Search

In this article the author outlines his understanding of self-psychology as an independent psychoanalytic treatment paradigm created by the late Heinz Kohut and initially geared toward the psychoan...

Background Harmful Alcohol use is frequent among opioid dependents patients undergoing agonist maintenance treatment. The objective assessment of harmful alcohol use can be done using laboratory measures of serum biomarkers. For community-based patients, there is often a requirement of an alternative method due to lack of onsite laboratory services. The aim of the study was to examine filter paper as a matrix to measure serum biomarkers of harmful alcohol use. Methods The initial phase involved standardization of the filter-paper-based assay. Conditions were optimised for extraction and estimation of alcohol biomarkers (Aspartate Aminotransferase; AST, Alanine Aminotransferase; ALT, Gamma Glutamyl transferase; GGT and Carbohydrate Deficient Transferrin; CDT) from the filter paper. For clinical validation, serum samples were collected from community clinics. Biomarker levels obtained from both the methods were correlated using linear regression analysis. Limits of agreement between the two methods was estimated using the Intraclass Correlation Coefficient (ICC). Results The extraction of enzymes (AST, ALT and GGT) from filter paper was carried out using the substrate buffer available with the reagent kit (Randox, UK). CDT was readily extracted from filter paper using deionised water. Serum biomarker levels measured from samples collected from community clinics correlated well with filter paper extracted levels (ICC 0.97-0.99). More than 90% of alcohol biomarker levels were recovered from the filter paper matrix using this method. Conclusion Filter paper has the potential to be used as a matrix to objectively measure alcohol biomarkers among opioid-dependent patients from community settings lacking onsite laboratory facilities.

A “4-{[1-(2,5-dihydroxyphenyl)ethylidene]amino}-1,5-dimethyl-2-phenyl-1,2-dihydro-3H-pyrazol-3-one” chemosensor (C1) synthesized by Condensation reaction using “4-amino-1,2-dihydro-1,5-dimethyl-2-phenylpyrazol-3-one” and “2,5-dihydroxy Actophenone”. It shows absorption peak at 326 nm due to the C=C bond (π-π* transition), while the absorption peak at 364 nm is caused by the C=O bond (n-π* transition). In the presence of copper C1 only demonstrated a change in absorption peak to higher wavelength (redshift) from 364 to 425 nm. The hue of both the C1+Cu(II) complex changed from bright yellow to dark brown colour with hypochromic shift appearance of a new peak at 425 nm. Even in the presence of other competing metal ions, the hypsochromic shift of the absorption band and the quenching of the fluorescence emission intensity were different for detecting Cu2+, in CH3OH-H2O (v/v = 6:4). Job's plot was used to compute the binding stoichiometry between C1 and Cu2+, and MASS and FTIR spectrophotometry were used to investigate the complexation process. The capacity of the C1 to bind Cu2+ was further proven using DFT simulations. The complex S1+Cu2+ has a HOMO-LUMO energy gap of 2.8002 eV, which is lesser than S1 (2.9991 eV). From these results, it can be seen that the specific binding of S1 to Cu2+ improves the stability of the S1+Cu2+ complex and effectively reduces the HOMO-LUMO energy gap. The C1 was successfully used in a real-world water sample analysis. Using the Benesi-Hildebrand and Scatchard plots, the Kb was calculated and found to be 47340M-1 and 48369M-1 respectively, showing the creation of stable complexation between Cu2+ and S1 with 1:1 Stoichiometry. The LOD of S1 for Cu2+ ion analysis was determined to be 649 nM. Strip sheets were also built and tested to detect varying amounts of Cu2+ aqueous solution, and their color change suggested that they might be used for on-site Cu2+ detection in polluted water.

Recently, the Association of University and College Counseling Center Directors (AUCCCD) published a White Paper on a multidimensional understanding of organizational structures for counseling cent...

Background and aims Children with autism spectrum condition often have specific difficulties with narrative comprehension, a skill which has a strong association with both concurrent and longitudinal reading comprehension. A better understanding of narrative comprehension skills in autism spectrum condition has the potential to provide insight into potential later reading comprehension difficulties and inform early targeted intervention. In the current study, the main objective was to investigate how differences in the medium of story presentation (paper-book vs. e-book) and differences in story narration (adult narration vs. in-app narration) would influence narrative comprehension in general, and between groups (autism spectrum condition and a receptive language-matched control group). We were also interested in how task engagement (visual attention and communication) differed between group and conditions and whether task engagement was related to narrative comprehension. Method Forty-two children with autism spectrum condition and 42 typically developing children were read a story either via a paper-book or an e-book with interactive and multimedia features. The e-book was either narrated by the experimenter (adult narrated iPad condition) or narrated by an in-app voiceover (e-book narrated iPad condition). Children’s behaviour during storybook reading was video recorded and coded for engagement (visual attention and communication). They then completed two measures of narrative comprehension: multiple-choice questions (measuring recall of literal information) and a picture ordering task (measuring global story structure). Results Contrary to predictions, we did not find any significant group or condition differences on either measure of narrative comprehension, and both groups demonstrated a similar level of narrative comprehension across the three conditions. We found differences in engagement between conditions for both groups, with greater visual attention in the e-book conditions compared to the paper-book condition. However, visual attention only significantly correlated with narrative comprehension for the typically developing group. Conclusion Overall, this study suggests that children with autism spectrum condition are just as able as language-matched peers to comprehend a narrative from storybooks. Presenting a story on an iPad e-book compared to a paper-book does not influence narrative comprehension, nor does adult narration of the story compared to in-app narration. However, on-task engagement is linked to narrative comprehension in typically developing children. Implications: Taken together, our findings suggest that e-books may be more successful than paper-based mediums at encouraging visual attention towards the story, but no better at supporting narrative comprehension and eliciting communication.

Established in 1950, the Association for University and College Counseling Center Directors (AUCCCD) is an international organization comprising universities and colleges (https://www.auccc...

Objective The National Academy of Neuropsychology (NAN), the American Academy of Clinical Neuropsychology (AACN), and the American College of Professional Neuropsychology (ACPN) collaborated to publish an update to their original position statements, confirming the organizations' opposition to third party observer (TPO). Method A review of literature addressing TPO effects, ethical standards, professional organization position statements, test publisher policies and new telemedicine developments was completed to obtain consensus on relevant issues in TPO and recording of neuropsychological evaluations. Results TPO has been shown to impact the cognitive functions most often assessed in forensic or medicolegal settings. Third party observation, whether in person, recorded or electronic, remains a potential threat to the validity and reliability of evaluation results, and violates test security guidelines, ethical principles and standards of conduct in the field. Demands for TPO in the context of medicolegal or forensic settings have become a tactic designed to limit the ability of the consulting neuropsychologist to perform assessment and provide information to the trier of fact. Conclusion The field of neuropsychology opposes the presence of TPO in the setting of medicolegal or forensic neuropsychological evaluations.

Purpose Administration of questionnaires to assess the diffusion of disordered eating behaviours via the web is becoming common today. The aim of this study is to assess whether two different approaches of administering a test to assess traits of eating disorders (EDs), orthorexia nervosa (ON) and muscle dysmorphia (MD) by email recruitment and online completion (web-based survey—WBS) and by in person recruitment and paper-and-pencil completion (paper-based survey—PBS), gives different results. Methods During 2 consecutive academic years, a self-reported questionnaire consisting of questions about personal characteristics and three tests for the evaluation of ON (ORTO-15), MD (MDDI-ITA), and EDs (EAT-26) were administered to two groups of undergraduates, respectively, as a WBS and a PBS. Results The WBS response rate was 6.7% (N = 137), and the PBS response rate was 86.5% (N = 372). The WBS group showed a statistically significant higher prevalence of students with eating disordered behaviours (21.2% vs 5.4%) and registered a higher mean score on the EAT-26 test (13.5 ± 11.1 vs 6.0 ± 8.0); no differences between the two groups emerged for ON and MD prevalence and test scores. Moreover, in the WBS group, the number of students with one or more tests with test scores above the cut-off values was significantly higher (46.0% vs 32.3%). Conclusion The choice of the approach to administer a questionnaire to assess the diffusion of EDs and related issues must take into account all the factors that can result in selection bias and that can affect the reliability of the results. Level of evidence Level V, descriptive cross-sectional survey.

Although executive function disorders are among the most prevalent cognitive impairments a consensus on diagnostic criteria has yet to be reached. With a view to harmonizing these criteria, the present position paper (i) focuses on the main dysexecutive disorders, (ii) examines recent approaches in both the behavioral and cognitive domains, (iii) defines diagnostic boundaries for frontal syndrome, (iv) reports on the frequency and profile of the executive function disorders observed in the main brain diseases, and (v) proposes an operationalization of diagnostic criteria. Future work must define the executive processes involved in human adaptive behavior, characterize their impairment in brain diseases, and improve the management of these conditions (including remediation strategies and rehabilitation).

The authors describe the application of a twice-weekly, exploratory psychotherapy, Transference-Focused Psychotherapy (TFP), to patients with Narcissistic Personality Disorder (NPD). The paper describes the pathology of object relations within which narcissistic pathology can be understood, and how TFP establishes a treatment framework to address narcissistic pathology. An outline of the assessment and treatment protocol is described along with a case example to illustrate the same. The application of TFP to patients with NPD follows from recent research demonstrating the effectiveness of TFP for patients with BPD including some patients with comborbid NPD. Although empirical studies of the efficacy of TFP for NPD are lacking and warranted the authors suggest that, in the absence of any other empirically supported treatment for NPD, TFP may be applied to this challenging patient population.

School systems across the country are transitioning from paper-based testing (PBT) to computer-based testing (CBT). As this technological shift occurs, more research is necessary to understand the practical and performance implications of administering CBTs. Currently, there is a paucity of research using CBTs to examine working memory (WM) performance, even though CBTs may negatively influence performance. The present study compared a WM CBT and PBT and found enhanced WM performance on the PBT across several verbal and visuospatial WM tests. This pattern was evident even after age was controlled, indicating that test mode effects were persistent across ages (4-11 years). CBTs on WM performance may yield lower scores due to developmental WM differences, increased cognitive workload, test mode effects stemming from individual access to technology, and participant characteristics, such as developmental, biological, or gender differences. The presence of divergent WM in CBT and PBT indicates the need for additional options for children at risk of academic failure because of testing modality.

Background A proportion of veterans experience post-traumatic stress disorder (PTSD). Research has shown reduced effectiveness of commonly offered psychotherapies in military personnel. Some research suggested the usefulness of art therapy for veterans with PTSD, but its mechanism of operation has been unclear. The current project aimed to establish participants’ perceptions of any impact of group art therapy and some of the perceived mechanisms of change. Method In a grounded theory design, single semi-structured interviews were conducted with nine veterans who had received group art therapy, two art therapists, and a veteran's wife. Interviews were transcribed and analysed. Findings Theorised categories included (a) art therapy group as “the family”, (b) “the gentle conductor”, (c) trust, (d) doing the work, (e) art therapy as "a communication tool", (f) "points of recognition", (g) "making things concrete", and (h) "not a cure". Limitations Shortcomings included a homogenous sample who all attended art therapy alongside other interventions, reliance on subjective and unmeasured symptom change, and researcher effects related to qualitative methodology. Conclusion The developed grounded theory is consistent with existing evidence and neuropsychological theory. Group art therapy may enable some veterans to prepare for verbal-only therapy, by offering a safe space in which to approach non-verbal traumatic and trauma-related contextual material in a controlled way. Artworks may provide a bridge to facilitate communication of experiences within subsequent verbal therapy and with loved-ones. It is suggested to replicate the project at different sites. Elements of the developed theory may be investigated further to establish its transferability.

Technological development has enabled the use of sophisticated methods for assessing multiple human behaviors. Despite the advantages of these new technologies, concerns exist regarding their equivalence with paper-based measures in epidemiological and health-related surveys. To date, literature on this topic in relation to adolescents is virtually nonexistent. This study compares respondents’ performance on the same survey using both paper- and electronic tablet-based assessment methods. A final sample of 135 adolescents (mean age 17.30 years, SD = 0.59; 56.3% males) consecutively completed two versions of the same survey on gambling behaviors and two questionnaires: The Gambling Motives Questionnaire (GMQ) and the South Oaks Gambling Screening-Revised for Adolescents (SOGS-RA). An ad-hoc questionnaire assessing participants’ satisfaction levels with each method was also used. The digital survey yielded a lifetime, past year, and past month gambling prevalence of 54.1%, 45.2%, and 27.4%, respectively. Paper-based prevalence rates were 3.7-5.2% lower (all p < .092) and there were discrepancies in gambling activities. Although the reliability of the questionnaires was high in both formats, total scores were consistently higher in the paper-based format. GMQ and SOGS-RA intraclass correlations between versions ranged from .856-.884. Unexpectedly, students preferred the paper-based survey to the e-assessment (51.5% vs. 48.5%) and also enjoyed it more (31.3% vs 26.1%). Paper- and tablet-based surveys yield different, albeit non-statistically significant, estimations of gambling behaviors even when the same participants were surveyed at one time. We recommend that consistency be routinely checked across assessment formats when adapting paper-and-pencil measures to digital formats

Essential Readings from the Melanie Klein Archives: Original Papers and Critical Reflections is an important compilation of personal documents and lectures from the Klein Archives, together with si...

Both Harris and Howard in their thoughtful papers examine the intersection of the psyche and the social in the context of COVID-19 and racial unrest. The combination of these events has brought int...

Cognitive deficits are a core feature of mental and behavioral disorders, leading to poor treatment adherence and functionality. Virtual reality (VR) methodologies are promising solutions for cognitive interventions in psychiatry once they provide greater ecological validity. This study assessed and compared two content-equivalent cognitive training (CT) interventions, delivered in desktop VR (Reh@City v2.0) and paper-and-pencil (Task Generator (TG)) formats, in patients with mental and behavioral disorders. 30 patients were randomly assigned to the Reh@City v2.0 group and the TG group. Both groups of patients underwent a time-matched 24-sessions intervention. Neuropsychological assessments were performed at baseline, post-intervention, and follow-up. A within-groups analysis revealed significant improvements in visual memory and depressive symptomatology after the Reh@City intervention. The TG group improved in processing speed, verbal memory, and quality of life (social relationships and environmental domains). Between groups, Reh@City led to a greater reduction in depressive symptomatology, whereas the TG group showed higher improvements in social relationships aspects of quality of life. At follow-up, previous gains were maintained and new improvements found in the Reh@City (global cognitive function, language, visuospatial and executive functions) and the TG groups (attention). The Reh@City significantly reduced depressive symptomatology, and the TG led to greater improvements in processing speed, abstraction, and social relationships domain of quality of life at follow-up. Both interventions were associated with important cognitive, emotional, and quality of life benefits, which were maintained after two months. Reh@City and TG should be considered as complementary CT methods for patients with mental and behavioral disorders. Trial registration The trial is registered at ClinicalTrials.gov, number NCT04291586.

Subgroup by treatment interaction assessments are routinely performed when analysing clinical trials and are particularly important for phase 3 trials where the results may affect regulatory labelling. Interpretation of such interactions is particularly difficult, as on one hand the subgroup finding can be due to chance, but equally such analyses are known to have a low chance of detecting differential treatment effects across subgroup levels, so may overlook important differences in therapeutic efficacy. EMA have therefore issued draft guidance on the use of subgroup analyses in this setting. Although this guidance provided clear proposals on the importance of pre-specification of likely subgroup effects and how to use this when interpreting trial results, it is less clear which analysis methods would be reasonable, and how to interpret apparent subgroup effects in terms of whether further evaluation or action is necessary. A PSI/EFSPI Working Group has therefore been investigating a focused set of analysis approaches to assess treatment effect heterogeneity across subgroups in confirmatory clinical trials that take account of the number of subgroups explored and also investigating the ability of each method to detect such subgroup heterogeneity. This evaluation has shown that the plotting of standardised effects, bias-adjusted bootstrapping method and SIDES method all perform more favourably than traditional approaches such as investigating all subgroup-by-treatment interactions individually or applying a global test of interaction. Therefore, these approaches should be considered to aid interpretation and provide context for observed results from subgroup analyses conducted for phase 3 clinical trials.

The advantages of administering questionnaires online include savings of time, savings of money, avoidance of data entry errors (Pasveer & Ellard, 1998) and less missing data (Stanton, 1998; Wood et al., 2006). In addition, participants are provided with the flexibility to complete the questionnaires whenever it fits into their schedule. In 2005, almost two decades ago, a still ongoing cross-sectional observational study on psychosocial aspects and psychological stress of cancer outpatients was launched at the Medical University of Vienna, including two standardised questionnaires, namely the Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983) and the Posttraumatic Symptom Scale (PTSS-10; Maercker, 2003; Stoll et al. 1999). Administration mode of this study will be switched from paper-pencil to online assessment. For boths questionnaires, we aim to investigate whether measurement equivalence between administration modes can be assumed.

Meta-analyses have shown that shame is particularly associated with social anxiety disorder (SAD) compared to other anxiety disorders. Theories of SAD put inflexible and rigid coping with shame at the heart of SAD, however little data have been collected to validate that shame is a central aspect of what maintains SAD, as well as that rigid and inflexible coping with shame mediates the relationship between shame and the impaired functioning and symptoms observed in SAD. In addition, we are not aware of studies that have examined the relationship between internal and external shame and SAD in the same study. This two-study paper aims to examine the respective roles of internal and external shame, self-criticism, and shame-regulation strategies in social anxiety using well-powered cross-sections of the population. Participants for both studies were recruited as part of project MESA using the website MTurk. Study one uses a cross-sectional survey design. Study two uses a 14-day daily diary design in which participants report on one social interaction at the end of each day in a brief survey.

Archangelo and O’Loughlin’s beautifully written paper begins with a reference to the experiments by Kenneth and Mamie Clark on Black children’s preference for white dolls. This preference has alway...

Irwin Hirsch has been a prolific representative and voice of the interpersonal psychoanalytical tradition for four decades now. His volume, More Human than Otherwise, collects sixteen of his previo...

This discussion focuses on one aspect of Farber’s work: the birth of the tango (this issue). The tango was created as a fusion of African and European immigrant culture in Argentina between the second half of the nineteenth century and the first twenty years of the twentieth century. The tango was one of the tools used by immigrants to socialize the pain of the loss of common roots, the lack of identity, and the sense of loneliness. The author reflects on the overlaps between tango and relational psychoanalysis, and muses on the impact of the loss of hugs and embraces in this worldwide pandemic caused by Covid and the collective trauma that it entails.

This article explores how young prenatal women negotiate, articulate, and manage their experiences of chronic pelvic pain (CPP). I argue that chronic pelvic pain lies at the intersection of chronic illness, pain, feminization, sex, and legibility, and that pain of this character is deeply stigmatized. Investigating it offers a visceral view into the affective layers of chronic pain. This project draws on ethnographic interviews with CPP sufferers aged eighteen to thirty, pelvic health care providers, and sex and treatment tool production companies. The analysis is rooted in histories of frigidity, hysteria, and chronic illness that together affect how CPP is socially understood today. This article explicates the critical differences between prompted recurrent pain and constant bodily pain in terms of the subjectivity of associated experiences, the problematic insistence on vaginal penetration as evidence of cure, and the dilemmas of treating pain with doubly painful therapies.