The elephant tied up with string: a clinical case study showing the importance of NHS provision of intensive,time-limited psychoanalytic psychotherapy treatments

Prof. Richard Layard's influential advocacy for greater provision of ‘evidence-based’ psychological therapies, based in part on an economic rationale, has lead to greatly increased provision of cognitive behavioural therapy (CBT) and short-term therapies for depression, through the Increasing Access to Psychological Therapies (IAPT) initiative, whilst longer-term psychodynamic treatments are under threat, criticised as lacking an evidence base. This paper argues for the continuing provision of intensive thrice-weekly psychoanalytic psychotherapy treatments, time-limited to two years. It does so by describing such a treatment within an NHS psychotherapy department with a patient with a long history of severe personality pathology, including significant levels of perversity. The paper describes the patient's difficulties and his movement through the treatment, focussing on his difficulties making genuine emotional contact, his destructiveness of such contact, his acting out in the treatment, his perversity and the vital working through of the ending. The shifts the patient made are described, and follow-up information on the patient is given. The paper discusses the unique benefits of time-limited treatment and intensive psychoanalytic treatments for this ‘hard-to-help’ group of patients, and the economic rationale that can be made for such treatments.     

The involvement of distinct visual channels in rapid attention towards fearful facial expressions

This paper reports five experiments demonstrating that the low spatial frequency components of faces are critical to the production of rapid attentional responses towards fearful facial expressions. In our main experiments, low spatial frequency (LSF) or high spatial frequency (HSF) face pairs, consisting of one fearful and one neutral expression, were presented on a computer screen for a brief period. Participants were required to identify as quickly as possible the orientation of a bar target that immediately replaced one of the faces. Responses were faster when targets replaced the location of LSF fearful faces, compared with LSF neutral faces. By contrast, there were no differences between responses to targets replacing HSF fearful versus HSF neutral faces. This facilitation in spatial orienting occurred specifically with short time intervals between faces and target, and is consistent with a rapid processing of fear cues from LSF inputs that can serve to guide attention towards threat events.     

Validation of the Career Adapt-Abilities Scale and an examination of a model of career adaptation in the Philippine context

This paper presents the validation of the Career Adapt-Abilities Scale (CAAS) in the Philippine context. The CAAS consists of four subscales, with six items each, measuring self-regulative psychosocial resources (e.g., concern, curiosity, control, and confidence) for coping with occupational tasks and transitions. Filipino university students (N = 289) and working adults (N = 495) participated in the study. Internal consistency estimates for the full scale and subscales ranged from .87 to .97. Confirmatory factor analyses supported the multidimensional and hierarchical model of career adaptability. The factor structure was similar to that obtained from the CAAS international validation from 18 countries. Results also suggested that career adaptability was positively associated with adaptivity in the form of tenacious goal pursuit and flexible goal adjustment as well as with adaptation outcomes of career satisfaction and promotability. Overall, the findings confirm the utility of CAAS in the Philippine context and support the model that states higher levels of personal adaptivity (willingness) and career adaptability (competence) relate to better adaptation outcomes in terms of career success.     

Memories of uncertain origin: Dreamt or real?

The existence of a memory whose origin, real or dreamt, was uncertain was reported by just over half of an undergraduate sample of 358. Each respondent described one such memory if they had one. The memories were typically of mundane events, although 10 respondents described possible crimes. Respondents were often concerned to resolve the origin of these memories. Their plausibility, vividness, and how well the events fitted into one's life were often considered by the respondents, but where resolution occurred it was frequently based on evidence obtained from the physical or social environment. The reported qualities of the event did not correlate with whether the respondent thought it more likely to have been originally a dream or a real event.     

The Startle Pattern in Infants in Response to Non-Auditory Stimuli

Abstract

Goldstein, K. Human Nature in the Light of Psychopathology. Cambridge: Harvard Univ. Press, 1940. Pp. 258 Reviewed by Frederick Wyatt. Reviewed by Frederick Wyatt

Katona, G. Organizing and Memorizing. New York: Columbia Univ. Press, 1940. Pp. 318. Reviewed by Livingston Welch     

Autonomous reasons for intending

An autonomous reason for intending to A would be a reason for so intending that is not, and will not be, a reason for A-ing. Some puzzle cases, such as the one that figures in the toxin puzzle, suggest that there can be such reasons for intending, but these cases have special features that cloud the issue. This paper describes cases that more clearly favour the view that we can have practical reasons of this sort. Several objections to this view are considered and rejected. Finally, it is considered whether the existence of such reasons would conflict with an attractive coherence principle linking the rationality of intending with that of acting as intended. The paper concludes with a qualified affirmation of autonomous reasons for intending.     

War Experiences Inventory: Initial Psychometric and Structural Properties

We examined the structural and psychometric properties of the War Experiences Inventory (WEI) with data from 255 post deployed service members (224 men and 31 women). Results from principal components analyses yielded a five-factor solution assessing sexual trauma, combat exposure, interpersonal distress, circumstances of deployment, and personal injury. Psychometric analyses revealed scale scores were internally consistent; validity evidence showed WEI subscales were significantly correlated with measures of readjustment, PTSD, psychological distress, and alcohol abuse. Findings provide preliminary evidence of structural and psychometric properties of the WEI and its utility in assessing war-related experiences in operations in Afghanistan and Iraq.