Psychotic withdrawal and the overthrow of psychic reality1

The author attempts to distinguish between the world of fantasy and the imagination (which fuels our capacity to ‘dream’) from a withdrawal into fantasy. In this withdrawal, the foundations of which are laid in childhood, a dissociation from psychic reality starts and from it the delusional world arises and constitutes the adult illness. During therapies of adult patients who have experienced a psychotic state, it is often possible to reconstruct the state of infantile withdrawal and understand how their dissociation from reality was ignored or unknowingly encouraged by their parents. Children destined to develop psychosis enter into the dissociated world not just as a defence against anguish or loneliness, but also for the pleasure of experiencing a delusional self‐suffi ciency and a gratifying omnipotence in which anything is possible. Mental workings that take place in the withdrawal do not follow the rules governing normal psychic functioning. Those fantasies cannot be either repressed or ‘dreamed’ in order to be transformed into thoughts. These psychopathological structures, which develop early and autonomously, have to be understood during analytical therapy in their origins and ‘deconstructed’ in order to help the patient to escape from their dominion. By means of clinical examples, the author tries to shed light on the possible ways of reaching patients in their psychotic shelters, thereby helping them to re‐emerge into a psychic reality.     

Contraction: On the Decision-Theoretical Origins of Minimal Change and Entrenchment

We present a decision-theoretically motivated notion of contraction which, we claim, encodes the principles of minimal change and entrenchment. Contraction is seen as an operation whose goal is to minimize loses of informational value. The operation is also compatible with the principle that in contracting A one should preserve the sentences better entrenched than A (when the belief set contains A). Even when the principle of minimal change and the latter motivation for entrenchment figure prominently among the basic intuitions in the works of, among others, Quine and Ullian (1978), Levi (1980, 1991), Harman (1988) and Gärdenfors (1988), formal accounts of belief change (AGM, KM – see Gärdenfors (1988); Katsuno and Mendelzon (1991)) have abandoned both principles (see Rott (2000)). We argue for the principles and we show how to construct a contraction operation, which obeys both. An axiom system is proposed. We also prove that the decision-theoretic notion of contraction can be completely characterized in terms of the given axioms. Proving this type of completeness result is a well-known open problem in the field, whose solution requires employing both decision-theoretical techniques and logical methods recently used in belief change.     

Health Behaviors of Childhood Cancer Survivors: What We’ve Learned

There has been a dramatic increase in the number of childhood cancer survivors due to improved cancer treatments. However, these survivors are at risk for numerous late-effects as a result of their cancer therapy. Engaging in health-protective behaviors and limiting risky health behaviors are vitally important for survivors given their increased risks and physical late-effects. For this paper, we systematically reviewed the literature on childhood cancer survivors’ health behaviors by searching for published data and conference proceedings using computerized databases and references, and summarized these results. We examined the literature describing the prevalence of a variety of health behaviors among survivors, identifying significant covariates, and describing health behavior interventions. Finally, we provided research recommendations and discussed an ongoing study designed to address some of the limitations in the existing literature. The research to date is limited and recommendations for future studies are outlined.     

Efficacy of CBT for benzodiazepine discontinuation in patients with panic disorder: Further evaluation

Despite its acute efficacy for the treatment of panic disorder, benzodiazepines (BZs) are associated with a withdrawal syndrome that closely mimics anxiety sensations, leading to difficulty with treatment discontinuation and often disorder relapse. An exposure-based cognitive-behavioral treatment for BZ discontinuation, Panic Control Treatment for BZ Discontinuation (CBT) targets the fear of these sensations and has demonstrated efficacy in preventing disorder relapse and facilitating successful BZ discontinuation among patients with panic disorder. In this randomized controlled trial, CBT was compared to taper alone and a taper plus a relaxation condition to control for the effect of therapist contact and support among 47 patients with panic disorder seeking taper from BZs. Based on the primary outcome of successful discontinuation of BZ use, results indicate that adjunctive CBT provided additive benefits above both taper alone and taper plus relaxation, with consistently medium and large effect sizes over time that reached significance at the six month follow-up evaluation. The efficacy of CBT relative to either of the other taper conditions reflected very large and significant effect sizes at that time. These findings suggest that CBT provides specific efficacy for the successful discontinuation from BZs, even when controlling for therapist contact and relaxation training.     

青少年早期社交回避与同伴关系问题:有调节的中介模型

为探讨青少年早期社交回避、同伴关系问题、情绪调节能力和学业成绩的关系,本研究构建了一个有调节的中介模型。采用自我报告、同伴提名和学校记录的方式对上海地区小学4年级至初中1年级共660名被试进行测查,结果显示:(1)社交回避可以正向预测同伴关系问题;(2)情绪调节能力在社交回避与同伴关系问题之间起部分中介作用;(3)学业成绩调节了社交回避通过情绪调节能力影响同伴关系问题的中介作用前半路径。相对于学业成绩较高的儿童,社交回避更容易通过学业成绩较低儿童的情绪调节能力影响同伴关系问题。研究结果不仅可以从情绪调节能力和学业成绩的角度为社交回避个体的同伴关系问题提供解释,而且对引导同伴社会化、提升社会适应的过程具有启示意义。     

The effect of the two feet-in-the-door technique on tobacco deprivation

The ‘Foot-in-the-door’ (FITD) is a well-known compliance technique that increases compliance with a request. Many investigations on this paradigm have generally used prosocial requests to test the effect of the technique. A new evaluation of the effect of the FITD technique was carried out on tobacco deprivation. A two feet-in-the-door technique in which the target request was preceded by two small target requests was used to encourage students to stop smoking for 24 h. The results were compared with two single foot-in-the- door procedures in which the final request was only preceded by one small request, as well as with a control condition using only a 24 h stop-smoking request. Results showed that the single FITD and the two feet-in-the-door procedures were effective to increase verbal compliance (accepting to stop smoking) but only the two feet-in-the-door technique significantly increased behavioural compliance (not smoking for 24 h) with the request.     

Correlates of tobacco use among tuberculosis patients in South Africa: A brief report

This study examined tobacco use by tuberculosis (TB) patients through socio-health variables. The sample comprised 724 TB patients (mean age 37.1 years, SD = 11.3; males = 71.4%) receiving care from 40 primary health facilities across South Africa. They completed a questionnaire at baseline and also at a six-month follow-up. Multivariate logistic regression analysis using generalised estimation equation (GEE) modelling found that daily or almost daily tobacco use significantly reduced over time overall. In terms of socio-health variables, males and those with a comorbid chronic disease had had signficantly higher usage of tobacco over the observation period.     

Development of social problem‐solving strategies and changes in aggressive behavior: A 7‐year follow‐up from childhood to late adolescence

The aim of this study was to predict a stability of aggressive behavior on the basis of social problem‐solving strategies. Subjects were a total of 120 children, but complete follow‐up data were available only in 47 cases. Their aggressive behaviors were peer rated, and problem‐solving strategies were assessed in childhood subjects being 10 years on average, and 7 years later. Association between a development of social strategies and changes in aggressive behavior was studied with personality‐oriented pattern analyses. The main finding was that a development of strategies predicted a stability or changes of aggressive behavior very well. Aggressive strategies, both in childhood and in adolescence, as well as a lack of constructive alternatives characterized permanently aggressive subjects. Turning from nonaggressive to aggressive behavior was also explained by aggressive problem‐solving strategies, while a positive development, i.e., turning from childhood aggressive to adolescent nonaggressive behavior, was possible only if a person had never used aggressive strategies. Agreement between behavior and strategies was higher among girls. The findings supported a claim that intervention of aggressive behavior may be possible by modifying social strategies. Aggr. Behav. 25:269–279, 1999. © 1999 Wiley‐Liss, Inc.     

Why Have We Been More Successful in Reducing Tobacco Use Than Violent Crime?

Tobacco control efforts have been associated with a significant reduction in the prevalence of tobacco use in the United States. Efforts to reduce the incidence of violent crime have been much less successful. This paper argues that progress on tobacco control stems from the existence of a clear, empirically based, and widely understood analysis of the tobacco problem that articulates (a) the harms associated with its use, (b) the causes of tobacco use, and (c) the programs and policies that could reduce tobacco use. This analysis has guided the development of a network of social organizations that have been advocating for policies and programs that are reducing tobacco use. In contrast, there is not a widely shared, cogent, and empirically based analysis of the problem of violent crime. As a result, efforts to combat violent crime are fragmented and it has proven difficult to generate support for preventive programs and policies. Substantial empirical progress has been made, however, on how violent crime could be prevented. That evidence is reviewed. It is argued that the articulation of this evidence is a critical first step for achieving widespread reduction in the incidence of violent crime. Communication of that evidence to audiences that matter will require that behavioral scientists become better organized to advocate for the adoption of empirically supported practices.