Compounding Vulnerability: Pregnancy and Schizophrenia

The predominant ethical framework for addressing reproductive decisions in the maternal–fetal relationship is respect for the woman's autonomy. However, when a pregnant schizophrenic woman lacks such autonomy, healthcare providers try to both protect her and respect her preferences. By delineating etic (objective) and emic (subjective) perspectives on vulnerability, I argue that options which balance both perspectives are preferable and that acting on etic perspectives to the exclusion of emic considerations is rarely justified. In negotiating perspectives, we balance the etic commitment to protect the vulnerable patient and her fetus from harm with the emic concern to empower a decisionally incapacitated woman. Equilibrium is best achieved by nurturing interdependent relationships that empower and protect the vulnerable woman. The analysis points to the need for better social support for mentally ill patients.     

无望抑郁认知易感操作化方法及其研究述评

合成分数、基于最弱联结假设提出的最大值以及基于解释方式差异性提出的个体内标准差是目前无望抑郁研究中应用较广的认知易感操作化方法.回顾无望抑郁研究所使用的认知易感操作化方法,梳理这些操作化方法对理解无望抑郁症状发展及其治疗的意义,可发现合成分数与最大值反映了无望抑郁认知易感因子之间关系的不同侧面,后续研究可继续对这两种操作化方法进行比较,以个体内标准差计算出的解释弹性可能是无望抑郁理论之外新的易感因素,可为治疗抑郁提供新的视角.     

Exploitation in Older Adults: Personal Competence Correlates of Social Vulnerability

ABSTRACT

Clinical assessment of older people at heightened risk of financial exploitation (also termed social vulnerability) is a difficult task. There are a number of previously untested domains of personal competence which could influence social vulnerability in later life. In this study, intellectual, cognitive, and social-cognitive functioning was assessed in a combined sample of dementia patients (n = 31) and neurologically healthy individuals (n = 68) aged 50 years or over. Informants provided assessments of participants' social functioning, personality, and social vulnerability. In the combined sample, multiple regression analyses revealed significant relationships between each personal competence domain and (lower) social vulnerability, apart from personality which was non-significant. General cognitive functioning and, in particular, executive functioning showed significant overlap with social vulnerability after controlling for memory and age. Social measures were also important correlates of vulnerability, indicating that both neurocognitive and social cognitive deficits may contribute to financial exploitation in later life.     

Effects of chronic cocaine administration on spatial learning and hippocampal spine density in two genetically different strains of rats

Lewis and Fischer-344 rats have been proposed as an addiction model because of their differences in addiction behaviour. It has been suggested that drug addiction is related to learning and memory processes and depends on individual genetic background. We have evaluated learning performance using the eight-arm radial maze (RAM) in Lewis and Fischer-344 adult rats undergoing a chronic treatment with cocaine. In order to study whether morphological alterations were involved in the possible changes in learning after chronic cocaine treatment, we counted the spine density in hippocampal CA1 neurons from animals after the RAM protocol. Our results showed that Fischer-344 rats significantly took more time to carry out test acquisition and made a greater number of errors than Lewis animals. Nevertheless, cocaine treatment did not induce changes in learning and memory processes in both strains of rats. These facts indicate that there are genetic differences in spatial learning and memory that are not modified by the chronic treatment with cocaine. Moreover, hippocampal spine density is cocaine-modulated in both strains of rats. In conclusion, cocaine induces similar changes in hippocampal neurons morphology that are not related to genetic differences in spatial learning in the RAM protocol used here.     

Feelings of vulnerability in response to threatening messages: Effects of self-affirmation

We examined effects of self-affirmation on feelings of vulnerability and behavioral intentions following exposure to personally threatening messages varying in message strength. In Experiment 1, female alcohol consumers read a strong message linking alcohol to breast cancer risk. Self-affirmed participants exhibited higher feelings of vulnerability concerning consumption levels and personal risk. In Experiment 2, female caffeine consumers read a weak or strong message linking caffeine to breast disease. Self-affirmed participants reported greater feelings of vulnerability to breast disease and greater intentions to reduce caffeine consumption (relative to control participants) only when reading the strong message. Effects on intentions were mediated by effects on feelings of vulnerability. These studies show that feelings of vulnerability can mediate effects of self-affirmation on intentions to change behavior under threat, although only in the presence of strong messages.     

Trauma, Shame, and Group Psychotherapy: A Self Psychology Perspective

This paper attempts to define trauma from a self psychology/intersubjective perspective and explores shame as a basic aspect of trauma. Self psychologically oriented group therapy is examined as an effective treatment modality for dealing with issues of shame as well as the after effects of trauma.     

Some images of the analyst's participation in the analytic process

This paper was originally presented at a workshop (with G. Atwood and S. Parks) on The analyst's participation in the analytic process'. The analyst's 'vulnerability' is highlighted, with specific reference to the ideas of Winnicott, Searles and Jung. Some personal metaphors for the nature of the analytic engagement are offered, as is the image of the 'troubled analyst' from a patient's dream. The burden and necessity of the analyst's participation are emphasized.     

Incremental Validity of Coping-oriented Marijuana Use Motives in the Prediction of Affect-based Psychological Vulnerability

The present investigation examined whether coping-oriented motives to use marijuana, as measured by the Marijuana Motives Measure (MMM; Simons et al. in J. Couns. Psychol. 45:265–273, 1998), were uniquely related to affect-based psychological vulnerability factors among marijuana users. Participants were 131 adult current marijuana users (72 women, M _age = 20.14, SD = 3.37 years). As hypothesized, after controlling for gender, cigarettes smoked per day, past 30-day marijuana use, total years of marijuana use, and alcohol consumption, coping motives were significantly and incrementally related to negative affect-based psychological vulnerability factors. No other marijuana use motives demonstrated a similar type of relationship to the dependent variables, providing a high degree of explanatory specificity. These data suggest that coping-oriented motives to use marijuana may be an important explanatory construct in better understanding marijuana and psychological vulnerability relations.     

Simul What? Toward a Grace for the Fearful

The doctrines of forensic justification and simul iustus et peccator assume a primarily moral theo‐cosmology. However, the former constricts the excessiveness of divine grace, while the latter fails to adequately capture the fullness of the human condition. Freeing divine grace and theological anthropology from the moral requires a shift in emphasis toward suffering and an acknowledgment that a deep root of sin is creaturely vulnerability. In this case, the incurved self might symbolize the fearful, pulling goods toward the self for protection. While accountability for sin remains important, the first response to the fearful, who act from a sense of deep vulnerability, is compassion rather than judgment. In this way grace attends to but ultimately exceeds the moral.