My life is a longing: Child abuse and its adult sequelae Results of the Brody longitudinal study from birth to age 30

The psychoanalytically oriented Brody longitudinal study has followed the psychological development of 76 individuals from birth to age 30. Ten suffered severe maltreatment in childhood in the form of rejection and/or physical abuse at the hands of one or both parents. This report describes the effects of child abuse on the emerging personalities of the children, as well as on their adult personalities and mental health. Specifi cally, as adults the maltreated children had signifi cantly more psychiatric illness (typically depressions and anxiety disorders), less mature psychological defense mechanisms, more insecure mental representations of attachment to their parents as indicated by the adult attachment interview, and a lower Global Assessment of Functioning than their well-treated counterparts. Additionally, their prevailing moods were joyless. Case examples show the emergence of symptoms, personality disorders, and defenses over time, as well as the workings of ameliorating infl uences. Several of the maltreated children made relatively successful adaptations as adults, indicating children's potential for resilience. Resilience, however, may be a superfi cial concept, for, in this series of cases, seemingly adequate coping in formerly mistreated children always came at the price of emotional vulnerability and compromised potential.     

儿童和少年情绪障碍相关社会心理因素探讨

儿童和少年情绪障碍是一组由家庭环境因素、认知倾向和个性心理等多种社会心理因素共同作用、相互影响的疾病。家庭是一个系统,对儿童和少年的心理和行为的塑造存在影响。家庭环境和个性因素是以认知倾向为中介产生对情绪的影响,家庭环境因素又影响了认知倾向的形成和个性的发展。从以上三个方面进行探讨,旨在为儿童和少年情绪障碍者的心理干预提供科学的理论依据。     

功能性内窥镜鼻窦外科应用的情况及问题

20世纪70年代,以慢性鼻窦炎/鼻息肉为主要治疗对象的功能性内窥镜鼻窦外科的创立和发展,开辟了鼻窦外科的新领域。功能性内窥镜鼻窦外科技术把鼻窦外科推向了新的阶段,使鼻窦炎临床治愈率提高到80%~90%,已成为国内外鼻窦炎外科治疗的主要方式。回顾功能性内窥镜鼻窦外科的发展历史,分析了鼻腔-鼻窦病变中应用的情况,并提出了应用中应处理好的两个问题,对准确把握功能性内窥镜鼻窦外科发展的趋势和特点具有重要的作用。     

Freud was Right… About the Origins of Abnormal Behavior

Freud's psychodynamic theory is predominantly based on case histories of patients who displayed abnormal behavior. From a scientific point of view, Freud's analyses of these cases are unacceptable because the key concepts of his theory cannot be tested empirically. However, in one respect, Freud was totally right: most forms of abnormal behavior originate in childhood. In this paper various factors are discussed that play a role in the etiology of abnormal behavior in children and adolescents. Furthermore, problems are signaled that hinder effective interventions for disordered youths.     

Review Essay on the Roots of Evil

I consider two essays by Joel Feinberg: his treatment of the moral obligation to obey the law, and his exploration of the evils of the Holocaust.     

Anorexia and the Trojan Horse: a reflexive review of written psychoanalytic encounters with anorexic patients

A selective and limited sample of clinical case studies of psychoanalytic psychotherapy with anorexic patients, focussing on the author/therapist’s experience of working with such patients, is examined. Patients’ depressive and often angry states of withdrawal, and projections, are frequently noted. A summary of more hopeful interactions, as selected from the literature reviewed, is offered. An understanding of anorexic defences is explored in relation to the ‘Trojan Horse’ mythology, in the sense that that which purports to be emotionally nourishing and sublime can be suspiciously viewed as seeking to enter and conquer, through subterfuge. Some existing challenges to traditional tenets of psychoanalytic clinical practice with anorexic patients are presented.     

From personality disorders to the fact-value distinction

Louis Charland’s claim that DSM Cluster B personality disorders are moral rather than clinical kinds has recently triggered a lively debate. In order to deliver a reliable report of the latter, both (1) Charland’s arguments concerning the impossibility of identifying and treating personality disorders without applying a morally laden conceptual framework and (2) some critical responses they provoked are discussed. Then, in turn, the conceptual history of the notion of personality disorder is traced, including not only well-recognized contributions from (3) medical psychiatry, psychoanalysis, and DSM nosology, but also (4) an important, but often neglected, tradition of virtue and moral character. Finally, (5) the idea of a normatively neutral concept of personality disorder is scrutinized in the context of its logical dependence on the fact-value distinction. The latter dichotomy’s recent criticism, in particular, is employed to support Charland’s argument and to suggest that the normative character of personality disorders may go much deeper than this or that DSM formulation.     

Efficacy of functional analysis for informing behavioral treatment of inappropriate mealtime behavior: A systematic review and meta‐analysis

Children diagnosed with a feeding disorder often exhibit inappropriate mealtime behavior such as throwing or swiping food, which can exacerbate feeding difficulties during treatment. We conducted a meta‐analysis of 86 behavioral treatments for inappropriate mealtime behavior from 23 studies to assess the extent to which treatments based on a pretreatment functional analysis were more efficacious than those treatments not based on a functional analysis. Procedural escape extinction and attention extinction for inappropriate mealtime behavior, as well as differential reinforcement for food acceptance or consumption, represented the most common treatments independent of whether a functional analysis was conducted. No difference was detected between treatments that were and were not based on a functional analysis, and mean effect size across measures was identical (79%). The requirement of a pretreatment functional analysis for inappropriate mealtime behavior is equivocal given that standard care often includes efficacious treatment components that are not informed by a functional analysis.     

An Inhibitory Learning Approach to Cognitive-Behavioral Therapy for Children and Adolescents

Although exposure-based cognitive-behavioral therapy (CBT) is efficacious for childhood anxiety and obsessive–compulsive disorder (OCD), many youth do not adequately respond to treatment. Extinction learning is an important process in exposure-based CBT. However, youth with anxiety disorders and OCD exhibit impairments in extinction processes that are best characterized by deficits in inhibitory learning. Therefore, the utilization of strategies to optimize inhibitory learning during exposures may compensate for these deficits, thereby maximizing extinction processes and producing more robust treatment outcomes for exposure-based CBT. This paper reviews several strategies to optimize inhibitory learning in youth with anxiety disorders and OCD, and presents practical examples for each strategy. This paper also highlights the difference between inhibitory learning-based exposures and prior conceptual approaches to exposure therapy in clinical practice. It concludes with a discussion of future directions for clinical research on inhibitory learning and exposure-based CBT in youth.     

Brain lateralization of phonological awareness varies by maternal education

Socioeconomic status (SES) has been shown to influence language skills, with children of lower SES backgrounds performing worse on language assessments compared to their higher SES peers. While there is abundant behavioral research on the effects of SES, whether there are differences in the neural mechanisms used to support language skill is less established. In this study, we examined the relation between maternal education (ME), a component of SES, and neural mechanisms of language. We focused on Kindergarten children, at the beginning of formal reading education, and on a pre‐reading skill, phonological awareness—the ability to distinguish or manipulate the sounds of language. We determined ME‐related differences in neural activity by examining a skill‐matched sample of typically achieving 5‐year‐old children as they performed a rhyme judgment task. We examined brain lateralization in two language processing regions, the inferior frontal gyrus (IFG) and superior temporal gyrus (STG). In the IFG, lateralization was related to ME but not skill: children with low ME showed bilateral activation compared to children with higher ME who showed leftward lateralization. In the STG, there was a skill by ME interaction on lateralization, such that children with high ME showed a positive relation between rightward lateralization and skill and children with low ME showed a positive relation between leftward lateralization and skill. Thus, we demonstrated ME is related to differences in neural recruitment during language processing, yet this difference in recruitment is not indicative of a deficit in linguistic processing in Kindergarten children.