The psychodynamic of panic attacks: A useful integration of psychoanalysis and neuroscience1

This article tries to explain, in the light of some neuroscientific and psychoanalytical considerations, the repetitive pattern of panic attacks. Freud considered the panic attack as an ‘actual neurosis’ not involving any conflictual process. Recent neuroscientific findings indicate that psychosomatic reactions, set off by a danger situation, depend on the primitive circuit of fear (including the amygdala) characterised by its speed, but lack accurate responses and may also be activated by harmless stimuli perceived erroneously as dangerous. The traumatic terror is stored in implicit memory and may be set off by a conditioned stimulus linked to a previous danger situation. In the panic attack, the traumatic event is created by the imagination and this construction (a micro‐delusion), built in loneliness and anxiety, has the same power as the real trauma. A mutual psychosomatic short‐circuit between body and psyche, in which terror reinforces the somatic reactions and the psychic construction, is established. Therefore, it is important to highlight these constructions in order to analyse and transform them. In the second part of the article the author reviews the main psychoanalytical theories about panic attacks, stressing how, in his opinion, panic attack is a consequence of the breakdown of the defence organisation at various levels and may appear during periods of life crisis. Two patients suffering from a deficit of personal identity are presented. The various organisations and the different levels (biological, neuroscientific, associative, traumatic) of the panic attack determine different kinds of therapeutic approaches (pharmacological, cognitive and psychoanalytical). While the psychopharmacological treatment is aimed at reducing the neurovegetative reaction and the cognitive method is attempting to correct the associative and perceptive processes of fear signals, psychoanalytical therapy represents both a specific means to free patients from panic attacks as well as an indispensable route for their emotional growth.     

Evaluating the effects of physical reactions on aggression via concurrent‐operant analyses

Under naturally occurring conditions, the individual who is the target of aggression is likely to physically react to evade the aggressor and avoid physical harm. Like other forms of attention that occur following problem behavior, physical reactions may maintain problem behavior. However, evaluating the effects of physical reactions is complicated by issues related to therapists' ability to consistently and safely control their reactions, which may prove difficult to achieve in functional analyses. We evaluated the utility of a concurrent‐operant analysis to test behavioral sensitivity to physical reactions. The results suggest that the concurrent‐operant analysis may be useful when therapists cannot consistently refrain from responding contingent on problem behavior in the control condition of a more typical functional analysis.     

SHORES: A Practical Mnemonic for Suicide Protective Factors

Guidelines for addressing and managing client suicide risk include discussing and conceptualizing protective factors. Counselors should be able to recall and discuss suicide protective factors that are applicable across client populations. SHORES, a suicide protective factors mnemonic that is supported by the literature, has applications for risk assessment and crisis intervention across settings, preventative care, strengths‐based management, and counselor training. A case example and discussion serve to illustrate the wide‐ranging application of SHORES in counseling practice.     

Translating knowledge into interventions: An ‘individual by context’ approach to bullying

Bullying affects a considerable number of children and adolescents, with serious consequences for school performance, health and emotional well-being. To understand bullying a promising approach is the individual by context approach, which implies that social contexts can either attenuate or exacerbate the effect of individual characteristics on bullying behaviour. Within this interactional framework, the paper reviews studies which lie at the intersection between two research areas, bullying knowledge and anti-bullying interventions research. Specifically, studies that show how the relation between individual vulnerability and bullying is moderated by class norms, peer behaviours and teacher interventions will be discussed. Following these results, translation implications will be analysed focusing on: 1) studies evaluating interventions which aim to change peer behaviours and class norms; 2) studies investigating the circumstances under which an intervention may work or not; and 3) studies focusing on the effectiveness of an intervention in relation to the different target population.     

失败恐惧对大学生失败学习的影响：一个有调节的中介模型

基于保护动机理论,将经历失败事件的596名大学生作为研究对象,探讨失败恐惧对大学生失败学习的影响机制,分析保护性努力的中介效应与应对导向的调节效应。研究发现：（1）失败恐惧显著正向预测大学生失败学习;（2）保护性努力在失败恐惧与大学生失败学习间起部分中介效应;（3）应对导向在失败恐惧与保护性努力的关系中起调节效应,应对导向越高的大学生,其失败恐惧对保护性努力的正向影响越大。     

On the development of a benign superego- thoughts arising from psychoanalytical work with children and grownups

ABSTRACT

The human psyche unfolds through the internalization of the presence of the object; little by little the child makes the functions and characteristics of the object her own. Part of the internalization of the primary objects result in the superego formation. When the internalized object is reliably present, protecting and need fulfilling the superego will be formed into a benign inner structure, which has self-observing, self-regulatory and ideal forming functions. A good internal object lays the basis for a well- functioning and protective superego, whereas an object experienced as too distant and not there when needed results in internalizations which build a harsh and persecuting superego. The focus in this article is on the development of a benign superego.     

Trajectories of public psycho-behavioural responses relating to influenza A(H7N9) over the winter of 2014-15 in Hong Kong

Objective: To explore trajectories of public psycho-behavioural responses over one influenza A(H7N9) epidemic wave, and examine the interplays among social norm influence, disease worry and protective behaviours.

Methods: Participants were 464 adults who completed the baseline and at least two follow-up assessments on their H7N9-related Perceived Susceptibility, Perceived Severity, Perceived Efficacy, Worry, Social Norms influence and Protective Behaviours in a five-phase longitudinal survey over one H7N9 epidemic wave. Latent growth modelling (LGM) identified trajectories of these psycho-behavioural responses while multi-process LGM examined the inter-relationships among trajectories of Social Norms influence, Worry and Protective Behaviours.

Results: Trajectories of Perceived Susceptibility, Worry, Social Norms and Protective Behaviours increased initially but declined as the epidemic decayed, while Perceived Severity increased linearly and Perceived Efficacy remained stable across the epidemic. Change in Social Norms influence was significantly associated with change in Worry (β?=?0.65) which was significantly associated with change in Protective Behaviours (β?=?0.62).

Conclusion: The public’s threat appraisal but not efficacy appraisal may have been well-informed by epidemic-related information. Social Norms may be important contributors of public emotional response to an epidemic. Communication via social networks during an epidemic could be important for regulating public emotional response and guiding their behavioural change.