Recommendation Recall and Satisfaction After Attending Breast/Ovarian Cancer Risk Counseling

This study examined women’s recall of physician recommendations as well as patient satisfaction following participation in a breast/ovarian cancer risk and prevention program. Participants were 41 high risk women who attended a cancer risk program 4–6 months earlier. Two-thirds of women who received recommendations for tamoxifen treatment and genetic testing did not recall these recommendations upon follow-up. A number of women misunderstood recommendations and a quarter of the sample recalled recommendations that were not made during the consultation. Although these high risk women were generally satisfied with their counseling visit, those individuals who received particularly complex sets of recommendations reported feeling less understood and were less satisfied with the counseling. Findings underline the importance of examining recommendation recall, in addition to perceptions of cancer risk, when evaluating the clinical implications of cancer risk assessment.     

Parent Proneness to Shame and the Use of Psychological Control

We examined the link between parent proneness to shame and two forms of psychological control, overprotection and critical/rejecting behavior, in parents of preschoolers. Because shame is self-condemning, proneness to shame affects intrapersonal and interpersonal functioning. We hypothesized that parents’ emotion-regulatory responses to shame would increase the likelihood of psychological control: anxiety by leading to overprotection mediated by a worrisome approach to the child, and anger/hostility by leading to critical/rejecting parenting mediated by negative reactivity to the child. Participants were 198 mother-father pairs with a child 3.6 to 4.5 years of age. Overprotective and critical/rejecting parenting were assessed using both self and spouse reports of parenting practices. In addition, parents completed measures of proneness to shame, worrisome overconcern about the child, and negative reactivity to the child. Structural equation modeling yielded results that supported mediation by negative approach to the child for mothers’ and fathers’ critical/rejecting behavior. For fathers but not mothers, shame was indirectly associated with overprotective parenting through worrisome approach to the child. Parents’ proneness to shame may be an important factor leading to the use of psychological control.     

Perirhinal cortex resolves feature ambiguity in configural object recognition and perceptual oddity tasks

The perirhinal cortex (PRh) has a well-established role in object recognition memory. More recent studies suggest that PRh is also important for two-choice visual discrimination tasks. Specifically, it has been suggested that PRh contains conjunctive representations that help resolve feature ambiguity, which occurs when a task cannot easily be solved on the basis of features alone. However, no study has examined whether the ability of PRh to resolve configural feature ambiguity is related to its role in object recognition. Therefore, we examined whether bilateral excitotoxic lesions of PRh or PPRh (perirhinal plus post-rhinal cortices) in the rat would cause deficits in a configural spontaneous object recognition task, and a configural simultaneous oddity discrimination task, in which the task could not be solved on the basis of features, but could only be solved using conjunctive representations. As predicted by simulations using a computational model, rats with PPRh lesions were impaired during a minimal-delay configural object recognition task. These same rats were impaired during a zero-delay configural object recognition task. Furthermore, rats with localized PRh lesions were impaired in a configural simultaneous oddity discrimination task. These findings support the idea that PRh contains conjunctive representations for the resolution of feature ambiguity and that these representations underlie a dual role for PRh in memory and perception.     

Anxiety: the importunate companion. Psychoanalytic theory of castration and separation anxieties and implications for clinical technique

In this article I consider the implications of our differing psychoanalytic theories of anxiety on clinical technique. Drawing on differentiations between the focus on separation or castration anxiety and the relative neglect of the latter in contemporary writing, I look in detail at two clinical examples of psychoanalysis in borderline young adults to exemplify the issue. 1     

Evidence for a General ADHD Factor from a Longitudinal General School Population Study

Recent factor analytic studies in Attention-Deficit/Hyperactivity Disorder (ADHD) have shown that hierarchical models provide a better fit of ADHD symptoms than correlated models. A hierarchical model includes a general ADHD factor and specific factors for inattention, and hyperactivity/impulsivity. The aim of this 12-month longitudinal study was to test the generalizability of the hierarchical models of ADHD within an elementary school population of 6–9 year old children (250 boys, 260 girls). Examination of differences as a function of informant (parent vs. teacher ratings), sex, and time was conducted. Six potential factor structures for the 18 items of the SWAN (Strengths and Weaknesses of ADHD-symptoms and Normal-behavior) scale were tested using confirmatory and exploratory factor analyses. Hierarchical models with a general ADHD factor and two or three specific factors best accounted for parent and teacher reports of symptoms for both boys and girls and at two time points separated by a 12-month interval. Findings indicate that the 18 SWAN items measure a common latent trait as well as orthogonal factors or dimensions of inattention and hyperactivity/impulsivity.     

Reasons for Action and Psychological Capacities

Most moral philosophers agree that if a moral agent is incapable of performing some act ф because of a physical incapacity, then they do not have a reason to ф. Most also claim that if an agent is incapable of ф-ing due to a psychological incapacity, brought about by, for example, an obsession or phobia, then this does not preclude them from having a reason to ф. This is because the ‘ought implies can’ principle is usually interpreted as a claim about physical, rather than psychological, capacities. In this paper I argue for an opposing view: if we don’t have reasons to do things that we are physically incapable of doing, then neither do we have reasons to do things we are psychologically incapable of doing. I also argue that extending the ‘ought implies can’ principle to psychological capacities makes the principle more attractive.     

Evidence for a general factor model of ADHD in adults

Objective: To examine factor structures of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) symptoms of ADHD in adults. Method: Two sets of models were tested: (a) models with inattention and hyperactivity/impulsivity as separate but correlated latent constructs and (b) hierarchical general factor models with a general factor for all symptoms and separate specific factors for inattention and hyperactivity/impulsivity. Participants were 751 adults with ADHD. Two models with correlated factors and two general factor models of ADHD symptoms were tested. Results: The general factor model provided a better fit of the data than the correlated models. The general factor model with one general and three (inattention, motoric, and verbal hyperactivity/impulsivity) specific factors best accounted for the adults' symptoms. Conclusion: These results suggest a unitary component to ADHD symptoms as well as dimensional specific factors. The replication of a general factor in adults suggests continuity of symptom presentation from childhood into adulthood. Clinical implications are discussed.