Change after long-term psychoanalytic psychotherapy

Psychoanalytic psychotherapy in clinical practice is traditionally a long-term treatment conducted by well-trained psychotherapists. However, very few studies have been published that evaluate the effects of such treatment. To redress this lack of studies, 55 individuals selected for long-term psychoanalytic psychotherapy (average, 3 years) were invited to participate in a naturalistic study. The psychotherapists had a mean of 15 years of professional experience. The 36 patients who completed psychotherapy manifested a substantial reduction in symptomatic suffering and decreased levels of character pathology, as measured by the Karolinska Psychodynamic Profile (KAPP) and the Karolinska Scales of Personality. Generally, such changes were not found in the individuals who did not engage in treatment. In the therapy group, improvements were found on eight KAPP subscales defining different aspects of character: Intimacy and Reciprocity, Frustration Tolerance, Regression in the Service of the Ego, Coping with Aggressive Affects, Conceptions of Bodily Appearance and their Significance for Self-esteem, Sexual Function, Sexual Satisfaction, and Personality Organization. The results indicate that individuals who engaged in psychotherapy improved their capacity to handle crucial aspects of life and reduced their symptomatic suffering.     

Assessment of maladaptiveness: a core issue in the diagnosing of personality disorders.

Although an operationalized and commonly accepted definition of maladaptiveness is lacking, the delineation of personality traits as being adaptive or maladaptive is essential in diagnosing personality disorders (PDs). A way to explore the meaning of maladaptiveness is to compare how patients from all DSM-III-R PDs relate to different traits and dimensions of various dimensional models of personality. In the present study, the Karolinska Scales of Personality (KSP) were used in a sample of 94 psychiatric outpatients who were assessed according to severity of maladaption and according to type of predominant cluster type of deviant traits. Only one of four factors of the scores of the KSP subscales, "Interpersonal Aversiveness," was related to degree of maladaption, indicating high detachment, suspicion, irritability, dysphoria, and low socialization as core features of maladaptiveness. Three subscales of the KSP Socialization were all associated with maladaptiveness. However, one subscale, "Childhood Adjustment," was also related to the predominant cluster type of personality pathology.     

Temperamental Vulnerability and Suicide Risk After Attempted Suicide

The aim was to extend recent findings of suggested temperamental features in attempted suicide and to explore possible domains of vulnerability to suicide risk after attempted suicide. Fifty-four psychiatric inpatients hospitalized after a suicide attempt underwent lumbar puncture for analysis of CSF 5-HIAA concentration and also completed the Karolinska Scales of Personality (KSP) before discharge from the hospital. Suicide attempters scored high on Somatic Anxiety, Psychic Anxiety, and Muscular Tension, and low on Socialization, findings that support recent findings in suicide attempters followed up after an emergency room visit. Five patients committed early suicide, i.e., within 3 years, and the overall long-term suicide mortality after attempted suicide was 13%. There were significant correlations between survival time among early suicides and CSF 5-HIAA (r = .87;p = .054), and the following KSP scale t scores: Somatic Anxiety (r = ?.96;p < .05), Impulsivity (r = ?.88; p < .05), and Socialization (r = .90; p < .05). KSP Socialization showed correlations with CSF 5-HIAA (r = .89; p = .046) among the early suicides. Features of temperamental vulnerability to suicide risk after attempted suicide might involve anxiety proneness, impulsivity, low socialization, and low CSF 5-HIAA.     

The Swedish National Adult Reading Test (NART-SWE): a test of premorbid IQ

The purpose of this study was to construct a Swedish version of the National Adult Reading Test (NART-SWE), a test for assessment of premorbid IQ, and to investigate its validity and reliability on healthy controls and patients with mild Alzheimer's disease. As Swedish pronunciation rules are fixed, NART-SWE was constructed using loan words. NART-SWE has satisfactory psychometric properties: Inter-rater and retest reliability as well as internal consistency are very high. The NART-SWE demonstrates face validity. In addition, high correlation with IQ was obtained. A significant model emerged when using NART-SWE to predict IQ. Furthermore, no significant differences were observed when comparing performance for healthy controls' with that of patients with Alzheimer's disease on NART-SWE. It does appear that reading of irregular words is intact in mild Alzheimer's disease.     

HAUERWAS'S WITH THE GRAIN OF THE UNIVERSE1 AND THE BARTHIAN OUTLOOK: A Few Observations

This article has two main divisions, the first consisting in parts 1–3, the second in parts 4–8. The purpose of the first division is to assess Hauerwas's contentions regarding what he takes to be serious debilities in modern theological culture. The objects of Hauerwas's criticism are: (1) natural theology; (2) reason as it is represented in the structure of the modern university and in the “Enlightenment Project”; and (3) liberal Protestantism—the latter particularly as it turns up, by his account, in Reinhold Niebuhr's theology. The article will offer a defense of natural theology and an alternative approach to Niebuhr's theology while showing how Hauerwas's contentions concerning these two matters are mistaken. Parts 4–8 are theological studies. These studies concentrate on selected though main aspects of Hauerwas's outlook. Part 4 concerns a problematic implication of the notion, mainly from Barth, of divinity's humanity; Part 5 a note of difficulty from William James about the idea of the theistic God and its pertinence to the Barthian or Hauerwasian God; Part 6 the relation between belief and witness; Part 7 theology's discourse and analogy; Part 8 the Barthian‐Hauerwasian theology as a metaphysics. Part 1, concerning natural theology, stands over both divisions. These observations are not in the main intended as textual studies, though in certain passages the analysis is closely attentive to Hauerwas's text. Also, the paper does not offer the sort of account that would come from a historian, intellectual biographer, or social or cultural analyst or critic. Its focus is philosophical‐theological criticism.     

How to Assess a Model's Testability and Identifiability

Formal definitions are given of the following intuitive concepts: (a) A model is quantitatively testable if its predictions are highly precise and narrow. (b) A model is identifiable if the values of its parameters can be ascertained from empirical observations. (c) A model is redundant if the values of some parameters can be deduced from others or if the values of some observables can be deduced from others. Various rules of thumb for nonredundant models are examined. The Counting Rule states that a model is quantitatively testable if and only if it has fewer parameters than observables. This rule can be safely applied only to identifiable models. If a model is unidentifiable, one must apply a generalization of the Counting Rule known as the Jacobian Rule. This rule states that a model is quantitatively testable if and only if the maximum rank (i.e., the number of linearly independent columns) of its Jacobian matrix (i.e., the matrix of partial derivatives of the function that maps parameter values to the predicted values of observables) is smaller than the number of observables. The Identifiability Rule states that a model is identifiable if and only if the maximum rank of its Jacobian matrix equals the number of parameters. The conclusions provided by these rules are only presumptive. To reach definitive conclusions, additional analyses must be performed. To illustrate the foregoing, the quantitative testability and identifiability of linear models and of discrete-state models are analyzed. Copyright 2000 Academic Press.     

Psychological masculinity-femininity via the gender diagnosticity approach: heritability and consistency across ages and populations

Several aspects of the Gender Diagnosticity (GD) approach of Lippa (1995) to measuring the psychological trait of masculinity-femininity within sexes were explored in four samples ranging from 363 to 5,859 individuals, including Swedish and Australian adults, U.S. elderly, and Australian adolescents. Two ways of deriving GD scales yielded highly similar results. Moderate stability of individual differences was found across ages 12 to 16 among adolescents, but substantial shifts over age occurred in relationships with Eysenck scales. Considerable generality of GD scales was obtained across languages and populations. Substantial heritabilities (about 40%) and minimal effects of shared family environments suggest that within-sex masculinity-femininity behaves as a fairly typical personality trait. Cross-age continuity appeared mainly to reflect the influence of the genes.     

The sounds of dominance.

A study was conducted to determine the effects of vocal cues on judgements of dominance in an interpersonal influence context. Physical measures of human vocal cues and participant ratings of dominance were obtained from videotapes of actors delivering short influence messages. After controlling for linguistic and visual content of messages, results indicated that mean amplitude and amplitude standard deviation were positively associated with dominance judgments, whereas speech rate was negatively associated with dominance judgments. An unexpected interaction revealed that mean fundamental frequency (F₀) was positively associated with dominance judgments for male speakers but not significantly associated with dominance judgments for female speakers. F₀ standard deviation was not significantly associated with dominance judgments. Results support the conclusion that dominance judgments are inferred from multiple sources of information and that some vocal markers of dominance are more influential than others.     

Knowledge and Attitudes Regarding Non-Invasive Prenatal Testing (NIPT) and Preferences for Risk Information among High School Students in Sweden

Non-invasive prenatal testing (NIPT) was recently introduced for prenatal testing of genetic disorders. Cell-free fetal DNA is present in maternal blood during pregnancy and enables detection of fetal chromosome aberrations in a maternal blood sample. The public perspective to this new, simple method has not been illuminated. The views of young people (i.e. future parents) are important to develop suitable counseling strategies regarding prenatal testing. The aim was to explore Swedish high school students’ attitudes, knowledge and preferences regarding NIPT. A questionnaire was completed by 305 students recruited from one high school in Stockholm, November and December 2014. Most students (80 %) considered prenatal testing as good. The majority (65 %) was positive or very positive towards NIPT and 62 % stated that they potentially would like to undergo the test if they or their partner was pregnant. The vast majority (94 %) requested further information about NIPT. Most students (61 %) preferred verbal information, whereas 20 % preferred information via the Internet. The majority of the high school students was positive towards prenatal testing and most was positive towards NIPT. Further, information was requested by the vast majority before making a decision about NIPT. Most of the students preferred verbal information and to a lesser extent information via the Internet. The attitudes, knowledge and preferences for risk information concerning NIPT in young adults are important, in order to increase knowledge on how to educate and inform future parents.     

Hypothalamo-Pituitary-Adrenocortical Regulation Following Lesions of the Central Nucleus of the Amygdala

Previous reports indicate that the central nucleus of the amygdala (CeA) stimulates adrenocorticotropin and corticosterone secretion, suggesting a role for this region in central hypothalamo-pituitary-adrenocortical (HPA) stress regulation. To evaluate this hypothesis, this study assessed the impact of CeA lesion on the response of hypophysiotrophic paraventricular nucleus (PVN) neurons to acute restraint and chronic unpredictable stress exposure. In contrast to previous reports, CeA lesions did not affect corticosterone or ACTH secretion induced by acute stress. Acute restraint increased PVN corticotropin releasing hormone (CRH) mRNA expression, increased the number of parvocellular PVN neurons expressing the co-secretagogue arginine vasopressin (AVP), and induced cFOS mRNA expression in the parvocellular PVN. However, there was no additional effect of CeA lesion on any measure of PVN activation. Chronic unpredictable stress exposure induced long-term activation of the HPA axis, noted by thymic involution, adrenal hypertrophy and increased PVN CRH mRNA expression. Stress-induced changes in thymus and adrenal weights were not affected by CeA lesion. Further, CeA lesion rats did not differ from controls in post-stress CRH mRNA expression. However, basal CRH mRNA expression was increased in the PVN of CeA rats, suggesting that the CeA plays a role in long-term inhibition of the PVN. The results of these studies are not consistent with the hypothesis that the CeA is necessary for stress-induced pituitary-adrenocortical activation. Rather, this region may play a stressor-specific modulatory role in regulation of HPA function.