Intrusive images in PTSD and in traumatised and non-traumatised depressed patients: a cross-sectional clinical study

Although intrusive images are a hallmark of post-traumatic stress disorder (PTSD) and also occur in depression, little is known about the differences and similarities of such images in these conditions. Our study focuses on the qualities and triggers of intrusive images and responses to them in three groups--patients with PTSD, and depressed patients with and without trauma (n=65)-to highlight the diagnostic specificity of intrusive images for PTSD and depression. We distinguished intrusive images from verbal intrusive cognitions such as rumination and intrusive (brief) lexical thoughts. Consistent with the literature, the intrusive images of PTSD patients had a more "here-and-now quality" and were perceived more visually compared to those of both depressed groups. The groups showed a good deal of similarity concerning other image qualities. Most importantly, the intrusive images in PTSD and depressed patients with and without trauma were perceived as similarly distressing. Rumination and intrusive (brief) lexical thoughts were two of the five most named triggers of intrusive images. Limitations, such as the lack of a control group, and the clinical implications of these results are discussed, demonstrating the need to help non-PTSD patients with and without trauma to deal with intrusive images.     

Between memory and destiny: Repetition1

This essay focuses mainly on the topic of repetition (agieren)—on its metapsychological, clinical, and technical conceptions. It contains a core problem, that is, the question of the represented, the nonrepresented, and the unrepresentable in the psyche. This problem, in turn, brings to light the dialectical relation between drive and object and its specific articulation with the traumatic. The author attributes special significance to its clinical expression as ‘destiny’. He points out a shift in the theory of the cure from recollection and the unveiling of unconscious desire, to the possibility of understanding ‘pure’ repetition, which would constitute the very essence of the drive. The author highlights three types of repetition, namely, ‘representative’ (oedipal) repetition, the repetition of the ‘nonrepresented’ (narcissistic), which may gain representation, and that of the ‘unrepresentable’ (sensory impressions, ‘lived experiences from primal times,’‘prelinguistic signifiers,’‘ungovernable mnemic traces’). The concept‐the metaphor‐drive embryo brings the author close to the question of the archaic in psychoanalysis, where the repetition in the act would express itself. ‘Another unconscious’ would zealously conceal the entombed (verschüttet) that we are not yet able to describe‐the ‘innermost’ rather than the ‘buried’ (untergegangen) or the ‘annihilated’ (zugrunde gegangen)‐through a mechanism whose way of expression is repetition in the act. With ‘Constructions in analysis’ as its starting point, this paper suggests a different technical implementation from that of the Freudian construction; its main material is what emerges in the present of the transference as the repetition of ‘something’ lacking as history. The memory of the analytic process offers a historical diachrony whereby a temporality freed from repetition and utterly unique might unfold in the analysis. This diachrony would no longer be the historical reconstruction of material truth, but the construction of something new. The author briefly introduces some aspects of his conception of the psyche and of therapeutic work in terms of what he has designated as psychic zones. These zones are associated with various modes of becoming unconscious, and they coexist with different degrees of prevalence according to the psychopathology. Yet each of them will emerge with unique features in different moments of every analysis, determining both the analyst's positions and the very conditions of the analytic field. The zone of the death drive and of repetition is at the center of this essay. ‘Pure’ repetition expresses a time halted by the constant reiteration of an atemporal present. In this case, the ‘royal road’ for the expression of ‘that’ unconscious will be the act. The analyst's presence and his own drive wager will be pivotal to provide a last attempt at binding that will allow the creation of the lost ‘psychic fabric’ and the construction, in a conjectural way, of some sort of ‘history’ that may unravel the entombed (verschüttet) elements that, in these patients' case, come to the surface in the act. The analysand's ‘pure’ repetition touches, resonates with something of the new unconscious of the analyst. All of this leads the author to underline once again the value of the analyst's self‐analysis and reanalysis in searching for connections and especially in differentiating between what belongs to the analyst and what belongs to the analysand. A certain degree of unbinding ensures the preservation of something ungraspable that protects one from the other's appropriation.     

How to turn a hawk into a dove and vice versa: Interactions between emotions and goals in a give-some dilemma game

The present study investigated emotional influences on behavior in a one-shot, simultaneous, give-some dilemma game. In accordance with functional perspectives on the role of discrete emotions, we found fear to reduce, and guilt to increase levels of cooperation. Moreover, we showed individual differences in the effect of induced emotional states. Specifically, results indicated that inducing fear reduced cooperation only for individuals with a pro-social value orientation, and that guilt induction increased cooperation only for individuals with a pro-self value orientation. We also established that both social value orientations could be adequately described in terms of differences in chronically accessible goals (as assessed by value-importance ratings). These results, therefore, seem to support our hypothesis that individual differences in the behavioral consequences of induced emotional states are related to variation in chronic accessibility of general goals associated with a particular emotional state.     

Exploring Power and Gender Issues Emergent in an Institutional Workshop on Preventing Clergy Sexual Misconduct

The Eastern Synod of the Evangelical Lutheran Church in Canada (ELCIC) sponsors the Crossing the Boundaries (CTB) workshop, a program that focuses on the maintenance of appropriate boundaries in clergy-congregant relationships as a means to prevent clergy sexual misconduct. Drawing primarily on an analysis of the synod-sanctioned workshop materials, an observation of the workshop, and interviews with 10 pastors who have attended the workshop, this paper explores differing conceptions of power and gender held by the synod officials and workshop participants.     

肝豆状核变性（Wilson病）治疗策略的变革及思考

评析肝豆状核变性(WD)当前的治疗方法,主要有低铜饮食,铜的螯合剂青霉胺及曲恩汀,锌制剂和四硫钼酸胺,肝移植。介绍WD治疗策略的变革:不再提倡驱铜疗法以去除堆积的铜,而是使血液中的游离铜离子浓度常态化以逆转铜中毒,并结合2007年《柳叶刀》WD治疗专家共识进行思考。最后,展望未来对WD可能的根治疗法,即基因治疗、肝细胞移植及现在可施行的肝移植。     

巴西医疗保障体系

从巴西医疗保障体系的建立、资金筹集和使用等方面介绍巴西医疗保障体系,重点关注巴西全民统一医疗制度。鉴于巴西与我国在卫生系统绩效和医疗保障制度改革中所面临的相似挑战,试图通过对巴西医疗保障体系比较详细地介绍及与我国进行简单的对比,总结成功经验、吸取教训为我国建立全民覆盖的医疗保障体系提供借鉴和参考。     

ART伦理督导的实践与评价

在生殖中心(医院)中,将伦理原则的学习与技术规范的掌握相结合,将伦理学评价与员工的奖惩机制相结合,将伦理学研究与管理骨干的培养相结合,将伦理原则的贯彻与工作总结相结合;发挥医学伦理委员会监督的权威作用,重视群众监督手段的督促作用,借助国家行政督导机构和行业法规的震慑作用,是ART增强道德约束能力的有效机制。     

IAT范式下自尊内隐性的再证明

该研究用IAT测量了被试的内隐自尊,并通过操纵被试在不同的认知负荷条件下进行外显自我评价来考察外显自我评价和内隐自尊之间的关系。得到的结论是,在低认知负荷条件下进行外显自我评价时,外显自我评价和内隐自尊没有表现出一致性;在高认知负荷条件下进行外显自我评价时,外显自我评价和内隐自尊表现出一致性。该研究在IAT范式下表明了内隐自尊和外显自尊的分离,内隐自尊具有无意识性和自动化的特点。     

解题反思对数学学业优差生解题过程的影响

考察解题反思对数学学业优生和差生解题结果及所用策略的不同影响。选取初一至初三年级的数学学业优生和差生为被试,以一套连加数问题为实验材料,进行一对一的测试,前后进行两次测试。对反思组优差生(优生12人,差生10人)和无反思组优差生(优生14人,差生14人)解题过程的比较,发现:1)解题后立即进行反思能够提高差生的解题正确率,但是延长解题时间;2)先前的解题反思对优生和差生后续解题时的正确率和解题时间均不产生明显影响;3)解题后立即进行反思能够促进优生和差生使用高效策略,放弃低效策略;4)先前的解题反思在后续解题中仍然促进学生使用高效策略,对优生的促进作用比对差生更明显。     

英国心理学会介绍

英国心理学会成立于1901年,有较长的历史;现有会员4万4千多人,在英国心理学研究和应用方面发挥了重要的领导和协调作用。该文介绍了英国心理学会的组织结构及它在2006年的活动情况。