ON BECOMING ABLE TO PLAY: INDIVIDUAL CHILD PSYCHOANALYTIC PSYCHODRAMA AND THE DEVELOPMENT OF SYMBOLIZATION

In this paper, the authors analyze the relevance and transformative potential of individual psychoanalytic psychodrama in the treatment of children with severe impairments in symbolization. Central features of this modality, including promoting the representation of early traumatic experiences, are presented and discussed. Specific features include double‐envelope containment of the co‐therapists’ group and play leader, consequent diffraction of the transference‐determining portrayal, gradual integration, and initial figuration of coexisting split‐off fragments. Drawing on in‐depth clinical material, the authors show how psychodrama tempers the potentially traumatic effects of the encounter with the object, allowing these patients to access the transitional area of play.     

Why did adolescents have sleep problems after earthquakes? Understanding the role of traumatic exposure,fear, and PTSD

To examine the relationships between trauma exposure, fear, post‐traumatic stress disorder, and sleep problems in adolescents, 746 adolescent survivors of the 2008 Wenchuan earthquake in China were assessed at 1 year (T1) and 1.5 years (T2) after the earthquake using a trauma exposure questionnaire, a fear questionnaire, a child posttraumatic stress disorder symptom scale, and a subscale on child sleep problems. The results showed that T1 trauma exposure were not directly associated with sleep problems at T1 and T2, but played a positive role in sleep problems at both T1 and T2 indirectly through T1 posttraumatic stress disorder and T1 fear. T1 trauma exposure was also positively and indirectly associated with T2 sleep problems through T1 posttraumatic stress disorder via T1 sleep problems, or through T1 fear via the path from T1 posttraumatic stress disorder to T1 sleep problems. These findings indicated that fear and posttraumatic stress disorder 1 year after the earthquake played a mediating role in the relationship between trauma exposure at 1 year after the earthquake, and sleep problems at both 1 year and 1.5 years after the earthquake, respectively. In particular, posttraumatic stress disorder also had a multiple mediating effect in the path from trauma exposure to sleep problems via fear. Furthermore, the findings indicated that sleep problems were relatively stable between 1 and 1.5 years after an earthquake.     

Commitment in romantic relationships as a function of partners’ encoding of important couple-related memories

The purpose of the present study was to investigate how significant couple-related events are encoded in the episodic memory of each partner of a romantic relationship and how they relate to each of these partners’ level of commitment in an independent and additive fashion. Each partner of a couple reported a significant couple-related memory and rated their level of need satisfaction experienced during the event of the memory. In addition, each partner was shown his/her partner’s memory and also rated their own level of need satisfaction for this event. Results showed that partners need satisfaction ratings of their own memory positively predicted their own commitment to the relationship directly (for women) as well as through their need satisfaction generally experienced in the relationship (for men). In addition, men’s need satisfaction ratings of their own memory were associated with women’s commitment while controlling for women’s need satisfaction ratings of men’s memory, but no such cross-partner effects were found for women. Overall, the findings shed light on an initial understanding of how a person’s own memory of an event can impact another person’s attitudes even when taking into account this other person’s memory encoding of that same event.     

Successfully controlling intrusive memories is harder when control must be sustained

After unpleasant events, people often experience intrusive memories that undermine their peace of mind. In response, they often suppress these unwanted memories from awareness. Such efforts may fail, however, when inhibitory control demands are high due to the need to sustain control, or when fatigue compromises inhibitory capacity. Here we examined how sustained inhibitory demand affected intrusive memories in the Think/No-Think paradigm. To isolate intrusions, participants reported, trial-by-trial, whether their preceding attempt to suppress retrieval had triggered retrieval of the memory they intended to suppress. Such counter-intentional retrievals provide a laboratory model of the sort of involuntary retrieval that may underlie intrusive memories. Using this method, we found that longer duration trials increased the probability of an intrusion. Moreover, on later No-Think trials, control over intrusions suddenly declined, with longer trial durations triggering more relapses of items that had been previously been purged. Thus, the challenges of controlling retrieval appear to cause a decline in control over time, due to a change in state, such as fatigue. These findings raise the possibility that characteristics often true of people with psychiatric disorders – such as compromised sleep, and increased demand on control – may contribute to difficulties in suppressing intrusive memories.     

Los Degradados: Out,down, dead: Transmitted and inflicted trauma as encountered in the analysis of a 6‐year‐old girl1

The author presents the analysis of a precocious traumatized little girl, which reveals the ways in which historical trauma is transmitted and intrafamilial trauma is both disguised and represented. The play as it evolves is seen to simultaneously communicate what the child struggles with and to resolutely try to hide what has actually happened. Analyst and child together participate in play which utilizes displacement, enactment and interactive enactment, the latter play mode being the very hallmark of profound traumatic experience. Carlotta, the child, helps the analyst to follow her quest for meaning making even as the interaction between them adheres to and departs from the deepening pentimenti of traumatic experience, which needs to be unraveled and reconstructed in order that her own developmental progression can be rejoined. The analysis facilitates Carlotta's capacity to play in a more unfettered fashion and to assist her family's recovery as well.     

Impaired ability to give a meaning to personally significant events in patients with schizophrenia

Schizophrenia is a severe mental illness affecting sense of identity. Autobiographical memory deficits observed in schizophrenia could contribute to this altered sense of identity. The ability to give a meaning to personally significant events (meaning making) is also critical for identity construction and self-coherence. Twenty-four patients with schizophrenia and 24 control participants were asked to recall five self-defining memories. We assessed meaning making in participants’ narratives (spontaneous meaning making) and afterwards asked them explicitly to give a meaning to their memories (cued meaning making). We found that both spontaneous and cued meaning making were impaired in patients with schizophrenia. This impairment was correlated with executive dysfunctions and level of negative symptoms. Our results suggest that patients’ difficulties in drawing lessons about past experiences could contribute to explain the lack of coherence observed in their life trajectories and their impaired social adjustment abilities. Implications for psychotherapy are also discussed.     

青少年创伤后心理反应的影响机制及其干预研究

汶川地震后青少年的心理反应受到社会的普遍关注。本文作者及其团队对汶川地震后青少年的心理反应进行了为期6年的研究,以期为震后青少年的心理恢复和发展提供帮助。本文主要介绍了6年来本团队在创伤后心理反应的理论分析、青少年创伤后心理反应的状况及其相互关系、影响因素及其机制、干预策略等方面所进行的探索,较为全面地阐述了创伤后青少年主要的心理反应及其研究的理论基础,概括了青少年创伤后应激障碍、抑郁和创伤后成长的状况及其发展趋势,深入分析了影响青少年创伤后应激障碍和创伤后成长的影响机制,提出了针对创伤后青少年的心理干预策略,并探究了未来研究需要关注的内容。     

The relationship between susceptibility to false memories, dissociativity, and paranormal belief and experience

One hundred participants completed a News Coverage Questionnaire concerning personal memories of where they were, what they were doing and who they were with when footage of dramatic news events was first shown on television, as well as asking them to recall details of the footage itself. These news items included four events that are known to have been captured on film and one item concerning non-existent footage of the bombing of a nightclub in Bali. Overall, 36% of respondents reported false memories of the alleged footage of the Bali bombing. Participants reporting false memories were found to score significantly higher than those who did not report such memories on the Australian Sheep–Goat Scale, on various subscales of the Anomalous Experiences Inventory (Belief, Experience and Ability) and on the Dissociative Experiences Scale, supporting the hypothesis that believers in the paranormal may be more susceptible to false memories than non-believers.     

创伤骨科的不当医疗

不当医疗问题已经引起社会各界的广泛关注,它包括过度医疗行为、错误医疗行为和缺陷性医疗行为。创伤骨科疾病不当医疗既与医学发展水平和医学本身规律特点有关,又与现行医疗体制、医院经营机制有关,是患者及家属、医务人员和社会等多因素参与,受现行医学科学发展制约的治疗行为。应避免不当医疗,追求适度医疗,尽量达到最优化医疗。