Psychosis,symbol, affectivity 1: etiopathogenesis and treatment through analytical psychology

This is the first of two papers concerning our study into an integrated approach to psychotic disorders, conducted at the University of Palermo’s Psychiatry Unit Polyclinic over approximately 15 years. Here we will explore and reflect upon the acute psychotic condition mainly from a theoretical and conceptual perspective, while in the second paper we will explore the clinical perspective. From the point of view of psychopathology, and in the light of C.G. Jung’s conceptualization of analytical psychology, as well as calling on contributions from other authors from the systemic-relational and post-psychoanalytic field, we will clarify the ideas developed over these last few years by our team. From a more speculative perspective we will advance new interpretive hypotheses in an attempt to thoroughly understand the nature of the psychotic condition, both on a psychodynamic relational and a neuroscientific level. The paper describes how we revised our understanding of psychosis from a brain disease to a process aimed at the rearrangement of psychic functioning, as anticipated by John Weir Perry nearly 40 years ago.     

Illusory 3-D rotation induced by dynamic image shading

Observers' perceptions of the three-dimensional structure of smoothly curved surfaces defined by patterns of image shading were investigated under varying conditions of illumination. In five experiments, observers judged the global orientation and the motion of the simulated surfaces from both static and dynamic patterns of image shading. We found that perceptual performance was more accurate with static than with dynamic displays. Dynamic displays evoked systematic biases in perceptual performance when the surface and the illumination source were simulated as rotating in opposite directions. In these conditions, the surface was incorrectly perceived as rotating in the same direction as the illumination source. Conversely, the orientation of the simulated surfaces was perceived correctly when the frames making up the apparent-motion sequences of the dynamic displays were presented as static images. In Experiment 6, moreover, the results obtained with the computer-generated displays were replicated with solid objects.     

Brain Oxidative Damage Following Acute Immobilization and Mild Emotional Stress

We studied the role of free radicals on brain oxidative damage in rats after acute immobilization stress (restraint) and mild emotional stress (handling). To investigate brain oxidative damage, CuZn and Mn dependent superoxide dismutase (CuZn SOD, Mn SOD) activities, lipid peroxidation (TBARs), Na ⁺ K ⁺ ATPase activity, protein carbonyl (PrC), and reduced and oxidized glutathione (GSH, GSSG) levels were measured in the cerebral cortex (CTX), hippocampus (HIP), and striatum (ST) of the animals after the two different stress stimuli. Because stress produces abnormalities in the hypothalamic-pituitary-adrenal axis, the intensity of the two stress conditions were measured by plasmatic corticosteroid (COR) levels: particularly, COR levels doubled in handled rats and increased 15-fold in restrained animals. The SOD activities increased in CTX and decreased in HIP of the handled rats, while in ST a significant decrease in handled animals but an increase in restrained animals occurred. TBARs, GSH, and GSSG levels remained unchanged, while an index of glutathione redox decreased significantly in ST of handled animals and in CTX of restrained ones. Na ⁺ K ⁺ ATPase activity increased significantly in the HIP and ST of both groups of stressed rats. The stress induced a remarkable increase in PrC levels in all studied cerebral areas. These findings provide evidence to support the idea that stress produces oxidants but that the oxidative damage in stress differs in cerebral areas and could contribute to the degenerative mechanism of aging.     

Callous-unemotional traits,borderline personality,and self-injury in gothic subculture

The present study investigates individual characteristics of a sample of young adults from gothic subculture, in terms of personality traits (i.e., borderline personality and callous-unemotional traits), prevalence and functions of non-suicidal self-injury behaviours (i.e., internal emotion regulation, external emotion regulation, social influence, and sensation seeking). Fifty-one young adults (28 girls and 23 boys, mean age = 26.20, SD = 4.61) were recruited at a gothic meeting in Italy. They completed self-report questionnaires related to self-injury behaviours and self-injury functions, along with measures of borderline personality disorder and callous-unemotional traits. The results indicated that nearly 65% of the participants reported having committed self-injury at least once. Moreover, both bivariate and multivariate analyses indicated that self-injury behaviours were related to borderline personality and internal emotion regulation function. Lastly, association between considered personality traits and self-injury functions were investigated. Overall, results indicated that in gothic subculture self-injury has the function of regulating emotion to maintain the integrity of the Self and is related to the perception of a traumatic reality in which derealization coexists with extreme self-directed aggression.     

Disparity and shading cues cooperate for surface interpolation

In two experiments, we tested whether disparity and shading cues cooperated for surface interpolation. Observers adjusted a probe dot to/lie on a surface specified either by a sparse disparity field, a continuous stereo shading or monocular shading gradient, or both cues. Observers' adjustments were very consistent with disparity information but their adjustments were much more variable with shading information. However, observers significantly improved their precision when both cues were present, relative to when only disparity information was present. These results cannot be explained by assuming that separate modules analyze disparity and shading information, even if observers optimally combined these cues. Rather, we attribute this improvement to a process through which the shading gradient constrains the disparity field in regions where disparities cannot be directly measured. This cooperative process may be based on the natural covariation existing between these cues produced by the retinal projection of smooth surfaces.     

Temporal integration of motion and stereo cues to depth

In three experiments we investigated the integration of three-dimensional information provided over time by different depth cues. In the first experiment, we found that the perceptual derivation of surface orientation from the optic flow was affected by the prior presentation of static stereo information in the same spatial location. This bias weakened as the length of the motion sequence increased, but it was still present after 800 msec. In the second experiment, conversely, we found that the perceived orientation of a stereo-specified surface was not influenced by the prior presentation of a static stereo surface. In a third experiment, we found that two surfaces defined by identical disparity fields did not elicit the same perceived depth if, previously, one of them had been specified by a conjunction of stereo and motion information. This effect was found to last for at least 400 msec. Taken together, these findings indicate that interactions exist among different sources of depth information, even when they are provided at different moments of time.     

Distortions of depth-order relations and parallelism in structure from motion

Four experiments related human perception of depth-order relations in structure-from-motion dis-plays to current Euclidean and affine theories of depth recovery from motion. Discrimination between parallel and nonparallel lines and relative-depth judgments was observed for orthographic projections of rigidly oscillating random-dot surfaces. We found that (1) depth-order relations were perceived veridically for surfaces with the same slant magnitudes, but were systematically biased for surfaces with different slant magnitudes. (2) Parallel (virtual) lines defined by probe dots on surfaces with different slant magnitudes were judged to be nonparallel. (3) Relative-depth judgments were internally inconsistent for probe dots on surfaces with different slant magnitudes. It is argued that both veridical performance and systematic misperceptions may be accounted for by a heuristic analysis of the first-order optic flow.     

Influence of a stereo surface on the perceived tilt of a monocular line.

This study addressed the issue of how a stereo-specified surface influences the perceived two-dimensional orientation of a monocularly viewed line. In a series of three experiments, it was found that, in general, when a monocular line was embedded in a disparity field specifying a planar surface slanted about the horizontal axis, the tilt of the line depended on the slant of the surface in which it was embedded and on whether the line was presented in the left or in the right visual field. These results, predicted by perspective geometry, are compatible with the hypothesis that the monocular line is perceived as part of the stereo surface. Moreover, it was found that timing is a crucial factor in determining the strength of the effect. The effect was at a maximum when the monocular line and the stereo surface were presented together, with no prior presentation of the surface. The influence of the stereo surface on the monocular line was substantially reduced, however, when the surface alone preceded the combined presentation of the line and the surface.     

Influence of a stereo surface on the perceived tilt of a monocular line

This study addressed the issue of how a stereo-specified surface influences the perceived twodimensional orientation of a monocularly viewed line. In a series of three experiments, it was found that, in general, when a monocular line was embedded in a disparity field specifying a planar surface slanted about the horizontal axis, the tilt of the line depended on the slant of the surface in which it was embedded and on whether the line was presented in the left or in the right visual field. These results, predicted by perspective geometry, are compatible with the hypothesis that the monocular line is perceived as part of the stereo surface. Moreover, it was found that timing is a crucial factor in determining the strength of the effect. The effect was at a maximum when the monocular line and the stereo surface were presented together, with no prior presentation of the surface. The influence of the stereo surface on the monocular line was substantially reduced, however, when the surface alone preceded the combined presentation of the line and the surface.     

Psychosis,symbol, affectivity 2: another perspective on the treatment of psychotic disorder

This is the second of two papers concerning our study into an integrated approach to psychotic disorders conducted at the University Psychiatry Unit of Palermo’s Polyclinic over approximately 15 years; this paper concentrates on the clinical phenomena. The study aimed to find the best possible treatment and to improve the prognosis of this patient group. We have explored the efficacy of a range of psycho-therapeutic (cognitive-behavioural, systemic-relational, psychodynamic, group and others), psycho-pharmaceutical, psychiatric rehabilitative and psycho-educational treatments, with a hermeneutic approach instead of a systematic one. The study’s conclusions, described in the paper, are that all psychotic functions start with a nuclear psychic issue connected to emotional development. We describe how the most significant symptoms of acute psychotic manifestations (delusions and misperceptions) make use of an encrypted psychological meaning that can be decoded through the patient’s symbolic language. This language is a key element in diagnosis and in the choice of treatment. The paper describes how we revised our understanding of psychosis from being a brain disease to being a process aimed at the rearrangement of psychic functioning. Our significant results are described.