Too much – not enough. The representation of the body and the meaning of symptoms in patients with eating disorders

Eating disorders cover different clinical syndromes, all of which are characterized by an immense focus on food, body and weight, an endless attempt to combat the body and by a fluctuation between ‘too much and not enough’ on different levels (e.g., behaviourally, mentally, physically).

The aim of this article is to contribute to the psychoanalytic understanding of eating disorders, to highlight the vital importance of the symptoms as a psychological survival strategy and to illustrate similarities between eating disordered patients as well as the very different pathways that can lead to an eating disorder. Two clinical cases are presented, one very shortly and one in more detail.     

Revealing the Difference: Between Conflict Mediation and Law Enforcement—Living and Working Together as a Conceptual and Methodological Turning Point to Activate Transformation in a Juvenile Criminal Mediation Service

This article aims at proposing the construct of living and working together in organizations as an interpretation and tool proposed in a Juvenile Criminal Mediation Service, in order to highlight how important it was as a turning point in activating the working group's reflexive function as far as their sense of belonging, otherness, culture of diversity, and work subject matter are concerned and start an important transformation process in the very service delivery. Our proposal finds its roots in a follow-up experience regarding the aforementioned service, which has been taking place for almost three years. It was structured in three different phases: a research phase evaluating process and results of the activity that was carried out; a phase of monitoring the mediation practice; a research-action phase in a clinical perspective on the working group's operating mode. The leverage of living and working together in organizations is specifically proposed as far as this last working phase is concerned, lasting approximately ten months.     

Four Roles of Ethical Theory in Clinical Ethics Consultation

When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity. These four roles of ethical theory in clinical ethics consultation are described and their significance highlighted, while an example case is used as an illustration throughout.     

How Robust is the Influence of Causal Explanation on Clinical Judgments? Assessments in Structured Clinical Interviews

When causal life-event explanations for disorder symptoms are available, clinicians tend to explain away those symptoms (Ahn, Novick, &; Kim, 2003 Ahn, W., Novick, L. R., &; Kim, N. S. (2003). Understanding behavior makes it normal. Psychonomic Bulletin Review, 10(3), 746–752. doi:10.3758/BF03196541[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Meehl, 1973 Meehl, P. E. (1973). Why I do not attend case conferences. In P. Meehl (Ed.), Psychodiagnosis: Selected papers (pp. 225–302). Minneapolis, MN: University of Minnesota Press. [Google Scholar]), eschewing formal diagnostic guidelines such as the DSM-5 (American Psychiatric Association, 2013 American Psychiatric Association [APA]. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.[Crossref] , [Google Scholar]). We asked whether this effect is attenuated in the context of a structured diagnostic clinical interview procedure, which deliberately directs evaluators' attention to symptoms alone, or whether it is robust enough to continue to emerge. Across two experiments, lay evaluators given causal life-event explanations for disordered behaviors gave them lower judgments of abnormality and need for treatment compared to evaluators not given such explanations, regardless of whether they used a structured clinical interview. Thus, causal life-event explanations may have significant impact on clinical evaluations regardless of the mode of assessment. Implications for the clinical utility of structured interviews and the role of life-event context in diagnosis and classification are discussed.     

Quality Choice and Product Differentiation in Monopoly Theory: An Application to the Puritan Church

French engineer and transport economist Jules Dupuit (1804–1866) conjectured more than 150 years ago that, in the context of a three‐part tariff concerning French railroads, a discriminating monopolist will find it most profitable to distort product (service) quality at each of the two ends of the quality spectrum in order to prevent consumers in the middle class (i.e., the second of three classes) from defecting to either end (i.e., first or third class). This study extends a branch of the literature on the economics of religion by arguing that 17th‐century Puritan theologians in colonial America used, in a way that is consistent with Dupuit's insights, Puritan religious doctrines related to eternal salvation and witchcraft to distort the quality, at both ends of the quality spectrum in a three‐part tariff construct, of the religious services they provided to their parishioners. In doing so, we employ economic modeling from seminal studies of the medieval Roman Catholic Church.     

Internal cohesion psychotherapy: The nature,principles and application

Psychotherapy is widely used to treat different mental health disorders and emotional difficulties. The main objective of psychotherapy is to help clients become aware of and have control over their thoughts, moods, feelings and behaviours, as well as create healthy strategies to respond to challenging situations. Since the existing psychotherapy approaches and other methods of treatment are not always effective in treating mental health disorders, there is still space for new approaches to fill this gap. In this paper, we provide information about internal cohesion psychotherapy, which is a new integrative approach. This paper presents a new approach to eclectic psychotherapy, focussing on four detrimental aspects of human functioning through different time perspectives.     

美国临床心理学培养模式的演进及展望

受到社会、组织及自身发展因素的影响, 美国临床心理学在不同时期存在着不同的培养模式。文章选取“科学家－实践者”模式、“实践者－学者”模式、“临床心理科学家”模式、“当下的临床科学家”模式及“循证实践者”模式等五种最具代表性的经典模式, 介绍了1949年以来美国临床心理学培养模式的特点及发展规律。认为“循证实践者”模式修正了前面四种培养模式的个体主义倾向, 将单个的“科学家－实践者”, 分化成“科学家”与“实践者”两个集团, 强调实践者遵循科学家提供的最佳证据, 考虑病人的特征、文化与价值观, 在管理者协调下开展实践。这种模式代表着当代临床心理学培养模式的发展方向。     

Marital Status and Adjustment 1 Year Post-Spinal-Cord-Injury

The current study employed a case-control design to examine the impact of marital status on adjustment among individuals with spinal cord injury (SCI) 1 year post-injury. Two groups of 53 individuals (i.e., single versus married individuals) were matched case-for-case on age (i.e., within 10 years), education, gender, race, and lesion level. Although not specifically matched, etiology of SCI, and number of rehospitalizations and days rehospitalized during the past year were not significantly different between groups. Outcome measures included the Satisfaction With Life Scale, the Craig Handicap Assessment and Reporting Technique (CHART), and the SF-12. Results indicated that overall self-reported QOL was significantly lower among single individuals as compared to their matched married counterparts. Similarly, self-reported handicap was significantly higher among single individuals, particularly in the areas of social integration and economic self-sufficiency. In contrast, overall physical and mental health were not different across groups.     

Psychology in Medical Settings in Thailand

This article explores the development of psychology as a profession in Thailand, its challenges, and future trends. There are currently very few Thai psychologists who are active in the medical fields in comparison to other health care professions. Being held back by limited education and training, many psychologists see their future career as less than promising. The lack of professional licensing standards and dominance of psychiatry further limit their career advancement. However, tremendous opportunities await those who persevere to expand their roles beyond the traditional assessment, treatment, and research models. A small number of them have ventured out into unexplored territories such as behavioral medicine, AIDS counseling, health promotion, and prevention of mental health problems. There is a strong potential for Thai psychologists to make significant contributions in these areas. It is clear that higher standards of education and more rigorous training are needed if this goal is to be realized in the near future.     

A Psychometric Normative Database for Pre-Lung Transplantation Evaluations

This study describes the quality of life and psychological characteristics of a large sample (N = 201) of adult patients evaluated for lung transplantation. In light of the interdisciplinary nature of pre-lung transplant evaluations, establishing norms for measures commonly used in the assessment of transplant candidates has been a priority for the University of Florida transplant programs. Forty-eight percent of the patients reported symptoms of mild to moderate depression. Although quality of life indices were associated with disease severity and exercise tolerance, psychosocial measures generally were not. These data contribute uniquely to the transplant literature and provide valuable normative information on the largest lung transplant cohort reported to date.