On the nature and standing of psychoanalytic psychotherapy

In this paper, I offer some reflections on the standing of psychoanalytic psychotherapy in the National Health Service (NHS), with special reference to contemporary forms of evidence-based thinking. I consider what may follow when a narrow view of science or psychotherapeutic practice becomes conventional wisdom and assumes dominance. I place stress on the potential loss to NHS psychology and psychiatry if psychoanalytic psychotherapy becomes increasingly marginalized on the one hand, or overly standardized on the other.     

Modeling Interactions Between Latent Variables in Research on Type D Personality: A Monte Carlo Simulation and Clinical Study of Depression and Anxiety

Several approaches exist to model interactions between latent variables. However, it is unclear how these perform when item scores are skewed and ordinal. Research on Type D personality serves as a good case study for that matter. In Study 1, we fitted a multivariate interaction model to predict depression and anxiety with Type D personality, operationalized as an interaction between its two subcomponents negative affectivity (NA) and social inhibition (SI). We constructed this interaction according to four approaches: (1) sum score product; (2) single product indicator; (3) matched product indicators; and (4) latent moderated structural equations (LMS). In Study 2, we compared these interaction models in a simulation study by assessing for each method the bias and precision of the estimated interaction effect under varying conditions. In Study 1, all methods showed a significant Type D effect on both depression and anxiety, although this effect diminished after including the NA and SI quadratic effects. Study 2 showed that the LMS approach performed best with respect to minimizing bias and maximizing power, even when item scores were ordinal and skewed. However, when latent traits were skewed LMS resulted in more false-positive conclusions, while the Matched PI approach adequately controlled the false-positive rate.     

Evaluating Structural Equation Models for Categorical Outcomes: A New Test Statistic and a Practical Challenge of Interpretation

This research is concerned with two topics in assessing model fit for categorical data analysis. The first topic involves the application of a limited-information overall test, introduced in the item response theory literature, to structural equation modeling (SEM) of categorical outcome variables. Most popular SEM test statistics assess how well the model reproduces estimated polychoric correlations. In contrast, limited-information test statistics assess how well the underlying categorical data are reproduced. Here, the recently introduced C₂ statistic of Cai and Monroe (2014) is applied. The second topic concerns how the root mean square error of approximation (RMSEA) fit index can be affected by the number of categories in the outcome variable. This relationship creates challenges for interpreting RMSEA. While the two topics initially appear unrelated, they may conveniently be studied in tandem since RMSEA is based on an overall test statistic, such as C₂. The results are illustrated with an empirical application to data from a large-scale educational survey.     

Perceived behavioural control,subjective norms,attitudes and intention to use condom: A longitudinal cross-lagged design

Based on the Theory of Planned Behaviour (TPB), the purpose of this investigation was to examine the directionality of the association among condom use, intention, attitudes, subjective norms and perceived behavioural control. The present study investigated the nature of these relationships using a longitudinal cross-lagged design applied to data from a cohort of 958 randomly selected Italian adults. Using structural equation modelling, two cross-lagged panel analyses revealed reciprocal relationships between intention and attitudes and between intention and condom use. Contrary to expectations, baseline subjective norms and perceived behavioural control did not predict subsequent intention to use condom when controlled for the autoregressive effect of intention at T1 on the same variable at T2. Also, perceived behavioural control at T1 did not influence condom use at T2 after controlling for the effect of baseline intention. The possibility of reciprocity was also tested for all relations and significant results were found. The moderation effect of perceived behavioural control on the relationship between intention and condom use was not significant. The differences in age, gender and partnership status were taken into account in the analyses.     

Perfectionism and health: A mediational analysis of the roles of stress,social support and health-related behaviours

This study tested a model derived from personality theory in which perceived stress, perceived social support, health-risk and health-promotion behaviours mediate the relationship between perfectionism and perceived physical health. A sample of 538 undergraduate students completed a web-based survey assessing multi-dimensional perfectionism, perceived stress, perceived social support, health behaviours, physical health and a scale tapping elements of the five-factor model of personality. Analyses that account for the effects of traits from the five-factor model (e.g., neuroticism, conscientiousness and extraversion) indicated that socially prescribed perfectionism was associated with poorer physical health and this association was fully mediated by higher levels of perceived stress and lower levels of perceived social support. Self-oriented perfectionism was related complexly to health such that it was related to poorer health via higher levels of perceived stress, but was also related to better health via higher levels of perceived social support. Our findings illustrate the need for considering key mediators of the link between perfectionism and poor health outcomes.     

Review of Evnine,Simon J., Epistemic Dimensions of Personhood,New York: Oxford University Press, 2008, pp. viii + 176, £32.50 (cloth)

The different occurrences of a word in a sentence cannot be identified with the one word type, nor with its many tokens. What then are occurrences of a word? How can one type occur more than once in another type? Is the conception of ‘structural universals’ that leads to these questions incoherent, as Lewis maintained? I argue against the answer Wetzel suggested, which identifies sentences with functions from numbers to expressions, and propose instead that occurrences of one type in another are subtypes with different relative positions in the whole. Types have subtypes as well as tokens. Occurrences in non-symmetrical types like sequences are individuated by their relative positions in the type. Occurrences in a symmetrical whole have different positions but stand in the same relations to the other components. They are numerically different subtypes that do not differ from each other qualitatively.     

Failure to Mentalize: Defect or Defense?

ABSTRACT

The author reviews current thinking on the phenomena of failure to mentalize and provides an alternative to the structural defect point of view. Also included are some clinical implications of this alternative viewpoint.