Two modalities of manic defences: Their function in adolescent breakdown

The aim of this paper is to explore two different modalities of manic defences and their specific underlying anxieties. I will describe the relation between these defences and the role of the superego and their specific function in adolescent breakdown. While one type of manic defence operates by the ego’s identification with a sadistic superego the other one operates via evacuation of a guilt-inducing superego. I will illustrate the proposed ideas with clinical examples from the analysis of two adolescents. This paper stresses the specific differences between these two modalities and the clinical importance of both identifying and addressing the enactment in the transference of the unconscious phantasies and anxieties (paranoid and depressive) that give rise to these two types of defences.     

Seeing in the Dark: A View into Dissociation and Healing

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched’s (2013) recommendation for a “binocular stance” to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client’s unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.     

Visual context processing and its development in gamers and non-gamers

Visual context processing was investigated in both action video game players and nonplayers using the Ebbinghaus illusion task (N = 312, 39.4% female) in a cross-sectional study design. When presented in context, players showed markedly poorer target size discrimination accuracy compared with nonplayers in the 6-, 7-, 8-, and 9-years old age groups, but this difference was reduced in 10-years old group and diminished in adults. When presented in isolation (no-context), the two groups displayed similar performance in all age groups. Furthermore, nonplayers (linear) and players (bell curve) showed profoundly different age-related differences in context processing. These findings provide evidence that players might have enhanced perceptual bias to process visual context in the transition from early childhood to early adolescence, and the differences between the two groups start at early ages and continue with distinct developmental profiles.     

Susceptibility to prosocial and antisocial influence in adolescence following mindfulness training

Mindfulness training programmes have shown to encourage prosocial behaviours and reduce antisocial tendencies in adolescents. However, less is known about whether training affects susceptibility to prosocial and antisocial influence. The current study investigated the effect of mindfulness training (compared with an active control) on self-reported prosocial and antisocial tendencies and susceptibility to prosocial and antisocial influence. 465 adolescents aged 11–16 years were randomly allocated to one of two training programmes. Pre- and post-training, participants completed a social influence task. Self-reported likelihood of engaging in prosocial and antisocial behaviours did not change post-training, and regardless of training group, participants showed a higher propensity for prosocial influence than for antisocial influence. Finally, participants were less influenced by antisocial ratings following both training programmes.     

Intra- and interpersonal factors and adolescent wellbeing during COVID-19 in three countries

COVID-19 has altered adolescents' opportunities for developing and strengthening interpersonal skills and proficiencies. Using data from adolescents in Italy, the United States, and the United Kingdom, we examined the relation between internalizing symptoms assessed pre-pandemic or when pandemic-related restrictions were lifted (Time 1) and associated internalizing symptoms during a subsequent restrictive pandemic period (Time 2). Across all 3 countries, we found significant and consistent effect sizes in the relation between Time 1 and Time 2 internalizing symptoms. We further examined the direct and moderating impact of self-efficacy and contextual supports for adolescents' internalizing symptoms. Higher self-efficacy was associated with lower levels of internalizing symptoms at Time 2 in all 3 countries. Additionally, the relation between Time 1 and 2 internalizing symptoms was buffered by regulatory self-efficacy and peer support in Italy, but in the U.S., higher levels of general self-efficacy instead had an exacerbating effect on the relation between Times 1 and 2 internalizing symptoms. Results are discussed in the context of utilizing cross-national datasets to examine similarities in adolescent well-being over time and in the face of varying government responses to the pandemic.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

Global self-evaluations and perceived instability of self in early adolescence: A cohort longitudinal study

A cohort longitudinal design with four adjacent cohorts of students ( n = 1689) followed over two years was used to study key issues identified in the research literature on the development of self-evaluations in early adolescence. There was no clear relationship between age/grade and self-evaluations. We found no support for a "stressful periods" hypothesis with respect to self: Possible changes were very gradual and quite small. However, there was a consistent "relative age" effect implying that younger students within a grade had more negative self-evaluations. There were small but consistent sex differences in self-evaluations in favor of the boys; more detailed analyses of very negative self-evaluations suggested that the early adolescent years are the period in which a sex difference in depression related symptomatology begins to emerge. Finally, the usefulness of some kind of effect size measure and advantages and problems associated with a cohort longitudinal design were discussed.     

Diagnosis and Assessment of Depression and Suicidality Using the NIMH Diagnostic Interview Schedule for Children (DISC-2.3)

The Diagnostic Interview Schedule for Children (DISC-2.3) was studied in a sample of 265 adolescent inpatients to determine type and concurrent validity of depressive symptoms and depressive disorder diagnoses for different DISC-2.3 informants (parent, adolescent, both). The Children's Depression Rating Scale — Revised, Reynolds Adolescent Depression Scale (RADS), Suicide Ideation Questionnaire — Junior, Spectrum of Suicide Behavior Scale, and clinical consensus diagnoses were used to assess concurrent validity. Results indicated that (1) parents, compared to adolescents, reported a higher prevalence of all depressive symptoms with the exception of weight change; (2) DISC-2.3 depressive and suicidality symptoms were related positively to independent validating criteria for all informant conditions, suggesting good concurrent validity; (3) the DISC-2.3 both informant condition correctly identified the most depressive disorders; and (4) the parent, but not the adolescent, DISC-2.3 Informant condition contributed to the prediction of clinical consensus diagnoses of depression after taking into account RADS scores.     

Self-concept of African-American male youth: Self-esteem and ethnic identity

The role of perceived efficacy, parent support, and community involvement in the self-esteem and ethnic identity of 68 African-American male youth were investigated in this research. The results provided support for the distinctiveness of ethnic identity and self-esteem. A sense of mastery was positively associated with both self-esteem and ethnic identity. Parent support was associated with self-esteem, while community involvement and an appreciation of African-American heritage were positively related to ethnic identity. Implications for future research and the evaluation of prevention and support programs for youth are discussed.     

Neurobehavioral deficits,adolescent traumatic brain injury,and transition to college

Outcome following traumatic brain injury (TBI) has been frequently evaluated for adults, although there has been minimal research on adolescents with TBI. It has been argued that TBI sequelae may be more difficult for adolescents to adjust to given developmental changes in physical (puberty), interpersonal (self-concept), and environmental domains (transition to college). In addition, it is commonly acknowledged that moderator variables such as psychiatric history, family functioning, substance use, and sexuality impact functional outcome following TBI, although it is often difficult to objectively evaluate these variables. The current study examined relationships among TBI-related deficits, moderator variables, and academic outcomes for six adolescents transitioning to college. The findings suggest that it may not be appropriate to predict functional outcome based solely on objective neuropsychological results. However, moderator variables appear to have a more direct relationship with outcome, depending on the moderator variable and the individual.