Changes in Children's Episodic Narratives Through Long-Term Repeated Recall: Longitudinal Case Studies1

This study aimed to investigate whether a child's narrative of a particular past episode would change in repeated reporting over the long term, and if so, how it would change. To answer these questions, I conducted longitudinal case studies of episodic reports by children every 2–6 months, from their early childhood to the age of 10–15 years. Criteria for inclusion were set in advance; seven episodic narratives meeting these criteria were analyzed. Two types of changes in the narratives were observed, as expected: that of including other information, and that of an event suddenly being reported after no recall for several years. Information from the children's surroundings seemed to be substantially involved in these changes in their episodic narratives. The present results also indicate that mothers' episodic memories are not always reliable and that the schema children have can influence their episodic memories.     

Treating Childhood Social Anxiety Disorder With Virtual Environments and Serious Games: A Randomized Trial

Disseminating efficacious psychological treatments remains a challenge for researchers and clinicians. In the case of social anxiety disorder (SAD), Social Effectiveness Therapy for Children (SET-C) has been demonstrated as an efficacious intervention, but elements of the protocol, such as peer generalization sessions, remain challenging to conduct in typical clinical settings. To address this need, we developed an artificially intelligent, web-based application, Pegasys-VR™, designed to replace peer generalization sessions and enhance homework compliance. The feasibility of Pegasys-VR™ was tested in a randomized controlled trial in comparison to SET-C. The results indicated that both programs were equally efficacious in decreasing anxiety and improving social skill in social encounters. Sixty-three percent (63%) of children treated with SET-C and 60% treated with Pegasys-VR™ did not meet diagnostic criteria for SAD at posttreatment. Pegasys-VR™ is a feasible, efficacious, and dissemination-friendly element of a comprehensive treatment program for social anxiety disorder in children.     

Psychosis,symbol, affectivity 1: etiopathogenesis and treatment through analytical psychology

This is the first of two papers concerning our study into an integrated approach to psychotic disorders, conducted at the University of Palermo’s Psychiatry Unit Polyclinic over approximately 15 years. Here we will explore and reflect upon the acute psychotic condition mainly from a theoretical and conceptual perspective, while in the second paper we will explore the clinical perspective. From the point of view of psychopathology, and in the light of C.G. Jung’s conceptualization of analytical psychology, as well as calling on contributions from other authors from the systemic-relational and post-psychoanalytic field, we will clarify the ideas developed over these last few years by our team. From a more speculative perspective we will advance new interpretive hypotheses in an attempt to thoroughly understand the nature of the psychotic condition, both on a psychodynamic relational and a neuroscientific level. The paper describes how we revised our understanding of psychosis from a brain disease to a process aimed at the rearrangement of psychic functioning, as anticipated by John Weir Perry nearly 40 years ago.     

Application of Yoga as a Spiritual Practice to Enhance Counselor Wellness and Effectiveness

In this article, we explore potential benefits of yoga, an ancient Indian tradition for spiritual growth and development, for counselors. Counselors use themselves as instruments to support clients and are constantly exposed to the traumatic experiences of clients, which may leave them susceptible to secondary traumatic stress or compassion fatigue (Shallcross, 2011). Yoga can help counselors not only in achieving holistic wellness but also in developing a way of being consistent with the characteristics of an effective counselor. Furthermore, yoga, as a spiritual practice, can empower counselors to embark on a spiritual journey driven by their own personal experiences.     

General vs health‐specific consideration of immediate and future consequences to explain eating and exercise behavior in a Norwegian student population: A randomized survey experiment

Over several decades, the consideration of future consequences (CFC) construct has been used to explain and predict health behaviors. However, the reported associations between CFC and health behaviors are relatively weak, leading to the low explanatory power of the models. Recent research suggests that CFC can be a domain‐specific construct. In this study, we explored the psychometric properties of the Norwegian CFC‐general and CFC‐health questionnaires in terms of factor structure and discriminant and convergent validity and tested the association between the general and domain‐specific CFC and exercise and eating behaviors. In a randomized survey experiment, 1,001 university students were assigned to either a CFC‐general or a CFC‐health questionnaire. In the tested models, two dimensions of CFC, consideration of immediate consequences (CFC‐I) and consideration of future consequences (CFC‐F), were independent variables. The exercise and eating behaviors, measured both as self‐evaluated behaviors and self‐reported frequency measures, were dependent variables. The results showed that in both CFC‐general and CFC‐health, CFC‐I and CFC‐F are distinct dimensions that differentially explain variance in health behaviors. A domain‐specific CFC‐health explained a significantly higher amount of variance in self‐reported eating and exercising behaviors than a general CFC. Self‐evaluated health behaviors were better explained by CFC than self‐reported behavioral frequencies. Practical implications of the findings and avenues for future research are discussed.     

La psychothérapie assistée par la MDMA dans la prise en charge du syndrome de stress post-traumatique

Posttraumatic stress disorder (PTSD) is estimated to remain chronic and severe for 25–50% of patients despite psychotherapeutic treatment. Part of the reasons is that patients with PTSD can have difficulties in establishing a good therapeutical alliance with the therapist. Moreover, they often fail to re-think the content of the trauma without being overwhelmed by negative emotions and tend to rely on avoidance strategies and/or to abandon the therapy. MDMA (“ecstasy”) is a drug classified as an entactogen (en “within”, tactus “touch”, and gen “produce”), an amphetamine with psychedelic properties that possesses psychopharmacological properties to overcome these issues. Indeed, MDMA triggers the release of oxytocin, which favors the establishment of interpersonal relationship based on kindness and trust. Moreover, MDMA diminishes the activity of the amygdale, allowing patients to work on challenging memories with less fear and anxiety. Finally, MDMA may also provide access to meaningful spiritual experiences, release of tensions and a sense of healing on a non-verbal level that are not completely understood. But are viewed as important by patients. Today, there is no evidence that the use of MDMA in a clinical setting has bad neurologic, psychological or cognitive consequences. Results of phase II trials in the United States and Europe confirm that MDMA favors psychotherapy's outcome without severe adverse effects. Phase III trials are underway. The Multidisciplinary Association for Psychedelic Studies (MAPS) has published online a method proposal and trains therapists in MDMA-assisted psychotherapy.ConclusionFood and Drug Administration (FDA) and European Medicines Agency (EMA) could approve this therapeutic tool in the coming years.     

What is agentic about the Spatial Agency Bias? How pragmatic relevance contributes to the spatial representations of actions

The mental imagination of (social) actions has been shown to follow a left‐to‐right trajectory, with the thematic agent associated with the left position (Spatial Agency Bias, Suitner & Maass in Advances in Experimental Social Psychology, 53, 2016, p. 245–301). For example, individuals asked to choose a picture that visualizes the sentence “Tom kicks George” tend to choose an image where the agent, Tom, is positioned on the left‐hand side rather than on the right‐hand side. However, as an alternative to the thematic role of the agent, such findings may reflect a mental representation following pragmatic relevance. Specifically, a pragmatic perspective holds that word order and syntactic functions are strategic devices to communicate that the element is important for the sentence. Thus, positioning in the described picture‐matching task may actually reflect the agent's pragmatic relevance instead of agency per se. As a test, we vary whether sentences are written in the active versus the passive voice. Results from five studies indicate that the passive voice results in the tendency to place the agent on the right‐hand side rather than on the left‐hand side of a picture. Instead, the acted‐upon person is positioned on the left‐hand side of a picture. A sixth experiment reveals that for the passive voice, the agent is still seen as more agentic than the receiver, but is considered less relevant. The findings are congruent with the proposed pragmatic relevance account. Implications for the Spatial Agency Bias as well as for building mental representations in general are discussed.     

Factors associated with the socioemotional development of preterm infants

Preterm birth is a risk factor for problems in interactions with others. We compared the difference in socioemotional development between hospital discharge and at six months of corrected age of infants born ≤32 weeks and assessed the impact of maternal and infantile factors on socioemotional development rate within a 6 month’s period. Mother-child dyads (n = 144) were assessed by the Mother-Baby Observation Protocol 0–6 months through a video microanalysis. Multivariate model was built. Neonatal, maternal and child factors were associated with interactive gaze, initiate contact, responsiveness, infantile vocalization, and thus contributed to the socioemocional development of preterm infants with their mothers.     

Computer‐based training to teach observers to accurately score problem behavior using fast forwarding at 5x normal speed

The current study evaluated whether a computer‐based training program could improve observers' accuracy in scoring discrete instances of problem behavior at 5x normal speed using a multiple‐baseline design across subjects. During pretraining and posttraining, observers attempted to score multiple examples of problem behavior at 5.0x without feedback. During training, participants scored multiple examples of problem behavior at 5.0x with automated feedback. Researchers measured omission (missing problem behavior) and commission (scoring other behavior as problem behavior) errors and the total duration of scoring time to determine the observers' accuracy and efficiency, respectively. After training, all participants scored instances of problem behavior with less than 11% error using 5.0x. The time required to score the videos across 90‐min observations was reduced by 66%. Results extend previous evaluations of fast forwarding by demonstrating that the training program could be used to teach observers to accurately score problem behavior using a speed faster than 3.5x.     

Reflections on the role of the analytic setting in the light of COVID-19

There have been many reflections, both individual and collective within our Institutes, on the effects on our work with patients caused by COVID-19 and the requirement to move suddenly from the setting of our own consulting rooms to working with patients online (see also, the previous issue of this Journal). This paper focuses on what we have learned from these experiences that can add to our knowledge about the role of the setting in analytic work. Drawing on Bleger’s (1967) seminal paper highlighting the usual setting as a mute projection carrier for primitive wishes and affects, the paper explores how different patients have reacted to the loss of the analyst as the guardian of the setting and in particular as an embodied presence. Some key questions and challenges for both patients and analysts during the pandemic, when ‘the setting begins to weep’, are explored.