The internet and psychotherapy with adolescents and preadolescents: some thoughts about the countertransference

Technological advances in the computer and communication fields (the internet, social networks, virtual realities,) have created a world in which most of our patients, especially pre-adolescents and adolescents, are immersed. In this paper we think about the meaning of ‘digital natives’ communication in the framework of the therapeutic relationship and the resulting countertransference. Interactions through technology, we argue, significantly reduce the difference between being together and being separate and can make it very difficult to experience a feeling of authentic intimacy or loss. Furthermore, exploring the world through the web does not provide children with the opportunity to ask questions and give voice to their doubts: it is a one-direction communication. These elements need to be considered in the therapeutic relationship with pre-adolescents and adolescents. In this paper we present three cases in which the world of internet enters into the sessions and we illustrate the countertransference this arouses and how it needs to be worked through.     

A Historical and Theoretical Review of Cognitive Behavioral Therapies: From Structural Self-Knowledge to Functional Processes

This paper critically examines the historical conceptualization of cognitive behavioral psychotherapy approaches (CBT) as a direct clinical counterpart of the cognitive revolution. The main “second wave” cognitive psychotherapies, either standard cognitive therapy (CT) or constructivist, in spite of their differences, share a common conceptualization of psychopathological factors as superordinate structural cognitive content belonging to the self: self-beliefs, self-schemata, personality organizations and so on. On the other hand, rational emotive behavior therapy (REBT) is an exception given that in REBT self-knowledge is not the core psychopathological tenet, being rather a derivate mechanism. Moreover, in non clinical cognitive science cognition is conceived as a regulatory function that operates retroactively and not in a hierarchically super- ordered fashion centered on the self. A historical review suggests that in both CT and constructivist model the structuralistic model of self-centered cognition may have emerged for both cultural and scientific reasons: self-centered cognitive models may be more readily understandable to clinicians as they allow for a straightforward identification of operationalizable self-beliefs. The emergence of new “third wave” process-centered CBT approaches may represent a comeback to functionalism, where cognition is considered again a regulatory function and not a structure. In addition, REBT’s interest in dysfunctional evaluations not focused on the self presaged this clinical and scientific turning point toward functionalism.     

Sociodemographic risk and early environmental factors that contribute to resilience in executive control: A factor mixture model of 3-year-olds

Young children at sociodemographic risk generally demonstrate lower executive control (EC), although with substantial heterogeneity across children. Given this marked variability, there may be some at-risk children who display higher EC and may be buffered from or resilient to the effects of sociodemographic risk who can be studied to identify the contributory factors. In this study, factor mixture modelling was used to determine whether subgroups of 3-year-old children existed based on their observed performance on a battery of EC tasks. Results indicated 2 latent groups: One characterized by lower EC and the other by higher EC. Both sociodemographically at-risk and low-risk children were represented in each group, yielding 4 risk-status-by-EC groups, where at-risk higher EC children were termed the resilient group. Proximal household enrichment (e.g., exposure to learning materials, varied enriching experiences, academic and language stimulation, parental responsivity) distinguished the resilient group from lower performing children of similar risk status, whereas distal financial resources and proximal social network resources did not distinguish these two groups. Results suggest potential intervention targets to promote optimal EC development, particularly among children at risk.     

The Hippocampus and Delayed Recall: Bigger is not Necessarily Better?

Healthy young female participants were tested on a measure of delayed verbal recall and then received volumetric Magnetic Resonance Imaging (MRI) scans. The analysis of the MRI scans focused on the volume of the hippocampus. Left hippocampal volume was negatively associated with the level of delayed verbal recall performance. This relationship was confirmed in further testing. This finding is consistent with a previous report of a similar relationship in healthy elderly individuals, but not in patients with Alzheimer's disease, in whom the opposite relationship was observed. An explanation of these findings in terms of impaired neural pruning of the hippocampus is advanced, whereby insufficient pruning of the hippocampus during childhood and adolescence (following adequate growth) may lead to reduced mnemonic efficiency.     

Response to restrictive policies: Reconciling system justification and psychological reactance

Here we propose a dual process model to reconcile two contradictory predictions about how people respond to restrictive policies imposed upon them by organizations and systems within which they operate. When participants’ attention was not drawn to the restrictive nature of the policy, or when it was, but their cognitive resources were restricted, we found evidence supporting a prediction based on System Justification Theory: Participants reacted favorably to restrictive policies, endorsing them and downplaying the importance of the restricted freedom. Only when we cued participants to focus their undivided attention on the restrictive nature of the policy did we find evidence supporting a prediction based on psychological reactance: Only then did participants display reactance and respond negatively to the policies.     

The Protective Value of Hardiness on Military Posttraumatic Stress Symptoms

This study examined the protective effects of hardiness (dispositional resilience) on self-reported posttraumatic stress disorder (PTSD) symptoms in a sample of postdeployed service members. Hardiness was negatively related to PTSD symptoms. Time in the military, number of deployments, and total time spent on deployment were all positively related to PTSD symptoms. Hardiness moderated the effects of time in the military on PTSD symptoms, such that time in the military had no effect on those who were high in hardiness. Hardiness did not moderate the effects of either deployment measure. Suggestions to modify current military resilience training programs to most effectively enhance the benefits of hardiness are discussed.     

Sleep Disturbances Among Combat Military Veterans: A Comparative Study Using Subjective and Objective Sleep Assessments

The sleep characteristics of 37 military veterans and active-duty service members (17 with PTSD and 20 without PTSD) of recent wars were analyzed to determine if combat deployment, with its associated sleep restriction, may be an alternative explanation for the sleep complaints found among combat veterans with PTSD (as determined by PTSD Checklist Military Version scores). Over a 1-week period, sleep data were collected using sleep actigraphy and self-report. Across the entire sample, subjective and objective assessment methods of sleep were strongly correlated, although there were some notable within-group differences. Specifically, although sleep duration between groups did not differ based on actigraphy, veterans without PTSD reported sleeping 1 h and 11 min (p = .002) longer than did veterans with PTSD. In an effort to determine why individuals without PTSD might be overreporting sleep, we found that symptoms of emotional arousal (anger, anxiety, and nightmares) were significantly correlated with self-reported sleep duration, suggesting a pattern of higher autonomic arousal found in veterans with PTSD. Thus, although sleeping for 6 h, the higher levels of emotional arousal reported by veterans with PTSD may mean that they do not perceive their sleep as restful. Further research is necessary to determine if the sleep architecture of veterans with PTSD is actually different from that of combat veterans without PTSD and if such differences are actually amenable to standard behavioral treatments for this disorder.     

Diminished joint coordination with aging leads to more variable hand paths

Differences in joint coordination between arms and due to aging were studied in healthy young and older adults reaching to either a fixed, central target or to the same target when it could unexpectedly change location after reach initiation. Joint coordination was investigated by artificially removing the covariation of each joint’s motions with other joints’ motions. Uncontrolled manifold analysis was used to partition joint configuration variance into variance reflecting motor abundance (V_UCM) and variance causing hand path variability (V_ORT). The extent to which V_ORT, related to the consistency of the hand path, increased after removing a joint’s covariation indicated the strength of its coordination with other joints. Young adults exhibited stronger indices of joint coordination, evidenced by a larger increase in V_ORT after removing joint covariation than for older adults. This effect was more striking for the dominant right compared to the left arm for young adults, but not for older adults, especially with target uncertainty. The results indicate that interjoint coordination in young adults leads to less hand path variability compared to older adults.