FROM PRIMARY MATERNAL PREOCCUPATION TO DEAD MOTHER*

Ferenczi (1929) writes about the unwelcome child who is not ushered into this world with care and grows up in the grip of the death instinct, with a depressive streak and a weakness in the capacity for life. Andre Green’s (1986) concept of the dead mother describes a similar phenomenon, by which the image of a loving mother is transformed into an inanimate, dead parent. The absent mother becomes the negative, which will then take up a central position in the child’s psyche. Winnicott (1956) describes a different maternal participation, and proposes that towards the end of her pregnancy the ordinary devoted mother develops a psychological condition which he calls primary maternal preoccupation, the main feature of which is the mother’s heightened attunement to her baby at the expense of all else. I suggest that there is a potent and clinically relevant connection among these concepts: a depressed or damaged mother can still provide temporary devotion before reverting back to a state of depressive absence and that, conversely, even the devoted mother will eventually recover from the state of primary maternal preoccupation and begin to tend to other matters, and the mother’s reclaiming herself can be traumatic for the child even under the best of circumstances. The connection among these concepts is illustrated with clinical material, including transference and countertransference implications, from the treatment of a young woman who grew up as an unwelcome child.     

Does virtual intimacy exist? A brief exploration into reported levels of intimacy in online relationships.

This study examined the levels of intimacy reported by individuals in face-to-face and computer-mediated (or "virtual") romantic relationships. As suggested by the media and promised by online dating services, some degree of intimacy was reported in computer-mediated relationships, but stronger intimacy was reported in all participants' face-to-face relationships. Results also indicated that individuals who had online, virtual relationships reported less intimacy in their own face-to-face relationships compared to individuals who had engaged exclusively in face-to-face relationships, suggesting that people may turn to virtual relating after challenges in their face-to-face experiences.     

Context-dependent memory for meaningful material: information for students

Context-dependency effects on memory for lists of unrelated words have been shown more often with recall than with recognition. Context dependency for meaningful text material was examined using two standard academic testing techniques: short answer (recall) and multiple choice (recognition). Forty participants read an article in either silent or noisy conditions; their reading comprehension was assessed with both types of test under silent or noisy conditions. Both tests showed context-dependency effects in which performance was better in the matching conditions (silent study/silent test and noisy study/noisy test) than in the mismatching conditions (silent study/noisy test and noisy study/silent test). Context cues appear to be important in the retrieval of newly learned meaningful information. An academic application is that students may perform better on exams by studying in silence. Copyright © 1998 John Wiley & Sons, Ltd.     

Acceptability of,and Information Needs Regarding,Next-Generation Sequencing in People Tested for Hereditary Cancer: A Qualitative Study

Next generation sequencing (NGS) for patients at risk of hereditary cancer syndromes can also identify non-cancer related mutations, as well as variants of unknown significance. This study aimed to determine what benefits and shortcomings patients perceive in relation to NGS, as well as their interest and information preferences in regards to such testing. Eligible patients had previously received inconclusive results from clinical mutation testing for cancer susceptibility. Semi-structured telephone interviews were subjected to qualitative analysis guided by the approach developed by Miles and Huberman. The majority of the 19 participants reported they would be interested in panel/genomic testing. Advantages identified included that it would enable better preparation and allow implementation of individualized preventative strategies, with few disadvantages mentioned. Almost all participants said they would want all results, not just those related to their previous diagnosis. Participants felt that a face-to-face discussion supplemented by an information booklet would be the best way to convey information and achieve informed consent. All participants wanted their information stored and reviewed in accordance with new developments. Although the findings indicate strong interest among these individuals, it seems that the consent process, and the interpretation and communication of results will be areas that will require revision to meet the needs of patients.     

Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years

Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n?=?138) or SCT (n?=?96) (age 18–35 years, 35 % male, 94 % African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p?=?.004) but not intention (p?=?.18) or behavior (p?=?.69). At baseline, 114 (48.7 %) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6 %) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p?=?.04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.     

The sickening rug: a repeating static pattern that leads to motion-sickness-like symptoms

The nauseogenic properties of a patterned rug that reputedly caused motion-sickness-like symptoms in those who viewed it was the topic of this study. Naive observers viewed a 1:1 scale image of the black-and-white patterned rug and a homogeneous gray region of equivalent luminance in a counterbalanced within-subjects design. After 5 min of viewing, symptoms were assessed with the simulator sickness questionnaire (SSQ), yielding a total SSQ score and sub-scores for nausea, oculomotor symptoms, and disorientation. All four scores were significantly higher in the rug condition. Observers also reported significantly more self-motion perception in the rug condition, even though they were seated during the experiment. Results are consistent with findings that suggest that neurologically normal individuals who view a repeating static pattern can experience unpleasant symptoms, some of which are similar to motion sickness.