When less is more: An exploration of psychoanalytically oriented hospital‐based treatment for severe personality disorder4

This paper discusses the main findings of a prospective study based at the Cassel Hospital, a centre dedicated to the psychoanalytically informed residential treatment of severe personality disorders. The results‐showing that significantly greater improvements on a number of outcome indicators were found in patients exposed to the psychoanalytically informed treatment programmes compared to a general psychiatric approach based on management and pharmacotherapy alone‐underscores the importance and the centrality of the psychoanalytic input in the treatment of severe personality disorders. However, the results of the study also suggested that some features of long‐term hospital treatment might carry the risk of iatrogenic and anti‐therapeutic effects for a sub‐group of patients with severe borderline core pathology. The authors present the clinical and psychodynamic implications of the study results based on an understanding of the internal and interpersonal mode of functioning of borderline patients.     

Precedent Autonomy and Subsequent Consent

Honoring a living will typically involves treating an incompetent patient in accord with preferences she once had, but whose objects she can no longer understand. How do we respect her “precedent autonomy” by giving her what she used to want? There is a similar problem with “subsequent consent”: How can we justify interfering with someone's autonomy on the grounds that she will later consent to the interference, if she refuses now? Both problems arise on the assumption that, to respect someone's autonomy, any preferences we respect must be among that person's current preferences. I argue that this is not always true. Just as we can celebrate an event long after it happens, so can we respect someone's wishes long before or after she has that wish. In the contexts of precedent autonomy and subsequent consent, the wishes are often preferences about which of two other, conflicting preferences to satisfy. When someone has two conflicting preferences, and a third preference on how to resolve that conflict, to respect his autonomy we must respect that third preference. People with declining competence may have a resolution preference earlier, favoring the earlier conflicting preference (precedent autonomy), whereas those with rising competence may have it later, favoring the later conflicting preference (subsequent consent). To respect autonomy in such cases we must respect not a current, but a former or later preference.     

预期式时距估计年龄差异的初步研究

以5s、13s和26s为目标时距,采用产生法和复制法,探讨了预期式条件下时距估计的年龄差异。结果表明在单任务作业中。年老被试和年轻被试两个年龄组之间估计时距的平均值没有显著差异,但年老被试比年轻被试的估计时距具有更大的变异性。单一的内部时钟频率变化的假设并不能对单任务条件下时距估计的年龄差异做出合理的解释。时距估计的年龄差异可能是内部时钟频率变化和认知过程变化交互作用的结果。     

前瞻记忆的自评和延时特点

前瞻记忆的自评和延时研究目前由于实验任务的不同结果差异很大。该文采用由前瞻记忆自我评价题目构成的并且包含前瞻记忆任务的测验材料,探索了前瞻记忆研究的一种新方法,研究了可能影响前瞻记忆的几个因素。结果发现,0延时与其它延时(7min,17min,27min,57min)均有显著差异,其它各延时之间没有显著差异,年龄对前瞻记忆和前瞻记忆自我评价均有显著影响,前瞻记忆与性别、人格、智力、回溯记忆没有显著相关。     

Is personal growth initiative associated with later life satisfaction in Chinese college students? A 15‐week prospective analysis

Personal growth initiative (PGI) is presumed to foster positive change leading to positive psychological adjustment. Accordingly, in this study we examined PGI as a predictor of life satisfaction 15 weeks later in a sample of 152 Chinese college students. Time 1 PGI was found to explain a significant amount of unique variance in Time 2 life satisfaction, even after controlling for Time 1 life satisfaction and Time 2 PGI. Specifically, (lower) intentional behavior and planfulness at baseline emerged as significant predictors of later life satisfaction. No evidence was found indicating that life satisfaction at Time 1 accounted for any significant amount of unique variance in PGI processes at Time 2, after controlling for baseline PGI processes and concurrent life satisfaction. Overall, the present findings are the first to demonstrate the importance of PGI as a prospective predictor of positive psychological adjustment in adults.     

How do loss- and restoration-oriented coping change across time? A prospective study on adjustment following spousal bereavement

Background and objectives: According to the Dual Process Model (DPM), shifting between loss-oriented (LO) and restoration-oriented (RO) coping is essential for adjustment following bereavement. Knowledge about how LO and RO coping change over time and how such changes are related to adjustment is missing. With a prospective design this study investigated (1) relations between levels of LO/RO coping and selected outcomes and (2) changes in LO/RO coping across time and their relations to adjustment.

Methods: A sample of 145 spousal bereaved individuals completed questionnaires measuring LO and RO coping, grief symptoms, positive affect, and attachment orientation approximately 2–3 months (baseline) and 7 months (follow-up) post-loss.

Results: High usage of LO coping was associated with poorer outcomes and high usage of RO coping was associated with better outcomes at both baseline and follow-up. Individuals generally shifted towards more RO coping across time and those who exhibited this shift showed lower levels of grief at follow-up compared to individuals who changed towards more LO coping across time.

Conclusions: Individuals showing more RO coping reported better adjustment both early and later in the bereavement process. Changes in coping orientation over time might be useful for understanding complicated grief reactions following loss.     

An investigation of the relations between stress and prospective memory

ABSTRACT

Prospective memory (PM), or remembering to perform intentions in the future, has important implications for one’s daily functioning and quality of life. Another common human experience is stress. Despite the significance and ubiquity of both PM and stress, our understanding of the relations between them is limited. The aim of the current study was to further delineate the relations between acute stress, chronic stress, non-focal event-based PM, and time-based PM. The results of the study revealed that acute stress induction after PM intention formation did not contribute to differences in non-focal event-based PM performance or time-based PM performance. However, self-reported chronic stress was significantly correlated with enhanced monitoring and time-based PM. In the present study, participants may have had optimal levels of enduring stress that contributed to enhanced monitoring behaviour (i.e. the prospective component of PM) and the ability to complete time-based intentions.