Clinical Assessment of Prementalizing Modes of Psychic Functioning in Children and Their Parents in the Context of Trauma

ABSTRACT

As psychoanalytic psychotherapy for children depends on their capacity to mentalize, it is essential to integrate this dimension in their psychological assessment. Mentalization refers to the capacity to identify and comprehend the mental states (feelings, thoughts and intentions) underlying and explaining one’s own behaviors and those of others. This vital ability, which develops during the first five or six years of life in the context of a secure parent-child attachment, is often impaired in children subjected to neglect and maltreatment. Based on rigorous and systematic clinical observations made in youth protection and child psychiatry services, the authors suggest that the children in these settings, along with their parents, frequently present a prementalizing mode of psychic functioning. Further, the authors propose operationalizing the teleological, psychic equivalence, and pretend modes as they might be observed in older children and their parents. To this end, they begin by identifying behaviors, attitudes, and relational patterns potentially linked to each of these modes within a theoretical framework. Next, they describe the characteristics of these children’s narratives, play, and artistic productions. Lastly, three clinical vignettes are used to illustrate how the prementalizing modes are manifested. The results of this clinical assessment can guide the choice of techniques to be used in child psychotherapy.     

Mentalization-based Interventions in Child Psychiatry and Youth Protection Services II: A Model Founded on the Child’s Prementalizing Mode of Psychic Functioning

ABSTRACT

The systematic and rigorous observations of children in child psychiatry and Youth Protection Services in Quebec revealed that most of these children presented multiple, complex and often severe problems, and did not seem to benefit much from classic psychodynamic psychotherapy. Owing to a poorly developed mentalizing capacity, many of these children did not use symbolic play as a means of expressing their intrapsychic conflicts and relational difficulties and did not communicate much verbally with clinicians. It was noted also that these children’s inner world was dominated by prementalizing modes of thinking, namely, the teleological mode, the psychic equivalence mode, and the pretend mode. This article is the last in a series of three. The first concerns the clinical assessment of prementalizing modes of psychic functioning in children and their parents. The second lays out the general objectives, principles and interventions of a mentalization-based treatment for children. This third article presents specific intervention strategies adapted to children’s predominant mode of thinking. The objectives and techniques regarding each mode are discussed. Three clinical examples serve to illustrate the interventions. The authors suggest that these children must develop a certain degree of mentalizing capacity before they can benefit from classic psychodynamic psychotherapy.     

Palatability shifts in taste and flavour preference conditioning

Changes in palatability of tastes and flavours as a result of flavour preference conditioning were examined. In Experiment 1, when tastes were paired with glucose in a reverse-order differential conditioning paradigm, rats acquired conditioned preferences for CS + and displayed more hedonic responses to CS + than to CS - in a postconditioning taste reactivity test. In Experiment 2, rats that received oral infusions of flavours as CSs during a reverse-order conditioning procedure expressed both palatability shifts and conditioned preferences for CS + . Rats that received a forward conditioning procedure acquired a preference for CS + , but the palatability of CS + was unchanged. In Experiment 3, hungry rats drank mixtures of a flavour CS and a calorific or sweet tasting reinforcer in a long-exposure conditioning paradigm. When tested hungry, rats preferred CS + whether they had acquired flavour-calorie or flavour-taste associations. However, CS + became more palatable only for rats that acquired flavour-calorie associations. These results suggest that acquisition of flavour preferences, as measured by 2-bottle tests, may not always be accompanied by enhanced palatability.     

Explaining Premature Mortality Across Fields of Creative Endeavor

It has been established that eminent creative writers tend to die younger than their counterparts in other creative-achievement domains. The present study replicates these findings using a data set of 2102 eminent historical subjects from seven different disciplines, and reviews three extant explanations for this phenomena. Each explanation was tested using an indicator of versatility. None of the life-span hypotheses extended from each explanation to the interaction of achievement domain × versatility was supported. In particular, no models were able to account for the precipitous decrease (2.7 to 8.6 years) in the life spans of versatile scientists when compared to nonversatile scientists. Consequently, a new explanatory model was proposed that draws on psychopathology, vocation choice, and personality characteristics as factors underlying the apparent differences in life span across achievement domains and versatility.     

Acculturation-related variables, sexual initiation, and subsequent sexual behavior among Puerto Rican, Mexican, and Cuban youth.

The relationship among acculturation-related variables, past sexual activity, and subsequent sexual behavior was examined for a sample of Latino youth in the United States over a 12-month period. A subsample from the National Longitudinal Study of Adolescent Health database was analyzed by means of a prospective design. History of sexual intercourse predicted subsequent sexual behavior over the ensuing 12 months. The acculturation-related variables were related to whether an adolescent reported being sexually active at Wave 1 but in a complex fashion. Among recent immigrants, youth from English-speaking homes were less likely to be sexually active than those from Spanish-speaking homes. The opposite was observed for youth who were born in the United States or who had resided in the United States most of their lives.     

Executive functions in early childhood: The role of maternal and paternal parenting practices

We investigated the association between mothers' and fathers' harsh parenting and sensitive parenting practices and child's executive functions (EF) in early childhood in 607 families. We focused on three broad dimensions of child EF: Emergent metacognition, inhibitory self‐control, and flexibility measured with the parent‐reported Behavior Rating Inventory of Executive Function‐Preschool Version. Less sensitive parenting of the mother and harsher parenting of the father were related to lower scores of emergent metacognition and inhibitory self‐control. Parenting was not associated with child flexibility. This study extends previous research on the association between parenting and EF by the focus on the role of the father and demonstrates independent effects of mother and father on child EF.