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.     

Choosing what to choose from: Preference for inclusion over exclusion when constructing consideration sets from large choice sets

Decision making is a two‐stage process, consisting of, first, consideration set construction and then final choice. Decision makers can form a consideration set from a choice set using one of two strategies: including the options they wish to further consider or excluding those they do not wish to further consider. The authors propose that decision makers have a relative preference for an inclusion (vs. exclusion) strategy when choosing from large choice sets and that this preference is driven primarily by a lay belief that inclusion requires less effort than exclusion, particularly in large choice sets. Study 1 demonstrates that decision makers prefer using an inclusion (vs. exclusion) strategy when faced with large choice sets. Study 2 replicates the effect of choice set size on preference for consideration set construction strategy and demonstrates that the belief that exclusion is more effortful mediates the relative preference for inclusion in large choice sets. Studies 3 and 4 further support the importance of perceived effort, demonstrating a greater preference for inclusion in large choice sets when decision makers are primed to think about effort (vs. accuracy; Study 3) and when the choice set is perceived as requiring more effort because of more information being presented about each alternative (vs. more alternatives in the choice set; Study 4). Finally, Study 5 manipulates consideration set construction strategy, showing that using inclusion (vs. exclusion) in large choice sets leads to smaller consideration sets, greater confidence in the decision process, and a higher quality consideration set.     

Intersections of personal vs. collective trauma during the COVID-19 pandemic: the hijacking of the human imagination

This paper explores how the deadly shadow of COVID-19 passing over the Earth constitutes a collective trauma that frequently opens up or ‘triggers’ un-remembered personal trauma, and it provides clinical examples of these intersections. The paper further explores how the human imagination, which we normally utilize to make meaning out of traumatic experience, can be hijacked by fear – leading to avoidance of suffering and to illusory formulations and alternative realities such as conspiracy theories. Alternatively, the imagination can be employed in more realistic and creative ways – leading through conscious suffering to healing and wholeness. Which path the imagination takes is shown to depend on the capacity of individuals to feel the full reality of the human condition in general and the exquisite vulnerability of our existence as fragile human beings at this moment in history. Ernest Becker’s analysis of our ‘denial of death’ and his urgency to embrace our common human vulnerability is explored in relation to Jung’s early tendency to deny the body. The author proposes that the more creative uses of the imagination, connected to a more humble and realistic apprehension of our common destiny, may be seen in the ‘Black Lives Matter’ movement that swept the world in the aftermath of the COVID-19 outbreak.     

Be a Mom,a Web-Based Intervention to Prevent Postpartum Depression: Results From a Pilot Randomized Controlled Trial

Be a Mom is a self-guided web-based intervention, grounded in cognitive behavioral therapy, delivered to postpartum women to prevent persistent postpartum depression [PPD] symptoms. We aimed to evaluate Be a Mom in terms of its preliminary efficacy, feasibility, and acceptability. A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention (Be a Mom) or to the waiting-list control group. Participants in both groups completed baseline (T1) and postintervention (T2) assessments. The 194 women presenting risk factors/early-onset PPD symptoms were allocated to the intervention (n = 98) or to the control (n = 96) group. A significant Time × Group interaction effect was found for both depressive and anxiety symptoms, with women in the intervention group presenting a larger decrease in symptoms from T1 to T2 (p < .05). Less than half of the women (41.8%) completed Be a Mom. Most women (71.4%) would use Be a Mom again if needed. Results provide preliminary evidence of the Be a Mom’s efficacy, acceptability and feasibility, although further research is needed to establish Be a Mom as a selective/indicative preventive intervention for persistent PPD.     

Factor analysis of the heterosexist harassment,rejection, and discrimination scale in lesbian,gay, bisexual,transgender, and queer people of colour

The factor structure of the Heterosexist Harassment, Rejection, and Discrimination Scale (HHRDS) was examined in lesbian, gay, bisexual, transgender, and queer (LGBTQ) people of colour. Two hundred participants completed a survey with the HHRDS and several mental health scales. A confirmatory factor analysis suggested the original HHRDS structure fit the data poorly. Exploratory factor analyses found a different 2-factor structure, consisting of harassment/rejection and family discrimination. Convergent validity analyses demonstrated that family discrimination had the largest association with depression and anxiety, indicating that family discrimination may be particularly salient among LGBTQ people of colour. This study supports the use of the HHRDS in racially/ethnically diverse samples, but with a slightly different factor structure. Examining discriminatory experiences from family members is an important direction for future research in LGBTQ people of colour.     

A Meta-Analysis of Program Characteristics for Youth with Disruptive Behavior Problems: The Moderating Role of Program Format and Youth Gender

There is high variability in efficacy for interventions for youth with disruptive behavior problems (DBP). Despite evidence of the unique correlates and critical consequences of girls’ DBP, there is a dearth of research examining treatment efficacy for girls. This meta-analysis of 167 unique effect sizes from 29 studies (28,483 youth, 50% female; median age: 14) suggests that existing treatments have a medium positive effect on DBP (g = .33). For both boys and girls, the most effective interventions included (a) multimodal or group format, (b) cognitive skills or family systems interventions, and (c) length-intensive programs for (d) younger children. Boys demonstrated significantly greater treatment gains from group format interventions compared to girls, which is particularly important given that the group program format was the most prevalent format for boys and girls, with 14 studies involving 10,433 youth encompassing this category. This is the first meta-analysis to examine the effect of program characteristics in a sample of programs selected to be specifically inclusive of girls. Given that girls are underrepresented in intervention research on DBP, findings are discussed in terms of gender-responsive considerations and elucidating how key aspects of program structure can support more effective intervention outcomes for youth.     

Racialized Sexual Discrimination (RSD) in the Age of Online Sexual Networking: Are Young Black Gay/Bisexual Men (YBGBM) at Elevated Risk for Adverse Psychological Health?

Young Black gay/bisexual men (YBGBM) are a highly marginalized population across multiple health outcomes. Most research on YBGBM health has focused on HIV/sexual health, but there is a demonstrable need for research examining racism and psychosocial functioning among this population. Racialized Sexual Discrimination (RSD), also known as sexual racism, is an important but under-investigated phenomenon that may have implications for the psychological health and well-being of YBGBM. This paper provides an overview of empirical research on RSD as experienced by gay/bisexual men of color in online partner-seeking venues. First, the researchers discuss how racialized experiences are a documented online phenomenon, with a variety of manifestations, and identify the potential effects that this phenomenon may have on the psychosocial health of YBGBM, and gay/bisexual men of color as a whole. Second, the researchers synthesize the RSD literature with a broader literature examining psychological well-being across race and sexual orientation. Third, the researchers present a theoretically grounded conceptual model detailing the pathways between RSD and psychological well-being using a stress and coping framework. The paper concludes with recommendations for future research on this topic, including scale development and hypothesis testing.     

The intersectionality of race/ethnicity and socioeconomic status on social and emotional skills

The intersectionality of race/ethnicity and socioeconomic status (SES) in predicting social and emotional (SE) skills was examined for 81,950 6th–8th graders. At low levels of SES, White students tended to have the lower SE scores. However, as SES increased, they tended to have higher scores relative to minority groups. Across SES levels, Asian students showed higher Academic Discipline and Self-Regulation scores. The SES and SE skill relationship was less pronounced for underserved minority groups. This may be among the first reports where a measure of SE skills has documented different relationships with SES as a function of race/ethnicity. Possible explanations for these findings, as well as implications for designing culturally responsive programs that focus on SE skills, are discussed.