Walter Bradford Cannon: Pioneer of stress research

Walter Bradford Cannon, M.D., made a significant contribution to psychology and medicine with the discovery of the stress response around 1915, setting the cornerstone for psychosomatic medicine. This brief, introductory article etches out the nature of his contribution and sets the stage for Dr. Bradford Cannon to reflect on his father's important professional contributions and personal life in the following article.     

Adverse Housing Conditions and Early‐Onset Delinquency

Housing constitutes an important health resource for children. Research has revealed that, when housing conditions are unfavorable, they can interfere with child health, academic performance, and cognition. Little to no research, however, has considered whether adverse housing conditions and early‐onset delinquency are significantly associated with one another. This study explores the associations between structural and non‐structural housing conditions and delinquent involvement during childhood. Data from the Fragile Families and Child Wellbeing Study (FFCWS) were employed in this study. Each adverse housing condition was significantly associated with early‐onset delinquency. Even so, disarray and deterioration were only significantly linked to early delinquent involvement in the presence of health/safety hazards. The predicted probability of early‐onset delinquency among children exposed to housing risks in the presence of health/safety hazards was nearly three times as large as the predicted probability of early‐onset delinquency among children exposed only to disarray and/or deterioration, and nearly four times as large as the predicted probability of early‐onset delinquency among children exposed to none of the adverse housing conditions. The findings suggest that minimizing housing‐related health/safety hazards among at‐risk subsets of the population may help to alleviate other important public health concerns—particularly early‐onset delinquency. Addressing household health/safety hazards may represent a fruitful avenue for public health programs aimed at the prevention of early‐onset delinquency.     

自立人格与心身症状：特质-应激-症状相符中介模型的检验

自立人格是新近提出的一种新的心身症状的保护性人格因素。为了探索自立人格抵御心身症状的机制, 提出了特质-应激-症状相符中介模型。该模型涉及应激中介模型假设、特质-应激相符假设、特质-症状相符假设三个理论假设。使用青少年学生自立人格量表、青少年生活事件量表和症状自评量表3种问卷对674名有效被试进行了调查, 以检验该模型。结果发现：①应激调节模型不被支持, 自立人格特质是通过应激的中介作用来负向预测心身症状; ②人际自立对心身症状的负向预测能力明显大于个人自立, 人际自立对人际性和个人性症状均有独立的预测能力, 个人自立则对人际性症状没有独立的预测能力; ③个人自立对应激的预测能力大于人际自立, 个人自立对人际和个人应激均有独立的预测能力, 人际自立则对个人应激没有独立的预测能力; ④修正后的自立人格的特质-应激-症状相符中介模型能够获得支持。总之, 本研究的结果显示：人际自立主要通过人际应激的中介作用负向预测心身症状总分; 个人自立则通过应激(包括人际与个人应激)的中介作用负向预测个人性症状。     

A Spinozan lens onto the confusions of borderline relations

In this paper the author describes how, in his analytic work with difficult personality disorders, he uses a neo-Spinozan position or attitude of alpha-thinking and functioning to understand, clarify, and so to manage confused and confusing psychosomatic 'body-mind' and emotional relations, both internally and inter-personally. Two case examples are given, followed by reflections on technique and on the limits of mourning, transformation and irony. The author suggests that a private, ideational double-aspect, mind-body position may be helpful in working with these analysands. This analytic mode may create a radically different understanding by incorporating a relational system of containment, self-containment, observation and memory. In addition, the author gives his own version of the aetiology and dynamics of borderline states and relations, and weaves the two cases he reports on into reflections on his countertransferential responses, reactions, inter-actions and 'reverie' through the lens of a neo-Spinozan conceptual system.     

In the grip of the python: Conflicts at the university-industry interface

When the University of Toronto withdrew a contract it held with me in December 2000, it initiated a sequence of events that led to a public letter to the University from senior figures in the world psychopharmacology community protesting against the infringement of academic freedom involved and a first ever legal action, undertaked by this author, seeking redress for a violation of academic freedom. The issues of academic freedom surrounding this case have been intertwined with a debate about the possibility that the selective serotonin reuptake inhibitor (SSRI) group of antidepressants have the potential to trigger suicidality in a subgroup of patients. Whether the SSRIs do trigger suicidality or not, exploration of this issue has given rise to a number of worrying sets of observations. First, in my view, there is evidence that pharmaceutical companies have miscoded raw data on suicidal acts and suicidal ideation. Second, this author also maintains that there is a growing body of examples of ghostwriting of articles in the therapeutics domain. Many of the tensions evident in this case, therefore, can be linked to company abilities to keep clinical trial data out of the public domain — this is the point at which the pharmaceutical python gets a grip on academia.     

Psychosocial effects associated with dental fear in adult dental patients with avoidance behaviours

Abstract

The most obvious consequence of a genuine dental phobic reaction is the avoidance of necessary dental care. Previous research has indicated that such avoidance has adverse effects on an individual's oral health status, and also reduces the quality of life. However, systematic investigations in this area of dentistry are few and clinical observations and interviews may often fail to elicit information regarding the impairment created outside the dental situation. The present investigation assessed the presence and levels of emotional and social life effects among dental phobic patients with regard to the prevalence of dental and general fears and the length of time for which dentistry had been avoided. It was shown that a majority of the patients felt that they had to curtail their social relations, and many, especially long-term avoiders, reported wide-spread negative social life effects. Often this had extended into feelings of loneliness or to overt social isolation. It remains to be seen whether fear of dentistry itself produces disadvantage or whether these effects are mainly related to personality factors, which can also promote the development of dental fear. Alternatively, poor dental health, which is probably more frequent in anxious patients, may be perceived by these patients and thus impair social relationships.     

Psychosomatic breast and alexithymic breast: A Bionian psychosomatic perspective

The author develops the concept of ‘psychosomatic breast’ in both clinical and theoretical terms, a concept developed by Bion (1962b) to account for a breast in charge of primary symbolization and of the psychosomatic integration of the infant's raw physiological, emotional and sensory experiences. As such, the psychosomatic breast is a prototype, a core in the mother endowed with the capacity for reverie insofar as the transformative function of the latter not only pertains to the primary symbolization of emotional life, but also to its secondary symbolization. The author contends that a primal failure in the transformation of such raw emotional and sensory experiences through the reverie of primary objects results in the incorporation of an ‘alexithymic breast’ – a kind of obstructive object that has become impervious to communication via projective identification and has been internalized as a source of psychic and physical breakdown. This early deficiency in parental reverie is experienced by the infant as a primitive disaster that establishes a point of fixation, a fault line in psychosomatic organization which the individual is likely to regress to, at a later stage, by developing physical illness. The author illustrates the dynamics and the economy of the conflict between psychosomatic and alexithymic breasts thanks to fragments from the analysis of a woman who developed cancer in the course of her psychoanalysis and was eventually cured.