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PubMedDate not supplied

Parental representations in drug-dependent patients and their parents.

The Parental Bonding Instrument (PBI), a measure of perceived parental care and protection, was administered to drug-dependent patients and their parents with the aim to assess the reliability of the instrument in such samples and to compare the parental representations across generations. Ninety drug-dependent patients and 44 mothers and 35 fathers participated. Reliability indices were calculated, and parental representations of parents and their offspring were compared. Linear regression analyses were performed with the patient's PBI score as the dependent variable and the mother's and father's PBI scores as predictor variables. The reliability indices were highly satisfactory and varied between 0.61 and 0.91. The parental bonding of patients, fathers, and mothers was similar. All three groups reported high maternal and paternal control and low maternal care, a pattern characteristic of an "affectionless control" rearing style. Maternal care received by the fathers and paternal protection received by the mothers predicted the care and protection they themselves gave to their drug-dependent offspring.

Adult↗
PubMed1999

Intersegmental dynamics are controlled by sequential anticipatory, error correction, and postural mechanisms.

The purpose of this study is to examine the mechanisms underlying control of intersegmental dynamics during reaching movements. Two experiments were conducted to determine the relative contributions of anticipatory and somatosensory feedback mechanisms in controlling intersegmental dynamics and whether adaptation to novel intersegmental dynamics generalizes across a range of movement directions. The mechanisms used to control interaction torques were examined by altering the inertial load of the forearm. Movements were restricted to the shoulder and elbow and supported on a horizontal plane by a frictionless air-jet system. Subjects made rapid out-and-back movements over a target line presented on a computer screen. The screen cursor disappeared at movement onset, and hand paths were displayed after each movement. After subjects adapted to a novel inertial configuration, the position of an attached mass was changed on pseudorandom trials. During these "surprise" trials, movements were initiated with the torque patterns appropriate to the previously learned inertial condition. As a result, characteristic errors in initial movement direction were predicted by an open-looped forward simulation. After these errors occurred, feedback mediated changes in torque emerged that, surprisingly, further decreased the accuracy of movement reversals. Nevertheless at the end of movement, the hand consistently returned to the starting position. It is plausible that the final position was determined completely by feedback-mediated changes in torque. In a second experiment, adaptation to a novel inertial load during movements made in a single direction showed limited transfer across a range of directions. These findings support and extend those of previous reports, which indicated combined anticipatory and postural mechanisms to coordinate rapid reaching movements. The current results indicate a three-stage control system that sequentially links anticipatory, error correction, and postural mechanisms to control intersegmental dynamics. Our results, showing limited generalization across directions, are consistent with previous reports examining adaptation to externally applied forces and extend those findings to indicate that the nervous system uses sensory information to recalibrate internal representations of the musculoskeletal apparatus itself.

Adaptation, Physiological↗
PubMed1990

The firing of hippocampal place cells in the dark depends on the rat's recent experience.

Hippocampal "place cells" fire when a freely moving rat is in a given location. The firing of these cells is controlled by visual and nonvisual environmental cues. The effects of darkness on the firing of place cells was studied using the task of Muller et al. (1987), in which rats were trained to chase randomly scattered food pellets in a cylindrical drum with a white cue-card attached to the wall. The position of the rats was tracked via an infrared LED on the headstage with a video system linked to computer. Two experimental protocols were used: in the first, lights were turned off after the rat had already been placed in the chamber; in the second, the rat was placed in the darkened chamber. The dark segments produced by these 2 methods were identical with respect to light and other cues but differed with respect to the rat's experience. The firing patterns of 24 of 28 cells were unaffected by darkness when it was preceded by a light period. In contrast, the firing patterns of 14 of 22 cells changed dramatically when the rats were put into the darkened chamber. Furthermore, the majority of cells that changed their firing pattern in initial darkness maintained that change when the lights were turned on. These results show that place cells can fire differently in identical cue situations and that the best predictor of firing pattern is a combination of current cues and the rat's recent experience. The results are discussed in terms of mnemonic properties of hippocampal cells and "remapping" of place cell representations.

Animals↗
PubMed1996

Form difference computations in restorative dentistry utilizing the macroelement method.

The comparison between the size and shape (form) of two structures or the analysis of one object under differing conditions is important in restorative dentistry. Despite rapid advances in digitizing technologies, form comparison is still mainly limited to scalar measurements. The objective of this study was to test the potential use of a newly developed tensorial morphometric difference technique, the macroelement method, in a model restrative system where the processing and materials properties are known duplication of a denture anchor in stone via polysulfide, addition silicone, and polyether impression materials. Nine machined landmarks were utilized to construct a nine-sided element for macroelement analysis. Macroelement results compared well with the known impression materials properties of polymerization shrinkage and incomplete recovery in terms of: (1) larger die diameter, (2) smaller die (vertically), (3) horizontal direction of maximum expansion, and (4) vertical direction of maximum contraction. Also, macroelement results along boundary lines were equal to the traditional form difference measure of change in length/length of those lines. The macroelement method provided results which are superior to those of traditional methods in that both (1) the magnitude and direction of difference at any point on the structure could be determined, and (2) the graphical representation of the results provides an intuitive appreciation of how and where the forms differ Therefore, since macroelement results: (1) compare well with known materials properties and traditional measures, and (2) have the above-stated advantages, tensorial techniques such as the macroelement method, used in conjunction with new digitizing technologies, can be used better to describe the kinematics of form difference. With the description of the kinematics provided by the technique, the dynamic cause of the form difference can be ascertained with the investigators knowledge of materials. The investigators can then suggest changes to be made in materials and/or techniques that would enable the desired size and shape to be obtained.

Anisotropy↗
PubMed1997

The intuition of the negative in Playing and reality.

The author draws some parallels between his own conceptions on the work of the negative with some ideas presented by Winnicott in the ultimate version of his paper on 'Transitional objects and transitional phenomena'. He underlines the germs of the intuition of the negative in Winnicott's general theory ('not me possession', transitional object as not being the breast, the decathexis of the representation of the object). He then goes on to examine in detail the clinical material of a patient, in the last part of the paper, which has been published posthumously. In this last part the negative is mentioned explicitly and the idea is openly presented. We have here a concept of which Winnicott had the intuition without having the possibility of considering its full development and implications. It so happened that the patient whose clinical material is published in 'Playing and Reality' came to the author to continue her analytic experience. One can compare the material presented in these two analytical relationships. The author comments about his relationship with the patient and of the way she meets his own hypotheses.

Adult↗
PubMed1982

Parental representations of transsexuals.

The parental representations of 30 male-to-female transsexuals were rated using a measure of fundamental parental dimensions and shown to be of acceptable validity as a measure both of perceived and actual parental characteristics. Scores on that measure were compared separately against scores returned by matched male and female controls. The transsexuals did not differ from the male controls in their scoring of their mothers but did score their fathers as less caring and more overprotective. These differences were weaker for the comparisons made against the female controls. Item analyses suggested that the greater paternal "overprotection" experienced by transsexuals was due to their fathers being perceived as offering less encouragement to their sons' independence and autonomy. Several interpretations of the findings are considered.

Female↗
PubMed1981

[Total fusion with an object and its destruction].

On the basis of four partly narcissistic-neurotic, partly narcissistically disturbed borderline-patients who are very severely disturbed in their self- and in their object-representation the author explains how total fusion-tendencies may become fatal for the object, if this wants to separate itself even just a bit. The object turns then abruptly from a "good" into a "bad" one. In a fifth example it is described how, in deep and especially in the endogenous depression, the fusion-tendency with a near object may lead to an expanded suicide. The danger, which should not be underestimated, for near related persons of these heavily narcissistically disturbed, respectively - in the depression - emptied human beings is underlined. Forensic viewpoints which follow the destruction of the object because of a total fusion-tendency are discussed.

Adult↗
PubMedDate not supplied

Methods for improving the signal-to-noise ratio of endogenous-evoked potentials.

A stimulus leads to a cortical response (i.e., evoked potential [EP]) which may be recorded from electrodes attached to the scalp. However, background cortical activity, considered as noise (n), is typically of equal or greater magnitude than the response, which is considered as signal (s). This situation leads to the masking of the presence of the electrocortical signal. Two methods are described which enable the enhancement of the signal with respect to the noise. The first method outlined is time-domain averaging. Its relation to Fourier averaging is also presented. Time averaging can lead to an enhancement of the signal with respect to the noise, known as the signal-to-noise ratio (SNR), by a factor of root N; N being the number of trials recorded. However, latency variability (i.e., jitter) present in the signal leads to a decrement in this maximal potential enhancement. The second technique is an adaptive filter method of averaged cross-correlations, developed by Woody (1967), which deals with the variable latency problem. The development of a latency corrected average developed by McGillem and Aunon (1977) is also presented. The final section describes methods for data handling once the electrocortical signal has been enhanced. It is then necessary to describe the EP quantitatively. Principal Components Analysis (PCA) allows for the quantitative compact representation of the evoked potential waveform. The method also allows for the testing of the effects of explanatory variables on the EP.

Animals↗
PubMed2004

A new spreadsheet method for the analysis of bivariate flow cytometric data.

BACKGROUND: A useful application of flow cytometry is the investigation of cell receptor-ligand interactions. However such analyses are often compromised due to problems interpreting changes in ligand binding where the receptor expression is not constant. Commonly, problems are encountered due to cell treatments resulting in altered receptor expression levels, or when cell lines expressing a transfected receptor with variable expression are being compared. To overcome this limitation we have developed a Microsoft Excel spreadsheet that aims to automatically and effectively simplify flow cytometric data and perform statistical tests in order to provide a clearer graphical representation of results. RESULTS: To demonstrate the use and advantages of this new spreadsheet method we have investigated the binding of the transmembrane adhesion receptor CD44 to its ligand hyaluronan. In the first example, phorbol ester treatment of cells results in both increased CD44 expression and increased hyaluronan binding. By applying the spreadsheet method we effectively demonstrate that this increased ligand binding results from receptor activation. In the second example we have compared AKR1 cells transfected either with wild type CD44 (WT CD44) or a mutant with a truncated cytoplasmic domain (CD44-T). These two populations do not have equivalent receptor expression levels but by using the spreadsheet method hyaluronan binding could be compared without the need to generate single cell clones or FACS sorting the cells for matching CD44 expression. By this method it was demonstrated that hyaluronan binding requires a threshold expression of CD44 and that this threshold is higher for CD44-T. However, at high CD44-T expression, binding was equivalent to WT CD44 indicating that the cytoplasmic domain has a role in presenting the receptor at the cell surface in a form required for efficient hyaluronan binding rather than modulating receptor activity. CONCLUSION: Using the attached spreadsheets and instructions, a simple post-acquisition method for analysing bivariate flow cytometry data is provided. This method constitutes a straightforward improvement over the standard graphical output of flow cytometric data and has the significant advantage that ligand binding can be compared between cell populations irrespective of receptor expression levels.

Animals↗
PubMed1991

[Early childhood violent and sexual traumatization].

Violent and sexual child abuse represents an extreme traumatization that can continue to influence the lives of affected children into adulthood. Freud (1917) provided a concept of the influence of this extreme form of traumatization in his model of the traumatic neurosis. It is described as an after-the-fact attempt to master the flood of sensations that characterizes the trauma. More recent theoretical models identify a collapse of the ego during trauma as well as the effects of this collapse on the formation of self and object representants at the heart of the traumatic event. As a result of the collapse of the ego during trauma, the traumatized individual does not succeed in forming mature memories of the experience. Immature memories of trauma are marked by, among other things, very diffuse, near physical feelings that cannot be integrated into the ego (Cohen 1980). From the perspective of object relation theories, the lack of integration of "bad" and "good" self of the traumatized individual is emphasized by the abuser. Drawing on case studies, the authors illuminate the importance of the principle of the answer (Heigl-Evers/Heigl 1979, 1983) to the efforts to differentiate and integrate in the treatment of extremely traumatized patients.

Adolescent↗
PubMed1992

Parental perceptions and psychopathology.

Various theories of personality and psychopathology hypothesize that there should be a relationship between parental perceptions and level of psychopathology. However, there has been relatively little research investigating the parental perceptions-psychopathology relationship, and much of the research in this area has been methodologically flawed. The present study tested four hypotheses regarding the parental perceptions-psychopathology relationship, using a parental representations measure that circumvents many of the problems that have characterized previous research on this topic. Results indicated that psychiatric patients (N = 66): a) viewed both parents more negatively than did members of a matched sample of 66 normal subjects; b) expressed significantly greater ambivalence regarding both parents than did normal subjects; and c) described both parents at a more primitive conceptual level than did normal subjects. As predicted, there was a parallel relationship between perceptions of the parents and overall level of psychopathology within the inpatient sample. The findings are discussed in the context of traditional trait-oriented personality theories as well as more recent social learning theories of personality.

Adult↗
PubMedDate not supplied

Anorexia nervosa: a psychoanalytic commentary.

A discussion of "The Fear of Being Fat," by C. Philip Wilson, M.D. The view is presented that primary emphasis on sexual conflicts, especially Oedipal, as causative psychological factors in anorexia nervosa is a limiting and narrow view of the problem. The symptomatology and sexual and aggressive conflicts and fantasies, with the accompanying defenses, can best be understood within the framework of the process of separation of self from object and the seemingly insoluble dilemma in regard to the struggle to achieve a sense of separateness and individuality. This has its effects on the development of the body image, with its internalized symbolic representations of the environment, and through the body image on the ego, superego, and instinctual life. Anorexia nervosa is an expression of ego-defective development arising from varying degrees of failure to resolve the process of developing a sense of individuality. There result primitive aggression, archaic guilt, and great difficulties in establishing an integrated sense of sexual identity. Sexualization of all aspects of interpersonal relationships is fostered by intensification of the need for sensory stimulation, e.g., by touch, the fantasy of touch, by vision, and by oral fantasies and activities. This leads to intensification of defenses against overt sexual expression on all levels, as well as against primitive aggressive fantasies and guilt. The symbolic significance of various symptoms in anorexia nervosa is discussed.

Anorexia Nervosa↗
PubMed2005

Anatomy of the clitoris.

PURPOSE: We present a comprehensive account of clitoral anatomy, including its component structures, neurovascular supply, relationship to adjacent structures (the urethra, vagina and vestibular glands, and connective tissue supports), histology and immunohistochemistry. We related recent anatomical findings to the historical literature to determine when data on accurate anatomy became available. MATERIALS AND METHODS: An extensive review of the current and historical literature was done. The studies reviewed included dissection and microdissection, magnetic resonance imaging (MRI), 3-dimensional sectional anatomy reconstruction, histology and immunohistochemical studies. RESULTS: The clitoris is a multiplanar structure with a broad attachment to the pubic arch and via extensive supporting tissue to the mons pubis and labia. Centrally it is attached to the urethra and vagina. Its components include the erectile bodies (paired bulbs and paired corpora, which are continuous with the crura) and the glans clitoris. The glans is a midline, densely neural, non-erectile structure that is the only external manifestation of the clitoris. All other components are composed of erectile tissue with the composition of the bulbar erectile tissue differing from that of the corpora. The clitoral and perineal neurovascular bundles are large, paired terminations of the pudendal neurovascular bundles. The clitoral neurovascular bundles ascend along the ischiopubic rami to meet each other and pass along the superior surface of the clitoral body supplying the clitoris. The neural trunks pass largely intact into the glans. These nerves are at least 2 mm in diameter even in infancy. The cavernous or autonomic neural anatomy is microscopic and difficult to define consistently. MRI complements dissection studies and clarifies the anatomy. Clitoral pharmacology and histology appears to parallel those of penile tissue, although the clinical impact is vastly different. CONCLUSIONS: Typical textbook descriptions of the clitoris lack detail and include inaccuracies. It is impossible to convey clitoral anatomy in a single diagram showing only 1 plane, as is typically provided in textbooks, which reveal it as a flat structure. MRI provides a multiplanar representation of clitoral anatomy in the live state, which is a major advantage, and complements dissection materials. The work of Kobelt in the early 19th century provides a most comprehensive and accurate description of clitoral anatomy, and modern study provides objective images and few novel findings. The bulbs appear to be part of the clitoris. They are spongy in character and in continuity with the other parts of the clitoris. The distal urethra and vagina are intimately related structures, although they are not erectile in character. They form a tissue cluster with the clitoris. This cluster appears to be the locus of female sexual function and orgasm.

Anatomy↗
PubMed2006

Information and communication technologies in higher education: evidence-based practices in medical education.

In contrast to traditional meta-analyses of research, an alternative overview and analysis of the research literature on the impact of information and communication technologies (ICT) in medical education is presented in this article. A distinction is made between studies that have been set up at the micro-level of the teaching and learning situation and studies on meso-level issues. At the micro-level, ICT is hypothesized to foster three basic information processing activities: presentation, organization, and integration of information. Next to this, ICT is expected to foster collaborative learning in the medical knowledge domain. Empirical evidence supports the potential of ICT to introduce students to advanced graphical representations but the studies also stress the importance of prior knowledge and the need for real-life tactile and practical experiences. The number of empirical studies focusing on the impact of ICT on information organization is restricted but the results suggest a positive impact on student attitudes and relevant learning gains. However, again, students need a relevant level of prior knowledge. Empirical studies focusing on the impact of ICT on information integration highlight the positive impact of ICT-based assessment and computer simulations; for the latter this is especially the case when novices are involved, and when they master the prerequisite ICT skills. Little empirical evidence is available regarding the impact of computer games. Research results support the positive impact of ICT-based collaboration but care has to be taken when skills development is pursued. At the meso-level, the available empirical evidence highlights the positive impact of ICT to promote the efficiency of learning arrangements. Research grounds the key position of ICT in a state-of-the-art medical curriculum. Recent developments focusing on repositories of learning materials for medical education have yet not been evaluated. The article concludes by stressing the need for evaluative studies, especially in the promising field of ICT-based collaborative learning. Furthermore, the importance to be attached to the position and qualifications of the teaching staff is emphasized.

Belgium↗
PubMed1994

Trauma, the good object, and the symbolic: a theoretical integration.

Psychic trauma has returned as a central concept for psychoanalysis after a period of relative eclipse since Ferenczi's pioneering work. Our search for a common clinical understanding of trauma, however, may have been hampered by the lack of a shared definition within the diversity of contemporary theoretical models. In this paper, the threat of destruction or loss of the good object, here redefined as a function of symbolic representation of the human world of cultural meanings and value, is proposed as a common ground for theories as diverse as those of Ferenczi, Freud, Klein, and Lacan. As a corollary, the role of the psychoanalyst in treatment of traumatised patients must be viewed in relation to the symbolic function of the good object. When this function has been damaged, the analyst cannot rely upon the intrinsic features of analytic treatment to provide conditions of safety for therapeutic re-experiencing of the past and for facilitation of a new object experience, but must at times take active measures. It is suggested that Ferenczi may have tried to become the good object for his patients, rather than using the analytic position to help restore the symbolic function. Loewald's clinical theory is presented as consistent with the latter approach.

Humans↗
PubMed1997

Need and responsiveness in the treatment of a severely traumatized patient: a relational perspective.

Severely traumatized patients may exhibit poor functioning and a great deal of dependence upon the therapist. The question is raised as to what such patients truly need from a therapist, and the concept of optimal responsiveness is described. These patients may display complex blends of deficits, resulting from inadequate structuralization, together with pathological internal representations. Their expressed needs in therapy may be true requirements and/or expressions of wishes to be compensated for past suffering and refusal to assume adult functioning. Discerning what might constitute optimal responsiveness to true needs may be further complicated by the propensity some of these patients have for dysfunctional and impulsive behavior. A case is presented that illustrates some of the difficulties in determining how to respond to intense expressions of need, including needs for constant availability of the therapist and for physical contact. It is concluded that although this patient did not need everything from the therapist that she initially thought that she did, her needs were so great that an outpatient treatment situation often seemed insufficient. Despite an overall positive outcome for the patient, the treatment experience was very difficult for the therapist.

Adult↗
PubMed1999

[A study of the movement of the articulatory organs in Japanese geminate production ANX-ray microbeam analysis].

The pattern of movements of the articulatory organs, particularly the tongue and lips, in the production of Japanese geminate was analyzed using an X-ray microbeam system. Special attention was paid to clarify the difference in the pattern of movements in geminate production from that in simple and long vowel production. The subject was a Japanese male who spoke the Tokyo dialect of Japanese. Goldpellets were attached to the uppersurface of the tongue body and dorsum, lowerlip and lower Jaw using dental adhesive. Another reference pellet was placed on the nasal dorsal, and a goldfilling in the left first upper incisor was also used as a reference. The movement of each pellet during the production of test utterances was tracked using an X-ray microbeam system developed at Wisconsin University and the data output was read into a computer memory core for further analysis. During recording sessions, the subject uttered a series of nonsense test words/papiH/./paHpiH/ and /paQpiH/, where /Q/ indicates a geminate and /H/ indicates a long vowel. A comparison was also made between the utterances produced at the normal speed and those produced at the maximal speed. The movement data were analyzed using a Sun computer system. It was found that the velocity of vertical lip movement was almost constant, regardless of the type and speed of utterance and that the variation in its movement pattern was relatively small. On the other hand, the movement of the tongue body and dorsum was significantly slower and its pattern was more variable in the production of geminate compared with simple and long vowel production. It was concluded that the tongue body and dorsum movements during Japanese geminate production can be regarded as a feature-specified articulator representation called phonological underspecification.

Humans↗
PubMed1994

Object constancy and adult psychopathology.

In this paper, the author has summarised Mahler's views on the initial acquisition of object constancy in early childhood. He then attempts to delineate its vicissitudes during oedipal phase, latency, adolescence, and various phases of adult development. Following this, the author describes, with the help of brief clinical vignettes, six psychopathological syndromes of adult life associated with disturbed object constancy: (i) impaired optimal distance; (ii) persistent splitting of self- and object-representations, with the concomitant intensification of affects; (iii) paranoia; (iv) inordinate optimism and the 'someday' fantasy; (v) malignant erotic transference; and (vi) impaired capacity to mourn, intense nostalgia and the 'if-only' fantasy. Finally, the author outlines the technical implications of these concepts and attempts to show that six tasks seem especially important for analytic work with such patients: (i) safeguarding the analyst's 'holding' function; (ii) interpreting splitting mechanisms, especially as these pertain to negative transference; (iii) maintaining optimal distance; (iv) discerning nonverbal communications, especially through countertransference; (v) encouraging developmental initiatives; and (vi) facilitating mourning, not only of past losses but also of those inherent in the analytic situation. Through all this, the author attempts to highlight, elucidate and extend modestly the work of Margaret Mahler.

Adult↗