Blunted amygdala activity is associated with depression severity in treatment-resistant depression

Up to 50% of individuals with major depressive disorder (MDD) do not recover after two antidepressant medication trials, and therefore meet the criteria for treatment-resistant depression (TRD). Mindfulness-based cognitive therapy (MBCT) is one promising treatment; however, the extent to which MBCT influences clinical outcomes relative to baseline neural activation remains unknown. In the present study we investigated baseline differences in amygdala activation between TRD patients and healthy controls (HCs), related amygdala activation to depression symptoms, and examined the impacts of MBCT and amygdala activation on longitudinal depression outcomes. At baseline, TRD patients (n = 80) and HCs (n = 37) participated in a functional magnetic resonance imaging task in which they identified either the emotion (affect labeling) or the gender (gender labeling) of faces, or passively viewed faces (observing). The TRD participants then completed eight weeks of MBCT or a health enhancement program (HEP). Relative to HCs, the TRD patients demonstrated less amygdala activation during affect labeling, and marginally less during gender labeling. Blunted amygdala activation in TRD patients during affect labeling was associated with greater depression severity. MBCT was associated with greater depression reductions than was HEP directly following treatment; however, at 52 weeks the treatment effect was not significant, and baseline amygdala activation across the task conditions predicted depression severity in both groups. TRD patients have blunted amygdala responses during affect labeling that are associated with greater concurrent depression. Furthermore, although MBCT produced greater short-term improvements in depression than did HEP, overall baseline amygdala reactivity was predictive of long-term clinical outcomes in both groups.     

From the Marrow of the Mountain

This article focuses on the experience of finding a new source of water since the fountain fed by the neighbor’s source dried up in the middle of an alpine summer of farming in the Swiss Alps. This new water source is on ancestral land owned by three cousins of different viewpoints. Central to the story is the developing friendship between the local dowser and one of the owners, a Swiss-Californian woman determined to move the management of this jeweled terrain, with structures and customs, out of patriarchal ways into stewardship. The pristine land is highlighted, as is the vanishing knowledge of the old ways.     

The particularity and phenomenology of perceptual experience

I argue that any account of perceptual experience should satisfy the following two desiderata. First, it should account for the particularity of perceptual experience, that is, it should account for the mind-independent object of an experience making a difference to individuating the experience. Second, it should explain the possibility that perceptual relations to distinct environments could yield subjectively indistinguishable experiences. Relational views of perceptual experience can easily satisfy the first but not the second desideratum. Representational views can easily satisfy the second but not the first desideratum. I argue that to satisfy both desiderata perceptual experience is best conceived of as fundamentally both relational and representational. I develop a view of perceptual experience that synthesizes the virtues of relationalism and representationalism, by arguing that perceptual content is constituted by potentially gappy de re modes of presentation.     

Organization of the bilingual lexicon: Categorical versus alphabetic cuing in Russian-English bilinguals

The mechanism by which Russian native speakers store and retrieve Russian and English words from lexical memory was investigated in two experiments in which fluency of retrieval was compared for categorical and alphabetic cues. We hypothesized that fluency in Russian would be higher for categorical cues but that fluency in English would be higher for alphabetical cues because native language words would have been stored by meaning, while second-language words would have been stored according to dictionary usage. Subjects retrieved more Russian than English words with categorical cues, but their retrieval was the same for the two languages with alphabetic cues. In addition, fluency was greater overall with alphabetical than categorical cues. We attributed the greater fluency in Russian with the categorical cues to the early age at which the concepts were acquired, which made them more accessible in the native language. These findings support the idea that access codes for words may vary depending upon how they are originally learned.This research was supported by Research Grants AFOSR 89-0442 and F49620-92-J-0119 from the U.S. Air Force Office of Scientific Research to Joan Gay Snodgrass. We are indebted to an anomymous reviewer for constructive comments on an earlier version of this article.     

Global Mental Health: A Call for Increased Awareness and Action for Family Therapists

Global mental health (GMH) is an emerging field that focuses on the need for culturally sensitive mental health services in low‐ and middle‐income countries (LMICs). While many new initiatives have been established worldwide to understand GMH needs and to provide care in LMICs, family therapists have primarily worked with families in high‐income countries. The few existing family‐based initiatives in GMH focus on psychoeducation and are typically not based on general systems theory. However, emerging trends in family therapy may enable family therapists to impact mental health issues in LMICs. These trends, which are shared interests of both family therapy and GMH, include collaborative care, a growing emphasis on the importance of culture in understanding and treating mental health issues, recognition of the ability of families to support or impede recovery from mental illness, and the use of strength‐based and evidence‐based treatments. This paper describes ways for family therapists to become active in the GMH community.     

The Perception of Honour-Related Violence in Female and Male University Students from Morocco,Cameroon and Italy

The study investigates the perception of honour-related violence against women in female and male university students from three countries - Morocco, Cameroon, Italy – all considered honour cultures but different in terms of various other sociocultural factors, such as family structure and gender roles. One hundred fourteen Moroccan (47 females, 67 males), 106 Cameroonian (41 females, 65 males) and 103 Italian (51 females, 52 males) students attending Turin University and currently living in Turin, answered a questionnaire to evaluate an act of honour-related violence by a father against his daughter. The results showed that the perception of this act was influenced by the participants’ nationality: Italians evaluated the incident as more serious and more as a crime than Moroccans, and the latter more than Cameroonians. Furthermore, Italians attributed less responsibility to the victim and more responsibility to the assailant than Moroccans and Cameroonians did; accordingly, they also proposed more severe punishment for the assailant than Moroccans and Cameroonians. The results also showed an interaction between nationality and gender: Cameroonian women attributed more responsibility to the victim and less to the assailant than Cameroonian men, and Italian men attributed less responsibility to the assailant than Italian women. These results are interpreted in terms of the importance attributed to family honour in the three countries and their differences in social organisation and gender roles.     

Authoritativeness and Responsibility in the Analytic Exploratory Process Discussion of Elisa’s Case

Following the clinical exploratory process of Francesca Colzani’s case, this discussion emphasizes how the authoritativeness of the analysts’ contribution has to do with her/his responsibility for a self-reflexive attitude. We do not speak of power as much as of the possibility for and openness to change, which is stimulated by both of the subjectivities that are brought into play. The paper underlines the dialogue between poetic meaning and analytic meaning suggesting an innovative bidirectionality: from poetic language to the analytic process, but also from the analytic process to poetic language.