Case Report: Object Relations Family Therapy as a Model for Genetic Counseling

Object relations family therapy (ORFT) is a psychoanalytically based approach for the treatment of couples and families which stresses the importance of past relationships. The therapist assumes a parentlike role and provides a holding environment in which clients can explore unconscious motivations. This paper will discuss the applicability of this method to genetic counseling. The case of a couple seen for recurrent trisomies will be presented and used as an example to discuss how ORFT might serve as a framework in a genetic counseling session.     

Psychoanalysis and Diplomacy: Part I. Individual and Large Group Identity

Starting with Sigmund Freud, psychoanalysts have written on a variety of topics relating to the diplomatic and political realms; but thus far their contributions primarily have been theoretical in nature, and have offered little of practical use to most diplomats and politicians. Various psychoanalytic theories have been applied, resulting in diverse conceptualizations: Wars are inevitable because of our inherent aggressive drives; a nation-state serves a maternal function for its members; certain large groups exhibit behaviors similar to those of adolescents. Yet these ideas do not significantly help us understand day-to-day events around the world, practical political issues, or international relations and diplomatic decisions.     

On the relation between object manipulation and stereotypic self-injurious behavior

Results from a number of studies have shown an inverse relationship between stereotypic behavior and object manipulation. The purposes of this study were to determine whether techniques similar to those used previously (prompting and reinforcement) would be effective in increasing object manipulation under both prompted and unprompted conditions, and to ascertain whether increases in object manipulation would result in decreases in stereotypic self-injurious behavior (SIB). Two individuals with developmental disabilities who engaged in SIB maintained by automatic reinforcement participated. Results showed that object manipulation increased from baseline levels when experimenters prompted participants to manipulate leisure items, but that object manipulation was not maintained under unprompted conditions, and rates of SIB stayed within baseline levels. We then attempted to increase object manipulation further by (a) reinforcing object manipulation, (b) blocking SIB while reinforcing manipulation, and (c) preventing SIB by applying protective equipment while reinforcing object manipulation. Reinforcing object manipulation alone did not affect levels of object manipulation. Blocking effectively reduced attempts to engage in SIB for 1 participant but produced no increase in object manipulation. When the 2nd participant was prevented from engaging in SIB through the use of protective equipment, rates of object manipulation increased dramatically but were not maintained when the equipment was removed. These results suggest that stimulation derived from object manipulation, even when supplemented with arbitrary reinforcement, may not compete with stimulation produced by stereotypic SIB; therefore, direct interventions to reduce SIB are required.     

The "Perceptual Wedge Hypothesis" as the basis for bilingual babies' phonetic processing advantage: new insights from fNIRS brain imaging

In a neuroimaging study focusing on young bilinguals, we explored the brains of bilingual and monolingual babies across two age groups (younger 4-6 months, older 10-12 months), using fNIRS in a new event-related design, as babies processed linguistic phonetic (Native English, Non-Native Hindi) and nonlinguistic Tone stimuli. We found that phonetic processing in bilingual and monolingual babies is accomplished with the same language-specific brain areas classically observed in adults, including the left superior temporal gyrus (associated with phonetic processing) and the left inferior frontal cortex (associated with the search and retrieval of information about meanings, and syntactic and phonological patterning), with intriguing developmental timing differences: left superior temporal gyrus activation was observed early and remained stably active over time, while left inferior frontal cortex showed greater increase in neural activation in older babies notably at the precise age when babies’ enter the universal first-word milestone, thus revealing a first-time focalbrain correlate that may mediate a universal behavioral milestone in early human language acquisition. A difference was observed in the older bilingual babies’ resilient neural and behavioral sensitivity to Non-Native phonetic contrasts at a time when monolingual babies can no longer make such discriminations. We advance the “Perceptual Wedge Hypothesis” as one possible explanation for how exposure to greater than one language may alter neural and language processing in ways that we suggest are advantageous to language users. The brains of bilinguals and multilinguals may provide the most powerful window into the full neural “extent and variability” that our human species’ language processing brain areas could potentially achieve.     

Brain activation during spatial updating and attentive tracking of moving targets

Keeping aware of the locations of objects while one is moving requires the updating of spatial representations. As long as the objects are visible, attentional tracking is sufficient, but knowing where objects out of view went in relation to one's own body involves an updating of spatial working memory. Here, multiple object tracking was employed to study spatial updating and its neural correlates. In a dynamic 3D-scene, targets moved among visually indistinguishable distractors. The targets and distractors either stayed visible during continuous viewpoint changes or they turned invisible. The parametric variation of tracking load revealed load-dependent activations of the intraparietal sulcus, the superior parietal lobule, and the lateral occipital cortex in response to the attentive tracking task. Viewpoint changes with invisible objects that demanded retention and updating produced load-dependent activation only in the precuneus in line with its presumed involvement in updating spatial working memory.     

Language and syntactic impairment following stroke in late bilingual aphasics

Purpose

Bilingual aphasia generally affects both languages. However, the age of acquisition of the second language (L2) seems to play a role in the anatomo-functional correlation of the syntactical/grammatical processes, thus potentially influencing the L2 syntactic impairment following a stroke. The present study aims to analyze the influence of late age of acquisition of the L2 on syntactic impairment in bilingual aphasic patients.

Methods

Twelve late bilingual participants (speaking French as L2 and either English, German, Italian or Spanish as L1) with stroke-induced aphasia participated in the study. The MAST or BAT aphasia batteries were used to evaluate overall aphasia score. An auditory syntactic judgement task was developed and used to test participants syntactic performance.

Results

The overall aphasia scores did not differ between L1 and L2. In a multiple case analysis, only one patient had lower scores in L2. However, four patients presented significantly lower performances in syntactic processing in the late L2 than in their native language (L1). In these four patients the infarct was localized, either exclusively or at least partially, in the pre-rolandic region.

Conclusion

This pilot study suggests that, in late bilingual aphasics, syntactic judgment abilities may be more severely impaired in L2, and that this syntactic deficit is most likely to occur following anterior lesions.     

现实场景典型空间位置关系客体的解码效应

通过探讨典型空间关系客体对中单个客体的视觉工作记忆,考察空间位置关系的解码特征和主动客体记忆优势。结果发现：（1）当客体以符合空间位置关系方式呈现时,记忆更准确;（2）符合空间位置关系条件下单个客体提取反应时更长,上方客体反应时更短,记忆更准确;（3）兼具空间位置关系与动作关系客体对中的主动客体记忆正确率更高。结果表明,现实场景客体空间分组中单个客体提取时存在解码现象和顺序效应,对现实中的上方与主动客体存在加工偏好。     

The impact of a rural or urban context in eating awareness and self‐regulation strategies in children and adolescents from eight European countries

Complex relationships exist between eating behaviour and personal and environmental factors. Rural and urban geographic contexts seem to play a role in eating behaviour, and therefore deserve a deeper study. A healthy eating behaviour and the conditions that promote it are a major issue in the promotion of adolescent health. The study aims to investigate the associations between the area of residence (urban vs. rural), self‐regulation strategies (TESQ‐E) and eating behaviours among children and adolescents. A total of 11,820 adolescents (50.6% girls) participated in the study, with a mean age of 13.30 years (SD= 2.13). Nine countries (The Netherlands, United Kingdom, Poland, Portugal, Denmark, Romania, Germany, Finland and Belgium) completed a questionnaire in the school context, asking about the use of self‐regulation strategies, eating behaviour awareness/care and sociodemographic questions such as age, gender and residential area. Both areas of residence (urban vs. rural) are associated with eating awareness/care in Romania and Portugal, controlling for age, gender and self‐regulation strategies. In some European countries at least, and most probably around the world, health promotion should focus on an ecological approach that includes the understanding of the effect of both environmental factors and personal skills on eating behaviour/awareness.     

ANALYTIC MIND USE AND INTERPSYCHIC COMMUNICATION: DRIVING FORCE IN ANALYTIC TECHNIQUE,PATHWAY TO UNCONSCIOUS MENTAL LIFE

Developed from established psychoanalytic knowledge among different psychoanalytic cultures concerning unconscious interpsychic communication, analysts' use of their receptive mental experience—their analytic mind use, including the somatic, unconscious, and less accessible derivatives—represents a significant investigative road to patients' unconscious mental life, particularly with poorly symbolized mental states. The author expands upon this tradition, exploring what happens when patients unconsciously experience and identify with the analyst's psychic functioning. The technical implications of the analyst's “instrument” are described, including the analyst's ego regression, creation of inner space, taking mind as object, bearing uncertainty and intense affect, and self‐analysis. Brief case vignettes illustrate the structure and obstacles to this work.     

Object representations are biased toward each other through statistical learning

The visual system is remarkably efficient at extracting regularities from the environment through statistical learning. While such extraction has extensive consequences on cognition, it is unclear how statistical learning shapes the representations of the individual objects that comprise the regularities. Here we examine how statistical learning alters object representations. In three experiments, participants were exposed to either random arrays containing objects in a random order, or structured arrays containing object pairs where two objects appeared next to each other in fixed spatial or temporal configurations. After exposure, one object in each pair was briefly presented and participants judged the location or the orientation of the object without seeing the other object in the pair. We found that when an object reliably appeared next to another object in space, it was judged as being closer to the other object in space even though the other object was never presented (Experiments 1 and 2). Likewise, when an object reliably preceded another object in time, its orientation was biased toward the orientation of the other object even though the other object was never presented (Experiment 3). These results demonstrated that statistical learning fundamentally shapes how individual objects are represented in visual memory, by biasing the representation of one object toward its co-occurring partner. Importantly, participants in all experiments were not explicitly aware of the regularities. Thus, the bias in object representations was implicit. The current study reveals a novel impact of statistical learning on object representation: spatially co-occurring objects are represented as being closer in space, and temporally co-occurring objects are represented as having more similar features.