The use of observation in the psychoanalytic treatment of a 12-year-old boy with Asperger's syndrome

The author describes some aspects of a once-weekly psychoanalytic psychotherapy of a 12-year-old boy diagnosed with Asperger's syndrome. The patient's emotional and cognitive development had been impaired since early life, possibly due to an internal deficit and to the likelihood of inadequate environmental holding. He was unaware of having difficulties but was underachieving academically, was socially isolated and often visibly unhappy in his life. The patient's denial, splitting, and projection of emotion and insight presented the therapist with the difficult task of how to reach him. In order to communicate with him emotionally, the therapist created a modified technique which reflected the patient's development from part-object to whole-object relationships. This development became apparent in the sessions and was interpreted in the transference relationship. An account of the patient's early years was pieced together from a detailed commentary of what was being observed and intuited by the therapist during the sessions, as well as by an understanding of the countertransference. By the end of two years' treatment, the patient's sensitivity and creativity, which had been buried beneath a self-sufficient, autistic-like encapsulation, finally began to emerge in his communications with his therapist.     

Constant vigilance: Heritage values and defensive pessimism in coping with severe acute respiratory syndrome in Singapore

The present study investigates the congruency of defensive pessimism in the Asian context and its role in coping with the severe acute respiratory syndrome (SARS) crisis in Singapore. Data collected from 174 Singaporeans supported the hypothesized relationships among Chinese values, defensive pessimism, SARS-related fears, compliance to preventive health-related behaviors and negative outcomes. Path analysis revealed that individuals' endorsement of Chinese value clusters − prudence, industry, and civic harmony − positively predicted their levels of defensive pessimism. The results also indicated that defensive pessimism had a direct positive effect on SARS-related fears and, SARS-related fears, in turn, were directly related to direct preventive health-related behaviors but not related to indirect preventive behaviors. In addition to the indirect effect of Chinese values on direct preventive health-related behaviors, Chinese values had a direct positive effect on both direct and indirect preventive health-related behaviors. Consistent with our contention that defensive pessimism has the potential for leading to particular negative outcomes, defensive pessimism was found to influence negative outcomes but this relationship was partially mediated by SARS-related fears.     

Biases in the perceived prevalence and motives of severe acute respiratory syndrome prevention behaviors among Chinese high school students in Hong Kong

In two studies conducted in Hong Kong during and immediately after the outbreak of severe acute respiratory syndrome (SARS), participants displayed several social cognitive biases when they estimated the prevalence of and inferred the motives underlying SARS preventive behaviors. First, participants who practiced preventive behaviors (practicers) consistently estimated that more people practiced such behaviors than did non-practicers (false consensus bias). Second, for some preventive behaviors, participants believed that their own behaviors were more motivated by prosocial concerns (relative to self-interest) than were other practicers (pluralistic ignorance). Finally, non-practicers underestimated the importance of prosocial concerns underlying some preventive behaviors (actor-observer bias). We discussed the relevance of these social cognitive biases to health education and to Hong Kong people's psychological reactions to SARS.     

Body representations and cognitive ontology: Drawing the boundaries of the body image

The distinction between body image and body schema has been incredibly influential in cognitive neuroscience. Recently, researchers have begun to speculate about the relationship between these representations (Gadsby, 2017, 2018; Pitron & de Vignemont, 2017; Pitron et al., 2018). Within this emerging literature, Pitron et al. (2018) proposed that the long-term body image and long-term body schema co-construct one another, through a process of reciprocal interaction. In proposing this model, they make two assumptions: that the long-term body image incorporates the spatial characteristics of tools, and that it is distorted in the case of Alice in wonderland syndrome. Here, I challenge these assumptions, with a closer examination of what the term “long-term body image” refers to. In doing so, I draw out some important taxonomic principles for research into body representation.     

Working Memory In Individuals With Fragile X Syndrome

The present research tests the hypothesis that fragile X syndrome (FXS) is associated with a deficit in working memory (WM) and the deficit is more pronounced the higher the control requirements of the task. To this purpose, 15 boys with FXS and 15 typically developing children, matched for mental age, assessed with Logical Operation Test, were tested with batteries of 4 verbal and 4 visuospatial WM tasks requiring different levels of control. Children with FXS showed a performance equal to controls, in WM tasks requiring low and medium-low control but significant impairment in correspondence with greater control requirements. Results show that boys with FXS present a WM deficit only when high control is required by the task, supporting the hypothesis that control can be a critical variable distinguishing WM functions and explaining intellectual differences. On the contrary the hypothesis that the FXS is associated with a visuospatial deficit was not supported.     

Where in the brain is the self?

Localizing the self in the brain has been the goal of consciousness research for centuries. Recently, there has been an increase in attention to the localization of the self. Here we present data from patients suffering from a loss of self in an attempt to understand the neural correlates of consciousness. Focusing on delusional misidentification syndrome (DMS), we find that frontal regions, as well as the right hemisphere appear to play a significant role in DMS and DMS related disorders. These data are placed in the context of neuroimaging findings.     

‘An Association for All’—Notions of the Meaning of Autistic Self‐Advocacy Politics within a Parent‐Dominated Autistic Movement

In this paper, we seek to explore the tensions between advocacy and self advocacy autistic movements in a Swedish context with a special focus on the meanings that enable the production of particular understandings of autism and the autistic subject. Drawing on articles written for the Swedish advocacy magazine Empowerment written for and by people with autism, the discourse analysis explores two competing discourses: a reformist and a radical. The reformist discourse underlines a goal of (political) representation expressed in Empowerment. It may be understood as an important part of producing a legitimate autistic political subject–positioned as a full member, with a full membership–within a parent‐dominated autistic advocacy movement. The reformist discourse can be viewed as a result of a negotiation, where full membership is conditioned on the parents' terms and granted on specific terms. These include working together (neuro‐inclusively), advocacy based on interest rather than identity/position as a specific target/member group, agreement upon a definition of autism as a disability (a deficit) a person has rather than an identity. In relation to this, an alternative legitimate autistic subject is produced through invoking the counter‐hegemonic radical discourse. Such a narrative produces the ‘Asperger’ or ‘Aspie’. Here, the ‘full membership’ refers to a sense of identification with sense of belonging to and being at home with other people with autism. It contains a certain amount of autistic solidarity within the group of adults with autism. Copyright © 2014 John Wiley & Sons, Ltd.     

Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects

Irritable bowel syndrome (IBS) is a highly prevalent disorder with a significant impact on quality of life. The presence of psychological symptoms in IBS patients such as catastrophic worry and behavioral avoidance suggests the possible efficacy of cognitive behavioral interventions. Exposure-based cognitive behavioral therapy (CBT) has proven to be a promising approach but has only been investigated in a few studies and mainly via the Internet. Therefore, the aims of this study were to extend and replicate previous findings and to evaluate whether an individual, face-to-face, exposure-based CBT leads to improvement in gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life in IBS patients. Thirteen patients with IBS according to Rome III criteria participated in a single-case experimental study using a five-week baseline and a subsequent twelve-session intervention phase focusing on psycho-education, mindfulness and in vivo exposure. Standardized measurement of gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life was conducted weekly during baseline as well as intervention phase and at six-month follow-up. Results showed that over 70% of patients improved significantly on gastrointestinal symptoms, pain catastrophizing, and quality of life. Effects on avoidance behavior were modest. These results strengthen and extend earlier findings and provide further support for the efficacy of exposure-based strategies for IBS.     

Le point de vue des adultes avec une trisomie 21 sur leurs relations fraternelles et aux pairs extrafamiliaux : impact sur leur vie intrapsychique et intersubjective

This exploratory study concerns the sibling's bonds, and the bonds with extrafamilial peers, in the perspective of people with intellectual disability. Four adults with intellectual disability, who are siblings, are included in this research, associating a half-directive interview and the Family Apperception Test administration. The results signed the increased presence of positives affects. Identification and differenciation process are identified, but implied a work about the normality by the people with a disability. Finally a co-occurrence between the configuration of sibling system and of social bond is observed. This bond has to be studied, but before, researchers have to work on methodological aspects for this research.     

Taxonomy of moderators that govern explicit memory in individuals with intellectual disability: Integrative research review

This integrative research review aims to discover moderators that influence explicit memory performance of individuals with intellectual disability (ID). We reviewed 47 explicit memory studies (since 1990) that were conducted in populations with ID. We suggest a taxonomy of moderators related to the participants, encoding and retrieval stages, where only an interrelation between the three dictates memory performance. We found that individuals with nonspecific ID can achieve the same level of recognition as individuals with typical development (TD) with the same chronological age when all encoding moderators are favorable. Recognition tests facilitate recollection more than free recall in all etiologies. The performance of individuals with ID was poorer than that of individuals with TD in all auditory memory tasks. Spatial location memory varied with task demands, practice, intention, age and intelligence. We conclude with suggestions for further research and educational implications.