Three boys and their stories: Atypical eating and primitive relations1

Eating disorders of whatever category, especially the most severe ones such as anorexia or bulimia, are often considered typical of the female sex. While this is correct concerning these two disorders, I suggest that there are other eating disorders that are more frequent among boys, especially the ones concerning atypical relations to food, notwithstanding the evidence that the already very well‐known syndromes of bulimia and anorexia are also gaining ground among males. However, similar, unspecified eating disorders do not seem to occur so often among girls. Clinical data from my private practice should be taken for granted considering these matters, since I do not yet have statistical data to back up my thesis. In examples from three clinical cases involving boys and one female vignette, I shall attempt to establish a relation between eating disorders and primitive relations with men and women. This relation goes well beyond the oft‐cited ‘contemporary’ causes of eating disorders. In addition, I shall situate these differences among symptoms of both sexes and relate them to impasses in different stages of emotional development, as well as to the extent to which girls’ identification with their mother’s sex can influence their acquisition of eating disorders.     

Associations Between Symptoms of Borderline Personality Disorder,Externalizing Disorders,and Suicide-Related Behaviors

Borderline personality disorder and externalizing disorders are associated with suicide-related behaviors. The present study examined whether symptoms of borderline personality disorder mediate the relationship between externalizing disorders and suicide-related behaviors. Diagnostic interviews were administered to 344 participants (n = 233 women). Results indicated that symptoms of antisocial personality disorder, alcohol use disorders, and drug use disorders each were significantly associated with suicide threats and self-injurious behavior in women and symptoms of antisocial personality disorder were associated with suicide attempts in women. With the exception of the association between symptoms of alcohol dependence and self-injurious behaviors, borderline personality disorder symptoms mediated or partially mediated all associations between externalizing disorders and suicide-related behaviors in women. These results highlight the importance of assessment and treatment of borderline personality disorder symptoms in individuals with externalizing disorders, particularly in the presence of suicide-related behaviors.

Would We Recognize Progress if We Saw it? A Commentary

Comments on the nature of special education as an enterprise and judgment of its progress are offered. Five independent but necessary and sufficient criteria for judgment of progress in special education for students with emotional or behavioral disorders are suggested. Comments are made on each of the articles in the series, and concluding remarks call for more data and better thinking.     

Psychiatric Disorders in Clinical Genetics I: Addressing Family Histories of Psychiatric Illness

This is the first article of a two-part professional development series addressing genetic counseling for personal and family histories of psychiatric disorders. It is based on an Educational Breakout Session presented by the Psychiatric Special Interest Group of the National Society of Genetic Counselors at the 2006 Annual Education Conference. This article examines issues that arise in addressing family histories of psychiatric illness, while the second article in the series considers the generation and provision of individualized recurrence risks for psychiatric disorders. In this article we discuss the importance of managing uncertainty for affected individuals and their close family members who have been referred to genetics for a number of different indications. We then use four simulated cases to make recommendations about the scope and timing of discussions related to the psychiatric family history.     

克恩伯格边缘性人格组织理论述评

边缘性人格组织是人格障碍的内在结构。克恩伯格主要从非特异性自我虚弱性、现实检验、原始防御机制、病理性的内在客体关系以及身份认同紊乱五个方面阐述了边缘性人格组织理论。该理论弥补了DSM-Ⅳ中人格障碍诊断标准的无理论化倾向的缺陷,并为深入理解人格障碍的心理病理学提供了一个系统框架。     

Tactile orientation constancy: Do proprioception and attention affect the tactile vertical?1

Abstract: Tactile vertical, defined as the edge orientation that participants perceive to be vertical, was examined in four experiments. In Experiment 1, we touched the participants’ cheek, lips, or hand with an edge and asked them to judge its orientation with regard to gravitational vertical, both when the stimulated body part was upright (or, in the case of the lips, aligned), and when it was tilted (lips, distorted). We found that when the head or hand was tilted forward 30°, or when the lower lip was distorted approximately 38° to the left or right, the tactile vertical shifted in the same direction by only a fraction (8.7, 8.6, and 36.3% for the cheek, lips, and hand, respectively) of the change in orientation of the stimulated region. The results indicated considerable, but usually incomplete, orientation constancy. In Experiment 2, we measured tactile vertical on the hand for forward tilts from 0° to 45°. We found that as the hand was tilted, the tactile vertical increasingly shifted in the same direction as the hand (i.e., a tactile Aubert effect). In Experiment 3, the effect of attentional focus on tactile vertical was examined by comparing the tactile vertical of participants who attended to body‐centered coordinates, and others who attended to gravitation‐centered coordinates. We found that focusing on body‐centered coordinates caused a decrease in orientation constancy. We sought to examine the role of attention further in Experiment 4, measuring tactile vertical on the cheek of persons with temporomandibular disorders. Compared with normal participants, these participants displayed significantly lower constancy. The results were accounted for by a narrowing of attention to painful signals, so that proprioceptive information was attended to less. In conclusion, the degree of tactile orientation constancy that participants demonstrate varies as a function of body site and attentional focus.     

Feasibility and Acceptability of Cognitive Bias Modification for Interpretation as an Adjunctive Treatment for OCD and Related Disorders: A Pilot Randomized Controlled Trial

Cognitive models implicate interpretation bias in the development and maintenance of obsessive compulsive and related disorders (OCRDs), and research supports Cognitive Bias Modification for Interpretation (CBM-I) in targeting this mechanism. However, prior studies in OCRDs have been limited to nonclinical populations, adolescents, and adults in a laboratory setting. This study evaluated the feasibility and acceptability of CBM-I as an adjunctive intervention during intensive/residential treatment (IRT) for adults with OCRDs. We modified a lab-based CBM-I training for adults seeking IRT for OCRDs, and conducted a feasibility trial (N = 4) and subsequent pilot RCT; participants (N = 31) were randomized to receive CBM-I or psychoeducation. Benchmarks were met for feasibility, acceptability, and target engagement. From pre- to post-intervention, the CBM-I group showed a large effect for change in interpretation bias (d = .90), whereas this effect was trivial (d = .06) for psychoeducation. This was the first study to evaluate CBM-I in naturalistic treatment for adults seeking IRT for OCRDs. Findings support the feasibility and acceptability of CBM-I in this novel sample and setting. A larger scale RCT is needed to determine whether CBM-I can enhance OCRD treatment response.     

Troubles musculosquelettiques,pratique instrumentale et ressentis des musiciens d’orchestre professionnels en confinement dû à la COVID-19

IntroductionProfessional orchestra musicians frequently suffer from musculoskeletal disorders related to their working conditions. In the spring of 2020, the lockdown and the interruption of their professional activities because of the COVID-19 pandemic could have presented an opportunity for them to recuperate but could also have increased their professional uncertainty and been a source of negative emotions.ObjectiveThe first objective is to evaluate the evolution of musicians’ musculoskeletal disorders in relation to the interruption of their professional activities due to COVID-19. The second is to examine the impact of professional uncertainty caused by the pandemic on their instrument practice as a function of the emotions it generated.MethodA questionnaire concerning instrument practice and musculoskeletal disorders was completed by 439 French orchestra musicians in 2019 (period of professional activity). During lockdown (April 2020), a second questionnaire measuring these variables as well as professional uncertainty, emotions, emotional exhaustion, and the lockdown experience was completed by 172 musicians.ResultsInstrument practice and musculoskeletal disorders decreased between the periods of activity and lockdown. Professional uncertainty during lockdown correlated with negative emotions. Emotional exhaustion mediated the relations between uncertainty and the effort perceived when practicing one's instrument on the one hand and the pleasure experienced during practice on the other.ConclusionFor orchestra musicians in lockdown, uncertainty was related to negative emotions. Playing their instrument required more effort and was not associated with well-being, emphasizing the difficulties regarding the resumption of their professional activity in conditions which would limit the risk of injury.