Erna and Melanie Klein

Erna was one of the child patients treated by Melanie Klein in Berlin, employing her recently discovered play technique. Since Erna died in Chile, the authors considered the IPA Congress in Santiago an opportunity to present a paper as a homage both to Erna and, especially, to Klein. She learned much from that very disturbed child, which she later used to sustain the ongoing development of her theories. The paper explores biographic data relevant to understanding both the case and the theories. It analyses the case material to follow Klein in the discovery and the handling of the child's transference and the harsh expressions of hate, jealousy and envy, which are brought in, with sad consequences, by strong persecutory feelings. Klein's comparison of this case with that of Freud's Wolf-man is also considered, mostly to show that the similarities were less than originally claimed, and that Klein, perhaps, was introducing a theoretic shift which led her technique to gradually change from ' Nachträglichkeit ' to the 'signification-resignification' pair, akin to Strachey's concept of the mutative interpretation. Lastly, the comprehension of Erna's strong psychotic traits and the links with later developments of the theory on psychosis are studied.     

BIOMEDICAL ETHICS: MUSLIM PERSPECTIVES ON GENETIC MODIFICATION

Technology pertaining to genetically modified foods has created an abundance of food and various methods to protect new products and enhance productivity. However, many scientists, economists, and humanitarians have been critical of the application of these discoveries. They are apprehensive about a profit‐driven mentality that, to them, seems to propel the innovators rather than a poverty‐elimination mentality that should be behind such innovations. The objectives should be to afford the most benefit to those in need and to prevent hunger around the world. Another major concern is the safety of genetically modified food. Muslims, as well as those in other religious communities, have been reactive rather than proactive. Muslims must connect scientific knowledge and ethical behavior based on faith. In Islam, there is no divide between the two. God has commanded us to seek knowledge and make discoveries to better our lives and our environment. We are trustees of this world and everything in it. The poor, the sick, and the wayfarers have a right to be fed and cared for. God reminds Muslims continuously that the earth and all the heavens belong to God; therefore, no one should feel hunger, no one should suffer or be prevented from sharing this bounty.     

Online measurement of mental representations of complex spatial decision problems: Comparison of CNET and hard laddering

This paper introduces the online Causal Network Elicitation Technique (CNET), as a technique for measuring components of mental representations of choice tasks and compares it with the more common technique of online ‘hard’ laddering (HL). While CNET works in basically two phases, one in open question format and one as guided linking of attributes and benefits, HL works completely structured with revealed attributes and benefits. Mental representations of two activity travel tasks were collected with both techniques among members of a nationwide Dutch household panel. The results confirm the hypothesis that the revealed format of variables in HL has an effect on the indication of variables as the elicited mental representations are almost twice as big for HL than for CNET. Furthermore, it turned out that CNET is more sensitive in measuring shifts among attributes in the mental representations for situational changes of the activity-travel task.     

Sociobiology and Moral Discourse

In the intellectual lineage of sociobiology (understood as evolutionary social science), this article considers the place of moral discourse in the evolution of emergent systems for mediating behavior. Given that humans share molecular systems, reflex systems, drive systems, emotional systems, and cognitive systems with chimpanzees, why is it that human behavior is so radically different from chimpanzee behavior? The answer is that, unlike chimps, humans possess symbolic systems, empowering them to override chimplike default morality in favor of symbolically mediated moral codes. The article concludes with a brief discussion of the power of religious symbols to influence moral behavior by reprogramming emotional systems.     

Curriculum Evaluation and Assessment of Multicultural Genetic Counselor Education

Multicultural competence in genetic counseling integrates racial-cultural knowledge, awareness, and skills into clinical interventions and research practices. Researchers and educators often cite racial-cultural factors as obstacles for visible racial-cultural people seeking help. However, the professional's unfamiliarity of how his or her own racial-cultural group affiliations are influenced by the history of discrimination and oppression coupled with their lack of self-understanding of racial-cultural issues for him- or herself has also limited the effectiveness of genetic counseling. The purpose of this study is to evaluate the effectiveness of the Handbook of Cross-Cultural Genetic Counseling, a multicultural curriculum developed for genetic counselor education for increasing multicultural counseling competence. The multicultural curriculum was evaluated for its effectiveness of increasing multicultural counseling competence using a nonequivalent control group design. A participant's multicultural counseling competence was hypothesized to increase after being taught the curriculum. The curriculum was effective for increasing multicultural counseling competence. Additionally, achieved multicultural counseling competence was not influenced by when the curriculum was taught. Trend analyses measuring the longitudinal impact of the curriculum on multicultural competence were significant. Implications of the results are discussed.     

An Assessment of Ethnocultural Beliefs Regarding the Causes of Birth Defects and Genetic Disorders

With the expansion of genetic services to various cultural groups, genetic counselors encounter clients who hold diverse beliefs inscribed by their culture about health conditions. Thus, clients may attribute the cause of a birth defect or genetic condition to a culturally-based health belief. This present study was conducted as a pilot study in order to assess the beliefs about the causes of birth defects and genetic disorders held by women of different ethnocultural backgrounds. This study proposed that women who do not have a family history of a disorder will differ in their knowledge about the cause of a birth defect or genetic disorder compared to women who have an affected child. In addition, this study determined to what extent culturally-based health beliefs are attributed to being the cause of a birth defect or genetic disorder in the 1990s.     

Genetic Counselors' Judgments of Patient Concerns: Concordance and Consequences

The aims of this prospective study were to determine (a) the concordance between patient concerns and genetic counselors' judgments of these concerns, (b) the predictors of patient and counselor judgments, and (c) the relationship between concordance and patient outcomes. Patients' and counselors' views were sought before and after 131 routine genetic consultations. Before consultations, there was concordance about level of patient concern to within one point in 63% (82/131) of consultations and about type of patient concern in 60–84% of consultations. Lack of concordance in judging level and type of concern was associated with lower satisfaction with information and higher anxiety after the consultation. The biggest predictor of counselor judgment of concern was professional background: doctors judged patients to be more concerned than did nurses. Concordance of concern was predicted by counselors' experience in genetics: less experienced counselors overestimated patient concern. Future research needs to determine whether improving judgment of concern improves patient outcome.     

Psychological Interventions and Genetic Testing: Facilitating Informed Decisions About BRCA1/2 Cancer Susceptibility

Genetic testing for inherited cancer susceptibility, based on the recently identified. BRCA1 and BRCA2 genes, will soon be available on a large scale. However, at present, genetic test results do not lead to clearly indicated diagnostic or preventive measures, and the nature of the psychological impact of BRCA1/2 testing is still largely unknown. This uncertainty, combined with preliminary evidence suggesting significant individual differences in reactions to genetic susceptibility feedback, constitutes a unique challenge for any individual contemplating such testing. We outline the nature of this challenge and then propose an intervention strategy designed to help individuals make deeply processed and psychologically well-informed decisions with regard to their genetic susceptibility. The intervention is guided by recent research findings and theory on the cognitive–emotional processing of cancer-risk information. Specifically, the goal is to prepare the individual for genetic testing by (1) cognitively and emotionally activating, or preliving, the individual's potential reactions to testing feedback; (2) facilitating accurate appraisal of the individual's cognitive–emotional reactions; and (3) enabling the individual to process these reactions through the use of well-established clinical techniques.     

Multi‐set factor analysis by means of Parafac2

We consider multi‐set data consisting of observations, k = 1,…, K (e.g., subject scores), on J variables in K different samples. We introduce a factor model for the J × J covariance matrices , k = 1,…, K, where the common part is modelled by Parafac2 and the unique variances , k = 1,…, K, are diagonal. The Parafac2 model implies a common loadings matrix that is rescaled for each k, and a common factor correlation matrix. We estimate the unique variances by minimum rank factor analysis on for each k. The factors can be chosen orthogonal or oblique. We present a novel algorithm to estimate the Parafac2 part and demonstrate its performance in a simulation study. Also, we fit our model to a data set in the literature. Our model is easy to estimate and interpret. The unique variances, the factor correlation matrix and the communalities are guaranteed to be proper, and a percentage of explained common variance can be computed for each k. Also, the Parafac2 part is rotationally unique under mild conditions.