‘Battling with the unlaid ghost’: psychotherapy with a child traumatised in infancy

This paper attempts to explore the nature and consequences of early trauma on the mental development of a 9-year-old boy I have called Luke. The traumatic event occurred within the context of a more chronic and ongoing trauma, which was due to the lack of receptive and containing parental figures. The combination of these two kinds of traumatic experiences had a destructive impact on the making of Luke's internal world and greatly disrupted the development of his capacity for thought. I will specifically refer to the theory of trauma and to Bion's theory of thinking in order to illustrate the crucial link between trauma and mental work and the complex challenge it brings. I will describe how, during the course of 2 years of intensive treatment, Luke gradually became able to restore his capacity for mental functioning, which made it possible for him to begin to think about and make sense of his extreme emotional experiences.

Dans cet article, l'auteur cherche à explorer la nature et les conséquences, pour le développement psychique d'un garçon de neuf ans qu'il appelle Luke, d'un traumatisme précoce. L'événement traumatique s'est produit dans le contexte d'une situation traumatique plus chronique et plus globale en raison de l'absence de figures parentales réceptives et contenantes. L'association de ces deux types de vécu traumatique, avec leur impact destructeur sur la construction du monde interne de Luke, a créé des perturbations majeures du développement de sa capacité à penser. L'auteur se réfère tout particulièrement à la théorie du traumatisme ainsi qu'à la théorie de l'activité de pensée de W. R. Bion afin d'illustrer le lien fondamental qui existe entre traumatisme et travail psychique, ainsi que le défi complexe que ce travail doit confronter. L'auteur montre qu'au cours de deux années de traitement intensif Luke a progressivement retrouvé ses capacités de fonctionnement psychique, de sorte qu'il a pu commencer à réfléchir à ses vécus émotionnels insoutenables et réussir à y comprendre quelque chose.

Mots-clés: Traumatisme, “pare-excitation”, fonctionnement psychique, théorie de l'activité de pensée, fonction alpha, attaques contre l'activité de liaison

Riassunto: In questo articolo si cerca di esplorare la natura e le conseguenze del trauma precoce sullo sviluppo mentale di un bambino di nove anni che chiamerò Luca. L'evento traumatico accadde all'interno di un contesto di trauma pi[ugrave] cronico e duraturo dovuto all'assenza di figure parentali recettive e contenitive. La combinazione di questi due tipi di esperienze traumatiche ebbe un impatto distruttivo sul mondo interno di Luca e interferì enormemente con lo sviluppo della sua capacità di pensare. Farò principalmente riferimento alla teoria del trauma e alla teoria del pensiero di Bion per illustrare il legame particolare tra trauma e lavoro mentale e la complessa sfida che ne consegue. Descriverò come durante il lavoro intensivo di due anni, Luca divenne gradualmente capace di recuperare la sua capacità di funzionamento mentale che gli permise di incominciare a pensare e dare un senso alle sue esperienze emotive estreme.

Parole chiave: trauma, scudo protettivo, funzionamento mentale, teoria del pensiero, funzione alfa, attacco al legame

Der Artikel versucht, die Eigenschaften und Konsequenzen von frühem Trauma auf die psychische Entwicklung eines 9-jährigen Jungens, den ich Luke nenne, zu betrachten Das traumatische Ereignis passierte im Umfeld eines mehr chronischen und fortdauernden Traumas, wegen Mangel an rezeptiven und haltenden elterlichen Figuren. Die Kombination dieser zwei Arten von Trauma hatte eine destruktive Auswirkung auf das Entstehen von Lukes innerer Welt und störte erheblich die Entwicklung seiner Denkfähigkeit. Ich werden mich speziell auf Traumatheorie und auf Bion's Theorie des Denkens beziehen, um die entscheidende Verbindung zwischen Trauma und mentaler Arbeit und der komplexen Herausforderung, die das mit sich bringt, zu illustrieren. Ich werde beschreiben, wie Luke allmählich im Laufe einer zwei-jährigen intensiven Behandlung in der Lage war, seine Fähigkeit für mentales Funktionieren wiederherzustellen, was es ihm ermöglichte anzufangen, über seine extremen emotionalen Erfahrungen nachzudenken und Sinn herzustellen

Keywords: Trauma, Schutzschild, mentales Funktionieren, Theorie des Denkens, Alphafunktion, Angriffe auf Verbindungen     

Role of amygdala-prefrontal cortex circuitry in regulating the expression of contextual fear memory

The basolateral amygdala (BLA) and medial prefrontal cortex (mPFC) are inter-connected regions involved in fear memory expression. The reciprocal nature of projections between these areas differs along the rostrocaudal extent of BLA. This study investigated the role of functional interactions between BLA and the prelimbic (PL) subregion of mPFC in mediating contextual fear memory. Freezing served as the measure of conditioned fear. Experiments 1–3 examined the effects of left, right or bilateral infusion of bupivacaine into anterior BLA (aBLA), posterior BLA (pBLA) or PL on fear memory expression. Reversible inactivation of left, right or bilateral aBLA impaired fear memory expression. Bilateral inactivation of pBLA or PL also disrupted the expression of fear memory, although left or right inactivation alone had no significant effects in either region. Experiment 4 examined the effects of functionally disconnecting pBLA and PL on contextual fear memory by infusing bupivacaine unilaterally into pBLA and PL in the ipsilateral or contralateral hemisphere. Fear memory expression was impaired by asymmetric inactivation of pBLA and PL; however, a similar effect was also observed with symmetric inactivation of these regions. Bupivacaine infusion did not affect behavior in the open field, likely ruling out non-specific effects of inactivation on innate fear and locomotor activity. These results demonstrate different roles for rostral and caudal BLA in mediating the expression of contextual fear memory. They also raise the possibility that pBLA–PL circuitry is involved in subserving fear memory expression via complex processing mechanisms, although further research is needed to confirm this preliminary finding.     

Psychometric properties of the Danish 16PF and EPQ

A Danish translation of the Cattell's 16PF has been used in studies evaluating the effects of prenatal drug exposure. This paper reports a psychometric analysis of the 16PF and Eysenck's EPQ based on a sample of 558 young Danes. Many 16PF scales had unacceptable psychometric properties (as indicated by coefficient alpha and item–total score correlations), but more satisfactory results were obtained with the EPQ N and E scales. A factor analysis of all 16PF and EPQ scales suggested a six factor solution that roughly corresponds to the second-order factor structure obtained by Krug and Johns (1986). It is concluded that the second-order factor structure should be the basis of interpretation of the 16PF in both practical and research contexts.     

Data, model, conclusion, doing it again

This paper explores the robustness of conclusions from a statistical model against variations in model choice (rather than variations in random sampling and random assignment to treatments, which are the usual variations covered by inferential statistics). After the problem formulation in section 1, section 2 presents an example from Box and Tiao in which variation in parent distribution is modeled for a one sample location problem. An adaptive Bayesian procedure permits to use a weighted mixture of parent distributions rather than choosing just one, such as a normal or a uniform distribution.In section 3 similar considerations are applied to an event history model for the influence of education and gender on age at first marriage, but here the conclusions are hardly influenced by the choice of the duration distribution. In section 4 a brief discussion of model choice in factor analysis and structural equation models is followed by a more elaborate treatment of the choice of integer valued slopes for item response functions in the OPLM model which is an extension of the Rasch model. A modest simulation study suggests that Adaptive Bayesian Modeling with a mixture of sets of slopes works better than fixing one set of postulated slopes.The paper concludes with some remarks on the roles and sources of prior distributions followed by a short epilogue which argues that simultaneous consideration of a class of models for the same data is sometimes superior to exclusively analyzing the data under one specific model chosen from such a class.This article is based on the Presidential Address Ivo W. Molenaar gave on June 20, 1998 at the 1998 Annual Meeting of the Psychometric Society held at the University of Illinois in Champaign, Illinois. Thanks is given to John Wiley & Sons and George C. Tiao for granting permission to reprint three figures from the book George C. Tiao wrote with George E. P. Box titled Bayesian Inference in Statistical Analysis.—EditorThanks are due to Anne Boomsma, Jeffrey Hoogland, Mark Huisman, Tom Snijders, Marijtje Van Duijn, and Norman Verhelst for suggesting improvements and/or assisting with data analyses.     

不同注意条件下动态面孔表情识别的ERP研究

利用ERP技术对16名被试在不同注意负荷下对动态表情识别的脑时程特点进行了考察,结果发现：N170成分不受注意负荷和表情效价影响;低注意负荷条件下动态表情加工早期负性表情诱发的EPN成分（early posterior negativity）显著大于中性、正性表情,后期高级分析阶段正、负性表情均诱发明显的LPP成分（late positive potentials）,且负性较正性表情诱发更大的LPP成分;而在高注意负荷条件下并未发现表情识别诱发明显的EPN或LPP成分。这些结果说明,动态表情识别明显受到注意资源调节,只有在注意资源不断增加时表情加工才会出现注意偏向效应,尤以负性表情的加工优势最为凸显且持久,正性表情相对微弱和短暂。     

BION'S THINKING ABOUT GROUPS: A STUDY OF INFLUENCE AND ORIGINALITY

One of Bion's least‐acknowledged contributions to psychoanalytic theory is his study of the relationship between the mind of the individual (the ability to think), the mentalities of groups of which the individual is a member, and the individual's bodily states. Bion's early work on group therapy evolved into a study of the interplay between mind and bodily instincts associated with being a member of a group, and became the impetus for his theory of thinking. On the foundation of Bion's ideas concerning this interaction among the thinking of the individual, group mentality, and the psyche‐soma, the author presents his thoughts on the ways in which group mentality is recognizable in the analysis of individuals.     

Does frontal brain activity mediate the effect of depression prevention in adolescents? A pilot study

We investigated whether (a) depression prevention was associated with depressive symptoms and medial-frontal alpha asymmetry in adolescents; (b) alpha asymmetry mediated the association between participation in a prevention program and depressive symptoms; and (c) gender affects these associations. In our randomised control group study, we compared a universal prevention program (n = 40 adolescents, 14 females) with a non-intervention control condition (n = 39 adolescents, 20 females) in German secondary school students (mean age: 13.53 years, SD = 0.53). We collected data at baseline, post-intervention, 6-month, and 12-month follow-up using the Self-Rating Questionnaire for Depressive Disorders (SBB-DES) and resting medial-frontal alpha activity on F3 and F4. We found that girls benefitted from participating in the prevention program in regards to their depressive symptoms at 12-month follow-up but not alpha asymmetry. In boys, participation in the prevention program was associated with their alpha asymmetry at 6-month follow-up but not their depressive symptoms. Alpha asymmetry did not mediate the effects of the prevention program on depressive symptoms in either gender. Although participation in the prevention program was associated with both depressive symptoms and alpha asymmetry, those associations seem independent from each other. Possible explanations for this result pattern are discussed.     

Effects of male postpartum depression on father–infant interaction: The mediating role of face processing

It is estimated that postpartum depression affects up to 25% of men. Despite such high prevalence, the majority of studies on postpartum depression are focused on mothers, and the role of paternal depression and its effects on infant development have been overlooked by researchers and clinicians. The present study aimed to fill this gap by investigating the effect of paternal postpartum depression on father–infant interactions. In addition, we examined whether differences in face recognition mediated the effects of paternal postpartum depression on father–infant interactions. A total of 61 father–infant dyads (17 postpartum depression, 44 controls) took part in the study. Results revealed that compared to controls, fathers with postpartum depression had a worse pattern of interaction with their infants on measures of responsiveness, mood, and sensitivity; they also had greater difficulty in recognizing happy adult faces, but greater facility in recognizing sad adult faces. Depressed fathers attributed greater intensities to sad adult and infant faces. The tendency to attribute greater intensity to sad adult faces was confirmed as a partial mediator of the effect of paternal postpartum depression on measures of father responsiveness and as a full mediator of the effects of paternal depression on father sensitivity. Clinical implications and suggestions for further studies are discussed.