Addictive Personality Factors

This study was designed to compare mean scores obtained by alcoholics, compulsive gamblers, smokers, chronic joggers, and control subjects on six subfactors of the MacAndrew Alcoholism Scale. Results indicated that some MacAndrew factors may be more sensitive to addictive pathology than others. Alcoholics emerged as the most pathological group, in terms of scores on the Cognitive Impairment, Social Maladjustment, and Risk Taking scales. Gamblers and smokers appeared to be distinctly different, more socially oriented addicts. Frequency of jogging was negatively related to measures of addiction but positively related to measures of compulsiveness.     

A Comparative Study of the Intelligence of Jewish Preschool Boys and Girls of Orthodox Parentage

Children aged 2-51/2 to 5-1/2 were pretrained on two three-choice simple discrimination problems presented consecutively, which were followed by training on 10 unique oddity sets. Transfer data were obtained from those Ss who learned the oddity problems by presenting five new oddity sets.

All three Groups learned the second pretraining problem more quickly than the first, although on both problems the two older Groups learned faster than the youngest Group. Nearly all the Ss learned to select the correct stimuli on the 10 three-choice oddity sets. Sixty-four percent of the children between 2-1/2 and 4-1/2 evidenced transfer to the five new oddity sets, indicating comprehension of the oddity relationship and the ability to respond on the basis of this higher-order solution. This finding is contrary to that predicted by contemporary theories of cognitive development (e.g., 3, 8).

The remaining Ss had either learned to choose the odd stimulus, but were unable to maintain a relational choice when presented with new sets, or solved the original discrimination by applying specific solutions to a 10-problem simultaneous three-choice discrimination problem.     

A Wild West of the Mind

§258 of Wittgenstein's Philosophical Investigations is often seen as the core of his private language argument. While its role is certainly overinflated and it is a mistake to think that there is anything that could be called the private language argument, §258 is an important part of the private language sections of the Philosophical Investigations. As with so much of Wittgenstein's work, there are widely diverse interpretations of why exactly the private diarist's attempted ostensive definition fails. I argue for a version of the no-stage-setting interpretation of the failure of private ostension. On this interpretation, the reason why the diarist cannot establish a meaning for ‘S’ is that she lacks the conceptual-linguistic stage-setting needed to disambiguate the concentration of her attention (the private analogue of an ostensive definition). Thus, the problem with any subsequent use of ‘S’ is not that there is no criterion of correctness for remembering the meaning of ‘S’ correctly, or for re-identifying S correctly in the future. Rather, it is because of the initial failure to define ‘S’ that there is nothing that could count as a criterion of correctness for the future use of ‘S’; there is nothing to remember or re-identify. My argument for the no-stage-setting interpretation consists in showing how well it fits into the rest of the Philosophical Investigations and in defending it against objections from Robert J. Fogelin, Anthony Kenny, and most recently John V. Canfield. Kenny's and Canfield's objections are found to suffer from problems regarding memory scepticism.     

Method Acting and Gestalt Therapy with Couples

SUMMARY

Techniques taken from Method acting may be useful therapeutic tools and may lend themselves to adoption by Gestalt therapists. Similarities between the goals and procedures of Method acting and Gestalt therapy are described in some detail. The importance and effectiveness of enacted fantasy are discussed, and techniques of Method acting are described in terms of their relation to Gestalt theory. The importance and application of these techniques to Gestalt therapy with couples are discussed.     

The Case Study of Jacob: Childhood Sexual Abuse and the Limitations of the Holding Environment

Childhood sexual abuse and trauma influence relational development in significant ways. Notable among them are the development of a patient's internal object world, fantasies, and sense of self. Dynamic formulations and holding techniques are used to identify, process, and alter fractured relational dynamics. However, the use of such techniques may also influence a patient's narrative process, pulling them away from the realities of their life as lived. Using the case study method, focusing specifically on the patient's narrative development, this article examines the impact of analytic framing on a patient's experience of child sexual abuse and trauma.     

The End of the Solidly Democratic South: The Impressionable‐Years Hypothesis

The partisan realignment of the White South, which transformed this region from being solidly Democratic to being the base of the Republican Party, has been the focus of much scholarship. Exactly how it occurred is unclear. Widespread individual‐level attitude changes would be contrary to the well‐known within‐person stability of party identification. However, according to the impressionable‐years hypothesis, events that occur during adolescence and early adulthood may have a lasting impact on later political attitudes. This would suggest that cohort replacement may be driving partisan realignment. We test this possibility using data from the American National Election Studies from 1960 to 2008. Consistent with the impressionable‐years hypothesis, Southern Whites from the pre‐Civil Rights cohort (born before 1936) maintained their Democratic Party identification longer than their younger counterparts. However, all cohorts in the South have changed their partisan attitudes at comparable rates over time, contrary to the impressionable‐years hypothesis. These data suggest that the partisan realignment of the South was driven by both cohort replacement and within‐cohort attitude change. More targeted case studies of older cohorts living through the civil rights era, and of younger cohorts in the post‐Reagan era, yield results generally consistent with the impressionable‐years hypothesis. More generally, our findings suggest that very large scale events are required to disrupt the normal continuity of party identification across the life span.     

Further developments of the concept of fantasy

After the Isaacs' seminal work on the nature and function of unconscious phantasy (1948), several authors (mostly in the British Society) have reflected on the topic and tried to extend the concept of fantasy. In this paper I shall examine the contributions of Winnicott, Gaddini, Joseph and Anne Marie Sandler that aim at broadening this psychoanalytic concept. The authors that I have considered share a focus mostly on the early stages of child development. Both Winnicott and Gaddini belong to a line of thinking that explores the vicissitudes of the primary emotional development of the infantile self (in the mother‐infant relationship) involving the earliest processes of holding and bodily and kinaesthetic fantasy that form the bodily integrity of the person. The Sandlers focused mostly on the concept of the past unconscious understood as a place of primitive vicissitudes with a deficit in figuration where the process of repression is missing. The present unconscious phantasy (that is located in the here and now) has the function of rendering the past unconscious phantasy partly accessible; otherwise it would remain unknowable.     

从雌激素替代治疗的历史看临床决策的影响因素

20世纪40年代,动物实验提供的致癌效应证据限制了雌激素替代治疗的应用。20世纪60年代,价值观因素极大地推动了雌激素替代治疗,以至于关于致癌效应的证据被忽视。20世纪70年代,人群研究提供的致癌效应证据使得雌激素替代治疗的应用不断减少。20世纪80年代,致癌效应的消除和观察性流行病学研究提供的心脏保护证据,将雌激素替代治疗的应用推向了顶峰。20世纪末,大规模随机对照试验提供的有害效应证据推动了雌激素替代治疗应用的大幅下降。雌激素替代治疗一波三折的历史体现了证据、价值观在不同时期对临床决策的不同影响,说明只有遵循循证医学的实践模式,基于现有最佳的科学证据,并结合医生的临床经验与患者的价值观,才可能做出科学、有效的临床治疗决策。     

False Memories,Negative Affects,and Psychic Reality: The Role of Extra‐Clinical Data in Psychoanalysis1

Psychoanalysis as a treatment originated in the idea that neurosis is related to the ways in which individual psychic reality departs from actuality. Psychic reality includes memories, beliefs and their associated affects and fantasies connected with an individual's experience of the inner and outer world. The psychoanalytic determination of what meaningful memories or beliefs are inaccurate, distorted or false ordinarily relies upon principles of intra‐clinical validation. By itself, however, intra‐clinical validation is subject to limitations and pitfalls that conviction alone about what is actual cannot circumvent. Despite this fact, there are remarkably few analytic case reports demonstrating false or signifi cantly distorted memories through the use of data obtained from outside the consulting room. This paucity of reports may be related, at least in part, to the belief that the use of extra‐clinical data is essentially unanalytic or supports resistance. Based on the views that (a) psychic reality cannot be regarded as exclusively subjective or objective but is inherently both; and that (b) a goal of analysis is to achieve a different, acceptable and more accurate view of reality, the authors report a clinical case involving a confi rmably false pivotal memory and its associated negative affects. They discuss theoretical and technical considerations in utilizing extra‐clinical data during the treatment process.     

减少医师自卫医学行为的对策研究

根据自卫医学行为产生的原因,减少自卫医学行为有两个思路,一个是减轻医师的法律责任,另一个是化解医师在法律责任下所面临的风险.根据第二个思路,应该采取下面的措施:建立医师责任保险制度;建立医疗责任保险制度;实施医疗风险管理;提高医师个人的执业素养.