Rorschach correlates of self-reported attachment dimensions: dynamic manifestations of hyperactivating and deactivating strategies

We examined associations between self-reported attachment anxiety and avoidance and responses to the Rorschach test. Seventy-two, nonpatient Israeli adults participated in a 2-session study. In the first session, they completed a self-report scale tapping the dimensions of attachment anxiety and attachment avoidance. In the second session, they completed the Rorschach test. The Rorschach was administered and coded according to Exner's (2001) Comprehensive System scoring. We found that self-reports of attachment anxiety were associated with Rorschach scores thought to indicate difficulties in regulating and controlling emotions and self-perceptions of being relatively helpless and unworthy. Self-reports of attachment avoidance were associated with Rorschach scores thought to reflect lack of acknowledgment of need states and maintenance of a grandiose self. We discuss the findings in terms of implicit psychodynamic processes inherent in attachment-system functioning.     

Prevalence of ADHD and its subtypes in male and female adult prison inmates

There are few published studies of attention-deficit/hyperactivity disorder (ADHD) in adult inmates, and even fewer studies that have considered ADHD in adult inmates by gender. The present study examined the prevalence of ADHD, its subtypes, and associated psychological and neuropsychological comorbidity as a function of gender in a sample of 3,962 inmates (3,439 men and 523 women; mean age = 33.6 years, range 17-73) who had completed the 250-item, self-report, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (Text Revision) (DSM-IV-TR)-aligned Coolidge Correctional Inventory (CCI). The overall ADHD prevalence rate found was 10.5%, which is substantially higher than the rate among adults in the general population (2-5%). The female inmate ADHD prevalence rate (15.1%) was higher than the male inmate ADHD rate (9.8%), consistent with some previous studies. The most prevalent ADHD subtype for both genders was the hyperactive-impulsive subtype. The combined and inattentive ADHD subtypes had higher levels of comorbid psychopathology than the hyperactive-impulsive ADHD subtype. As the presence of ADHD and associated gender differentials may impact the success of rehabilitation and educative programs with inmates, the assessment of ADHD and comorbid psychopathology should be a priority in initial inmate screening and evaluation.     

Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding,Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS?, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS? report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS? reports were released to 14 families (N?=?28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N?=?24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS? reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS? report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).     

Grouping does not require attention

Many theories of visual perception stipulate that Gestalt grouping occurs preattentively. Subjects' failure to report perceiving even salient grouping patterns under conditions of inattention challenges this assumption (see, e.g., Mack, Tang, Tuma, Kahn, & Rock, 1992), but Moore and Egeth (1997) showed that although subjects are indeed unable to identify grouping patterns outside the focus of attention, effects of these patterns on visual perception can be observed when they are assessed using implicit, rather than explicit, measures. However, this finding, which is the only one to date demonstrating grouping effects without attention, is open to an alternative account. In the present study, we eliminated this confound and replicated Moore and Egeth's findings, using the Müller-Lyer illusion (Experiments 1 and 2). Moreover, we found converging evidence for these findings with a variant of the flanker task (Experiment 3), when the amount of available attentional resources was varied (Experiments 4 and 5). The results reinforce the idea that, although grouping outside the focus of attention cannot be the object of overt report, grouping processes can occur without attention.     

Changes in Primary Process Thinking of a Prepsychotic Adolescent in Psychotherapy

The main goal of this study was to measure longitudinally change in thought processes and reality testing of a prepsychotic adolescent undergoing psychotherapy. The Holt scoring system for measuring primary process from Rorschach responses was the main measuring instrument. Four Rorschachs were administered over a period of three years. The results of the latter were compared with the clinical ratings of two psychiatrists. While clinical change in response to treatment was slight, there did appear to be a shift from primary to more secondary forms of formal thought processes as determined by the Rorschach.     

Toward a Positive Military Psychology

The present study used an informant method of psychiatric assessment to evaluate Saddam Hussein, and these results were compared to a posthumous assessment of Adolf Hitler. Eleven Iraqi adults who lived under Hussein's influence for a median of 24 years completed the Coolidge Axis II Inventory, a measure of 14 personality disorders. The mean consensus among the 11 raters was r = .57. It revealed that Hussein probably reached diagnostic threshold for the sadistic (T score M = 81.0), paranoid (T score M = 79.3), antisocial (T score M = 77.4), and narcissistic (T score M = 74.2) personality disorders. The correlation between the consensus profile for Hussein and a consensus profile of 5 Hitler experts was r = .79, indicating a very strong similarity between the two profiles. It was concluded that Saddam Hussein had many of the same personality disorders or their features as Adolf Hitler, although sadistic features were stronger in Hussein than Hitler. It appeared that a “Big Four” personality disorders constellation emerged for these two dictators, and they were sadistic, antisocial, paranoid, and narcissistic. It was also found that Hussein might have had some traits or features of paranoid schizophrenia. Implications for diplomacy and negotiations with persons with similar personality profiles are proffered.     

Book reviews

Arvind Sharma, The Philosophy of Religion and Advaita Vedānra: A Comparative Study in Religion and Reason. University Park, Pennsylvania, The Pennsylvania State University Press, 1995, viii+232 pp., £29.50, $32.50. ISBN 0 271 01032 0.

Niels C. Nielsen Jr (ed.), Christianity After Communism: Social, Political and Cultural Struggle in Russia. Boulder, Westview Press, 1994, ix+171 pp., £37.00, $49.95. ISBN 0 8133 2365 7.

Mary Pickering, Auguste Comte: An Intellectual Biography, Volume 1, Cambridge, Cambridge University Press, 1993, xi+744 pp., £45.00, $49.95. ISBN 0 521 43405 X.

Christopher Herbert, Culture and Anomie: Ethnographic Imagination in the Nineteenth Century. Chicago, University of Chicago Press, 1991, 312 pp., $48 (hardback) ISBN 0 1226 32738 8, $16.95 (paperback) ISBN 0 226 32738 6.

Clifford Geertz, After the Fact: Two Countries, Four Decades, One Anthropologist. Cambridge, Massachusetts, Harvard University Press, 1995, 198 pp., $27.50. ISBN 0 674 00871 5.

William Hamilton, A Quest for the Post-Historical Jesus. New York, Continuum, 1994, 304 pp., $27.50. ISBN 0 8264 0641 6.

Valerie J. Hoffman, Sufism, Mystics, and Saints in Modern Egypt. University of South Carolina Press, 1995, 377 pp.+ notes and index. ISBN 1 57003 055 3.

Margaret H. Case (ed.), Heinrich Zimmer: Coming Into His Own. Princeton, Princeton University Press, 1994, vi+ 148 pp., $24.95. ISBN 0 691 03337 4.

Tessa J. Bartholomeusz, Women Under the Bō Tree: Buddhist Nuns in Sri Lanka. (Cambridge Studies in Religious Traditions 5.) Cambridge, Cambridge University Press, 1994, xx+284 pp., £37.50, $59.95. ISBN 0 521 46129 4.

Philip C. Almond, Heaven and Hell in Enlightenment England. Cambridge, Cambridge University Press, 1994, xiii+ 218 pp., £35. ISBN 0 521 45371 2.

George W. Stocking, Jr., After Tylor: British Social Anthropology 1888–1951. Madison, University of Wisconsin Press, London, Athlone Press, 1996, xx+441 pp., $40. ISBN 0 485 30072 9.

P. F. Kornicki and I. J. McMullen (eds), Religion in Japan: Arrows to Heaven and Earth. Cambridge, Cambridge University Press, 1996, xxv+315 pp., £40. ISBN 0 521 55028 9.

Michael Angold, Church and Society in Byzantium under the Comneni 1081–1261. 605 pp., $89.95 (cloth). ISBN 0521 26432 4.

David Nirenberg, Communities of Violence: Persecution of Minorities in the Middle Ages. Princeton, Princeton University Press, 1996, ix+301 pp., $29.95, £23.95. ISBN 0 691 03375 7.     

Jung and Gnosticism

Carl Jung interprets Gnosticism the way he interprets alchemy: as a hoary counterpart to his analytical psychology. As interpreted by Jung, Gnostic myths describe a seemingly outward, if also inward, process which is in fact an entirely inward, psychological one. The Gnostic progression from sheer bodily existence to the rediscovery of the immaterial spark trapped in the body and the reunion of that spark with the immaterial godhead symbolize the Jungian progression from sheer ego consciousness to the rediscovery of the unconscious within the mind and the integration of the ego with the unconscious to forge the self. For Jung, Gnostics are the ancient counterpart to present-day Jungian patients. Both constitute a psychological elite. Where most persons are satisfied with traditional means of connecting themselves to their unconscious, Gnostics and Jungians are sensi tive to the demise of those means and are seeking new ones. Where, alternatively, most other persons are oblivious to the existence of the unconscious altogether, Gnostics and Jungians are preoccupied with it. Gnostics project their unconscious onto the cosmos and are therefore striving to connect themselves to something external, not just, like Jungians, to something internal. Interpreting in Jungian terms the Gnostic myth Poimandres, I argue that Jungian psychology makes enormous sense of the myth, but not in the way that Jung envisions. Upon rediscovering his spark, the Gnostic seeks to reject his body altogether rather than to mesh the two. He does strive to reunite with the godhead, but the godhead is immateriality itself rather than, like the body, matter. Indeed, the godhead, taken psychologically, is only a projection of the unconscious onto the cosmos, so that the unconscious is thereby reuniting with itself. The Gnostic's uncompromising rejection of the body and, more, of the whole material world therefore symbolizes not, as Jung assumes, the Jungian ideal of wholeness but the Jungian nemesis of inflation or, worse, psychosis. I suggest that Jung misconstrues Gnosticism because he parallels it to alchemy, which does fit the Jungian ideal.