Direct and Indirect Effects of Adolescent Self-Control of Emotions and Behavioral Expression on Adult Health Outcomes

In the ongoing Jyväskylä Longitudinal Study of Personality and Social Development, we examined the direct and indirect effects of self-control of emotions and behavioral expression, as rated by teachers at age 14, on various self-reported health outcomes at age 36 in 123 women and 129 men. The relation between independent and dependent variables was expected to be mediated by health-related behaviors at age 36 (exercise, tobacco use, heavy drinking). Path analysis showed that, in men, low self-control of emotions was linked to self-assessed poor health and physical symptoms indirectly via health-risk behaviors, but directly to disabilities. Behavioral expression at age 14, indexed by social activity, was directly linked to disabilities. In women, behavioral expression was unrelated to health outcomes, but low self-control of emotions was indirectly linked to self-assessed poor health, physical symptoms, and disabilities via health-risk behaviors.     

Measuring Quality of Life in HIV and AIDS: A Review of the Recent Literature

This review addresses some of the recent issues surrounding the measurement of quality of life of people living with HIV and AIDS and discusses the properties of suitable instruments. More than 300 articles on quality of life in HIV and AIDS published since 1995 have been appraised. The structure and properties of two broad types of measure are considered: economic indicators or scales and subjective measures. While several good scales have been created for the assessment of people living with HIV infection, few were found to be conceptually comprehensive in terms of the dimensions offered for evaluation. Almost all these instruments were developed in the USA. Simple translation methods provide language versions that lack cross-cultural equivalence. A new cross-cultural methodology has recently been achieved in the development of the WHOQOL-HIV instrument as a measure for international research and its development is described.     

A Meta-Analytic Review of the Common-Sense Model of Illness Representations

A meta-analysis of empirical studies ( N = 45) adopting Leventhal, Meyer and Nerenz's (1980) Common Sense Model (CSM) of illness representations is presented. The average corrected intercorrelation matrix for the sample of studies showed that the CSM illness cognition dimensions of consequences, control/cure, identity and timeline followed a logical pattern supporting their construct and discriminant validity across illness types. A content analysis classified coping strategies into seven distinctive categories and health outcomes into six categories. Examining the average corrected correlation coefficients across the studies revealed that perceptions of a strong illness identity were significantly and positively related to the use of coping strategies of avoidance and emotion expression. In addition, perceived controllability of the illness was significantly associated with cognitive reappraisal, expressing emotions and problem-focused coping strategies. Perceptions of the illness as highly symptomatic, having a chronic timeline and serious consequences was significantly correlated with avoidance and expressing emotions coping strategies. Further, perceptions that the illness was curable/controllable was significantly and positively related to the adaptive outcomes of psychological well-being, social functioning and vitality and negatively related to psychological distress and disease state. Conversely, illness consequences, timeline and identity exhibited significant, negative relationships with psychological well being, role and social functioning and vitality. The analyses provide evidence for theoretically predictable relations between illness cognitions, coping and outcomes across studies.     

Walking in the lost child's tracks: revisiting the therapeutic nature of reclaiming

This paper outlines the research methodology used as part of a professional doctorate in psychoanalytic psychotherapy. The project researched the maternal state of mind following the loss of an infant or small child and the birth of the next baby. Three mothers were seen for psychoanalytic psychotherapy on a weekly basis as part of this research. They were encouraged to bring their new baby to sessions. The author describes how an interest in this area of research developed as a result of working as a child psychotherapist with 'replacement children' (Cain and Cain, 1964). An argument is made to show that the psychoanalytic method is unique and that the psychoanalytic setting may be considered an 'ideal laboratory' (Fonagy and Moran, 1993) for psychoanalytic psychotherapeutic research. Clinical material is used from one case study to show how material can be analysed and demonstrates the research methodology used within the project. The material explores the developing therapeutic relationship and focuses on the way one mother in the research group experienced the loss of a small child prior to the birth of her next baby. Cet article décrit brièvement la méthodologie de recherche employée dans le cadre d'un doctorat professionnel en psychothérapie psychanalytique. Le projet de recherche porte sur l'état psychique maternel à la suite de la perte d'un nourrisson ou d'un enfant en bas âge lorsque un nouveau bébé vient à naître. Dans le cadre de cette recherche, trois mères ont bénéficié d'une psychothérapie psychanalytique à raison d'une séance hebdomadaire. Il leur était proposé d'amener leur bébé aux séances. L'auteur décrit comment son intérêt pour ce champ de recherche s'est développé à partir de son travail de psychothérapeute d'enfants auprès d'"enfants de remplacement" [A. Cain & B. Cain 1964]. Elle affirme que la méthode psychanalytique à sa propre valeur et que le cadre psychanalytique peut être considéré comme un "laboratoire idéal" [P. Fonagy & G. Moran 1993] pour la recherche en psychothérapie psychanalytique. Le matériel clinique d'une étude de cas montre comment l'analyser et illustre la méthodologie de la recherche employée dans ce projet. Ce matériel explore l'évolution de la relation thérapeutique et traite en détail de la façon dont une des mères de l'échantillon a vécu la perte d'un enfant en bas âge avant la naissance de son bébé actuel. Questo articolo mette in rilievo la metodologia di ricerca utilizzata come parte di un dottorato professionale in psicoterapia psicoanalitica. Il progetto di ricerca studiava lo stato mentale materno conseguente la perdita di un neonato o bambino piccolo e la nascita del bambino successivo. Come parte della ricerca tre madri furono seguite una volta alla settimana in psicoterapia psicoanalitica, ed incoraggiate a portare alle sedute i loro nuovi bebe'. L'autore descrive come il suo interesse in questa area si e' sviluppato conseguentemente al suo lavoro come psicoterapeuta infantile con 'bambini sostituti' (Cain e Cain, 1964. Si cerca di mostrare l'unicita' del metodo psicoanalitico e come esso possa essere considerato un 'laboratorio ideale' (Fonagy e Moran, 1993) per la ricerca in psicoterapia psicoanalitica. Viene usato il materiale clinico di un caso per mostrare come esso possa essere analizzato e illustrare il metodo di ricerca usato nel progetto. Il materiale esplora la relazione terapeutica nel suo evolversi e si concentra sul modo in cui una madre nel gruppo di ricerca visse la perdita di un bambino piccolo precedente la nascita dell'altro bebe'. Dieser Artikel umreisst die Forschungsmethodik, die als Teil einer Doktorarbeit in psychoanalytischer Psychotherapie verwendet wurde. Das Projekt erforschte den müterlichen Gemütszustand nach dem Verlust eines Babys oder kleinen Kindes und der Geburt des nächsten Babys. Als Teil dieser Forschung wurden drei Mütter einmal wöchentlich in Psychotherapie gesehen. Sie wurden ermuntert, ihr Neugeborenes zu den Stunden mitzubringen. Die Autorin beschreibt, wie das Interesse in diesem Forschungsbereich sich als Folge ihrer Arbeit als Kinderpsychotherapeutin mit 'Ersatzkindern' entwickelt hatte. (Cain und Cain 1964). Es wird argumentiert, dass die psychoanalytische Methode einzigartig ist und das psychoanalytische Setting als ein 'ideales Labor' (Fonagy und Moran,1993) für psychoanalytische psychotherapeutische Forschung angesehen werden kann. Es wird klinisches Material einer Fallstudie benutzt, um zu zeigen, wie das Material analysiert werden kann und es demonstriert die Forschungsmethodik, die im Projekt benutzt wird. Das Material erforscht die sich entwickelnde therapeutische Beziehung und legt den Schwerpunkt auf die Art und Weise, wie eine Mutter in der Forschungsgruppe den Verlust eines kleinen Kindes vor der Geburt ihres nächsten Babys erlebte.     

The relevance of the Oedipus myth to fostered and adopted children

The paper makes a conceptual distinction between aggressive phantasies and acts against the object and a destructive form of potentially objectless violence resulting from attacks on the mental capacity for linking terms of –K. In thinking about the issue of the internal states leading to mindless destructiveness, the author suggests that such behaviour may result from active envious attacks on the capacity for linking, but that, in some cases, early trauma may result in a more passive breakdown of the human disposition for creating emotional mental links. The discussion of the clinical history of a destructive latency child who was born at six months of gestational age connects the traumatic beginning of his life with his violent behaviour.     

On childhood stuttering and the theory of clinging

In the treatment of stuttering I use the same therapeutic approach as with any other neurotic condition. I do not attempt to deal directly with the symptom, but try to make use of the child’s repetitive play to bring the damaging experience to the surface and to understand the underlying connections. This may, in part, be interpreted to the child. Difficulties to do with the need for an object (‘clinging’) are central. These are generally resolved spontaneously in a therapeutic relationship which offers security. Other problems, which manifest themselves in the negative transference, can be interpreted. Where the stuttering is long established and convulsive, it is not enough to understand the underlying dynamics. The child needs also to have repeated experience of spontaneous relaxation, e.g. in the course of joyful manual activity which can become a behaviour pattern (internalized). An important part of the therapeutic task is to deal with and relieve the anxiety of the mother. When the child has been stuttering for a time, a vicious circle can develop where the child’s stuttering induces anxiety in the mother and mother’s anxiety increases the child’s tendency to stutter. Case histories are used to illustrate the theme.     

Dreaming and personality: Wake-dream continuity,thought suppression,and the Big Five Inventory

Studies have found relationships between dream content and personality traits, but there are still many traits that have been underexplored or have had questionable conclusions drawn about them. Experimental work has found a ‘rebound’ effect in dreams when thoughts are suppressed prior to sleep, but the effect of trait thought suppression on dream content has not yet been researched. In the present study participants (N = 106) reported their Most Recent Dream, answered questions about the content of the dream, and completed questionnaires measuring trait thought suppression and the ‘Big Five’ personality traits. Of these, 83 were suitably recent for analyses. A significant positive correlation was found between trait thought suppression and participants’ ratings of dreaming of waking-life emotions, and high suppressors reported dreaming more of their waking-life emotions than low suppressors did. The results may lend support to the compensation theory of dreams, and/or the ironic process theory of mental control.     

When our thoughts are not our own: Investigating agency misattributions using the Mind-to-Mind paradigm

At the core of the sense of agency for self-produced action is the sense that I, and not some other agent, am producing and directing those actions. While there is an ever-expanding body of empirical research investigating the sense of agency for bodily action, there has, to date, been little empirical investigation of the sense of agency for thought. The present study uses the novel Mind-to-Mind paradigm, in which the agentive source of a target thought is ambiguous, to measure misattributions of agency. Seventy-two percent of participants made at least one misattribution of agency during a 5-min trial. Misattributions were significantly more frequent when the target thought was an arousing negative thought as compared to a neutral control. The findings establish a novel protocol for measuring the sense of agency for thought, and suggest that both contextual factors and emotional experience play a role in its generation.     

Unnoticed intrusions: Dissociations of meta-consciousness in thought suppression

The current research investigates the interaction between thought suppression and individuals’ explicit awareness of their thoughts. Participants in three experiments attempted to suppress thoughts of a prior romantic relationship and their success at doing so was measured using a combination of self-catching and experience-sampling. In addition to thoughts that individuals spontaneously noticed, individuals were frequently caught engaging in thoughts of their previous partner at experience-sampling probes. Furthermore, probe-caught thoughts were: (i) associated with stronger decoupling of attention from the environment, (ii) more likely to occur under cognitive load, (iii) more frequent for individuals with a desire to reconcile, and (iv) associated with individual differences in the tendency to suppress thoughts. Together, these data suggest that individuals can lack meta-awareness that they have begun to think about a topic they are attempting to suppress, providing novel insight into the cognitive processes that are involved in attempting to control undesired mental states.     

Discriminative Facility in Perceptions of Control and Its Relation to Psychological Distress

This study explored the relationship between discriminative facility and distress. Individuals high in discriminative facility were characterized by high perceptions of primary control and high use of problem- relative to emotion-focused coping with controllable stressors and by low perceptions of primary control, high perceptions of compensatory control, and low use of problem- to emotion-focused coping with uncontrollable stressors. Participants provided information regarding their perceptions of control (control over outcome and control over one's feelings), how they coped, and their level of stressor-specific distress with three stressors, which varied in degree of controllability. They also provided information regarding their level of general distress. Problem-focused coping was found to be adaptive with the two most controllable stressors, but more so when perceptions of primary control were high. Control over one's feelings was helpful with all three stressors, but more so for individuals who had low perceptions of primary control. Finally, individuals high in discriminative facility were found to experience less distress than individuals low in discriminative facility.