Repetitive antisaccade execution does not increase the unidirectional prosaccade switch-cost

An antisaccade is the execution of a saccade to the mirror-symmetrical location (i.e., same amplitude but opposite visual field) of a single and exogenously presented visual target. Such a response requires top-down decoupling of the normally direct spatial relations between stimulus and response and results in increased planning times and directional errors compared to their spatially compatible prosaccade counterparts. Moreover, antisaccades are associated with diffuse changes in cortical and subcortical saccade networks: a finding that has, in part, been attributed to pre-setting the oculomotor system to withhold a stimulus-driven prosaccade. Moreover, recent work has shown that a corollary cost of oculomotor pre-setting is that the planning time for a to-be-completed prosaccade is longer when preceded by an antisaccade (i.e., the unidirectional prosaccade switch-cost). Notably, this result has been attributed to antisaccades imparting a residual inhibition of the oculomotor networks that support the planning of stimulus-driven prosaccades. In the current investigation, we sought to determine if the number of antisaccades preceding a prosaccade increases this residual inhibition and thus influences the magnitude of the unidirectional prosaccade switch-cost. To that end, participants alternated between pro- and antisaccades after every second (i.e., AABB schedule) and every fourth (i.e., AAAABBBB schedule) trial. In addition, participants completed pro- and antisaccades in separate blocks of trials. Results demonstrated that task-switch prosaccades produced longer reaction times than their task-repetition and blocked condition counterparts, whereas antisaccade reaction times did not vary across task-repetition, task-switch and blocked condition trials. Most notably, the magnitude of the unidirectional prosaccade switch-cost was not modulated across the different task-switching schedules. Thus, we propose that the top-down requirements of the antisaccade task do not produce additive inhibition of stimulus-driven saccade networks.     

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent among adolescents enrolled in behavioral health services but remains undertreated, and the first-line treatment option, stimulant medication, is underutilized. To address this gap, this article introduces the Medication Integration Protocol (MIP): ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about integrating medication interventions into primary care; managing medication priorities for adolescents with multiple diagnoses, including substance use problems; and the compatibility of MIP with everyday practice conditions.     

Beyond the representation field

Abstract

This article outlines the importance of representation and several Freudian concepts such as Vorstellung, Trieb, and word and object representations. The author refers to the division of the analytical process into two main fields: the field of representation, and the field of the Real, which is characterized by impossibility. He then states that this field is the proper field of psychoanalysis. The author presents two clinical vignettes in an attempt to demonstrate the significance of the analytical act as a tool to deal with such extreme psychic situations.     

In dialogue with Daniel Stern: A review and discussion of The Present Moment in Psychotherapy and Everyday Life

Abstract

Daniel Stern's concepts of “present moment” and “now moment,” with impending kairos, are described. In the latter, the patient demands the authentic presence of the analyst. If the analyst can open himself to the patient, he proposes that this will result in more profound changes in the patient's implicit knowing than verbal interpretations in the narrative domain would lead to. The value of intersubjectively relating and dwelling more in the phenomenal than in the narrative dimension is highlighted. A similarity to the works of the existential psychoanalyst Harold Kelman is shown. The author agrees with, but also problematises, a tendency to favour the implicit, devaluing verbal understanding and interpretation, which may result in the patient not seeing the primitive levels in his inner life. For this purpose, works from D. W. Winnicott, Jessica Benjamin and Christopher Bollas, as well as others, are used. The author concludes that object relations and intersubjective theory need to complement each other that further, there is a need to give words to the middle-ground between the phenomenal and narrative dimensions.     

Primary shame,mortal wound and tragic circularity: Some new reflections on shame and shame conflicts

Invited to contribute some thoughts on recent developments in psychoanalytic thinking about shame, the author starts off with Aristotle's prescient analysis of shame and then focuses on accumulating experiences in the psychoanalytic treatment of patients with severe neuroses, in particular the close relationship of severe traumatization and chronic states of shame, and how this is reflected in shelfdestructive repetitions. Reminiscent of what we know from tragedy and the tragic dimension of human existence, this repetition compulsion shows a built‐in circularity. These circular dynamics have at their core struggles with deep woundedness that can variably be conceived of as primary pain, primary shame and primary anxiety. Consequently, throughout the experiences with these patients goes the absoluteness both of their conscience and of their ideal, what we know as the “archaic superego:”