because they were conducted at one site. This study of 151 psychiatry residents at seven U.S. psychiatry programs aims to address that limitation. Residents were surveyed on issues pertaining to ethics and professionalism education. Participants were found to support such curricula during training and to value its relevance to the practice of psychiatry. Gender differences and the influence of the “hidden curriculum” on such results merit further study.     

Mass psychology of the led and the leaders

Abstract

Some salient features of a Sullivanian perspective are given as a background for a discussion of the case of Anna. Lived experience is mentioned as of equal importance as fantasy. Technically, analytic inquiry in the form of questions is stressed. In his review of the case presentation, the author observes that too much emphasis is given to content, compared to form. He notes that the therapist does not report key transference and non-transference interactions with the patient and further suggests that the patient still has significant narcissistic problems. He suggests that it is time to confront the patient with her characterological ways of relating to the analyst.     

Psychopathy as Predictor and Moderator of Multisystemic Therapy Outcomes among Adolescents Treated for Antisocial Behavior

Objective

The aim of the present study was to determine whether psychopathic traits act as a predictor and/or moderator of the effectiveness of Multisystemic Therapy (MST).

Method

The sample included N?=?256 adolescents (188 boys and 68 girls) referred for conduct problems, randomized to MST or Treatment As Usual (TAU). The mean age was 16 years (SD?=?1.31). Assessments were carried out before and immediately after treatment (6 months later). Three psychopathic traits (callous/unemotional traits, narcissism, and impulsiveness) were assessed with parent reports. Adolescents and parents were informants on externalizing problems.

Results

MST was more effective than TAU in decreasing externalizing problems for the “lower callous/unemotional” and “lower narcissism” group, but not for the “high callous/unemotional” and “high narcissism” group (moderators). Impulsiveness was found to predict more post-treatment externalizing problems rated by adolescents (predictor), but not more post-treatment externalizing problems rated by parents.

Conclusions

These findings point out the clinical relevance of adequately assessing psychopathic traits in adolescents referred for treatment of antisocial behaviour, and identifying those adolescents who show high levels of these traits. It is important to tailor MST specifically to meet the needs of juveniles with high levels of callous/unemotional traits and high levels of narcissism to obtain the same level of effectiveness as with juveniles scoring lower on these traits.     

Voting and Values: Reciprocal Effects over Time

Two studies investigated reciprocal effects of values and voting. Study 1 measured adults' basic values and core political values both before (n = 1379) and following (n = 1030) the 2006 Italian national election. Both types of values predicted voting. Voting choice influenced subsequent core political values but not basic values. The political values of free enterprise, civil liberties, equality, law and order, military intervention, and accepting immigrants changed to become more compatible with the ideology of the chosen coalition. Study 2 measured core political values before (n = 697) and following (n = 506) the 2008 Italian national election. It largely replicated the reciprocal effects of voting and political values of Study 1. In addition, it demonstrated that left‐right ideology mediated the reciprocal effects of voting and political values. Moreover, voter certainty moderated these effects. Political values predicted vote choice more weakly among undecided than decided voters, but voting choice led to more value change among undecided voters.     

The influence of external stimulation on airflow detection by children with asthma

Abstract

The relevance and significance of the concept of a ‘competition of cues’ for the understanding of symptom perception in childhood asthma was investigated during detection of externally applied resistive loads on breathing. The concept predicts that subjects would respond less frequently and less accurately during external stimulation. The sample consisted of 36 children with and 36 without asthma, aged 7-18 years. Detection of airflow was measured in a neutral and in an external stimulation condition. The children breathed through a facemask and responded to changes in airflow by pressing a button. The stimulus presented and withdrawn was analogous to a decrease in lung function (Forced Expiratory Volume in one second) of 39%. Accuracy of detection of airflow was defined as correct minus false positive responses to load stimuli.

The results showed that children with and without asthma responded significantly less frequently during external stimulation than in the neutral condition. However, the accuracy of detection among non-asthmatics was not affected by external stimulation. Children with asthma responded significantly more accurately during external stimulation. The results are discussed in the light of children's accuracy to perceive actual airways obstruction.