On the immediacy of unconscious truth: understanding Betty Joseph's 'here and now' through comparison with alternative views of it outside of and within Kleinian thinking

Psychoanalysis emphasizes that in discovering psychic truth what is needed is not abstract or distant knowledge of this truth but rather an immediate encounter with it. In this paper the author examines the meaning of this immediacy through the study of Betty Joseph's notion of 'here and now,' which in recent years has been most directly associated with it. The author shows how Joseph's notion of 'here and now' continues a legacy beginning in Freud and taken up by Klein regarding the immediacy of unconscious truth that differs from other available analytic formulations of the term. To highlight the uniqueness of Joseph's contribution the author goes on to examine what distinguishes it within the kleinian framework. She does this in part through comparison with the clinical approach of Hanna Segal, whose focus on unconscious phantasy adheres to the same foundational legacy. The author points to the differences between Joseph and Segal and their significance, which have not been sufficiently elaborated in the analytic literature. She argues that viewing these differences within the context of a shared perspective on the role of unconscious truth in the analytic process and task enriches our understanding of the complexity of kleinian thinking and the meaning of truth in psychoanalysis. This understanding is also furthered by the recognition that many uses of the term 'here and now' in the analytic literature refer to something very different from what Joseph refers to and are based on a perspective that is fundamentally opposed to hers.     

Distinguishing general and specific personality disorder features and implications for substance dependence comorbidity

Clinical and population-based samples show high comorbidity between Substance Use Disorders (SUDs) and Axis II Personality Disorders (PDs). However, Axis II disorders are frequently comorbid with each other, and existing research has generally failed to distinguish the extent to which SUD/PD comorbidity is general or specific with respect to both specific types of PDs and specific types of SUDs. We sought to determine whether ostensibly specific comorbid substance dependence-Axis II diagnoses (e.g., alcohol use dependence and borderline personality disorder) are reflective of more pervasive or general personality pathology or whether the comorbidity is specific to individual PDs. Face-to-face interview data from Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were analyzed. Participants included 34,653 adults living in households in the United States. We used hierarchical factor models to statistically partition general and specific personality disorder dimensions while simultaneously testing for specific PD-substance dependence relations. Results indicated that substance dependence-Axis II comorbidity is characterized by general (pervasive) pathology and by Cluster B PD pathology over and above the relationship to the general PD factor. Further, these relations between PD factors and substance dependence diagnoses appeared to largely account for the comorbidity among substance dependence diagnoses in the younger but not older participants. Our findings suggest that a failure to consider the general PD factor, which we interpret as reflecting interpersonal dysfunction, can lead to potential mischaracterizations of the nature of certain PD and SUD comorbidities.     

The behavioral activation for depression scale-short form: development and validation

Following a landmark component analysis of cognitive therapy by Jacobson and colleagues (1996), there has been renewed interest in behavioral activation (BA) treatments for depression. The Behavioral Activation for Depression Scale (BADS) was developed to measure when and how clients become activated over the course of BA treatment. Multiple studies have provided initial support for the BADS but have also identified several potential problems. Four studies were conducted in order to develop and provide initial evaluation of a short form of the BADS that addresses these concerns. In Study 1, an exploratory factor analysis was conducted on existing data using the original BADS in order to identify items to retain for the short form. In Study 2, these items were administered to a new sample of college students with elevated depressive symptoms and were analyzed with exploratory and confirmatory factor analyses. Study 3 examined the predictive validity of the BADS-SF by examining the BADS-SF and depression scores in relation to activity tracking and reward-value ratings over the course of 1 week. Study 4 examined BADS-SF data over the course of BA treatment for two clients using cross-lagged panel correlations. With one client, changes in BADS-SF scores led changes in depression scores by 1 week, whereas with the other client changes in BADS-SF and depression scores occurred concurrently. These studies resulted in a nine-item scale that demonstrated good item characteristics as well as acceptable internal consistency reliability, construct validity, and predictive validity.     

The role of negative reinforcement in infant caregiving: an experimental simulation

We observed 11 undergraduates in an experiment designed to simulate infant caregiving. In negative reinforcement conditions experienced by all participants, a targeted caregiving response (e.g., rocking a baby doll) produced escape from, and avoidance of, a recorded infant cry. Nine participants' caregiving was shown to be controlled by this negative reinforcement contingency. Nine participants experienced an extinction condition that consisted of an inescapable cry, and the previously reinforced caregiving responses of 2 of these participants were resistant to extinction. For both of these participants, the previously reinforced response was eliminated when an alternative form of caregiving was reinforced. These results highlight the role of negative reinforcement in infant caregiving and suggest the need for additional research on the effects of crying on caregivers as well as the development of effective strategies for minimizing infant crying.     

The role of perceptual and cognitive processes in addition-subtraction studies with 5-month-old infants

After a brief familiarization period to either one or two toys 5-month-olds gave a clear preference for perceptually novel displays, suggesting that replicable findings of greater looking at an unexpected arithmetic outcome in addition/subtraction experiments cannot easily be attributed to simple familiarity preferences.     

Emotion Regulation and Attachment: Unpacking Two Constructs and Their Association

This study examined the association between the security of attachment and processes influencing the development of emotion regulation in young children. A sample of 73 4 1/2-year-olds and their mothers were observed in an emotion regulation probe involving mild frustration for children, and mothers and children were later independently interviewed about how the child had felt. Fewer than half the mothers agreed with children’s self-reports in the emotion they attributed to children (a lower rate than the concordance of observer ratings with children’s self-reports), and higher mother-child concordance was associated with secure attachment and mother’s beliefs about the importance of attending to and accepting their own emotions. Mother-child conversations about recent events evoking children’s negative emotion were also analyzed. Children were less likely to avoid conversing about negative feelings when they were in secure attachments and when mothers were more validating of the child’s perspective. Children’s greater understanding of negative emotions was also significantly associated with higher mother-child concordance and less child conversational avoidance. Taken together, these findings underscore the multiple influences of attachment on emotion regulation and the importance of children’s emotion understanding to these processes.     

The influence of heightened body‐awareness on walking through apertures

The reported study measured the ratio between aperture‐width and hip‐width that marked the critical transition from frontal walking to body rotation for male and female participants. Half of the participants of each sex wore form‐fitting lycra clothes and half loose‐fitting jogging suits. Participants wearing the form‐fitting clothing reported heightened body awareness relative to those wearing the loose‐fitting clothing. For male participants this difference was reflected in a smaller aperture‐to‐hip ratio in the form‐fitting than loose‐fitting clothing condition. That is, males walked frontally through smaller apertures when wearing form‐fitting than when wearing loose‐fitting clothing. For females there was no difference in walking action as a function of clothing style. Results are discussed in terms of the perception of action opportunities in the environment, the influence of body awareness on such perception and sex differences. Copyright © 2009 John Wiley & Sons, Ltd.     

Predicting excessive body image concerns among British university students: The unique role of Appearance-based Rejection Sensitivity

The present research examined the extent to which interpersonal concerns about rejection based on appearance, or Appearance-based Rejection Sensitivity (Appearance-RS), serves as an indicator of risk for excessive body image concerns. Extending previous research, we examined the association between Appearance-RS and symptoms of body dysmorphic disorder (BDD) and cosmetic surgery attitudes among 106 British university students. Consistent with predictions, Appearance-RS uniquely predicted greater degree of BDD symptoms after controlling for other known predictor variables. Also, as expected, Appearance-RS uniquely predicted acceptance of cosmetic surgery for both intrapersonal and social reasons and greater consideration of having cosmetic surgery in the future. These findings highlight the importance of assessing individuals’ sensitivity to rejection from others based on their physical appearance in investigations of excessive body image concerns.     

Developmental changes in the responses of preterm infants to a painful stressor

The purpose of this investigation was to examine longitudinally gestational age and developmental differences in preterm infants' self-regulatory abilities in response to a painful stressor, as well as associations between behavioral and cardiovascular responses. Participants included 49 healthy premature infants. Behavioral and cardiovascular responses to a heel stick blood draw were compared between infants of 28-31 and 32-34 weeks' gestation age at birth. Both gestational age groups displayed behavioral and cardiovascular indications of stress in response to the blood draw. However, both shortly after birth and several weeks later, infants born at younger gestational ages (28-31 weeks) were more physiologically reactive. Evidence that the behavioral stress responses of 28-31 weeks' gestation age group preterm infants do not reflect their physiological responses suggests that evaluation of preterm infants' experiences and risk require assessments of both physiology and behavior. The greater stress vulnerability of the 28-31 weeks' gestation group relative to the 32-34 weeks' gestation group and the implications of this for subsequent development are discussed.