Immersion in the surface1

In order to treat patients with a narcissistic structure showing a rigid shell of defence together with a lack of inner differentiation – insufficient subject/object constitution – one has to deal with a split kind of transference. Their compelling need for distance corresponds to their fragile self‐esteem. They feel threatened by the analysis and the analytic relationship. Because the seeming normality of these patients’ thinking and language is deceptive, a variation of psychoanalytic technique to facilitate the work with them is described and explained in detail. To transform their two‐dimensional ‘inner’ world, which functions in a PS modus, it is helpful to show them, with changing viewpoints step by step, their own manoeuvres, misconceptions and manipulative use of language within the analytic relationship. The gratifying extension of their self‐awareness leads to the introjection of the analyst’s alpha‐function. This makes possible a more distinct separation of subject and object representations and a transformation to a three‐dimensional, oedipally structured world with a strengthened capacity to symbolize. This method of working is grounded in Bion’s theory of thinking. A case vignette illustrates a development of this kind.     

TRANSFER OF AVERSIVE RESPONDENT ELICITATION IN ACCORDANCE WITH EQUIVALENCE RELATIONS

The present study investigates the transfer of aversively conditioned respondent elicitation through equivalence classes, using skin conductance as the measure of conditioning. The first experiment is an attempt to replicate Experiment 1 in Dougher, Augustson, Markham, Greenway, and Wulfert (1994), with different temporal parameters in the aversive conditioning procedure employed. Match‐to‐sample procedures were used to teach 17 participants two 4‐member equivalence classes. Then, one member of one class was paired with electric shock and one member of the other class was presented without shock. The remaining stimuli from each class were presented in transfer tests. Unlike the findings in the original study, transfer of conditioning was not achieved. In Experiment 2, similar procedures were used with 30 participants, although several modifications were introduced (formation of five‐member classes, direct conditioning with several elements of each class, random sequences of stimulus presentation in transfer tests, reversal in aversive conditioning contingencies). More than 80% of participants who had shown differential conditioning also showed the transfer of function effect. Moreover, this effect was replicated within subjects for 3 participants. This is the first demonstration of the transfer of aversive respondent elicitation through stimulus equivalence classes with the presentation of transfer test trials in random order. The latter prevents the possibility that transfer effects are an artefact of transfer test presentation order.     

工作记忆广度与自我损耗的关系

以往研究表明,工作记忆能力高的个体在自我控制方面也表现得更好,通过考察工作记忆广度（working memory span, WMS）与自我损耗的关系,有助于揭示这种现象的内在机制。66名被试随机分为损耗组和控制组,采用自动化操作广度测验测量WMS。双任务实验中,任务一为情绪抑制任务,任务二为Stroop任务。结果发现,损耗组的Stroop效应明显高于控制组。进一步分析显示,损耗组中高WMS被试的自我损耗效应要强于低WMS被试,此结果表明：高WMS个体在自我控制任务中表现得更好并不是因为固有的自我控制能量水平更高,而是因为他们倾向于在自我控制过程中投入更多能量。     

Use of social networking sites and associations with skin tone dissatisfaction,sun exposure,and sun protection in a sample of Australian adolescents

Objective: Previous research has indicated that greater exposure to traditional media (i.e. television, film, and print) predicted skin cancer risk factors in adolescents; however, the relationship between social media usage and these outcomes remains unexplored. We examined whether social networking site (SNS) usage, and the particular manner of this use, was associated with skin tone dissatisfaction, sun exposure and sun protection among Australian adolescents. We also explored sex differences in SNS usage related to tanning.

Method: A total of 1856 South Australian secondary school students completed the Australian School Students Alcohol and Drug 2014 survey. SNS usage related to tanning comprised posting pictures, posting text, viewing pictures, viewing text and liking or sharing posts.

Results: Adolescents spent 214.56 minutes, on average, per day using SNSs. Behaviours related to tanning that involved pictures (i.e. viewing pictures, posting pictures, and liking or sharing content) were significantly associated with more skin tone dissatisfaction, more sun exposure and less sun protection. Females performed all SNS-linked behaviours more frequently than did males, with the exception of posting text.

Conclusion: Australian adolescents spend a considerable amount of time using SNSs, and their behaviours related to tanning on these SNSs are significantly associated with skin cancer risk factors.     

Relation Between Aggression Exposure During Youth and Later Resting Skin Conductance Levels

Recent research efforts have focused on examining the relationship between environmental and physiological factors to better understand the effect that childhood chronic stress might have on adult health outcomes. This study examines the relation between childhood parental aggression exposure and the sympathetic nervous system (SNS), as measured by resting skin conductance levels (SCLs). Participants (N = 155) completed retrospective self-report measures of childhood exposure to interparental aggression and physically aggressive parenting. The 2-way interaction between exposure to physically aggressive parenting and interparental aggression accounted for unique variance in adulthood SCL. Sex differences emerged in this relationship. Results suggest that the type of aggression exposure might play an important role in the relationship between stressors in youth and resting SNS activity in adulthood. Future research areas are identified, including the need to examine plasticity in the SNS depending on the age of experienced aggression and the age of intervention.     

Disintegration of the self and the regeneration of ‘psychic skin’ in the treatment of traumatized refugees

This paper presents a tentative understanding of the characteristics of the extreme traumas, elsewhere called ‘complex PTSD’, that some refugees and asylum‐seekers bring into therapy. It suggests that these kinds of traumas suffered during adulthood may involve a disintegration of the self and a loss of ‘psychic skin’. This conceptualization is derived from the treatment of a refugee who survived multiple extreme traumas and with whom efforts were made in therapy to identify a complex methodology making use of supplementary therapeutic tools in addition to individual psychotherapy. The case demonstrates how the disintegration of self implies not only a deep somato‐psychic dissociation, but also a loss of intrapsychic and interpersonal space. In the treatment this was worked through via repetition of the victim‐aggressor dynamics at multiple levels. In the end, the therapeutic context was structured like a set of concentric layers, creating a ‘bandage’ over the patient's wounds whilst his ‘psychic skin’ was able to regenerate. The conditions triggered by extreme traumas in refugees challenge some of the cornerstones of individual psychoanalytic technique, as well as the idea that individual therapy may be thought of as existing in an environmental vacuum.     

Resiliency in the Face of Adversity: A Short Longitudinal Test of the Trait Hypothesis

Resilience represents coping with adversity and is in line with a more positive paradigm for viewing responses to adversity. Most research has focused on resilience as coping—a state-based response to adversity. However, a competing hypothesis views resilience or resiliency as a trait that exists across time and types of adversity. We tested undergraduates enrolled in social work classes at a large southern university at two time periods during a single semester using measures of adversity, positive and negative affect, and trait-based resiliency. Consistent with the trait-based resiliency, and in contrast to state-based resilience, resiliency scores were not strongly correlated with adversity at both testing points but were with positive affect, and resiliency scores remained the same over time despite adversity variations. There was no gender or ethnic group difference in resilience scores. Black/African Americans reported significantly less negative affect and more positive affect than White/Caucasians.     

Fearing shades of grey: individual differences in fear responding towards generalisation stimuli

Individual differences in fear generalisation have been proposed to play a role in the aetiology and/or maintenance of anxiety disorders, but few data are available to directly support that claim. The research that is available has focused mostly on generalisation of peripheral and central physiological fear responses. Far less is known about the generalisation of avoidance, the behavioural component of fear. In two experiments, we evaluated how neuroticism, a known vulnerability factor for anxiety, modulates an array of fear responses, including avoidance tendencies, towards generalisation stimuli (GS). Participants underwent differential fear conditioning, in which one conditioned stimulus (CS+) was repeatedly paired with an aversive outcome (shock; unconditioned stimulus, US), whereas another was not (CS?). Fear generalisation was observed across measures in Experiment 1 (US expectancy and evaluative ratings) and Experiment 2 (US expectancy, evaluative ratings, skin conductance, startle responses, safety behaviours), with overall highest responding to the CS+, lowest to the CS? and intermediate responding to the GSs. Neuroticism had very little impact on fear generalisation (but did affect GS recognition rates in Experiment 1), in line with the idea that fear generalisation is largely an adaptive process.     

糖尿病周围神经病变的临床特征及诊断

对称性多发性神经病是糖尿病周围神经病变最常见的类型,根据受损神经纤维的不同,其临床特征亦有差别。目前已有多种方法用于糖尿病周围神经病变的诊断,包括简单的筛查方法,神经电生理检查,定量感觉检查及形态学检查等,但其标准的诊断定义还未达成一致。     

Some technical implications of Klein's concept of 'premature ego development'

In this paper, the author revisits the problem of 'premature ego development' first introduced by Melanie Klein in 1930. She also highlights several developments in post-Kleinian thinking since the publication of that paper, which can be seen as offshoots of or complements to Klein's work. The author proposes a link between this category of precocious development and the absence of the experience of what Bion termed the 'containing object.' She puts forward several technical considerations relevant to analytic work with patients who suffer as a result of early developmental failures and presents various clinical vignettes in order to demonstrate the ways in which these considerations take shape in the analytic setting.