The end phase of analysis: indicators, functions, and tasks of termination

This paper considers the end phase of analysis. Beginning with a brief review of the literature on termination, specifically the indicators for initiating the termination process, we identify the structural attainments necessary for the patient to successfully complete the analysis and to maintain smooth post-analytic functioning. We stress in this regard the significance of self-analytic functions and the relative immutability of the transference neurosis. These points are illustrated with clinical examples. Our paper concludes with a discussion of the tasks and contributions of the analyst during the termination process. We make special reference to countertransference vulnerability resulting from the analyst's own termination experiences.     

The sociodemographic and psychosocial correlates of COVID-19 vaccine concerns among urban college students

COVID-19 vaccine concerns remain high among Americans. Although recent studies have investigated the sociodemographic disparities in vaccine concerns, less attention has been given to reasons for vaccine skepticism and psychosocial factors that may explain it. The current study examined specific types of vaccine concerns among a diverse sample of college students (N = 1985) living in New York City. Participants who identified as Black, younger, with later immigrant generational status, and those with more conservative political leanings reported more vaccine concerns. Concerns regarding vaccine side effects were the most frequently reported source of concern. Reason for getting vaccinated, personal experiences with COVID, and COVID stress was also associated with vaccine concerns. Study results emphasize the importance of sociodemographic factors and COVID knowledge and stress in examining and addressing vaccine concerns.     

Unconscious fantasy: developmental and self-psychological considerations

The authors view unconscious fantasy from the perspective of self psychology as a significant addition and emendation of the classical framework. A selective review of the pertinent literature is presented, followed by clinical material illustrating the contribution of self-psychological concepts to the understanding of unconscious fantasy formation.     

Ego function assessment of the psychoanalytic process

Pressing needs for objective and rapid clinical assessment of the psychoanalytic process are emerging in the current climate of social and medical change. The Ego Function assessment (EFA) method is presented as an available, valid, and reliable quantitative technique which can be used by clinicians for such objective evaluations. EFA formulations are dynamically highly relevant. They are directly derived from psychoanalytic theory and practice.     

On the nature of attachment in a borderline population: a preliminary investigation

Analyses of interpersonal behavior within a borderline population usually focus on object relations variables. In contrast, this preliminary research focuses on the nature of attachment styles and its relation to behavioral pathology. 24 hospitalized borderline patients were administered an Attachment Style Inventory and Millon Clinical Multiaxial Inventory. Analysis confirms predicted differences in attachment style between the borderline and normal control samples as well as indicates that a dependent style of attachment within this borderline sample is associated with less pathology than an avoidant, hostile, or resistant/ambivalent style. The implications of this preliminary work for full-scale research are addressed.     

Evaluation of a finger prompt variation in the treatment of pediatric feeding disorders

Children with feeding disorders often engage in refusal behavior to escape or avoid eating. Escape extinction combined with reinforcement is a well-established intervention to treat food refusal. Physical guidance procedures (e.g., jaw prompt, finger prompt) have been shown to increase food acceptance and decrease inappropriate mealtime behavior when more commonly employed escape extinction (e.g., nonremoval of the spoon) procedures are ineffective. The finger prompt, however, has not been extensively evaluated as a treatment adjunct to target food refusal, thus necessitating further examination. The purpose of this prospective study was to assess a variation of a finger prompt procedure to treat food refusal and to assess caregivers' acceptability of the procedure. Three children age 1 to 4 years admitted to an intensive feeding disorders program and their caregivers participated. The finger prompt was effective in increasing bite acceptance across all participants and decreasing or maintaining low levels of inappropriate behavior for 2 participants. The procedure was also acceptable to all caregivers.