Is there anybody there? A psychodynamic view of panic attack

The effectiveness of cognitive-behavioural therapy is frequently cited when adopting this model as treatment of choice for panic attacks and anxiety disorders. However, Frank (1974), in discussing treatment effectiveness and patient compliance, argues that 'the more closely the conceptual framework of therapy fits that of the patient, the more readily he can accept it' (p. 370). In the following process analysis, my client's clear requirement for an exploratory approach meant that it was a psychodynamic understanding of the complex aetiology of her panic attacks that ultimately produced improved coping skills and a subjective sense of improvement for her. Process analysis has been chosen to illustrate the theoretical base, clinical impact and experiential immediacy of psychodynamic work; attention is drawn to the importance of transference and countertransference experiences in the choice of clinical interventions which tally with the client's sense of internal reality.     

ADHD outside the laboratory: boys' executive function performance on tasks in videogame play and on a visit to the zoo

One current theory of attention-deficit/hyperactivity disorder (ADHD) proposes that a primary deficit in behavioral inhibition gives rise to secondary deficits in 4 executive functions and motor control. To date, empirical support for this model is based primarily on laboratory-based cognitive methods. This study assessed behavioral inhibition and executive functioning in children with ADHD in 2 real-life contexts: videogames (motor-skill target game, cognitively demanding adventure game) and an outing at the zoo (route tasks). Participants were a community sample of 57 boys diagnosed with ADHD (20 inattentive, 37 combined type) and 57 normally developing control boys, matched individually for age and nonverbal IQ. Operationally defined measures of behavioral inhibition and specific executive functions were derived from these activities and assessed under contrasting conditions of low or high working memory and distractor loads. There were no group differences in basic motor skills on the target game, nor in terms of the ability to inhibit a prepotent or ongoing response in the adventure videogame. However, boys with ADHD exhibited more self-talk, more effortful response preparation, and completed fewer challenges in the latter videogame. Also, they manifested inhibition deficits in terms of interference control during the route task at the zoo and took longer to complete the tasks. Typically, these differences were greatest under conditions of high working memory and distractor loads. Findings from this study suggest that cognitive difficulties in ADHD may be context dependent and that ADHD is associated with deficits in some but not all aspects of behavioral inhibition.     

Confirmation of an Inhibitory Control Deficit in Attention-Deficit/Hyperactivity Disorder

The objective of this study was to determine whether deficient inhibitory control distinguishes children with a diagnosis of attention-deficit/hyperactivity (ADHD) disorder, conduct disorder (CD), and comorbid ADHD + CD from normally developing children. Participants were rigorously diagnosed children (age 7 to 12 years) with ADHD (N = 72), CD (N = 13) or ADHD + CD (N = 47) and 33 control children (NC). We studied inhibitory control using the stop-signal paradigm, a laboratory task that assessed the ability to inhibit an ongoing action. The ADHD group had significantly impaired inhibitory control compared to NC, CD, and ADHD + CD children. These results indicate that children with ADHD have deficient inhibition as measured in the stop-signal paradigm and that ADHD occurring in the presence of ADHD + CD may represent a phenocopy of CD rather than a variant of ADHD.     

Selective inhibition in children with attention-deficit hyperactivity disorder off and on stimulant medication

Selective inhibition requires discrimination between auditory signals and is assessed using a modification of the stop-signal task. Selective inhibition was assessed in a group of 59 clinic-referred, DSM-IV-diagnosed children with attention-deficit hyperactivity disorder (ADHD) and compared to that of a community sample of 59 children. Methylphenidate (MPH) effects on selective inhibition were assessed in a subset of the ADHD sample that participated in an acute, randomized, placebo-controlled, crossover trial with 3 fixed doses of MPH. Children with ADHD performed more poorly than controls on the majority of selective stop-signal task parameters: they exhibited more anticipatory (invalid) responses, with less accurate and more variable responses on the response execution task, as well as a slower selective inhibition process. MPH improved speed of both inhibition and response execution processes; it also reduced variability of response execution and decreased nonselective inhibition. On the one hand, findings are consistent with purported inhibition deficit in ADHD, but on the other hand, suggest that neither the impairment itself, nor MPH effects, were restricted to inhibition.     

The evolutionary origins of natural pedagogy: Rhesus monkeys show sustained attention following nonsocial cues versus social communicative signals

The natural pedagogy hypothesis proposes that human infants preferentially attend to communicative signals from others, facilitating rapid cultural learning. In this view, sensitivity to such signals is a uniquely human adaptation and as such nonhuman animals should not produce or utilize these communicative signals. We test these evolutionary predictions by examining sensitivity to communicative cues in 206 rhesus monkeys (Macaca mulatta) using an expectancy looking time task modeled on prior work with infants. Monkeys observed a human actor who either made eye contact and vocalized to the monkey (social cue), or waved a fruit in front of her face and produced a tapping sound (nonsocial cue). The actor then either looked at an object (referential look) or looked toward empty space (look away). We found that, unlike human infants in analogous situations, rhesus monkeys looked longer at events following nonsocial cues, regardless of the demonstrator's subsequent looking behavior. Moreover younger and older monkeys showed similar patterns of responses across development. These results provide support for the natural pedagogy hypothesis, while also highlighting evolutionary changes in human sensitivity to communicative signals.     

When Home Is Where the Harm Is: Family Betrayal and Posttraumatic Outcomes in Young Adulthood

Research on institutional betrayal has found that institutional wrongdoing that fails to prevent or respond supportively to victims of abuse adds to the burden of trauma. In this two-study investigation with young adult university students, we demonstrated parallels between institutional betrayal and ways that families can fail to prevent or respond supportively to child abuse perpetrated by a trusted other, a phenomenon we call family betrayal (FB). In Study 1, psychometric analysis of a new FB questionnaire provided evidence of its internal consistency, unidimensionality, and convergent and discriminant validity. The majority (approximately 72%) of young adults abused in childhood reported a history of FB, with an average of 4.26 FB events (SD = 4.45, range 0–14). Consistent with betrayal trauma theory, Study 2 revealed that FB was 4× more likely to occur in relation to childhood abuse by someone very close to the victim (vs. non-interpersonal victimization), with a particularly strong effect for female participants. FB history predicted significant delay to disclosure of a self-identified worst traumatic event (η_p² = .017) and significant increases in dissociation (?R² = .05) and posttraumatic stress (?R² = .07) symptoms in young adulthood. Moreover, with FB in the regression models, only FB—not child abuse nor recent interpersonal victimization—predicted dissociation and clinically significant elevations in posttraumatic stress. Findings suggest that FB is a prevalent phenomenon among young adults abused as children and that it explains unique, clinically significant variance in posttraumatic distress, warranting increased attention from trauma researchers and clinicians.     

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.     

Improving image annotation via useful representative feature selection

This paper describes the automatic assignment of images into classes described by individual keywords provided with the Corel data set. Automatic image annotation technology aims to provide an efficient and effective searching environment for users to query their images more easily, but current image retrieval systems are still not very accurate when assigning images into a large number of keyword classes. Noisy features are the main problem, causing some keywords never to be assigned to their correct images. This paper focuses on improving image classification, first by selection of features to characterise each image, and then the selection of the most suitable feature vectors as training data. A Pixel Density filter (PDfilter) and Information Gain (IG) are proposed to perform these respective tasks. We filter out the noisy features so that groups of images can be represented by their most important values. The experiments use hue, saturation and value (HSV) colour feature space to categorise images according to one of 190 concrete keywords or subsets of these. The study shows that feature selection through the PDfilter and IG can improve the problem of spurious similarity.