Bion’s discovery of alpha function: Thinking under fire on the battlefield and in the consulting room

This paper has traced Bion’s discovery of alpha function and its subsequent elaboration. His traumatic experiences as a young tank commander in World War I (overlaid on, and intertwined with, childhood conflicts) gave him firsthand exposure to very painful emotions that tested his capacity to manage. Later, in the 1950s, after his analysis with Melanie Klein and marriage to Francesca Bion, he undertook the analysis of psychotic patients and learned how they disassembled their ability to know reality as a defense against unbearable emotional truths in their lives. This led Bion to identify an aspect of dreaming that was necessary in order for reality experience to be given personal meaning so that one may learn from experience. Simultaneous with working out this new theory of dreaming, Bion also revisited his World War I experiences that had remained undigested and all these elements coalesced into a selected fact – his discovery of alpha function. In subsequent writings, Bion explored the constituent factors of alpha function, including the container/contained relationship, the PS?D balance, reverie, tolerated doubt and other factors which I have termed the ‘Constellation for Thinking’.     

Type D personality,but not Type A behavior pattern,is associated with coronary plaque vulnerability

Personality traits are associated with major adverse coronary events (MACE) in patients with coronary artery disease (CAD). However, the link between personality traits and intravascular morphology in CAD patients is poorly understood. This study investigated the relationship between personality traits, specifically Type A behavior pattern and Type D personality, and plaque vulnerability. After adjustment for demographic and clinical factors, multivariable regression analysis showed no association between Type A and optical coherence tomography indices. However, Type D personality was independently associated with lipid plaque, thin cap fibroatheroma (TCFA), and fibrous cap thickness. More specifically, negative affectivity of Type D was related to lipid plaque, TCFA and fibrous cap thickness, and social inhibition was associated with plaque rupture. Our results show that Type D personality was associated with plaque vulnerability, independent of clinical factors. Measurement of negative affectivity and social inhibition will increase our understanding of the progressive phase of the plaque vulnerability, which can contribute to the early identification of high risk patients and reduce the incidence of MACE.     

Ethical intuitionism and the linguistic analogy

It is a central tenet of ethical intuitionism as defended by W. D. Ross and others that moral theory should re?ect the convictions of mature moral agents. Hence, intuitionism is plausible to the extent that it corresponds to our well-considered moral judgments. After arguing for this claim, I discuss whether intuitionists o?er an empirically adequate account of our moral obligations. I do this by applying recent empirical research by John Mikhail that is based on the idea of a universal moral grammar to a number of claims implicit in W. D. Ross’s normative theory. I argue that the results at least partly vindicate intuitionism.     

Modeling Interactions Between Latent Variables in Research on Type D Personality: A Monte Carlo Simulation and Clinical Study of Depression and Anxiety

Several approaches exist to model interactions between latent variables. However, it is unclear how these perform when item scores are skewed and ordinal. Research on Type D personality serves as a good case study for that matter. In Study 1, we fitted a multivariate interaction model to predict depression and anxiety with Type D personality, operationalized as an interaction between its two subcomponents negative affectivity (NA) and social inhibition (SI). We constructed this interaction according to four approaches: (1) sum score product; (2) single product indicator; (3) matched product indicators; and (4) latent moderated structural equations (LMS). In Study 2, we compared these interaction models in a simulation study by assessing for each method the bias and precision of the estimated interaction effect under varying conditions. In Study 1, all methods showed a significant Type D effect on both depression and anxiety, although this effect diminished after including the NA and SI quadratic effects. Study 2 showed that the LMS approach performed best with respect to minimizing bias and maximizing power, even when item scores were ordinal and skewed. However, when latent traits were skewed LMS resulted in more false-positive conclusions, while the Matched PI approach adequately controlled the false-positive rate.     

Categorization of two-dimensional and three-dimensional stimuli by 18-month-old infants

In two experiments, 18-month-old infants’ categorization of 3D replicas and 2D photographs of the same animals and vehicles were compared to explore infants’ flexibility in categorization across different object representations. Using a sequential touching procedure, infants completed one superordinate and two basic-level categorization tasks with 3D replicas, 2D cut out photographs, or 2D images on photo cubes (“2D cubes”). For superordinate sets, 3D replicas elicited longer mean run lengths than 2D cut outs, and 3D replicas elicited equivalent mean run lengths as 2D cubes. For basic-level sets, infants categorized high-contrast animal sets when presented with 3D replicas, but they failed to categorize any of the 2D photograph sets. Categorization processes appear to differ for 3D and 2D stimuli, and infants’ discovery of object properties over time while manipulating objects may facilitate categorization, as least at the superordinate level. These findings are discussed in the context of infants’ representation abilities and the integration of perception and action.     

The distressed (Type D) personality mediates the relationship between remembered parenting and psychological distress in cardiac patients

Objective: Both the distressed (Type D) personality (i.e. the combination of negative affectivity and social inhibition traits) and dysfunctional parenting styles are associated with anxiety and depression. As parenting styles have been related to personality development, dysfunctional parenting styles may also be associated with Type D personality. We examined whether remembered parenting was associated with anxiety and depression in cardiac patients and whether Type D personality mediated this relationship.

Methods: Our sample comprised 435 patients treated with percutaneous coronary intervention (PCI) and 123 patients with congestive heart failure (CHF). Patients completed the Hospital Anxiety and Depression Scale, Type D Scale (DS14), and Remembered Relationship with Parents (RRP¹⁰) scale.

Results: Remembered parenting was significantly associated with higher anxiety and depression levels and Type D personality. In multivariable linear regression analyses, Type D personality accounted for 25–29% of the variance in anxiety and 23–46% of the variance in depression, while remembered parenting was no longer significantly associated with these domains. Sobel tests and bootstrapping indicated that Type D personality mediated the relationship between remembered parenting and anxiety and depression.

Conclusion: Type D personality mediated the relationship between remembered parenting and anxiety and depression in both PCI and CHF patients.     

Type D personality predicts poor medication adherence in myocardial infarction patients

Type D personality, the combination of negative affectivity (NA) and social inhibition (SI), is an emerging risk factor in cardiovascular disease. This study aimed to examine one possible behavioural mechanism to explain the link between Type D and ill-health. It was hypothesised that Type D personality would predict medication adherence in myocardial infarction (MI) patients. In a prospective study, 192 MI patients (54 females and 138 males) completed measures of Type D personality and provided demographic and medical information 1 week post-MI, and then 131 patients went on to complete a self-report measure of medication adherence 3 months post-MI. It was found that Type D personality predicts adherence to medication, after controlling for demographic and clinical risk factors. Critically, the constituent components of Type D, NA and SI, interact to predict medication adherence, after controlling for the effects of each component separately. Poor adherence to medication may represent one mechanism to explain why Type D cardiac patients experience poor clinical outcome, in comparison to non-Type D patients. Interventions, which target the self-management of medication, may be useful in these high-risk patients.     

Demonstration and interpretation of ‘scutoid’ cells formed in a quasi-2D soap froth

ABSTRACT

Recently a novel type of epithelial cell has been discovered and dubbed the ‘scutoid’. It is induced by curvature of the bounding surfaces. We show by simulations and experiments that such cells are to be found in a dry foam subjected to this boundary condition.