What can we learn from psychoanalysis and prospective studies about chemically dependent patients?

Despite the common occurrence of drug abusers in the psychoanalytic clinic, contemporary literature on the subject, particularly among publications in the IJP, is sparse. This paper aims to review the most important psychoanalytic contributions on drug dependency in the past 100 years, then attempts to compare their postulations to the findings ofpertinent prospective studies. In these patients, a persistent symbiotic object relationship is found, which ties them to narcissistic functioning, where drug use is viewed in the light of both pleasure without object and omnipotently controlled need. The author also discusses the possible contribution of the mother and father in the genesis of this condition, focusing on the compromise of the paternal function as the deciding factor. The theoretical and technical implications of this approach are illustrated by clinical material.     

Evidence that rats discriminate between familiar and unfamiliar putative urinary odorants of adult male conspecifics

Adam [1976; Lehman and Adams, 1977] suggested that a resident rat makes an olfactory comparison of cage odor and other rat odor prior to attacking an unfamiliar conspecific intruder. The findings of the present study are consistent with the notion that rats discriminate between familiar and unfamiliar putative urinary odorants Adult male albino rats were tested for preferences between areas treated with familiar urine (11 hours pretest exposure), unfamiliar urine (no pretest exposure), and untreated areas. Subjects (N = 12) preferred areas treated with familiar urine over ones treated with unfamiliar urine (p < 0.05). Also, they (N = 12 per preference-test group) preferred areas treated with either urine over untreated ones (familiar versus clean, p < 0.01; unfamiliar versus clean, p < 0.05).     

Treatment of urethral catheter dependence: A case study of intervention in the interdisciplinary geriatric setting

This case report describes the assessment and treatment of a 69-year-old male medical patient with urethral catheter dependence. Assessment revealed an anxiety/phobic component to the dependence and hypothesized detrusor muscle deconditioning. Retraining of the bladder and desensitization to the anxiety-provoking situation were achieved by exposure to decatheterization in the context of a supportive adult day health care setting. Interdisciplinary collaboration between nursing and psychology were associated with successful functional, social, and psychological outcomes.A psychology intern at the Portland VA Medical Center at the time the study was conducted.     

The Psychology of Dependence Between Landlord and Sharecropper in Northeastern Brazil

Contrasting beliefs and attitudes held by sharecroppers and their landlord on a fazenda in Northeastern Brazil reveal a tendency to split one another into positively and negatively idealized images. Sharecroppers who ambivalently seek patronage construct good vs. bad landlords/patrons. The landlord, defensive about envy and hostility among sharecroppers, constructs good vs. bad tenants/workers. Theory from the Kleinian school of psychoanalysis concerning envy, splitting, and idealization provides a framework for interpreting ethnographic case materials.     

The functional state of the central nervous system in chemical stress

The psychosocial and physical factors, including chemical ones, which affect the human organism are considered by some authors to be stress factors which affect the functional state (FS) of the central nervous system (CNS). We calculated correlations among the clinical, psychological/psychometric, and quantitative electropsychological (QEEG) variables of the functional changes of the CNS in chemical stress. These data were based on occupational contact with lead as experienced by 402 workers, with styrene by 96, with shale-oil products by 252, with organic solvents by 77 workers, and a control group of 145 workers in different age groups. The QEEG data of 77 patients were analyzed to determine the chronic neurotoxic effects of industrial chemical substances by diagnosing the functional changes at the syndrome level. We concluded that occupational chemical factors impact the functional state of the CNS. During chemical stress -activity and total cerebral bioelectrical activity (BA) decreases. The use of psychometric/ psychological and QEEG methods makes it possible to diagnose the changes of the CNS as hypersthenic, hyposthenic, and organic psychosyndromes.     

Boring Infinite Descent

In formal ontology, infinite regresses are generally considered a bad sign. One debate where such regresses come into play is the debate about fundamentality. Arguments in favour of some type of fundamentalism are many, but they generally share the idea that infinite chains of ontological dependence must be ruled out. Some motivations for this view are assessed in this article, with the conclusion that such infinite chains may not always be vicious. Indeed, there may even be room for a type of fundamentalism combined with infinite descent as long as this descent is “boring,” that is, the same structure repeats ad infinitum. A start is made in the article towards a systematic account of this type of infinite descent. The philosophical prospects and scientific tenability of the account are briefly evaluated using an example from physics.     

Conceptualising Decadent Technology: A Case Study of Path Dependence in Radiotherapy

Abstract

Large-scale investments in health technologies often have limited evidence for effectiveness when first introduced. Nevertheless, professional and public discourses often present the advantages of such investments, with unknown risks, as necessary and entailing significant improvement. Such discourses are evident with the introduction of the Linac Adapted Conebeam Imager (LACI), introduced to improve the accuracy of radiotherapy treatments. From one perspective, the introduction of such technologies can be considered to be decadent since there is limited, if any, evidence of improvement of current standards and procedures, yet they are promoted as the latest and best technologies for solving societal problems. Connecting the concepts of decadence to those of path dependence, through the case of the LACI, enables the exploration of the ‘technical interrelatedness’ of technological changes. Building on the concept of path dependence, it is possible to demonstrate how introducing a closely related technology does not only become a low-risk course of action. Rather change is demanded (but not determined) as well as potential alternative systems being obscured. With decadent technologies, any future changes are not only dependent upon past introductions; but also they create a need for future changes. Such a view demonstrates how these technologies may not necessarily offer any improvements, but rather contribute to the creation of ongoing demand for unproven technologies. As a result they may encourage the introduction of increasingly complex technologies.     

Synthesis and characterization of nanocrystalline MoBi2Te5 thin films for photoelectrode applications

Molybdenum bismuth telluride thin films have been prepared on clean glass substrate using arrested precipitation technique which is based on self-organized growth process. As deposited MoBi₂Te₅ thin films were dried in constant temperature oven at 110°C and further characterized for their optical, structural, morphological, compositional, and electrical analysis. Optical absorption spectra recorded in the wavelength range 300–800?nm showed band gap (E _g) 1.44?eV. X-ray diffraction pattern and scanning electron microscopic images showed that MoBi₂Te₅ thin films are granular, nanocrystalline having rhombohedral structure. The compositional analysis showed close agreements in theoretical and experimental atomic percentages of Mo⁴⁺, Bi³⁺, and Te^2? suggest that chemical formula MoBi₂Te₅ assigned to as deposited molybdenum bismuth telluride new material is confirmed. The electrical conductivity and thermoelectric power measurement showed that the films are semiconducting with n-type conduction. The fill factor and conversion efficiency was characterized by photoelectrochemical (PEC) technique. In this article, we report the optostructural, morphological, compositional, and electrical characteristics of nanocrystalline MoBi₂Te₅ thin films to check its suitability as photoelectrode in PEC cell.     

基于易感人格的药物成瘾者工作记忆对执行控制功能的调节作用

为了解工作记忆在易感性人格对药物成瘾者执行控制功能和抑制性影响过程中的调节作用,采用BIS和SSS量袁以及连续操作测验（CPT）、2-back任务、威斯康星卡片分类任务（WCST）对150名药物成瘾者和100名年龄、性别及智商相匹配的非药物成瘾者实施冲动性人格、认知控制功能测试。结果发现在2-back任务正确率（工作记忆）高低不同的情况下,注意冲动性人格特质得分对执行控制功能会产生不同的影响。这说明工作记忆在冲动性人格对抑制性的影响中具有调节作用。     

Psychological treatment of hypnotic-dependent insomnia in a primarily older adult sample

Objective

This study tested cognitive behavior therapy (CBT) in hypnotic-dependent, late middle-age and older adults with insomnia.

Method

Seventy volunteers age 50 and older were randomized to CBT plus drug withdrawal, placebo biofeedback (PL) plus drug withdrawal, or drug withdrawal (MED) only. The CBT and PL groups received eight, 45 min weekly treatment sessions. The drug withdrawal protocol comprised slow tapering monitored with about six biweekly, 30 min sessions. Assessment including polysomnography (PSG), sleep diaries, hypnotic consumption, daytime functioning questionnaires, and drug screens collected at baseline, posttreatment, and 1-year follow-up.

Results

Only the CBT group showed significant sleep diary improvement, sleep onset latency significantly decreased at posttreatment. For all sleep diary measures for all groups, including MED, sleep trended to improvement from baseline to follow-up. Most PSG sleep variables did not significantly change. There were no significant between group differences in medication reduction. Compared to baseline, the three groups decreased hypnotic use at posttreatment, down 84%, and follow-up, down 66%. There was no evidence of withdrawal side-effects. Daytime functioning, including anxiety and depression, improved by posttreatment. Rigorous methodological features, including documentation of strong treatment implementation and the presence of a credible placebo, elevated the confidence due these findings.

Conclusions

Gradual drug withdrawal was associated with substantial hypnotic reduction at posttreatment and follow-up, and withdrawal side-effects were absent. When supplemented with CBT, participants accrued incremental self-reported, but not PSG, sleep benefits.