Depression and Huntington's disease: prevalence, clinical manifestations, etiology, and treatment

In order to determine the extent to which depression complicates Huntington's disease (HD), we have analyzed the existing literature on depression in HD in order to report the prevalence, clinical manifestations, and treatment of HD depression. By means of MEDLINE literature searches and reviews of HD articles' bibliographies, we identified for our analysis 16 HD depression studies. Our results indicate that the prevalence of depression is 30% for all HD patients. Clinical manifestations of HD depression include a marked increased risk for suicide. The etiology of HD depression is unclear, but may be due to a number of factors, such as dysfunction in the caudate nucleus, dysfunction in the ventral striatum, and various genetic factors that are discussed in this review. Case reports and case series support the efficacy of standard antidepressant interventions in resolving symptoms of depression. Efficacious treatments reported in the literature include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and electroconvulsive therapy. In this study, the successful anecdotal treatment of seven consecutive HD depressed patients with sertraline suggests that sertraline may be a safe and efficacious treatment of HD depression.     

Does a single session of reading literary fiction prime enhanced mentalising performance? Four replication experiments of Kidd and Castano (2013)

Prior experiments indicated that reading literary fiction improves mentalising performance relative to reading popular fiction, non-fiction, or not reading. However, the experiments had relatively small sample sizes and hence low statistical power. To address this limitation, the present authors conducted four high-powered replication experiments (combined N?=?1006) testing the causal impact of reading literary fiction on mentalising. Relative to the original research, the present experiments used the same literary texts in the reading manipulation; the same mentalising task; and the same kind of participant samples. Moreover, one experiment was pre-registered as a direct replication. In none of the experiments did reading literary fiction have any effect on mentalising relative to control conditions. The results replicate earlier findings that familiarity with fiction is positively correlated with mentalising. Taken together, the present findings call into question whether a single session of reading fiction leads to immediate improvements in mentalising.     

Thin Images Reflected in the Water: Narcissism and Girls’ Vulnerability to the Thin‐Ideal

The purpose of this research is to test how adolescent girls’ narcissistic traits—characterized by a need to impress others and avoid ego‐threat—influence acute adverse effects of thin‐ideal exposure. Participants (11–15 years; total N = 366; all female) reported their narcissistic traits. Next, in two experiments, they viewed images of either very thin or average‐sized models, reported their wishful identification with the models (Experiment 2), and tasted high‐calorie foods in an alleged taste test (both experiments). Narcissism kept girls from wishfully identifying with thin models, which is consistent with the view that narcissistic girls are prone to disengage from thin‐ideal exposure. Moreover, narcissism protected vulnerable girls (those who experience low weight‐esteem) from inhibiting their food intake, and led other girls (those who consider their appearance relatively unimportant) to increase their food intake. These effects did not generalize to conceptually related traits of self‐esteem and perfectionism, and were not found for a low‐calorie foods outcome, attesting to the specificity of findings. These experiments demonstrate the importance of narcissism at reducing girls’ thin‐ideal vulnerability. Girls high in narcissism disengage self‐protectively from threats to their self‐image, a strategy that renders at least subsets of them less vulnerable to the thin‐ideal.     

Choice in transition: Replication and extension to preschool children in a naturalistic setting

This study replicated previous basic research into the dynamics of choice and extended this analysis to children's behavior in a naturalistic setting. Two preschoolers with disabilities were observed interacting with their teachers at baseline and during an experimental analysis involving four pairs of concurrent variable‐interval schedules of adult attention implemented by an experimenter. Each child was exposed to four experimental phases in which the relative reinforcer rates for on‐ and off‐task behavior were 10:1, 1:1, 1:10, and reversed back to 10:1. The 10:1 phase was designed to mimic the same schedules and types of adult attention observed at baseline. We used the generalized matching equation to model steady‐state behavior at the end of the transition phases and to evaluate changes in sensitivity at various points throughout the phases. Choice in transition was evaluated by plotting log behavior ratios by session, cumulated time on‐ and off‐task and cumulated attention for on‐ and off‐task behavior by session, and interreinforcer behavior ratios following different sequences of the first four reinforcer deliveries. The generalized matching equation accounted for a large proportion of variance in steady‐state responding, sensitivity values increased steadily throughout the phases, patterns of choice in transition were similar to those reported in basic research, and interreinforcer preference generally shifted toward the just‐reinforced alternative. These findings are consistent with previous basic research and support the generality of the dynamics of choice to children's on‐ and off‐task behavior reinforced by adult attention.     

Narcissism,Bullying, and Social Dominance in Youth: A Longitudinal Analysis

A few previous studies have shown that narcissistic traits in youth are positively associated with bullying. However, research examining the developmental relationship between narcissism and bullying is lacking. Moreover, it is unclear whether narcissists constitute a homogeneous group and whether the bullying of narcissistic youth results in establishing social dominance over peers. The present work addresses these gaps. Children (N?=?393; M _age?=?10.3; 51 % girls) were followed during the last 3 years of primary school. Person-centered analyses were used to examine whether groups with distinct developmental trajectories for narcissism and two bullying forms (direct and indirect) can be identified, and how these trajectories are related. Multiple groups emerged for all constructs examined. For girls, higher narcissism was neither related to more intense bullying, nor to higher social dominance. In contrast, highly narcissistic boys were more likely than their peers to show elevated direct bullying, and in particular elevated indirect bullying. Hence, high narcissism is a risk factor for bullying in boys, but not in girls. However, narcissism is not always accompanied by high bullying, given that many boys on the high bullying trajectories were not high in narcissism. Results show that among narcissistic youth only those who engage in high levels of bullying are high in social dominance.     

Neural substrates of successful working memory and long-term memory formation in a relational spatial memory task

Working memory (WM) tasks may involve brain activation actually implicated in long-term memory (LTM). In order to disentangle these two memory systems, we employed a combined WM/LTM task, using a spatial relational (object-location) memory paradigm and analyzed which brain areas were associated with successful performance for either task using fMRI. Critically, we corrected for the performance on the respective memory task when analyzing subsequent memory effects. The WM task consisted of a delayed-match-to-sample task assessed in an MRI scanner. Each trial consisted of an indoor or outdoor scene in which the exact configuration of four objects had to be remembered. After a short delay (7–13 s), the scene was presented from a different angle and spatial recognition for two objects was tested. After scanning, participants received an unexpected subsequent recognition memory (LTM) task, where the two previously unprobed objects were tested. Brain activity during encoding, delay phase and probe phase was analyzed based on WM and LTM performance. Results showed that successful WM performance, when corrected for LTM performance, was associated with greater activation in the inferior frontal gyrus and left fusiform gyrus during the early stage of the maintenance phase. A correct decision during the WM probe was accompanied by greater activation in a wide network, including bilateral hippocampus, right superior parietal gyrus and bilateral insula. No voxels exhibited supra-threshold activity during the encoding phase, and we did not find any differential activity for correct versus incorrect trials in the WM task when comparing LTM correct versus LTM incorrect trials.     

Moving along to things left undone

This paper expands on three areas of clinical theory that are introduced and discussed in the lead paper and the others in this symposium. The first issue addressed is the concept of the real relationship as used in the moment of meeting model of psychotherapeutic change. Particular focus has been placed on the past, the present, and the hierarchy of goals in the treatment relationship. Second, the paper explores the concept of implicit relational knowledge with attention to the concepts of transference, countertransference, interpretation, and insight in the change process. Finally, the paper attends to the nature of the “now moment” in the moment of meeting model. Specifically explicated are ways this concept relates to changes in brain organization and also ways the moment of meeting model relates to other psychotherapy models, such as the relational schools and self-psychology. © 1998 Michigan Association for Infant Mental Health     

Dyadically expanded states of consciousness and the process of therapeutic change

This paper addresses an intersubjective issue that arises out of our model of therapeutic change: Why do humans so strongly seek states of emotional connectedness and intersubjectivity and why does the failure to achieve connectedness have such a damaging effect on the mental health of the infant? A hypothesis is offered—the Dyadic Expansion of Consciousness Hypothesis—as an attempt to explain these phenomena. This hypothesis is based on the Mutual Regulation Model (MRM) of infant–adult interaction. The MRM describes the microregulatory social-emotional process of communication that generates (or fails to generate) dyadic intersubjective states of shared consciousness. In particular, the Dyadic Consciousness hypothesis argues that each individual, in one case the infant and mother or in another the patient and the therapist, is a self-organizing system that creates his or her own states of consciousness (states of brain organization), which can be expanded into more coherent and complex states in collaboration with another self-organizing system. Critically understanding how the mutual regulation of affect functions to create dyadic states of consciousness also can help us understand what produces change in the therapeutic process. © 1998 Michigan Association for Infant Mental Health     

Implicit relational knowing: Its role in development and psychoanalytic treatment

It is increasingly apparent that “something more” than interpretation is needed to bring about change in psychoanalytic treatment. Drawing on clinical and developmental observations, we propose that interactional processes from birth onward give rise to a form of procedural knowledge regarding how to do things with intimate others, knowledge we call implicit relational knowing. This knowing is distinct from conscious verbalizable knowledge and from the dynamic unconscious. The implicit relational knowing of patient and therapist intersect to create an intersubjective field that includes reasonably accurate sensings of each person's ways of being with others, sensings we call the “real relationship.” This intersubjective field becomes more complex and articulated with repeated patient–therapist encounters, giving rise to emergent new possibilities for more coherent and adaptive forms of interaction. During a transactional event that we term a “moment of meeting,” a new dyadic possibility crystallizes when the two persons achieve the dual goals of complementary fitted actions and joint intersubjective recognition in a new form. We argue that such moments of meeting shift the relational anticipations of each partner and allow for new forms of agency and shared experience to be expressed and elaborated. © 1998 Michigan Association for Infant Mental Health