Cognitive deficits of executive functions and decision‐making in obsessive‐compulsive disorder

The nature of cognitive deficits in obsessive‐compulsive disorder (OCD) is characterized by contradictory findings in terms of specific neuropsychological deficits. Selective impairments have been suggested to involve visuospatial memory, set shifting, decision‐making and response inhibition. The aim of this study was to investigate cognitive deficits in decision‐making and executive functioning in OCD. It was hypothesized that the OCD patients would be less accurate in their responses compared to the healthy controls in rational decision‐making on a version of the Cambridge gambling task (CGT) and on the color‐word interference test and on a version of the Tower of Hanoi test (tower test) of executive functioning. Thirteen participants with OCD were compared to a group of healthy controls (n = 13) matched for age, gender, education and verbal IQ. Results revealed significant differences between the OCD group and the healthy control group on quality of decision‐making on the CGT and for achievement score on the tower test. On these two tasks the OCD group performed worse than the healthy control group. The symptom‐dimension analysis revealed performance differences where safety checking patients were impaired on the tower test compared to contamination patients. Results are discussed in the framework of cognition and emotion processing and findings implicate that OCD models should address, specifically, the interaction between cognition and emotion. Here the emotional disruption hypothesis is forwarded to account for the dysfunctional behaviors in OCD. Further implications regarding methodological and inhibitory factors affecting cognitive information processing are highlighted.     

To know or not to know: an application of Bion’s K and –K to child treatment1

The authors discuss an application of Bion’s conceptualisation of thinking and non-thinking states (K and –K links) to the treatment of a nine-year-old girl. The authors consider Bion’s interrelated concepts such as K and –K, container/contained, maternal reverie, and the development of thinking through alpha function to be highly applicable to child treatment. The afore-mentioned conceptual elements are used to elucidate case material over two consecutive hours. A K link is established between therapist and patient, the fragility of which link is then demonstrated by its deterioration into a –K link. Complex issues about knowing and not knowing are central in this girl’s clinical presentation. She was conceived through in vitro fertilisation (IVF), and subsequently diagnosed with cerebral palsy. The authors consider the emotional impact of this origin story and how the parents relate to it. The authors discuss how parents sometimes cope with perceived losses by wishing to shield or protect their children. This can have repercussions for children’s efforts to know (K) and not to know (?K). The fear that emotional knowledge will be too painful to bear can interfere with ‘learning from experience’. Bion’s premise that the purpose of analysis is the growth of the mind is synonymous with the child analyst’s goal of fostering development and understanding impediments to development.     

PSYKOANALYTISKT ORIENTERAD PSYKOTERAPI

The increasing discourse of the concept of intersubjectivity in modern psychoanalysis has pushed the interest in the intrapsychic and its emphasis on drive and object into the background. Authors who wish to avoid a one-sided focus on intersubjectivity usually subscribe to a dual dimensional approach, taking both perspectives into account. In this article, the analytic situation is described not in two, but in three dimensions, the analytic function constituting a third dimension necessary for the interplay between the other two dimensions. Focusing on the analyst's position, the author presents a model that consists of (1) the-analyst-as-subject, (2) the-analyst-as-function, and (3) the-analyst-as-object. The analytic function is understood to be invested with a particular form of desire and it is argued that the asymmetry between this desire of the analyst and the desire of the analysand is a central characteristic of the analytic situation.     

The present and absent object—on thinking and the capacity to symbolize

In this paper, Bion's different theories on the development of thinking will be introduced: on the one hand, his theory of thoughts as resulting from tolerance for the absence of the object, and on the other hand, dream thoughts and thoughts as resulting from the presence of the object, originally through the mother's containing function. The effects of failures in this development will be discussed; among other things, a hypertrophy of the apparatus of projective identification at the expense of thinking capacities. Briefly, a comparison will be made between a facilitating relation between container and contained and the oscillation between the paranoid-schizoid and depressive position, which Bion describes as a prerequisite for open symbolizing processes. Bion's theories and concepts will be supplemented by Winnicott's theories on the “creative illusion” and the breast/the mother as a “subjective object” as a precondition for the symbolizing capacity that later develops in the “potential space”. Very briefly, a comparison is made between Winnicott's term “the subjective object” and Segal's term “symbolic equation”. Clinical vignettes are interpolated.     

The Use of Rituals in Grieving for a Miscarriage or Stillbirth

Abstract

Preparation for their changing roles in family and society, as well as readying their intimate space for the arrival of an infant, totally engage expectant parents. Miscarriage or stillbirth may bring on a grief storm that strips away many tender roots and branches of new life in the community that the parents have been nurturing. Creation and participation in a grief ritual can bring the grieving parents to a healing resolution. This article describes the healing efficacy of ritual, its elements, and how a compassionate therapist can create one in collaboration with grieving clients.     

Reliability and plasticity of response inhibition and interference control

This study investigated the internal reliability, temporal stability and plasticity of commonly used measures of inhibition-related functions. Stop-signal, go/no-go, antisaccade, Simon, Eriksen flanker, Stroop and Continuous Performance tasks were administered twice to 23 healthy participants over a period of approximately 11 weeks in order to assess test–retest correlations, internal consistency (Cronbach’s alpha), and systematic between as well as within session performance changes. Most of the inhibition-related measures showed good test–retest reliabilities and internal consistencies, with the exception of the stop-signal reaction time measure, which showed poor reliability. Generally no systematic performance changes were observed across the two assessments with the exception of four variables of the Eriksen flanker, Simon and Stroop task which showed reduced variability of reaction time and an improvement in the response time for incongruent trials at second assessment. Predominantly stable performance within one test session was shown for most measures. Overall, these results are informative for studies with designs requiring temporally stable parameters e.g. genetic or longitudinal treatment studies.     

汉语学龄前儿童正字法意识的发展

本研究选择北京地区幼儿园3岁、4岁、5岁儿童各31、48、33名, 采用单部件意识测验和部件位置及功能意识测验系统探查了学龄前儿童的正字法意识各个层面的发展状况。单部件意识测验包括部件替换、部件缺失和部件旋转三个部分; 部件位置及功能意识测验分为假字和非字两个部分, 而非字又包括两形非字和形声非字。结果发现单部件意识测验中, 5岁组儿童在部件替换水平上的得分显著高于3岁组儿童, 而3岁组与4岁组、4岁组与5岁组儿童之间无显著差异; 部件缺失和部件旋转水平上, 三个年龄段的儿童的得分表现出明显的增长趋势。部件位置及功能意识测验中, 假字得分在三个年龄段之间无显著差异; 非字得分随年龄增长显著提高。这些结果表明, 单部件意识在学前期处于不断发展的阶段, 其中对部件替换的非字的拒绝能力发展较早, 部件缺失和部件旋转非字的拒绝能力发展较晚; 部件位置及功能意识在学前期已经开始发展, 3岁儿童已经具有假字符合正字法规则的认识, 但对非字违反部件位置合法性和功能完整性的认识直到4岁左右才开始萌芽, 5岁还未成熟。     

Interference suppression vs. response inhibition: An explanation for the absence of a bilingual advantage in preschoolers’ Stroop task performance

The well-documented advantage that bilingual speakers demonstrate across the lifespan on measures of controlled attention is not observed in preschoolers’ performance on Stroop task variations. We examined the role of task demands in explaining this discrepancy. Whereas the Color/Word Stroop used with adult participants requires interference suppression, the Stroop task typically used with preschoolers requires only response inhibition. We developed an age-appropriate conflict task that measures interference suppression. Fifty-one preschool children (26 bilinguals) completed this new Bivalent Shape Task and the Day/Night task used in previous research. Bilingual in comparison to monolingual children performed better on incongruent trials of the Bivalent Shape Task, but did not differ on other measures. The results indicate that the discrepancy between preschoolers and older individuals in performance on Stroop task adaptations results from characteristics of the task rather than developmental differences. Further, the findings provide additional support for the importance of interference suppression as a mechanism underlying the bilingual advantage.     

Depressive mood and smoking onset: A comparison of adolescents with and without asthma

This prospective population-based study aimed to compare associations between depressive feelings and smoking behaviour of adolescents with and without asthma. Data were collected from a two-wave 22–24 months prospective study among 5938 adolescents who completed self-report questionnaires. Logistic regression analyses showed that depressive feelings and smoking were related both cross-sectionally and longitudinally. Smoking behaviour was similar for adolescents with and without asthma, as well as its correlation with depressive feelings. However, participants with asthma were more likely to report depressive feelings than those without asthma, implying an indirect relationship between asthma and smoking behaviour. Implications for prevention are addressed.