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Concept: Psychoanalysis

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MacDonald argues that a suite of genetic and cultural adaptations among Jews constitutes a “group evolutionary strategy.” Their supposed genetic adaptations include, most notably, high intelligence, conscientiousness, and ethnocentrism. According to this thesis, several major intellectual and political movements, such as Boasian anthropology, Freudian psychoanalysis, and multiculturalism, were consciously or unconsciously designed by Jews to (a) promote collectivism and group continuity among themselves in Israel and the diaspora and (b) undermine the cohesion of gentile populations, thus increasing the competitive advantage of Jews and weakening organized gentile resistance (i.e., anti-Semitism). By developing and promoting these movements, Jews supposedly played a necessary role in the ascendancy of liberalism and multiculturalism in the West. While not achieving widespread acceptance among evolutionary scientists, this theory has been enormously influential in the burgeoning political movement known as the “alt-right.” Examination of MacDonald’s argument suggests that he relies on systematically misrepresented sources and cherry-picked facts. It is argued here that the evidence favors what is termed the “default hypothesis”: Because of their above-average intelligence and concentration in influential urban areas, Jews in recent history have been overrepresented in all major intellectual and political movements, including conservative movements, that were not overtly anti-Semitic.

Concepts: Genetics, Evolution, Politics, Jews, Judaism, Psychoanalysis, Antisemitism, Social movement

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This pragmatic randomized controlled trial tested the effectiveness of long-term psychoanalytic psychotherapy (LTPP) as an adjunct to treatment-as-usual according to UK national guidelines (TAU), compared to TAU alone, in patients with long-standing major depression who had failed at least two different treatments and were considered to have treatment-resistant depression. Patients (N=129) were recruited from primary care and randomly allocated to the two treatment conditions. They were assessed at 6-monthly intervals during the 18 months of treatment and at 24, 30 and 42 months during follow-up. The primary outcome measure was the 17-item version of the Hamilton Depression Rating Scale (HDRS-17), with complete remission defined as a HDRS-17 score ≤8, and partial remission defined as a HDRS-17 score ≤12. Secondary outcome measures included self-reported depression as assessed by the Beck Depression Inventory - II, social functioning as evaluated by the Global Assessment of Functioning, subjective wellbeing as rated by the Clinical Outcomes in Routine Evaluation - Outcome Measure, and satisfaction with general activities as assessed by the Quality of Life Enjoyment and Satisfaction Questionnaire. Complete remission was infrequent in both groups at the end of treatment (9.4% in the LTPP group vs. 6.5% in the control group) as well as at 42-month follow-up (14.9% vs. 4.4%). Partial remission was not significantly more likely in the LTPP than in the control group at the end of treatment (32.1% vs. 23.9%, p=0.37), but significant differences emerged during follow-up (24 months: 38.8% vs. 19.2%, p=0.03; 30 months: 34.7% vs. 12.2%, p=0.008; 42 months: 30.0% vs. 4.4%, p=0.001). Both observer-based and self-reported depression scores showed steeper declines in the LTPP group, alongside greater improvements on measures of social adjustment. These data suggest that LTPP can be useful in improving the long-term outcome of treatment-resistant depression. End-of-treatment evaluations or short follow-ups may miss the emergence of delayed therapeutic benefit.

Concepts: Pharmacology, Randomized controlled trial, Cognitive behavioral therapy, Major depressive disorder, Mood disorders, Primary care, Psychoanalysis, Beck Depression Inventory

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Narcissism levels have been increasing among Western youth, and contribute to societal problems such as aggression and violence. The origins of narcissism, however, are not well understood. Here, we report, to our knowledge, the first prospective longitudinal evidence on the origins of narcissism in children. We compared two perspectives: social learning theory (positing that narcissism is cultivated by parental overvaluation) and psychoanalytic theory (positing that narcissism is cultivated by lack of parental warmth). We timed the study in late childhood (ages 7-12), when individual differences in narcissism first emerge. In four 6-mo waves, 565 children and their parents reported child narcissism, child self-esteem, parental overvaluation, and parental warmth. Four-wave cross-lagged panel models were conducted. Results support social learning theory and contradict psychoanalytic theory: Narcissism was predicted by parental overvaluation, not by lack of parental warmth. Thus, children seem to acquire narcissism, in part, by internalizing parents' inflated views of them (e.g., “I am superior to others” and “I am entitled to privileges”). Attesting to the specificity of this finding, self-esteem was predicted by parental warmth, not by parental overvaluation. These findings uncover early socialization experiences that cultivate narcissism, and may inform interventions to curtail narcissistic development at an early age.

Concepts: Sociology, Child, Childhood, Knowledge, Psychoanalysis, Jacques Lacan, Narcissism, Narcissistic parents

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INTRODUCTION: It has been generally thought that the practice of bondage-discipline, dominance-submission, sadism-masochism (BDSM) is in some form associated with psychopathology. However, several more recent studies suggest a relative good psychological health of BDSM practitioners. AIM: The aim of this study was to compare scores of BDSM practitioners and a control group on various fundamental psychological characteristics. METHODS: For this aim, 902 BDSM and 434 control participants completely filled out online questionnaires. Associations were examined using χ(2) tests of independence with φ and Cramer’s V as effect size measures and eta or Pearson’s correlation. Group differences were tested using analysis of covariance, with partial η(2) as effect size measure. A priori contrasts were tested using α = 0.01 to correct for multiple testing; for all other tests we used α = 0.05, two tailed. MAIN OUTCOME MEASURES: The study used Big Five personality dimensions (NEO Five-Factor Inventory), attachment styles (Attachment Styles Questionnaire), rejection sensitivity (Rejection Sensitivity Questionnaire), and subjective well-being (World Health Organization-Five Well-being Index). RESULTS: The results mostly suggest favorable psychological characteristics of BDSM practitioners compared with the control group; BDSM practitioners were less neurotic, more extraverted, more open to new experiences, more conscientious, less rejection sensitive, had higher subjective well-being, yet were less agreeable. Comparing the four groups, if differences were observed, BDSM scores were generally more favorably for those with a dominant than a submissive role, with least favorable scores for controls. CONCLUSION: We conclude that BDSM may be thought of as a recreational leisure, rather than the expression of psychopathological processes. Wismeijer AAJ and van Assen MALM. Psychological characteristics of BDSM practitioners. J Sex Med **;**:**-**.

Concepts: Psychology, Personality psychology, Interpersonal relationship, Developmental psychology, Effect size, Psychiatry, Big Five personality traits, Psychoanalysis

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Background: Psychodynamic psychotherapy has been used to treat depression for more than a century. However, not all patients respond equally well, and there are few reliable predictors of treatment outcome. Methods: We used resting (18)F-fluorodeoxyglucose positron emission tomography ((18)FDG-PET) scans immediately before and after a structured, open trial of brief psychodynamic psychotherapy (n = 16) in conjunction with therapy process ratings and clinical outcome measures to identify neural correlates of treatment response. Results: Pretreatment glucose metabolism within the right posterior insula correlated with depression severity. Reductions in depression scores correlated with a pre- to posttreatment reduction in right insular metabolism, which in turn correlated with higher objective measures of patient insight obtained from videotaped therapy sessions. Pretreatment metabolism in the right precuneus was significantly higher in patients who completed treatment and correlated with psychological mindedness. Conclusions: Resting brain metabolism predicted both clinical course and relevant psychotherapeutic process during short-term psychodynamic psychotherapy for depression. © 2014 S. Karger AG, Basel.

Concepts: Psychology, Positron emission tomography, Clinical psychology, Psychotherapy, Insular cortex, Psychoanalysis, Psychodynamic psychotherapy, Psychodynamics

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The Task Force on Promotion and Dissemination of Psychological Procedures proposed rigorous criteria to define empirically supported psychotherapies. According to these criteria, 2 randomized controlled trials (RCTs) showing efficacy are required for a treatment to be designated as ‘efficacious’ and 1 RCT for a designation as ‘possibly efficacious’. Applying these criteria modified by Chambless and Hollon, this article presents an update on the evidence for psychodynamic therapy (PDT) in specific mental disorders.

Concepts: Randomized controlled trial, Psychiatry, Psychotherapy, Family therapy, Psychoanalysis, Psychodynamic psychotherapy, Psychodynamics, Depth psychology

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Mentalizing-the capacity to understand others' and one’s own behavior in terms of mental states-is a defining human social and psychological achievement. It involves a complex and demanding spectrum of capacities that are susceptible to different strengths, weakness, and failings; personality disorders are often associated with severe and consistent mentalizing difficulties (Fonagy & Bateman, 2008). In this article, we will argue for the role of mentalizing in the therapeutic relationship, suggesting that although mentalization-based treatment may be a specific and particular form of practice, the “mentalizing therapist” is a universal constituent of effective psychotherapeutic interventions. (PsycINFO Database Record © 2014 APA, all rights reserved).

Concepts: Psychology, Therapy, Clinical psychology, Psychiatry, Psychotherapy, All rights reserved, Psychoanalysis, Carl Jung

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Over the past decade, there has been an explosion of interest in clinical applications of attachment theory. In the present article, we briefly describe John Bowlby’s model of therapeutic change, the therapeutic relationship, and the therapist’s role in emotional healing. We then review empirical evidence for three key propositions in Bowlby’s model. First, a client’s sense of security during therapy is crucial for facilitating therapeutic work. Second, a therapist’s own sense of security contributes to positive therapeutic outcomes. Third, attachment insecurities can be effectively reduced in therapy, and movement toward greater attachment security is central to achieving favorable therapeutic outcomes. In sum, research evidence confirms the importance of establishing what Bowlby called a safe haven and a secure base within a therapeutic relationship.

Concepts: Therapy, Attachment theory, Psychoanalysis, John Bowlby

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Abstract One requirement for psychotherapy research is an accurate assessment of therapeutic interventions across studies. This study compared frequency and depth of therapist interventions from a dynamic perspective across four studies, conducted in four countries, including three treatment arms of psychodynamic psychotherapy, and one each of psychoanalysis and CBT. All studies used the Psychodynamic Intervention Rating Scales (PIRS) to identify 10 interventions from transcribed whole sessions early and later in treatment. The PIRS adequately categorized all interventions, except in CBT (only 91-93% categorized). As hypothesized, interpretations were present in all dynamic therapies and relatively absent in CBT. Proportions of interpretations increased over time. Defense interpretations were more common than transference interpretations, which were most prevalent in psychoanalysis. Depth of interpretations also increased over time. These data can serve as norms for measuring where on the supportive-interpretive continuum a dynamic treatment lies, as well as identify potentially mutative interventions for further process and outcome study.

Concepts: Therapy, Psychometrics, Cognitive behavioral therapy, Psychotherapy, Psychoanalysis, Sigmund Freud, Psychodynamic psychotherapy, Psychodynamics

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Suffering is commonly seen as an unconscious effort to alleviate painful feelings of guilt. However, suffering also aims at averting loss of ego functions and hence loss of mental stability. This second function of suffering is discussed in the light of Freud’s observations of characters wrecked by success and Weiss’s ideas about mutual love as a threat to mental stability. Hawthorne’s portrayal of Arthur Dimmesdale in The Scarlet Letter (1850), biographical material about the author, material from his diaries, and material from a psychotherapy case and an analysis illustrate the function of suffering to preserve mental stability in the face of heightened success and happiness. Hawthorne, it is argued, intuitively grasped this function of suffering in his novel.

Concepts: Psychoanalysis, Sigmund Freud, Ego psychology, Nathaniel Hawthorne, The Scarlet Letter, Carl Jung