Fathers' views of the effects on their families of children with Down syndrome

This study examined fathers' views about the effects of children with Down syndrome on themselves and their families. Taped interviews were obtained from 90 fathers of children aged from 7 to 14 years. Qualitative analysis of the interview data revealed 28 categories of comments made by fathers. The most frequent comment, made by 46% of fathers, was about the cheerful personality of their child with Down syndrome. About 42% of fathers talked about the initial trauma they experienced following the diagnosis; 43% of them bemoaned the restrictions imposed on the family, and 30% commented that the child had minimal effects on family life. The greatest concern expressed by fathers was the long-term provision for their children. More fathers commented on the positive effects on their marriage than on negative effects. The results of this study provide a somewhat different view of fathers' experiences to that found in the existing literature.     

Evidence for a Disturbance of the Body Schema in Neglect

Subjects with left neglect often fail to use and, in some instances, recognize the left side of the body. We performed a series of investigations to determine if this deficit is, at least in part, attributable to an impairment in the “body schema,” an internal three-dimensional, dynamic representation of the spatial and biomechanical properties of one's body. First, subjects were shown a series of pictures of a single hand and asked to determine if the stimulus was a right or left hand. Subjects with neglect but not other subjects with brain lesions identified pictures of left (contralesional) hands significantly less reliably than pictures of right hands. On the basis of evidence demonstrating that the identification of pictured hands involves the matching of the stimuli to an on-line mental representation of one's body, these data suggest that neglect may be associated with a disruption of, or failure to attend to, the body schema. Data from subsequent investigations contrasting patients with left neglect and Gerstmann's syndrome argue for a distinction between a body schema and a “body image,” or conceptual representation of the body which articulates with language.     

Luria's Neuropsychological Evaluation in the Nordic Countries

The publication of Luria's Neuropsychological Investigation (LNI) by Christensen in 1975 introduced Luria's evaluation procedures to worldwide neuropsychology. The LNI demonstrated the benefit of a thorough qualitative analysis of an individual patient's functioning as well as the usefulness of a comprehensive theory of brain functioning. This article reviews the experiences that led to the development of the LNI, discusses its use and extension in Scandinavian countries, and presents clinical and research applications of the LNI in diagnosis and rehabilitation. A series of case examples provides justification and validity for the continued use of the LNI and related procedures. Discussion of the advantages and disadvantages of the LNI and consideration of possible modifications of the procedures and interpretative methods provide the rationale for continued development of Luria's approach.     

Duty to Re-Contact: A Study of Families at Risk for Fragile X

DNA testing for Fragile X syndrome is now routinely available through a large number of diagnostic laboratories. We have surveyed individuals from British Columbia Fragile X families identified prior to the availability of DNA testing for FMR1 to determine if they are subsequently receiving information about DNA testing. Of the 78 individuals first seen before the cloning of the FMR1 gene, 39 (50%) had not been seen in the clinic to discuss DNA testing. We initiated a contact program with these 39 patients to determine their interest in DNA testing. Contact was made with 28 individuals, 20 of whom stated interest in testing either for themselves or for a relative. Patient opinions about DNA testing were assessed through questionnaires. In those individuals who stated an interest in DNA testing, the most common reason for wishing testing was to provide information to children or grandchildren. The most common disadvantages of testing indicated by this group were that they had finished their families and that they felt the test would not have a direct impact. The most common reasons individuals were not interested in DNA testing were that there were no family members appropriate to test and that the respondent had completed his or her family. DNA testing has been performed for 13 of the 28 (46%) contacted individuals and/or at least one relative. In view of the high level of interest for testing in families who had not been seen since the cloning of the FMR1 gene, we feel that FMR1 screening programs should include actively contacting previously seen individuals.     

Coniunctio—in bodily and psychic modes: dissociation, devitalization and integration in a case of chronic fatigue syndrome

Three years of analytical psychotherapy with a professional woman in mid-life, suffering from chronic fatigue syndrome (CFS), is described. Gradual recovery merged into mid-life changes; marriage, along with a new balance of maternal and paternal imagos, enabled her to trust enough to become pregnant— coniunctio in the most primal bodily and psychic modes.
Her life-long, schizoid type pattern, 'the pendulum of closeness and isolation', with its extreme of psycho-physical collapse and devitalization, was replayed in therapy. The analyst's symbolic attitude is emphasized, containing the patient's initial affective explosion and validating the physicality of her condition. Mirroring and steady rhythmic attunement became a new, pre-verbal, source of trust—vitalization; differentiation and separation replaced defensive splitting and dissociation. Then the overwhelmingly powerful bodily/maternal could be counterbalanced by the masculine, and a transitional space emerged for symbolic work.
Both the regressive and the dynamic aspects of CFS are located in the earliest undifferentiated, archetypal, bodily/psychic modes, when the frustration of primary needs evokes the defences of the self. It is argued that our psychodynamic understanding can contribute to the stalemate in seeing chronic fatigue syndrome as either an organic illness or depression, and that a new linking of the somatic and psychic calls for a new professional collaboration.     

心理咨询热线在突发性公共卫生事件中的应用分析

2003年SARS在中国一些地区的流行给社会公众在心理上带来了一定程度的影响,在SARS流行期间期间及时开通了面向公众的心理咨询热线,成为了广大公众寻求心理支持的有效途径,为缓解社会压力、促进社会正常秩序恢复起到了积极作用。该文结合中国科学院心理研究所“非典心理咨询热线”的统计数据,进一步探讨了心理咨询热线在应对突发性公共卫生事件中的作用和工作特点。     

关于证候定义的三点商榷

对证候定义研究中存在的问题进行剖析,提出三点商榷意见.首先,"证"是病理学概念,不是诊断学概念.其次,"证"发生在病人身上,并非由诊断"概括"出来.第三,应当把内在的病理改变与外在疾病征象区别开来.     

'Actual neurosis' and psychosomatic medicine: THE VICISSITUDES OFAN ENIGMATIC CONCEPT

Out of the concept of neurasthenia, the main non-psychotic diagnosis of nineteenth-century psychiatry besides hysteria, and on the basis of psychophysiological problems of his own, self-diagnosed as neurasthenia, Freud developed the notion of 'actual neurosis', a 'contentless psychic state' manifested by various somatic symptoms and a depressive mood, which he attributed to a chemical factor associated with aberrant sexual practices and in particular masturbation. Rejected by post-Freudian analysts as such along with the diagnosis of neurasthenia, the concept of 'actual neurosis' has survived under various theoretical schemes that seek to explain psychosomatic illness and somatisation, in general, with its concomitant poverty of affects and dearth of fantasy life. In more recent years, the concept of 'actual neurosis' has resurfaced under the label of chronic fatigue syndrome, a medical entity thought to be an immunological deficiency, while in psychoanalysis Freud's idea of a contentless mental state has been replaced by that of unconscious fantasy and symbolisation at a pre-genital or pre-verbal level.     

A comparison of general and specific instructions to promote task engagement and completion by a young man with Asperger syndrome

Previous research has suggested that the topography of instructions (general vs. specific) may influence the likelihood that young children comply with instructions. The purpose of the current study was to compare the rates of task completion of a young man diagnosed with Asperger syndrome when provided with general and specific instructions pertaining to the task. The results showed that specific instructions occasioned higher levels of task completion, even when no differential reinforcement contingencies were in place.     

An analysis of vocal stereotypy and therapist fading

A functional analysis for a boy with Down syndrome and autism suggested that vocal stereotypy was maintained by automatic reinforcement. The analysis also showed that instructions and noncontingent attention suppressed vocal stereotypy. A treatment package consisting of noncontingent attention, contingent demands, and response cost effectively reduced vocal stereotypy. The treatment package remained effective even when noncontingent attention was removed, making the procedure easier to implement. Also, the presence of the therapist in the room with the participant was faded systematically. After completion of fading, vocal stereotypy remained low during conditions similar to the no-consequence phase of the functional analysis.