Inequalities of power and sexual problems

The proposition that sexual problems can emerge as a response to structural inequalities of power is explored by reference to a case which forms part of our current clinical work and research in this area. It is suggested that inequalities of power between heterosexual partners and societal 'discourses' which support the use of sexuality, predominantly by women, as an influence strategy, can serve to promote the development and maintenance of sexual symptoms as forms of covert power struggles. An integration is attempted of systemic and feminist theories with some practical suggestions for therapists working with couples with sexual problems.     

Pathways to Problems – The Evolution of 'Pathology'

This paper describes a qualitative research study which compared accounts from interviews with families where difficulties had evolved into serious problems with those where an escalation into pathology has been avoided. These accounts confirm that family life is commonly seen to be problematic and stressful, particularly during transitional stages. Specifically, it appears that it is not simply the severity of the initial stresses and problems that distinguishes families, but the meanings that these evoke and the corresponding patterns of responses, especially the 'attempted solutions' that are set in motion. These responses, fuelled by external interventions, can launch families along pathological pathways. It is suggested that the meanings ascribed to difficulties and the ensuing responses are predominantly shaped and constrained by three factors: the dominant societally shared discourses of mental health and distress; the emotional resources and attachments of family members; and systemic interpersonal processes. Some therapeutic implications, especially the importance of assisting families to resist pathologizing processes are indicated.     

Mood-congruent attentional bias in dysphoria: maintained attention to and impaired disengagement from negative information

Attentional bias to negative information has been proposed to be a cognitive vulnerability factor for the development of depression. In 2 experiments, the authors examined mood-congruent attentional bias in dysphoria. In both experiments, dysphoric and nondysphoric participants performed an attentional task with negative, positive, and neutral word cues preceding a target. Targets appeared either at the same or at the opposite location of the cue. Overall, results indicate that dysphoric participants show maintained attention for negative words at longer stimulus presentations, which is probably caused by impaired attentional disengagement from negative words. Furthermore, nondysphoric participants maintain their attention more strongly to positive words. These results are discussed in relation to recent developments in the pathogenesis and treatment of depression.     

Effects of positive mood on attention broadening for self-related information

Studies on cognitive effects of positive emotions have associated positive emotions to broadened attention. Given the widely investigated relationship between self-focused attention and mood, it is important to investigate the effect of positive mood on visuospatial attention for self-related information. We used a performance-based measure to assess fluctuations in attentional broadening from self-related contrasted to not-self-related information. In Experiment 1, we checked that the self-related versus not-self-related stimuli did not evoke differential attention effects in general. In Experiment 2, we manipulated mood and found that an increase in positive mood was associated with a relative broadening of attention for self-related information. These results suggest that the meaning of the target of attention provides an interesting dimension for further investigation into the relation between positive emotions and attentional broadening.     

“There is Something not Quite Right with Brad…”: The Ways in Which Families Construct ADHD Before Receiving a Diagnosis

This study explored how four families who were in the midst of the process of a potential diagnosis of ‘Attention Deficit Hyperactivity Disorder’ (ADHD) for their child negotiated competing explanations of the problems. The research drew on a social constructionist, systemic and attachment lens to understand; (a) the constellations of meanings that are constructed by the families to explain the difficulties and (b) how families use strategies in their talk to account for or contest these constellations of meaning. A discursive analysis revealed that the families in this study, following initial explorations, adopted a sequential and cumulative dismissal of psychosocial explanations. Hence, the thrust of the conversation implicitly added up to the only possibility, the inevitable conclusion that it was ADHD. The malleability and flexibility in which the families explored these explanations varied and for some families the process of closure towards ‘illness’ as a dominant explanation sealed alternative conversations more than in others. The findings also revealed a complexity for the parents in balancing the need to offer discipline versus another response and this has clinical implications and highlights the need for further research in this area.     

Feeling happy enhances early spatial encoding of peripheral information automatically: electrophysiological time-course and neural sources

Previous research has shown that positive mood may broaden attention, although it remains unclear whether this effect has a perceptual or a postperceptual locus. In this study, we addressed this question using high-density event-related potential methods. We randomly assigned participants to a positive or a neutral mood condition. Then they performed a demanding oddball task at fixation (primary task ensuring fixation) and a localization task of peripheral stimuli shown at three positions in the upper visual field (secondary task) concurrently. While positive mood did not influence behavioral performance for the primary task, it did facilitate stimulus localization on the secondary task. At the electrophysiological level, we found that the amplitude of the C1 component (reflecting an early retinotopic encoding of the stimulus in V1) was enhanced in the positive, as compared with the neutral, mood group. Importantly, this effect appeared to be largely automatic, because it occurred regardless of the task relevance of the peripheral stimulus and prior to top-down gain control effects seen at the level of the subsequent P1 component. This early effect was also observed irrespective of a change of the target-related P300 component (primary task) by positive mood. These results suggest that positive mood can automatically boost the spatial encoding of peripheral stimuli early on following stimulus onset. This effect can eventually underlie the broadening of spatial attention, which has been associated with this specific mood state.     

Neurocognitive mechanisms behind emotional attention: Inverse effects of anodal tDCS over the left and right DLPFC on gaze disengagement from emotional faces

Background

Attention to relevant emotional information in the environment is an important process related to vulnerability and resilience for mood and anxiety disorders. In the present study, the effects of left and right dorsolateral prefrontal cortex (i.e., DLPFC) stimulation on attentional mechanisms of emotional processing were tested and contrasted.

Methods

A sample of 54 healthy participants received 20 min of active and sham anodal transcranial direct current stimulation (i.e., tDCS) either of the left (n = 27) or of the right DLPFC (n = 27) on two separate days. The anode electrode was placed over the left or the right DLPFC, the cathode over the corresponding contra lateral supraorbital area. After each neurostimulation session, participants completed an eye-tracking task assessing direct processes of attentional engagement towards and attentional disengagement away from emotional faces (happy, disgusted, and sad expressions).

Results

Compared to sham, active tDCS over the left DLPFC led to faster gaze disengagement, whereas active tDCS over the right DLPFC led to slower gaze disengagement from emotional faces. Between-group comparisons showed that such inverse change patterns were significantly different and generalized for all types of emotion.

Conclusions

Our findings support a lateralized role of left and right DLPFC activity in enhancing/worsening the top-down regulation of emotional attention processing. These results support the rationale of new therapies for affective disorders aimed to increase the activation of the left over the right DLPFC in combination with attentional control training, and identify specific target attention mechanisms to be trained.

     

Positive memory enhancement training for individuals with major depressive disorder

When in a negative mood state, individuals with major depressive disorder (MDD) may have difficulties recalling positive autobiographical memories in a manner that repairs that negative mood. Using cognitive bias modification techniques, investigators have successfully altered different aspects of cognition among individuals with MDD. However, little has been done to investigate the modification of positive autobiographical memory recall. This study examined the impact of a novel positive memory enhancement training (PMET) on the memories and subjective affective experiences of individuals with MDD (N = 27). Across a series of trials, participants first recalled a sad memory to elicit a negative mood state. They then recalled a happy memory and completed procedures to elicit a vivid, here-and-now quality of the memory. PMET procedures were hypothesized to promote mood repair via the recall of increasingly vivid and specific positive memories. PMET participants demonstrated improved memory specificity and greater perceived ability to “relive” positive memories. The procedures also repaired mood; PMET participants’ affect following recall of positive memories did not differ from control participants’ affect following recall of neutral memories. Results provide preliminary support for PMET as a method to improve the quality of positive memories and facilitate emotion regulation in MDD.     

A psychoanalytically informed hospitalization‐based treatment of personality disorders

This study presents a model of psychic change in personality disorders focusing on three dimensions: felt safety, mentalization and self‐object relations. Based upon this model a hospitalization‐based therapy program was created. Four scales to measure these three dimensions on the Object Relation Interview are discussed: the Felt Safety Scale, the Reflective Functioning Scale and the Bion Grid Scale and the Differentiation‐Relatedness Scale. A naturalistic symptom outcome study of the program showed a large effect on both symptoms and personality functioning. Furthermore, trajectory based on pre‐treatment patient characteristics (i.e., anaclitic versus introjective personality styles). Importantly, we also found a relation between symptomatic and personality change and change in felt safety and object relations. At 5‐year follow‐up, patients showed sustained improvement in symptomatic distress and further improvement in terms of personality and interpersonal functioning.     

Happy but still focused: failures to find evidence for a mood-induced widening of visual attention

In models of affect and cognition, it is held that positive affect broadens the scope of attention. Consistent with this claim, previous research has indeed suggested that positive affect is associated with impaired selective attention as evidenced by increased interference of spatially distant distractors. However, several recent findings cast doubt on the reliability of this observation. In the present study, we examined whether selective attention in a visual flanker task is influenced by positive mood induction. Across three experiments, positive affect consistently failed to exert any impact on selective attention. The implications of this null-finding for theoretical models of affect and cognition are discussed.