Dimensions of Pediatric Procedural Distress: Children's Anxiety and Pain During Immunizations

The purpose of this study was to isolate and compare children's procedural anxiety and pain. The study was conducted in a school-based pediatric health clinic with 39 fourth graders receiving 3 injection vaccinations over a 6-month period. Child and nurse ratings and an observational scale assessed anxiety and pain. Results suggest that anxiety and pain are highly correlated, however self-report and an observational measure discriminate between these constructs. Self-report and observational measurement indicated more pediatric pain than anxiety, whereas nurse reports did not indicate differences between children's pain and anxiety.     

PTSD and Emotional Distress Symptoms Measured After a Motor Vehicle Accident: Relationships with Pain Coping Profiles

This study explored differences among pain patients classified as Dysfunctional, Interpersonally Distressed, and Adaptive Copers on the Multidimensional Pain Inventory with respect to PTSD symptomatology, anxiety, and depression. Eighty-five patients with pain complaints who had experienced a serious motor vehicle accident were classified into these three pain coping categories and assessed using clinician and self-report measures. Results indicated that patients classified as Adaptive Copers (n = 24) showed less PTSD symptomatology, anxiety, and depressed mood, relative to individuals classified as Dysfunctional (n = 36) and as Interpersonally Distressed (n = 25), who did not differ on these dimensions. Emotional responses during the accident (fear, helplessness, danger, perceived control, and certainty that one would die) did not differentiate the groups. Pain profiles contributed to the prediction of self-reported PTSD symptoms, controlling for state anxiety. These data suggest that pain patients with both Dysfunctional and Interpersonally Distressed coping profiles are at elevated risk for a range of posttrauma problems following a serious motor vehicle accident.     

Murder: A psychotherapeutic investigation

This paper suggests that it is theoretically necessary and clinically useful to make a distinction between two types of psychic encapsulation within the broader literature. The proposed distinction, as it relates to these psychic structural manifestations, is illustrated here as applied to anorexia. The author suggests that psychic encapsulation is commonly encountered in work with anorexics, and that each type seems to imply a somewhat different therapeutic course. The distinction is made between anorexic patients who appear to display evidence of autistic/autistoid encapsulation as opposed to those who seem to manifest non-autistoid/later traumatic encapsulation – termed secondary adjunctive encapsulation in this paper. Defensive encapsulations are associated with pathological organisations of the personality – both within and beyond these structures, they exert an organising power over central mental processes. Psychic encapsulation and pathological organisations are defensive structural developments – the result of psychic trauma. Clinical material from three cases is presented to illustrate the arguments.     

Instruction Modes for Motor Control Skills Acquisition: A Randomized Controlled Trial

Abstract

The objective was to compare two different instruction modes used to teach patients with nonspecific chronic low back pain (CLBP) to perform a lumbar motor control task. The three intervention instruction modes used were: common verbal explanation of a motor task based on a motor control therapeutic exercise (MCTE-control group), MTCE instructed using motor imagery (MI) and MCTE instructed using tactile feedback (TF). The main outcome measure was lumbar motor control of the neutral position test. Forty-eight patients with CLBP were randomly allocated into three groups of 16 patients per group. The MI strategy was the most effective mode for developing the motor control task in an accurate and controlled manner, obtaining better outcomes than TF or verbal instruction.     

Is emotion regulation associated with cancer-related psychological symptoms?

Objectives: This study examined the cross-sectional and prospective relationships between subjective (cognitive reappraisal, expressive suppression and experiential avoidance) and objective (high-frequency heart rate variability [HF-HRV]) measures of emotion regulation (ER) and a set of psychological symptoms (anxiety, depression, fear of cancer recurrence [FCR], insomnia, fatigue, pain, and cognitive impairments) among women receiving radiation therapy for non-metastatic breast cancer.

Design: Eighty-one participants completed a battery of self-report scales within 10 days before the start of radiotherapy (T1) and within 10 days after its end (T2; approximately 6 weeks after T1). HF-HRV at rest was measured at T1.

Results: Canonical correlation analyses revealed that higher levels of experiential avoidance and expressive suppression were cross-sectionally associated with higher levels of all symptoms, except pain, at T1 and at T2 (both p’s?<?0.0001). Higher levels of suppression and reappraisal at T1 were marginally associated with reduced FCR and with increased depression and fatigue between T1 and T2 (p?=?0.07). HF-HRV was not associated with symptoms cross-sectionally or prospectively.

Conclusions: Although preliminary, these results are consistent with the hypothesis that maladaptive ER strategies, assessed subjectively, may cross-sectionally act as a transdiagnostic mechanism underlying several cancer-related psychological symptoms.     

Representante-representativo,représentant-représentation,ideational representative: Which one is a Freudian concept? On the translation of Vorstellungsrepräsentanz in Spanish,French and English1

The Freudian expression Vorstellungsrepräsentanz ( Freud, 1915b, 1915c ), which is rendered in the Standard Edition as ideational representative, is commonly translated in Spanish as representante-representativo and in French as représentant-représentation, among other renderings. An interdisciplinary conceptual inquiry, which applies linguistic semantics to the evaluation of the available Spanish and French renderings, concludes that this compound expression should be translated in these languages as representante ideativo and représentant idéatif, respectively, renderings which happen to correspond to Strachey’s translation into English in the SE. In contrast to most Spanish and French translations, this proposal conforms to the semantic principle of compositionality. On the one hand, it provides a suitable translation of the two parts of the compound. Thus it renders Vorstellung as idea, with the classical meaning of image or mental representation, which can be traced back to Hume’s empiricist philosophy, and it renders Repräsentanz as representative, with the meaning of delegate. On the other hand, its linguistic form preserves the attributive meaning relationship which exists between both concepts in the original German expression. Against the background of these semantic considerations, a theoretical question concerning Freudian metapsychology is discussed: the drive has a psychic representative, but is there a (mental) representation of the drive?