BOOKS RECEIVED

Abstract

Since the concept of imaginative elaboration of body functioning, which is essential to Winnicott's idea of psyche-soma, has rarely been investigated up to now, this article sets out to do this and tries to pursue the meaning and articulation of that concept in the corpus of Winnicott's theory. In this way, it contributes to bringing the body to the core of psychoanalytical theory.     

The Relationship of Suicidal Ideation to Objective and Subjective Executive Functioning

Prior research on executive ability and suicidal ideation (SI) has frequently failed to account for either symptom or performance validity. Similarly, studies have not adequately examined both objective performance on executive tests and subjective report of executive deficits in relationship to SI. The purpose of this study was to address these gaps in research by accounting for performance validity, symptom validity, and considering self-reported executive complaints with objective performance. We hypothesized that (a) increases in self-reported SI on the Personality Assessment Inventory (PAI; Morey, 1991 Morey, L. C. (1991). Personality Assessment Inventory: Professional manual. Tampa, FL: Psychological Assessment Resources. [Google Scholar]) Suicidal Ideation subscale would be related to poorer performance on objective and subjective tests of executive function and (b) level of self-reported depressive symptoms would moderate the relationship between SI and measures of executive function, such that individuals with higher levels of both depressive symptoms and executive dysfunction would be more likely to experience higher levels of SI. No measure of executive function was related to SI when accounting for demographic variables and depressive symptoms. Wisconsin Card Sort Test categories completed was the only measure of executive function to interact significantly with depressive symptoms to predict SI (β = .43). Of particular note, self-reported executive dysfunction was highly correlated with Beck Depression Inventory?II ( Beck, Steer, &; Brown, 1996 Beck, A. T., Steer, R. A., &; Brown, G. K. (1996). Beck Depression Inventory (2nd ed.). San Antonio, TX: The Psychological Corporation. [Google Scholar]) scores (r = .78). Clinical implications and future directions for research are discussed.     

American Military Veteran Entrepreneurs: A Comprehensive Profile of Demographic,Service History,and Psychosocial Characteristics

American military veterans are nearly twice as likely to be self-employed compared with nonveterans and are majority owners in 9% of all businesses nationwide. Despite their contribution to the broader economy and the potential for training programs to cultivate and foster successful self-employment and veteran-lead entrepreneurial ventures, research on veteran entrepreneurs remains limited. To gain a better understanding of the potential strengths and vulnerabilities of veteran entrepreneurs, the current study utilized data from a large, nationally representative sample to profile self-employed veterans (n = 230) and compare them with veterans who work as employees (n = 1,055) with respect to demographic, military service history, and psychosocial characteristics. Results indicated that self-employed veterans were older and more educated and more likely to utilize U.S. Department of Veteran’s Affairs (VA) health care. Self-employed veterans were more likely to serve in Vietnam and to serve in the military for fewer years. No differences were noted in perceived military experience, level of combat exposure, or military branch served as a function of self-employment. Although reporting more lifetime traumas, self-employed veterans did not experience higher rates of current or lifetime psychopathology or lower perceived quality of life. Potential protective resilience-promoting factors may be associated with the higher levels of openness, extraversion, optimism, achievement-orientation (purpose in life), and greater need for autonomy and professional development observed among self-employed veterans. Moreover, self-employed veterans demonstrated higher levels of gratitude, community integration, and altruistic service to others. Findings have potential to inform human resources management strategies and vocational training and reintegration initiatives for veterans.     

Direct touches to clear barriers: Developmental sensitivity of a new measure of the production of ineffective responses in infancy

Current interpretation of the object retrieval task (Diamond, 1990 Diamond, A. 1990. The Development and the Neural Bases of Higher Cortical Functions, New York, NY: New York Academy of Sciences.  [Google Scholar]) as an infant assessment of response inhibition requires evidence that younger infants make more ineffective attempts to retrieve toys through clear barriers. On two 30-second trials, infants (9 or 11 months of age) saw an inaccessible toy in the front or back of a clear box. The location of the infants touches corresponded with the toy's location and, on the second trial, the younger infants touched the box more. In previous research nonhuman primates with orbital-frontal, but not dorsa-lateral, lesions also made ineffective barrier touches. The current developmental decreases in barrier touches may selectively tap developmental increases in inhibitory control supported by the developing orbital-frontal cortex.     

Fatigue,emotional functioning,and executive dysfunction in pediatric multiple sclerosis

Objective: Fatigue, depression, anxiety, and executive dysfunction are associated with multiple sclerosis (MS) in adults. Existing research suggests similar problems in pediatric MS, but relationships between these variables have not been investigated. This study investigates the associations between executive functioning and fatigue, emotional functioning, age of onset, and disease duration in pediatric MS.

Methods: Twenty-six MS or Clinically Isolated Syndrome (CIS) patients, ages 7 to 18, were evaluated through a multidisciplinary demyelinating diseases clinic. Participants completed neuropsychological screening including Verbal Fluency, Digit Span, and Trail-Making Test. Parents completed rating forms of behavioral, emotional, and executive functioning. Patients and parents completed questionnaires related to the patient’s quality of life and fatigue. Pearson’s correlation coefficients were calculated to investigate relationships between fatigue, emotional functioning, and executive functioning, as well as to examine correlations between parent and child reports of fatigue.

Results: Rates of parent-reported anxiety, depression, fatigue, and executive dysfunction varied widely. Means were below average on the Trail-Making Test and average on Verbal Fluency and Digit Span, though scores varied widely. Various fatigue and emotional functioning indices—but not age of onset or disease duration—significantly correlated with various performance-based measures of executive functioning.

Conclusion: Results indicate pediatric MS is associated with some degree of fatigue, emotional difficulties, and executive dysfunction, the latter of which is associated with the two former. Notably, age of onset and disease duration did not significantly correlate with executive functioning. Results advance understanding of psychological and clinical variables related to neurocognitive outcomes in pediatric MS.     

Smaller splenium in children with nonverbal learning disability compared to controls,high-functioning autism and ADHD

The current study investigated morphological differences in the corpus callosum in children ages 8 to 18 years old with nonverbal learning disability (NLD; n = 19), high-functioning autism (HFA; n = 23), predominantly inattentive ADHD (ADHD:PI; n = 23), and combined type ADHD (ADHD:C; n = 25), as well as those demonstrating typical development (n = 57). Midsagittal area of the corpus callosum and five midsagittal anterior-to-posterior corpus callosum segments were examined using magnetic resonance imaging. Controlling for midsagittal brain area and age, no group differences were found for total corpus callosum area. This finding indicates that higher functioning children on the autistic spectrum do not have smaller corpus callosi as has been found in previous research with heterogeneous samples. Following segmentation of the corpus callosum, the NLD group was observed to have significantly smaller splenia compared to all other groups. Smaller splenia in the NLD group was associated with lower WASI PIQ scores but not WASI VIQ scores. Children with HFA were observed to have larger midbody areas than children with NLD and neurotypically developing children. Children with HFA and NLD demonstrated behavioral symptoms of inattention and hyperactivity similar to the ADHD groups indicating that corpus callosum differences seen in the NLD and HFA groups are not related to these behaviors.     

Improving executive functioning in children with fetal alcohol spectrum disorders

An extensive body of literature has documented executive function (EF) impairments in children with fetal alcohol spectrum disorders (FASD); however, few studies have aimed specifically at improving EF. One treatment program that shows promise for children with FASD is the Alert Program for Self-Regulation®, which is a 12-week treatment specifically designed to target self-regulation, a component of EF. The present study sought to examine if Alert would produce improvements in self-regulation that would generalize to other aspects of EF, behavior, and social skills in children with FASD. Twenty-five children aged 8–12 years diagnosed with an FASD were assigned in alternating sequence to either an immediate treatment (TXT) or a delayed treatment control (DTC) group. Both groups received a comprehensive evaluation of EF at baseline and upon completing therapy (TXT), or after a 12- to 14-week interval from baseline (DTC). Parents also completed questionnaires assessing EF and behavior at both time points. For the TXT group only, parent questionnaires were readministered at 6-month follow-up. At the 12-week follow-up, the TXT group displayed significant improvements in inhibitory control and social cognition. Parents of children in the TXT group reported improved behavioral and emotional regulation, as well as reduced externalizing behavior problems. These behavioral improvements along with further improved parent-rated inhibitory control was maintained at the 6-month follow-up. The EF disabilities in children with FASD can be remediated through a targeted treatment approach aimed at facilitating self-regulation skills.     

哈佛医学院医学人文课程体系设置探析

哈佛医学院医学人文课程体系较为完整系统.以描述哈佛医学院必修课课程设置为主体,从基础医学教育阶段的职业导论、病人—医生Ⅰ与病人—医生Ⅱ、社会与人口科学相关课程以及医学探索四大类课程和临床见习与实习阶段的病人—医生Ⅲ、临床管理相关课程以及凯普斯课程三大类课程出发,分别对各门课程的主要内容、课时安排、教学方法、评价方式等进行阐述.并以介绍十六大类五十余门选修课的课程设置为补充,剖析哈佛医学院医学人文课程体系发展现状.提出改革必修课程、完善选修课程、促进医学人文教育与专业教育整合的几点建议.     

Who Is Afraid of Death? Religiousness,Spirituality, and Death Anxiety in Late Adulthood

SUMMARY

Data from a sample of predominantly white, Christian men and women born in Northern California in the 1920s (N = 155) were used to test the hypothesis that traditional, church-centered religiousness and de-institutionalized spiritual seeking exemplify distinct, but equally adaptive, ways of approaching fear of death in old age. Although both religiousness and spirituality were related to positive psychosocial functioning (an integrated identity and involvement in everyday activities), only religiousness served as a buffer against the fear of death. This effect was consistent with the greater emphasis on conventionality and acceptance of social norms that characterized individuals high in religiousness. The absence of a relation between spirituality and fear of death reflected the spiritual individual's emphasis on personal searching, creativity, and the positive use of reminiscence. The implications of the findings for the management of death anxiety in old age are discussed.     

Studying Early Adolescents' Academic Motivation,Social-Emotional Functioning,and Engagement in Learning: Variable- and Person-Centered Approaches

This study used variable- and person-centered data analytic techniques to examine how early adolescents' academic motivation and social-emotional functioning were associated with their self-reported cognitive and behavioral engagement in the middle school classroom. Regression results showed that both motivational and mental health constructs contributed to the prediction of individual differences in classroom engagement. Person-centered analyses revealed between group variation in classroom engagement as a function of differing patterns of motivation and mental health among different subgroups of adolescents. Convergent and complementary information on these subgroups was provided by using two different grouping approaches. Findings are discussed in terms of broad patterns of promise or problems during early adolescence.