Zeitlosigkeit und Verg?nglichkeit (in) der Psychoanalyse

The author shows that the accessible psychoanalytic unconscious is not timeless. Freud??s ??timeless unconscious??, which was ontologized by himself and his successors, proves to be fiction with negative consequences. Assuming ??timeless?? primary processes psychoanalysis as a therapy would bite the hand which feeds it. Instead of contrasting linear time to the cyclic personal experience of time, the author suggests to speak about the ??emergence of lived time?? and the ??new moments?? of encounter in the therapeutic situation, to emphasize the importance of the opportune moment for change in contrast to the cyclic repetition of transference. In order to understand and approach disorders of time perception knowledge of unconscious conflicts and defense processes remains crucial. Even dreams are not timeless. While our conscious mind works according to chronological patterns, the pictorial representation in the particular form of thinking asleep, dreaming, makes it possible to map different memory traces simultaneously. Freud??s speculations about the ??timeless unconscious?? and Nirvana may originate from a longing for redemption. In contrast the author??s final chapter deals with the potential life span and transience of some central psychoanalytic concepts. Not even those who prove to be very close to observation can be attributed with ??eternal life??.     

Re-Visioning Medicine

Studies suggest that medical students and physicians have higher rates of anxiety, depression, and suicidal ideation than their peers in the general population. Some authors have suggested that medical culture perpetuates these problems by erecting “barriers to treatment,” preventing students and physicians from getting the help they need. Here, the author begins a broader examination of the potential role of culture by examining the myths and symbols that form the basis for medical culture and the medical self-image. The author argues that a medical self-image based on a de-contextualized medical mythology, the Asclepius myth, results in a sense of professional identity that is unbalanced, dehumanized, and characterized by unattainable expectations. The outward expression of this medical self-image, the medical culture, is often a-relational, unhealthy, stressed, or even toxic. The author suggests some ways of re-modeling medical culture, including its rituals and symbols, and medical education in ways that incorporate what is currently kept in its shadow.     

Clinical Reflection and Ritual as Forms of Participation and Interaction: Reply to Bass and Stern

We agree with the commentaries that Relational psychoanalysis has stood firmly against dichotomizing clinical reflection, on one hand, and interactional processes, on the other. Still, we wonder whether the relational literature has skewed toward interaction at the expense of concentrated attention to patients’ internal worlds. Predispositions toward interaction may diminish reflective space and quiet inwardness, which are themselves forms of analytic relating. We raise the possibility that the Relational model’s inclusive breadth, valuable as it is, might sometimes impede and even devalue discussions of specific technical matters. We consider clinical conceptualizations of ritual, “relating,” and “being in contact.”     

A Meta-Analysis of Behavioral Interventions for Adolescents and Adults with Autism Spectrum Disorders

Evaluation of evidence-based treatments is important for adolescents and adults with autism spectrum disorders (ASD) given the increasing number of interventions available and the prevalence of ASD. In this study, we sought to evaluate the effectiveness of behavioral interventions for this population by conducting a meta-analysis of published single-case research studies. A new metric for calculating effect size in single-case research, nonoverlap of all pairs, was utilized. In addition, the certainty of evidence, a system to evaluate research methodology, was applied to the reviewed articles. Forty-three articles were identified in the study. Results suggested that the behavioral interventions in the areas of academic skills, adaptive skills, problem behavior, phobic avoidance, social skills, and vocational skills have medium-to-strong effect sizes. Medium-to-high confidence in findings was noted for 81 % of the studies in the meta-analysis; however, three-fourths of the reviewed studies did not include treatment integrity, which may affect the ability to draw conclusions about the effectiveness of the interventions. Overall, the evidence is promising for the use of behavioral interventions for this population; however, additional research and dissemination are needed to fill the gap between research and practice in order for practitioners to meet the increasing demand as individuals with ASD age.     

Youth with Oppositional Defiant Disorder at Entry into Home-Based Treatment,Foster Care,and Residential Treatment

We explored and compared rates of youth diagnosed with oppositional defiant disorder (ODD) at entry into three broad program types, home-based care, foster care, and residential care. We also explored factors other than an ODD diagnosis that could be associated with program placement, and compared the presence of these factors in youth with and without an ODD diagnosis. Analyses were conducted using data from an ongoing, private-agency led, outcome measurement project. Programs were grouped into low (home-based), moderate (foster), or high (residential) categories, based upon levels of supervision and structure provided. A sample of 9,564 youth admitted into care between years 2005 and 2007 was used. Results suggested the following rates of ODD: 14.2 % overall; 7.9 % for low level programs; 5.3 % for moderate level programs; 21.1 % for high level programs. Rates were significantly different by program level (p ≤ 0.001). Sixty of 65 additional risk factors were also significantly associated with placement by level of program. No risk factors were unique to youth with ODD. Of the significant factors for youth with ODD, 4 were particularly strong: Classification as a child in need of services (CHINS), history of neglect, verbal aggression, and truancy. Youth classified as CHINS and with substantiated or suspected neglect were more likely placed into a moderate level program. Youth with verbal aggression or truancy were more likely placed into a high level program. Results suggested many factors are considered at program entry. Given the potential for poor prognosis and social costs of ODD, results support an individualized approach to placement determinations, with increased attention to symptoms of ODD and associated features at program entry.     

Between Black and White: Examining Grey Literature in Meta-analyses of Psychological Research

The inclusion of grey literature in meta-analyses and reviews is controversial. We examine both the advantages and challenges of including grey literature in meta-analyses. An exemplar meta-analysis of behavioral parenting interventions on parent behavior, child behavior, and parent adjustment outcomes is used to demonstrate these issues. It also explores the influence of the inclusion of grey literature on outcomes, including whether effect sizes are affected by the inclusion of grey literature and describes the challenges of searching for grey literature using traditional search engines such as Google and Yahoo. Homogeneity and publication bias are also examined. Based on these results, recommendations are presented for meta-analysts and researchers.     

Zipf’s word frequency law in natural language: A critical review and future directions

The frequency distribution of words has been a key object of study in statistical linguistics for the past 70 years. This distribution approximately follows a simple mathematical form known as Zipf’s law. This article first shows that human language has a highly complex, reliable structure in the frequency distribution over and above this classic law, although prior data visualization methods have obscured this fact. A number of empirical phenomena related to word frequencies are then reviewed. These facts are chosen to be informative about the mechanisms giving rise to Zipf’s law and are then used to evaluate many of the theoretical explanations of Zipf’s law in language. No prior account straightforwardly explains all the basic facts or is supported with independent evaluation of its underlying assumptions. To make progress at understanding why language obeys Zipf’s law, studies must seek evidence beyond the law itself, testing assumptions and evaluating novel predictions with new, independent data.     

Extending Parent–Child Interaction Therapy for Early Childhood Internalizing Problems: New Advances for an Overlooked Population

Although efficacious psychological treatments for internalizing disorders are now well established for school-aged children, until recently there have regrettably been limited empirical efforts to clarify indicated psychological intervention methods for the treatment of mood and anxiety disorders presenting in early childhood. Young children lack many of the developmental capacities required to effectively participate in established treatments for mood and anxiety problems presenting in older children, making simple downward extensions of these treatments for the management of preschool internalizing problems misguided. In recent years, a number of research groups have successfully adapted and modified parent–child interaction therapy (PCIT), originally developed to treat externalizing problems in young children, to treat various early internalizing problems with a set of neighboring protocols. As in traditional PCIT, these extensions target child symptoms by directly reshaping parent–child interaction patterns associated with the maintenance of symptoms. The present review outlines this emerging set of novel PCIT adaptations and modifications for mood and anxiety problems in young children and reviews preliminary evidence supporting their use. Specifically, we cover (a) PCIT for early separation anxiety disorder; (b) the PCIT-CALM (Coaching Approach behavior and Leading by Modeling) Program for the full range of early anxiety disorders; (c) the group Turtle Program for behavioral inhibition; and (d) the PCIT-ED (Emotional Development) Program for preschool depression. In addition, emerging PCIT-related protocols in need of empirical attention—such as the PCIT-SM (selective mutism) Program for young children with SM—are also considered. Implications of these protocols are discussed with regard to their unique potential to address the clinical needs of young children with internalizing problems. Obstacles to broad dissemination are addressed, and we consider potential solutions, including modular treatment formats and innovative applications of technology.