“They Go Too Far”: Reply to Review Essays by Lewes and O'Connor

Kenneth Lewes and Noreen O'Connor share little common ground in their discussions of Lesbian Lives. They agree that it represents, in Lewes's words, “important trends in psychoanalysis and more general intellectual discourse” (“the developing discourse on homosexuality, the ascendancy of feminist ideas within psychoanalysis, … the shift … from classical drive theory to … more … relational approaches, and the influence of postmodern social and literary thought”). But whereas O'Connor welcomes a text she sees as offering “critiques of traditional psychoanalysis's binary theorising of gender and sexuality,” Lewes finds that Lesbian Lives presents “certain questions and difficulties, especially to those who, like myself, espouse theoretical and political allegiances quite different from them.” This article responds to several of Lewes's distortions and misreadings, including his allegations that the authors believe they can “conduct therapy without theory or value” and that they “insist on the essential sameness of people who are heterosexual and homosexual.” Lewes also wrongly attributes to the authors a simplistic belief in “sexual fluidity” and the “multiplicity of selves.” Instead, the text of Lesbian Lives in various ways encourages psychoanalysis to incorporate into its developmental models what it has learned clinically about the multiple dimensions of subjective experience.     

Audio-visual integration of emotional cues in song

We examined whether facial expressions of performers influence the emotional connotations of sung materials, and whether attention is implicated in audio-visual integration of affective cues. In Experiment 1, participants judged the emotional valence of audio-visual presentations of sung intervals. Performances were edited such that auditory and visual information conveyed congruent or incongruent affective connotations. In the single-task condition, participants judged the emotional connotation of sung intervals. In the dual-task condition, participants judged the emotional connotation of intervals while performing a secondary task. Judgements were influenced by melodic cues and facial expressions and the effects were undiminished by the secondary task. Experiment 2 involved identical conditions but participants were instructed to base judgements on auditory information alone. Again, facial expressions influenced judgements and the effect was undiminished by the secondary task. The results suggest that visual aspects of music performance are automatically and preattentively registered and integrated with auditory cues.     

Transference Focused Psychotherapy for Patients with Comorbid Narcissistic and Borderline Personality Disorder

Clinical experience involving the treatment of patients with comorbid borderline and narcissistic personality disorders suggests that this patient population is among the more difficult to treat within the personality disorder spectrum. In this article, we present refinements of Transference Focused Psychotherapy (TFP) based on our clinical experience with and research data on patients with comorbid narcissistic personality disorder/borderline personality disorder (NPD/BPD). We briefly review object relations formulations of severe narcissistic pathology, as well as recent research in attachment and the allied concept of mentalization, which have provided a new lens through which to view narcissistic disorders. The research findings from two randomized clinical trials demonstrating the efficacy and effectiveness of TFP are presented. The data from the two Randomized Clinical Trials (RCT) allowed for the study of the characteristics of the subgroup of borderline personality disorder patients who have comorbid NPD/BPD. Findings on comorbidity, attachment status, capacity for mentalization, and level of personality organization of borderline patients with comorbid NPD/BPD, compared with borderline patients without comorbid narcissistic pathology (BPD), are presented. Clinical implications of the observed group differences are discussed, with a focus on refinements in the technique of TFP. Clinical case material is presented to illustrate the specific challenges posed by narcissistic patients to carrying out TFP in each phase of treatment.     

Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants (“intervention effect”). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.     

Short-Term Memory and Working Memory in Children with Blindness: Support for a Domain General or Domain Specific System?

The study explored the contribution of two component processes (phonological and executive) to blind children's memory performance. Children with blindness and sight were matched on gender, chronological age, and verbal intelligence and compared on measures of short-term memory (STM) and working memory (WM). Although the measures were highly correlated, the results from two experiments indicated that the blind children were superior to sighted children on measures of STM, but not on measures of WM. The results supported the notion that children with blindness have advantages on memory tasks that draw upon resources from the phonological loop. However, comparable performance between the ability groups on WM measures suggests there are domain specific aspects in the executive system.     

Fracture mechanisms of symmetrical tilt grain boundaries

The mechanisms of failure of symmetrical tilt boundaries have been investigated using an atomistic technique. The fracture process advances in steps that are related to the structural unit of the symmetrical tilt grain boundary. These boundaries are shown to fail through a combined mechanism involving dislocation emission in certain regions of the structural unit, followed by microcleavage, and again dislocation emission. The overall toughness of the boundaries is given by the combination of the toughness of these two processes.     

Elaboration and Autonomy Support in Low-Income Mothers' Reminiscing: Links to Children's Autobiographical Narratives

Maternal elaboration and autonomy support during reminiscing facilitate middle-class children's autobiographical narrative skills. In this study, low-income Hispanic, White, and Black mothers' elaboration and autonomy support in reminiscing were examined in relation to children's joint and independent autobiographical narratives and engagement. Sixty preschool children discussed three past events with their mothers and one past event with a researcher. Maternal elaboration was related to children's joint and independent autobiographical narratives, and autonomy support was related to children's joint and independent engagement. Hispanic mothers used a less elaborative style during conversations about misbehavior, and Hispanic children tended to have less advanced independent autobiographical narratives. Maternal elaboration and autonomy support appear to play different roles in children's autobiographical narratives. Further, reminiscing may serve different purposes in different racial/ethnic groups.     

The Role of Attachment Style and Depression in Patients with Hepatitis C

Patients infected with chronic hepatitis C virus (HCV) commonly suffer from the triad of depression, pain and fatigue. This symptom triad in HCV is likely influenced by additional psychological and interpersonal factors, although the relationship is not clearly understood. This retrospective study aimed to characterize the relationship between attachment style and depressive and physical symptoms in the HCV-infected population. Over 18 months, 99 consecutively referred HCV infected patients were assessed with the Hamilton Depression Rating Scale (HDRS), Fatigue Severity Scale, Patient Health Questionnaire-15 for physical symptoms and the Relationship Questionnaire for attachment style. An ANOVA was used to identify differences between attachment styles and Pearson correlations were used to evaluate the association between depression, fatigue and physical symptoms. Approximately 15 % of patients in the sample had a fearful attachment style. Patients with fearful attachment style had significantly higher depressive symptoms compared to a secure attachment style (p = .025). No differences in physical and fatigue symptoms were observed between attachment styles. Further, HDRS scores were significantly associated with fatigue scores (p < .001) and physical symptoms (p < .001), reinforcing the relationship between these symptom domains in HCV-infected patients. Although depressive, physical and fatigue symptoms are inter-related in HCV-infected patients, our study results suggest that only depressive symptoms were influenced by the extremes of attachment style. Screening of relationship styles may identify at-risk HCV-infected individuals for depression who may have difficulty engaging in care and managing physical symptoms.     

State Aid to Religiously Affiliated,Non-Public Schools: An Emerging Trend or Same Old Same Old?

This article reviews judicial attitudes with regard to the constitutionality of aid for children in religiously affiliated non-public schools. The first part highlights the extent to which the Supreme Court appears to have turned the corner in its willingness to examine the effective use of resources in regular education rather than just the acceptability of aid. The second section reviews how Congressional and regulatory activities have contributed to lower court decisions that continue to focus on the narrow issues of how much money can be spent and the appropriate locations for the delivery of services to children who attend religiously affiliated non-public schools rather than the quality of education that they may be eligible to receive. Given the distinctions between the ways in which children in religiously affiliated non-public schools are treated based on whether they have disabilities, this article examines recent legal trends in considering whether there will be a new era in providing children who attend religiously affiliated non-public schools with the state aid that they deserve.     

Anticipating the Societal Challenges of Nanotechnologies

“In this article we sketch out the landscape for this Special Issue on anticipating and embedding the societal challenge of nanotechnologies. Tools that actors may choose to employ for these processes are articulated, and further explored through the introduction of the seven articles which comprise this Issue. Taken together, these articles create a cogent narrative on the societal challenges posed by nanotechnologies. They are drawn together by three distinct themes, each of which is briefly considered within this context of this Introductory article”.