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The contributions of Marcel Proust to psychoanalysis.

This article is about the major contribution of Marcel Proust to psychoanalysis in his seven-part novel, A La Rècherche Du Temps Perdu (translated as Rembrance of Things Past, 1934). This work spans two decades, from 1988, when Proust writing to 1927, when the last part was published 5 years after his death. Proust, a literary scholar whose knowledge dated to the early Greeks, knew nothing of Freud or psychoanalysis. His major contributions were to the emergence of memory, specifically the exquisite details of the descriptive unconscious, which we can now explain in cognitive neuroscientific terms. Freud wanted to do this for all mental processes in 'The Project'. Proust contributed to the projective aspects of passionate love. Kernberg has pointed out that although psychoanalysts knew about transference love, idealization, and sex, love has only been a subject for us in the 1900s. Proust also wrote of jealousy as a necessary concomitant of love. He proposed that all humans had pluripotential sexuality and recognized the psychodynamics of the perversions in a way that is closer to modern psychoanalysts like Chassuguet-Smirgel. Proust was himself psychologically disabled, with an illness his father called neurasthenia, adding somatic components and abulia, inability to make decisions. We would probably recognize him today as having a borderline personality disorder, with superior cognition, depression, somatization, obsessions, compulsions, phobias, and severe anxiety, which he understood was the result of his inability to separate from his mother. Proust's findings in all these areas are compared with the psychoanalytic literature--Freud, to the present.

Famous Persons↗

Poor predictive validity of the Bayley Scales of Infant Development for cognitive function of extremely low birth weight children at school age.

OBJECTIVE: The Bayley Scales of Infant Development, Second Edition (BSID II) are commonly used to assess outcomes of extremely low birth weight (ELBW) infants. We sought to assess the predictive validity of the BSID II Mental Developmental Index (MDI) for cognitive function at school age. DESIGN/METHODS: Of 330 ELBW infants admitted in 1992-1995, 238 (72%) survived to the age of 8 years, of whom 200 (84%) were tested at both 20 months' corrected age (CA) and 8 years. Mean birth weight was 811 g, mean gestational age was 26.4 weeks, 41% were boys, and 60% were black. Measures included the BSID II at 20 months' CA and the Kaufman Assessment Battery for Children (KABC) Mental Processing Composite (MPC) at 8 years' postnatal age. BSID II MDI and MPC scores were compared and the predictive validity calculated for all 200 ELBW children and for the 154 ELBW neurosensory-intact subgroup. Predictors of stability or change in cognitive scores were examined via logistic regression adjusting for gender and sociodemographic status. RESULTS: For all ELBW children, the mean MDI was 75.6 +/- 16 versus a mean KABC of 87.8 +/- 19. For the neurosensory-intact subgroup, the mean MDI was 79.3 +/- 16 and the mean KABC was 92.3 +/- 15. Rates of cognitive impairment, defined as an MDI or KABC of <70, dropped from 39% at 20 months' CA to 16% at 8 years for the total ELBW population and from 29% to 7% for the neurosensory-intact subgroup. The positive predictive value of having an MPC of <70 given an MDI of <70 was 0.37 (95% confidence interval [CI]: 0.27, 0.49) for all ELBW infants, 0.20 (95% CI: 0.10, 0.35) for the neurosensory-intact subgroup, and 0.61 (95% CI: 0.42, 0.77) for the neurosensory-impaired subgroup. The negative predictive values were 0.98, 0.99, and 0.85 for the 3 groups, respectively. Neurosensory impairment at 20 months' CA predicted lack of improvement of cognitive function (odds ratio: 6.9; 95% CI: 2.4, 20.2). Children whose cognitive scores improved between 20 months and 8 years had significantly better school performance than those whose scores stayed at <70, but they did less well than those whose scores were persistently >70. CONCLUSIONS: The predictive validity of a subnormal MDI for cognitive function at school age is poor but better for ELBW children who have neurosensory impairments. We are concerned that decisions to provide intensive care for ELBW infants in the delivery room might be biased by reported high rates of cognitive impairments based on the use and presumptive validity of the BSID II MDI.

Blindness↗

Cognitive profile of patients with relapsing remitting multiple sclerosis.

Multiple sclerosis (MS) is a common disease in Western countries of temperate/cold climate, but in tropical countries an increasing number of cases have been diagnosticated. Moved by the lack of information about cognitive dysfunction of Brazilian MS patients, the present study attempted to describe features of neuropsychological alterations in patients with relapsing remitting MS living in the city of São Paulo. They were compared to healthy volunteers, matched for age and education. In the absence of global intellectual deterioration, the patients had a deficit: a) in learning and verbal long-term memory tasks and in visual long-term memory of complex figure; b) in timed tasks, accounted for by a slowness of mental processes; c) in tasks with a motor component. Tendency to depression was observed; anxiety levels were normal.

Adolescent↗

Fluid and crystallized intelligence: effects of diffuse brain damage on the WAIS.

In the 1940's two forms of intelligence, fluid and crystallized, were postulated. Active mental processing (WAIS performance subtests) were fluid while well learned abilities (WAIS verbal subtests) were crystallized. Brain damage was considered to affect fluid abilities more than crystallized. WAIS scores comparing normal and diffusely organically damaged subjects indicated that, as hypothesized, the verbal subtests were more affected than the performance subtests.

Atrophy↗

Cognitive, perceptual, and personal-social development of prematurely born preschoolers.

This study was designed to determine possible differences in the cognitive, perceptual, and personal-social development of prematurely and maturely born 3-yr.-olds which might foreshadow later learning problems. The subjects were 40 prematurely born graduates of a neonatal intensive care unit (birth weight less than 2,500 gm, less than 37 wk. gestation) matched on the pair-level with full-term controls on sex, race, post-conceptual age, and socioeconomic background. All subjects were singletons and parity was matched at the group level. No differences were found between the groups on tests of higher mental processes including the General Cognitive, Verbal, Quantitative, and Memory Scales of the McCarthy Scales of Children's Abilities, and researcher-devised measures of problem-solving competence. No differences in parental reports of personal-social development were noted. Prematures did not perform as well as controls on perceptual performance tasks, and this difference was interpreted as reflecting relatively impaired visual-motor coordination.

Child, Preschool↗

Generating probable consequences.

A study was conducted to examine some of the factors that influence peoples' generation of likely consequences associated with a major hypothetical life event, involving the loss of the function of one of one's own limbs. The design included four limbs involving two inclusion relations, thumb-hand and foot-leg, and two viewpoints involving consequences for one-self or for others. The results indicated that subjects generate more numerous consequences for primary than for secondary consequences, more for short-term consequences than for medium- or long-term ones, more for an inclusive limb than for an included limb (e.g., hand vs thumb), and more pertaining to one-self than to others. Individual differences in the generation of consequences were not associated with prior experience involving functional loss of the limbs tested or with general differences in academic performance. The results permit inference about some of the mental processes that accompany consequence generation.

Adaptation, Psychological↗

Psychology of computer use: IX. A menu of self-administered microcomputer-based neurotoxicology tests.

This study examined the feasibility of repeated self-administration of a newly developed battery of mental acuity tests which may have application in screening for fitness-for-duty or for persons who may be exposed to environmental stress, toxic agents, or disease. 16 subjects self-administered 18 microcomputer-based tests (13 new, 5 "core"), without proctors, over 10 sessions. The hardware performed well throughout the study and the tests appeared to be easily self-administered. Stabilities and reliabilities of the tests from the "core" battery were comparable to those obtained previously under more controlled experimental conditions. Eight of the new tests exceeded minimum criteria for metric and practical requirements and can be recommended as additions to the menu. Although the average retest reliability was high, cross-correlations between tests were low, implying factorial diversity. The menu can be used to form batteries with flexible total testing time which are likely to tap different mental processes and functions.

Diagnosis, Computer-Assisted↗

Laterality effects for music perception among differentially talented adolescents.

To examine the comparative nature of laterality patterns for music perception among differentially talented adolescents, 138 right-handed subjects (56 boys, 82 girls) trained in music, mathematics, and dance, respectively, were tested on dichotic chords and dichotic melodies tasks. Analyses demonstrated that only the musically trained subjects displayed task-dependent ear asymmetry, that is, a left-ear advantage for dichotic chords and a right-ear advantage for dichotic melodies. The mathematically and dance-talented students displayed a left-ear bias for both tasks of music perception. A control dichotic speech task showed a right-ear bias for all talent groups. The findings speak to how sensory information is managed by the mental-processing systems of differentially talented students and how talent training plays a role in shaping ear asymmetry.

Acoustic Stimulation↗

Coordination between breathing and mental grouping of pianistic finger movements.

6 pianists (age 22 to 43 years) performed a simple finger exercise at a spontaneously chosen most comfortable tempo on a Yamaha-Disklavier piano. Five versions of the exercise, notated in quarter notes, were presented with different types of meters: (1) 3/4, (2) 4/4, (3) 5/4, (4) 6/4, and (5) 7/4. The onsets of finger strokes were measured while respiration was recorded in parallel by means of a thermistor placed at the front of the dominant nostril. The chosen tempo (finger-beat-rate) was about 3 Hz on all trials but not exactly constant. Correspondingly, the meter-rate chosen was faster for 3/4 and 4/4 meter (around 1 Hz), slower for 5/4, 6/4, and 7/4 meter (around 0.5 Hz). Mean breathing rate while playing the piano (0.38 Hz) was significantly higher than while resting (0.22 Hz, p<.05). Pooling the data of all subjects, the ratios of instantaneous meter and breathing rates clustered around different integer values, depending on the type of meter. Also the individual data indicated integer ratios between instantaneous meter and breathing rates. Even periods of constant phase relations between onsets of the meter and of inspiration could be observed. Thus, the mental process of grouping the same piece of music by various musical meters interacts with unconscious breathing rhythm.

Adult↗

Physiological patterns during practice of the Transcendental Meditation technique compared with patterns while reading Sanskrit and a modern language.

This study tested the prediction that reading Vedic Sanskrit texts, without knowledge of their meaning, produces a distinct physiological state. We measured EEG, breath rate, heart rate, and skin conductance during: (1) 15-min Transcendental Meditation (TM) practice; (2) 15-min reading verses of the Bhagavad Gita in Sanskrit; and (3) 15-min reading the same verses translated in German, Spanish, or French. The two reading conditions were randomly counterbalanced, and subjects filled out experience forms between each block to reduce carryover effects. Skin conductance levels significantly decreased during both reading Sanskrit and TM practice, and increased slightly during reading a modern language. Alpha power and coherence were significantly higher when reading Sanskrit and during TM practice, compared to reading modern languages. Similar physiological patterns when reading Sanskrit and during practice of the TM technique suggests that the state gained during TM practice may be integrated with active mental processes by reading Sanskrit.

Adult↗

Diaschisis, site, time and other factors in raven performances of adults with focal cerebral lesions.

Analyses of Raven matrices performances by 35 patients with acute and 22 with chronic focal lesions restricted to the anterior or posterior regions of the left or right hemispheres illustrate the importance of controlling for diaschisis, specific site, time, age and other factors determining neuropsychological performances. These findings have important practical and theoretical implications with respect to the elucidation of principles underlying organization, disorganization and reorganization of human brain functions. They also suggest that many of the previous controversial and conflicting reports may be reconciled when these and other significant underlying factors are accounted for. Finally, they confirm Jackson's earlier observations of the critical role of the right posterior lobe in "visuopsychic" non verbal mental processes.

Brain↗

An Expert PArasite IdentificatiON (EPAION) system with multimedia support.

Until now computer-assisted parasite identification was based on database applications requiring data specification on an individual basis, thus limiting the ability of the system to handle rule-based knowledge as humans are used to do. A new Expert PArasite IdentificatiON (EPAION: Greek term for expert) system was developed to serve as an interface between the database and the user, where the database is a repository for bionomic and morphological facts about the parasites for the expert system. The system was developed by using a logic-based computer language which allows the definition of rules and facts to assist the creation of queries to the database. The components of the system are the knowledge base, the multimedia data base, the inference mechanism, and the graphical user interface. The operational modules of the system are the Parasite Identifier and the system Utilities. This expert system facilitates knowledge incorporation in a manner simulating the natural mental process, thus allowing the checking of the accuracy of the information that the user feeds to the computer and the creation of intelligent queries to the database. These characteristics accelerate focusing and optimize the parasite identification scheme regardless of the user's profile of competency.

Animals↗

Severe alcohol intoxication: a study of 204 consecutive patients.

We report a five month retrospective analysis of 204 consecutive patients seen in an adult medical emergency department with blood alcohol concentrations (BAC) in excess of 400 mg/dl. The average BAC was 467 mg/dl with a range of 400-719 mg/dl. In 153 patients (75%) the BAC was 400-500 mg/dl, in 47 patients (23%) the BAC was 500-600 mg/dl and in 4 patients (2%) the BAC was greater than 600 mg/dl. Eighty-eight percent of the patients were oriented to person, place, and time upon questioning, 12% were disoriented or unresponsive to noxious stimuli. None of the four patients whose BAC was greater than 600 mg/dl were initially alert and oriented and only eight of the unresponsive patients had a BAC below 500 mg/dl (p less than .001). Sixteen patients (8%) were admitted. Three of the admissions were for continued unresponsiveness presumed due to ethanol, the other thirteen were for coexistent medical conditions. There were no significant associations between BAC and vital sign abnormalities.

Adult↗

Readers' sensitivity to linguistic cues in narratives: how salience influences anaphor resolution.

Despite the general assumption that anaphoric inferences are necessary inferences, Levine, Guzmán, and Klin (2000) concluded that the probability of resolving noun phrase anaphors depends both on the degree of accessibility in memory of the antecedent concepts and the extent to which resolution is necessary to create a coherent discourse representation. Four experiments are presented in which the factors that influence readers' standard of coherence are investigated. We examine the hypothesis that readers are more likely to resolve anaphors that are perceived as salient; salience was manipulated both with a syntactic focusing structure (wh- clefts) and with the addition of prenominal adjectival modifiers. The results of a probe recognition time task provide support for the hypothesis that a variety of linguistic cues serve as mental processing instructions (Givón, 1992), which instruct readers as to how much attention to devote to processing.

Cognition↗

The use of schematic knowledge about sources in source monitoring.

Source monitoring refers to mental processes leading to attributions regarding the origin of information. We tested Johnson, Hashtroudi, and Lindsay's (1993) assumption that prior source-relevant knowledge is used in some source-monitoring tasks. In two experiments using different domains of schematic knowledge, two sources presented information that was expected for one source and somewhat unexpected for the other. In a later source-monitoring test, participants decided whether items had been presented by Source A, by Source B, or were new. The results of both experiments show that source identification is better for expected items than for somewhat unexpected items. Multinomial modeling analyses revealed that when participants do not remember the source of information, they guess that it was presented by the expected source. These results provide evidence for the claim that source monitoring can be based on prior knowledge and support a guessing hypothesis.

Adolescent↗

Do we know what we've learned from listening to the news?

This study investigates the relationship between knowledge acquisition and an awareness of that knowledge within the context of listening to the news. Subjects listened to a recording of a radio news program consisting of regular news items as well as editorials, manipulated to be of high or low personal relevance. They then completed a surprise memory test and rated their confidence in their answers. In contrast to many studies, the results indicated a strong positive confidence-accuracy relationship. Confidence ratings were generally a better predictor of an individual's performance than were predictions based on item difficulty. Whereas subjects reported strong and accurate feelings of knowing, they apparently lacked complementary feelings of not knowing. The implications of these findings and others are discussed.

Attention↗