Perceptual functions in prosopagnosia

Some patients with prosopagnosia may have an apperceptive basis to their recognition defect. Perceptual abnormalities have been reported in single cases or small series, but the causal link of such deficits to prosopagnosia is unclear. Our goal was to identify candidate perceptual processes that might contribute to prosopagnosia, by subjecting several prosopagnosic patients to a battery of functions that may be necessary for accurate facial perception. We tested seven prosopagnosic patients. Three had unilateral right occipitotemporal lesions, two had bilateral posterior occipitotemporal lesions, and one had right anterior-to-occipital temporal damage along with a small left temporal lesion. These lesions all included the fusiform face area, in contrast to one patient with bilateral anterior temporal lesions. Most patients had impaired performance on face-matching tests and difficulty with subcategory judgments for non-face objects. The most consistent deficits in patients with lesions involving the fusiform face area were impaired perception of spatial relations in dot patterns and reduced contrast sensitivity in the 4 to 8 cycles deg(-1) range. Patients with bilateral lesions were impaired in saturation discrimination. Luminance discrimination was normal in all but two patients, and spatial resolution was uniformly spared. Curvature and line-orientation discrimination were impaired in only one patient, who also had the most difficulty with more basic-level object recognition. We conclude that deficits in luminance, spatial resolution, curvature, line orientation, and contrast at low spatial frequencies are unlikely to contribute to apperceptive prosopagnosia. More relevant may be contrast sensitivity at higher spatial frequencies and the analysis of object spatial structure. Deficits in these functions may impair perception of subtle variations in object shape, and may be one mechanism by which the recognition defect in prosopagnosia can extend to other classes of object subcategorization.     

Developmental dyslexia and specific language impairment: same or different?

Developmental dyslexia and specific language impairment (SLI) were for many years treated as distinct disorders but are now often regarded as different manifestations of the same underlying problem, differing only in severity or developmental stage. The merging of these categories has been motivated by the reconceptualization of dyslexia as a language disorder in which phonological processing is deficient. The authors argue that this focus underestimates the independent influence of semantic and syntactic deficits, which are widespread in SLI and which affect reading comprehension and impair attainment of fluent reading in adolescence. The authors suggest that 2 dimensions of impairment are needed to conceptualize the relationship between these disorders and to capture phenotypic features that are important for identifying neurobiologically and etiologically coherent subgroups.     

The Psychological and Spiritual Efficacy of Confession

Several aspects of confession are discussed. A distinction is made between personal narrative and confession in the analytic setting, focusing on the emergence of the psychogenic secret: that secret which is hidden from the analysand's ego consciousness. Such an unconscious secret can lead to emotional and psychological guilt and distress. The transference is seen as an essential dynamic for psychologically efficacious confession.     

Incognito or not? the patient's subjective experience of the analyst's private life

This paper examines the meaning for the patient of the analyst's personal life and personality which are ostensibly banished from the consulting room. The therapist has a not‐always‐so‐secret “secret life”; that the patient is supposed to “not know”; about. Yet, more or less unconscious perceptions, impressions, and fantasies about extratherapeutic aspects of the analyst are omnipresent and significantly color the psychoanalytic enterprise.

Moreover the analyst as a person generally plays a critical and underacknowledged role in the patient's experience of the endeavor. Constructing multiple overlapping images of the analyst and of the analytic relationship, the patient discovers himself or herself in the matrix of these relationships with various images of the analytic other. The analysand is motivated to make sense of the analyst as wholly as possible, the better to place into context the analyst's interventions. The patient's resulting view of the analyst's subjective experience acts as a lens that filters and subtly alters the meaning of the analyst's communications.

I illustrate these points by relating my work with a patient whose dreams uncannily picked up on a (consciously) unknown aspect of my private life—my having a handicapped son. The treatment thereafter centered on the patient's identification with my child (as someone “disabled") and on the meaning of her having dreamt something so personal about her therapist.     

The earth is the Lord's: the biblical view of the environment

The Church needs a characteristically Christian voice in environment discourse. The Bible offers this in the form of symbols and stories. Familiar terms such as righteousness, covenant and atonement originated in the biblical teaching about creation, and the liturgy of the Temple was to maintain the creation. Angels and their music described the powers of creation and cosmic harmony, and Adam lost all this when he chose secular knowledge rather than Wisdom from the Tree of Life.     

Dreamwork beyond psychoanalysis

Abstract

Dr. Montague Ullman's work with dream groups is the main subject of this paper. After detailing his method there follows an account of the author's experience in a dream workshop run by Dr. Ullman. The theoretical issues involved in this work are discussed, particularly the ideas of Trigant Burrow, an early American analyst who believed in species connectedness, and David Bohm's theory of implicate order. Dr. Ullman's intention to return to the healing process in dreams to ordinary people is connected with the author's paper “Thoughts on the Healing Process.” The implications for psychoanalysis of these holistic ideas are considered.     

The Coming-Out Process and Its Adaptational and Health-Related Associations Among Gay, Lesbian, and Bisexual Youths: Stipulation and Exploration of a Model

A model is proposed and explored that links the coming-out process to the psychological functioning (i.e., self-esteem and distress) and sexual behaviors of gay, lesbian, and bisexual youths recruited from gay-focused community-based and college organizations in New York City. The coming-out process is multidimensional, consisting, as defined here, of involvement in gay/lesbian activities, attitudes toward homosexuality, comfort with homosexuality, self-disclosure of sexual identity to others, and sexual identity. The coming-out dimensions were related to self-esteem, distress, and unprotected sexual behaviors. In addition, the relations between the coming-out dimensions and unprotected sexual behaviors were explained by psychological functioning. In particular, limited involvement in gay/lesbian activities was associated with more unprotected sex. Negative attitudes toward homosexuality were related directly to more unprotected sex, and they were related indirectly to more unprotected sex by means of increasing emotional distress. These and other findings have implications for designing preventive interventions to increase the youths' psychological functioning and reduce their unprotected sexual behaviors.     

Measurement tool for preoperative anxiety in young children: The yale preoperative anxiety scale

To develop a preoperative anxiety scale (YPAS) for children undergoing surgery, 21 specific behaviors indicating anxiety were defined within five domains (activity, emotional expressivity, state of arousal, vocalization, and use of adults). A reliability Kappa analysis revealed that inter-observer agreement ranged from .66 to .94, while intra-observer Kappa ranged from .66 to .91. Validity analysis between a Visual Analog Scale and the YPAS revealed an r of .59 for entering the operating room. Multiserial analysis comparing the YPAS to the Vernon Anxiety Scale ranged from .61 to .64. Showing good to excellent observer reliability and validity, the YPAS proves to be an appropriate tool for studying children's responses in preoperative settings. As such, the new assessment instrument should be of interest to clinical and research neuropsychologists who need to assess a child's anxiety level prior to the undertaking of a given surgical procedure.     

Validity of the Self-Harm Behavior Questionnaire with Diverse Adolescents

Suicide and non-suicidal self-injurious behavior (NSSI) continue to be significant health problems for adolescents. Although there are many instruments available to assess self-harm behaviors, few have been validated for use with adolescents, and even fewer have been validated for use with different racial/ethnic groups. The Self-Harm Behavior Questionnaire (SHBQ) assesses NSSI, suicidal ideation, suicide threats, and past suicide attempts. Data from 1,386 racially/ethnically diverse adolescents (57.5% minority) were collected to examine the validity of the SHBQ in this age group. Analyses supported the four-factor structure, revealed the SHBQ is internally consistent, and provided evidence for convergent validity within Caucasian, African American, and Hispanic adolescents. However, slight differences were noted. Overall, the findings suggest the SHBQ is a useful assessment tool appropriate for use with Caucasian, African American, and Hispanic adolescents.