Methodology in subliminal psychodynamic activation: the next step in the debate

Subliminal psychdynamic activation methodology has recently been the subject of an exchange of views between Birgeg?rd and Sohlberg (1999) and Fudin (2000). The agreements and some remaining points of contention are summarized here. The main difference of opinion appears to concern unconscious verbal encoding in relation to subjective experience in subliminal stimulation and whether subliminal psychodynamic activation results are unreliable until a full explanation of how verbal encoding works is at hand. We conclude that clarifying perspectives is important and that those suggesting alternative explanations of results on subliminal psychodynamic activation must now empirically investigate their claims.     

The role of attentional biases in PTSD: is it interference or facilitation?

Although attentional biases have been demonstrated in individuals with posttraumatic stress disorder (PTSD), the cognitive methodologies used have not allowed for disambiguation of two types of attentional biases. It remains unclear if PTSD involves difficulty disengaging attention from threatening stimuli (interference) or facilitated detection. To differentiate between attentional interference and facilitation, 57 male Vietnam-era veterans (30 High PTSD and 27 Low PTSD) completed a visual search task with a lexical decision component. High PTSD veterans who engaged in the interference task first showed increased interference to threat-relevant words relative to Low PTSD veterans. However, no evidence was found for facilitated detection of threatening stimuli in PTSD.     

Staying in or moving away from structured activities: Explanations involving parents and peers

Adolescent participation in structured activities, meaning those with adult leaders, regular meetings, and skill-building activities, is related to good adjustment. Participation in unstructured, unsupervised, peer-oriented activities is related to poor adjustment. Structured activity participation is high in early adolescence and then declines, raising the question of why youths leave structured activities. The authors examined explanations involving parents and peers. They used longitudinal data from 861 youths (ages 13-17 years). Results showed that, compared with youths who stayed in structured activities, those who switched to hanging out on the streets were less likely to have peers in structured activities and had less positive feelings about the home context and more negative interactions with parents. In addition, delinquency predicted switching to hanging out in the streets and never joining structured activities in the first place. The results concerning parents support a theoretical explanation of how parents might unintentionally affect youths' leisure choices. Furthermore, the authors found some indications that positive feelings at home might protect youths who switch from structured activities to hanging out on the streets from increases in delinquency.     

Associations between childhood trauma and emotion-modulated psychophysiological responses to startling sounds: a study of police cadets

Childhood trauma may confer risk for adult psychopathology by altering emotional and physiological responses to subsequent stressors. Few studies have distinguished effects of childhood trauma from effects of current Axis I psychopathology on adult psychophysiological reactivity. The authors exposed 90 psychiatrically healthy police cadets to startling sounds under increasing threat of shock while assessing their eyeblink electromyogram (EMG), skin conductance (SC), and heart rate responses. When compared with those who did not endorse early trauma (n = 65), cadets reporting childhood trauma (n = 25) reported less positive emotion and showed greater SC responses across all threat levels. They also showed threat-dependent elevations in reported negative emotions and EMG responses. Results suggest that childhood trauma may lead to long-lasting alterations in emotional and psychophysiological reactivity even in the absence of current Axis I psychopathology.     

Psychiatric diagnoses in infancy: A comparison

This study investigated the specificity of diagnostic classification in two standardized systems: DSM-IV and Diagnostic Classification: Zero to Three. A sample of 82 infants aged 1–24 months suffering from various psychogenic and functional pediatric symptoms was diagnosed applying both systems. For DC: 0–3 (the Diagnostic Classification on Mental Health and Developmental Disorders of Infancy and Early Childhood), this study presents results with respect to the specificity of symptom patterns. Twelve out of 27 symptoms, specific for disorders in early infancy, showed high specificity and were significantly discriminative for the diagnostic entities. These symptoms were differentiated for frequency and severity of occurrence for each diagnosis. In the sample, DSM-IV and DC: 0–3 diagnoses were compared. Additionally, 13 items of biographical-biological data were collected (e.g., low SES combined with very young or older mothers resulted in an increased risk for psychiatric disorders in early infancy). The data provide support for the idea that the use of DC: 0–3 in early infancy may be helpful in relation to daily routines and research by increasing the range of clearly defined diagnostic entities.     

Day treatment of patients with personality disorders: experiences from a Norwegian treatment research network

This study sought to investigate the following research questions: Are time-limited day treatment programs for patients with personality disorder (PD) effective outside resourceful university settings, and what are the overall treatment results when the program is implemented on a larger scale? Do all categories and subtypes of PDs respond favorably to such treatment? How intensive should such day treatment programs be? All patients (n = 1,244) were consecutively admitted to eight different treatment programs in the Norwegian Network of Psychotherapeutic Day Hospitals from 1993 to 2000. Altogether, 1,010 patients were diagnosed with PD. Avoidant, borderline, not otherwise specified (NOS), and paranoid PD were the most common conditions. SCID-II and MINI were used as diagnostic instruments. Outcome measures included GAF Global Assessment of Functioning, (GAF; American Psychiatric Association, 1994), SCL-90R, CIP, Quality of Life, work functioning and parasuicidal behavior, measured at admittance, discharge and 1-year follow up. The attrition rate was 24%. The number of dropouts did not improve over time. As a group, completers with PD improved significantly on all outcome variables from admittance to discharge and improvement was maintained or increased at follow up. Treatment results were best for borderline PD, cluster C patients, PD NOS and No PD, and poorer for cluster A patients. Units with a high treatment dosage did not experience better outcomes than those with a low treatment dosage (10 hours per week). Results from the University unit were not better than those from units at local hospitals or mental health centers.     

Prevention opportunities in health care settings

Psychologists have an opportunity to offer their expertise at a time when health care settings are beginning to recognize the importance of behaviorally based interventions for improving health and health care. The authors review the changing patterns of health and illness that have led to an increased interest in the role of patient and provider behavior and discuss the many advantages of using health care settings as prevention sites. Examples of successful behaviorally based prevention programs are presented, along with the evidence supporting the cost-effectiveness of such programs. Challenges presented by working in health care settings are described. Throughout, the authors emphasize the multiple opportunities for psychologists' involvement across a wide variety of health care delivery sites.     

Depressed nursing home residents' activity participation and affect as a function of staff engagement

Behavioral interventions for depression target activity engagement and increased positive reinforcement, particularly from social interaction. Nursing homes provide limited opportunity for meaningful social engagement, and have a high prevalence of depression. Often residents obtain most of their social contacts from staff members. We present intra-individual correlations among positive staff engagement, resident affect, and resident activity participation from behavior stream observations of residents who were participants in an ongoing trial of an intervention for depression. Sixteen residents were observed 6 times weekly for 8 to 45 weeks, 5 minutes per observation. Positive staff engagement during the observations was significantly correlated with resident interest and pleasure. Positive staff engagement was related to resident participation in organized group activity; however, residents tended to be more engaged and show more pleasure when in informal group activities, especially those residents receiving the behavioral treatment. Positive staff engagement was not related to time in activities of daily living. Results have implications for understanding mechanisms and potential targets of interventions for depression.     

Strategies in landmark use by orangutans and human children

Landmark use has been demonstrated in a variety of organisms, yet the manner in which landmarks are encoded and subsequently used appears to vary between and sometimes within species, even when faced with identical landmark arrays. In the present experiments, orangutans and human children were shown a square array of identical landmarks and were trained to locate a hidden goal in the centre of the array. In Experiments 1 and 2, the search space appeared to be discrete, with white gridlines dividing up the space, and in Experiments 3a and 3b, the search space was uniformly coloured, making it appear continuous. In all experiments, following training, subjects were given a single expansion test, to determine their landmark strategy use, based on peak search activity. The orangutans appeared to use absolute directional vectors from individual landmarks, with peak search activities on the inner corners of the square array, and they used this strategy persistently. In contrast, human children showed two landmark-based strategies, absolute directional vectors and a relational or “middle” strategy, with the majority of children starting their search in the middle region. Although some children, especially young children, persistently used one strategy like the orangutans, many changed strategies when the original one failed to yield the hidden goal.     

Interactive effect of long-term mental stress and cardiac stress reactivity on carotid intima-media thickness: the Cardiovascular Risk in Young Finns study

The present study examined the interaction between vital exhaustion and cardiac reactivity and recovery on preclinical atherosclerosis assessed by carotid intima-media thickness (IMT) in young men and women. We measured heart rate (HR), respiratory sinus arrhythmia (RSA), and pre-ejection period (PEP) in response to mental arithmetic and speech tasks. Vital exhaustion and carotid IMT were also measured. Significant associations were observed for men aged 28-37 years, but not for men aged 22-25 years, nor for women in these age groups. It was shown that, among highly exhausted men in the older age group, lower HR reactivity was related to greater IMT. Our results also imply that, among non-exhausted men in this age group, slow HR and RSA recovery after acute stress predicted higher IMT. These results suggest that long-term stress as assessed by vital exhaustion is a risk only if it has resulted in ineffective cardiac stress reactivity. Autonomic imbalance resulting from chronic stress may be the common mechanism linking vital exhaustion and cardiac responsiveness to an increased risk of atherosclerosis.