Mens sana in corpore sano: Psychotherapy with a cerebral palsy child aged nine months

This paper is the acount of the psychoanalytic understanding and treatment of a nine-month-old cerebral-palsy infant and her mother. When first seen, Abigail hung over her mother's arm, and would scream unceasingly if moved from this position. The mother-child relationship seemed to involve their sticking to each other without looking or losing contact. The mother's hidden hate, anger and resentment were communicated non-verbally and Abigail showed signs of finding it difficult or impossible to integrate experiences, given the amount of trauma she had suffered from an attempted abortion and the lack of enough experience of being loved to enable her to grow internally.

The process of assessing the internal world of the infant and her mother, and the thinking and planning of the psychotherapy that followed, are described. In order to promote the secure attachment of the mother-child dyad, and the emotional growth of both, the helping process focused on understanding both the baby's and mother's states in order to make sense of the child's inner world to the mother. Because of the acute pain this process involved for the mother, she was treated individually too, by a different therapist.     

Book Reviews

Abstract

There are many brief, demanding, aborted cases that no one ever writes about. The typical psychoanalyst or psychoanalytic psychotherapist, however, has many outpatient cases that are shortlived, intense encounters with very disturbed patients. Rather than ignore these encounters as non-analytic or non-instructive, I think these cases add to our knowledge about the mind and its functions. In addition, it is unrealistic to think we can always help a very anxious and disturbed person to enter the treatment process with immediate success. It is more instructive to apply the analytic method and offer the patient what we can and have both analyst and patient learn as much as they can in the time they are able to stay together. Using case material, I show the Kleinian approach to working analytically with these difficult patients. Whether focusing on transference or extra-transference material, the analyst interprets the patient's internal phantasies and anxieties regarding the self and the self's important objects. This analytic stance tends to relieve the immediate anxiety and set the stage for potential self-reflection and the start of basic working-through processes.     

Patients’ intention to speak up for health care providers’ hand hygiene in inpatient diabetic foot wound treatment: a cross-sectional survey in diabetes outpatient centres in Lower Saxony,Germany*

Hand hygiene in wound care by health care providers (HCPs) is a key principle in treating hospitalized patients with diabetic foot infections. This study aimed to estimate the extent to which patients with type-2-diabetes (T2D) intend to speak up for HCPs’ hand hygiene during inpatient foot treatment, test whether this motivation increases given the hospital would invite patients to speak up, and identify associations with socio-demographics, knowledge of hand hygiene requirements, and diabetes-related factors. A questionnaire-survey was conducted in eight diabetes outpatient centres in Lower Saxony/Germany. Intentions to speak up (without and with institutional encouragement) and knowledge about hand hygiene during foot-care were assessed. Analyses of variance were conducted, partly as repeated measures-models with intention-items as within-subject factor. N = 473 patients participated (response = 77.4%). N = 177 (41%) strongly intended to speak up. Institutional encouragement was associated with an increased rate of strong (54% vs. 41%; p < .001) and higher mean intention (M = 3.9 vs. 3.4 with vs. without encouragement [5-point-scales]; F(1, 434)?=?41.5, p < .001). In patients without diabetic foot syndrome, this effect was limited to those with at least medium school education (F(2, 292)?=?4.4, p = .013) and knowledge on HCPs’ hand hygiene (F(2, 294)?=?3.1, p = .047). In conclusion, a majority of T2D-patients in diabetes outpatient centres intend to speak for HCPs’ hand hygiene in inpatient foot treatment, and are receptive to institutional encouragement. However, this presupposes at least medium education and knowledge about hand hygiene, emphasizing that patient empowerment begins with knowledge.     

Using optical illusions in the shoulder of a cycle path to affect lateral position

An important factor in single-sided accidents of older cyclists is that they ride off the cycle path onto the verge. Two experiments were performed to assess the feasibility of using virtual 3D objects in the verge to affect the lateral position of bicyclists. In the first experiment, different virtual objects were placed in the shoulder and 1150 passing bicyclists were observed using a fixed camera. The (standard deviation of the) lateral position and speed in four conditions with virtual objects differing in colour, structure, or 3D effect were compared with a control condition in which no virtual objects were applied. In a second experiment, the behaviour of 32 bicyclists aged 50 years or older was measured by mounting two digital action cameras with GPS on the participants’ bicycles. The participants cycled a route of approximately 12 km in which several locations were passed, one of these contained 15 virtual objects similar to the ones used in the first experiment placed in the shoulder of the cycle path. Cyclist behaviour was compared with behaviour at a control location consisting of a solitary two-way cycle path with a grass shoulder. Results indicate that the virtual objects in the tested format had little overall effect on cyclists’ behaviour. However, bicyclists were positioned closer to the virtual objects and the shoulder when they looked at the objects or when they reported that they saw them while cycling. This suggests that the overall visibility of the object design may have been too conservative.     

Psychiatry and religion: a perspective on meaning

ABSTRACT

A Position Statement on Spirituality and Religion in Psychiatry was issued by the World Psychiatric Association in 2016. Among many recommendations, this statement underscores the need for research on both religion and spirituality in psychiatry, especially on their clinical applications. In this contribution we will put light on the issue of meaning and meaning-making, i.e., an important field for every human, Particularly for individuals suffering from severe mental disorders. After an introduction about meaning in its religious/spiritual dimension, we will describe what needs to be studied in order to get a better knowledge as to how patients cope with meaning, and how they process (in terms of meaning-making) the outburst of a severe mental disorder such as schizophrenia.     

自定步调学习时间的习惯性反应：来自眼动的证据

习惯性反应指学习者根据自身阅读习惯来进行学习时间分配,它通常由词对位置这一外部线索激发。研究运用眼动记录技术,采用Metcalfe范式探讨词对位置和难度对学习时间分配的影响,以检验自定步调学习时间的习惯性反应。结果发现：（1）在自定步调总学习时间上,学习者倾向于对难度越大的项目分配越多的学习时间;（2）在前期自定步调学习进程上,当词对位置为易-中-难条件时,学习者倾向于优先在容易项目上分配较多的学习时间,接着是中等难度项目,最后是困难项目;当词对位置为难-中-易条件时,结果相反。这说明学习者的自定步调总学习时间受项目难度驱动,而前期自定步调学习时间受习惯性反应影响。     

老年人与青年人阅读空格文本的注视位置效应

采用EyeLink2000眼动仪,以14名老年人和14名青年人为被试,探讨他们阅读空格汉语文本的注视位置效应.阅读材料分为正常无空格文本和词间空格文本两种.结果发现:(1)在阅读词间空格文本和正常无空格文本时,老年人与青年人都表现出单次注视的首次注视是位于词的中心,多次注视的首次注视是位于词的开头;(2)老年人阅读正常无空格文本时对词尾的注视概率显著低于词间空格文本,而青年人则没有差异.结果表明老年人与青年人在阅读空格文本时存在注视位置效应.     

汉字认知过程中整字对部件的影响

英文研究中,"字优效应"是单词促进字母加工的一个重要依据。但中文研究中还存在一些争议。本研究通过两个实验考查了汉字的部件认知中,汉字整体对局部(部件)的影响。实验刺激材料分为三种,即左右结构或上下结构的真字、假字与部件字。目标部件为既能够放置于三种字符的左侧,又能放置于右侧(上部或下部)的汉字部件。实验一采用Reicher-Wheeler实验任务,先呈现刺激材料350ms,掩蔽后再呈现需要判断的目标部件,被试对目标部件进行按键反应。实验二中采用部件判断实验任务,先呈现需要判断的目标部件,再呈现刺激材料,被试对刺激材料中是否包含目标部件进行按键反应。记录反应时与正确率。27位健康女性大学生参与本实验。结果显示:(1)不论是Reicher-Wheeler实验任务还是部件判断实验任务,均显示部件字的部件认知判断速度最快。真字与假字相比,无"字优效应"。真字与部件字相比,存在着"字劣效应"。这些结果表明,汉字整字对汉字部件认知加工起到抑制作用;(2)两个实验任务均表现出汉字结构方式效应,即对左右结构的汉字的部件认知比上下结构的汉字更快;(3)部件的空间位置对部件识别存在影响。实验一中对下部件分辨最困难,分辨时间最长;实验二中发现对左部件的反应最快。字符结构方式效应与部件空间位置效应既存在于真字中,也存在于假字中。     

溃疡微环境稳态失衡与糖尿病足

糖尿病足是糖尿病常见并发症之一,是一个临床难治病,其病机复杂,病情缠绵难愈。基于以往认识基础上,本文侧重于对糖尿病足溃疡局部病理特点作一回顾性分析,了解溃疡局部因素在糖尿病足形成和发展中的作用。可能在理论上对既往认识糖尿病足血管病变、神经病变和感染三大影响因素基础上作一定延伸。由此引入的新疗法可能成为现行治疗糖尿病足必要的补充。     

汉字部件及其位置的发展研究

选取小学二年级、五年级学生和大学生对汉字部件及其位置的发展进行了研究。结果表明,汉字部件的发展在3个年级表现出一致的趋势。部件位置的发展趋势不一致,它在小学五年级阶段表现出更重要的作用。