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PubMed2005

'Projective transidentification': an extension of the concept of projective identification.

Questions about the concept of projective identification still persist. The author presents the following hypotheses: Klein's traditional view and Bion's extension and revision of it can be thought of as occupying a continuum in reverse. He postulates that Bion's concept of communicative intersubjective projective identification (which the author renames 'projective transidentification') is primary and inclusive of Klein's earlier unconscious, omnipotent, intrapsychic mode but includes Bion's 'realistic' communicative mode as well. The author hypothesizes, consequently, that intersubjective projective identification constitutes both the operation of an unconscious phantasy of omnipotent intrapsychic projective identification solely within the internal world of the projecting subject--in addition to two other processes: conscious and/or preconscious modes of sensorimotor induction, which would include signaling and/or evocation or prompting gestures or techniques (mental, physical, verbal, posturing or priming) on the part of the projecting subject; followed by spontaneous empathic simulation in the receptive object of the subject's experience in which the receptive object is already inherently 'hard-wired' to be empathic with the prompting subject.

Consciousness↗
PubMed2005

Radio-frequency identification: its potential in healthcare.

Radio-frequency identification (RFID) technology is just starting to make inroads into healthcare. RFID uses radio-frequency tags attached to people or objects to provide identification, tracking, security, and other functions that fall under the general heading of automatic identification and data capture (AIDC). In the retail supply chain, RFID is already well established as a way to reduce theft and track objects from manufacture through shipment to delivery. In healthcare, basic RFID is already being used to track patients for anti-elopement and anti-abduction programs. As more sophisticated systems move into hospitals, RFID is also beginning to see use to provide more extensive patient identification than traditional bar coding can, and to track and locate capital equipment within the hospital. In years to come, RFID could be used for a variety of applications, including tracking and matching blood for transfusions, tracking pharmaceuticals, and combating the counterfeiting of medical products. RFID may ultimately be used for many of the functions currently carried out using bar coding--but not until the cost of RFID comes down. For the foreseeable future, the two technologies are likely to be used in tandem in many hospitals. In this article, we describe the components and operation of RFID systems and detail the different ways in which these systems are being used, and could be used, in hospitals.

Hospital Administration↗
PubMed1990

[The dentist as an expert in disasters: dental identification in the disasters with the Zeebrugge ferry].

The Herald of Free Enterprise Disaster on the 6th of March 1987 just outside Zeebrugge harbour was without any doubt a disaster of major proportions. The ferry disaster highlighted different approaches in major incident procedures in both countries involved but nevertheless the identification team which was composed of both British and Belgian specialists did perform good work. The identification of the victims had to be done in three phases each of them with its own specific work and problems. As the process of identification of bodies is an exacting science, and forensic odontology is known to be among the most reliable scientific methods in mass disasters, it is easily understood that forensic odontology took an active part in all three phases of the identification process.

Denture Identification Marking↗
PubMed1989

[Identifications in several young alcoholics].

For this article we used personality tests (Rorschach, TAT), in particular, to study the problems of identification and identity among 16 young problem drinkers. Certain problems are analyzed in greater detail, for example absence or failure of identifications, identifications with collective ideals, incorporation fantasies, and some identification problems specific to adolescence. The author concludes that these young problem drinkers use their addictive behavior to transform identity problems in social conflicts. This transformation complicates for them all personal relationship that could include an authentic and individual expression of their problems.

Adult↗
PubMed1987

"I want to be a daddy!": meanings of masculine identifications in girls.

This paper suggests revisions in our understanding of feminine identity formation, the girl's negative oedipus complex, and masculine identifications in girls. Analytic material from the cases of three girls is used to explore the various origins and intrapsychic functions of masculine identifications at each phase of the girl's development. Accounts of feminine development based on such concepts as castration shock, primary femininity, primary identification with mother, or core gender identity are seen as oversimplified. Feminine and masculine identifications are neither primary nor secondary, but the product of a long line of development, of ongoing conflict resolution, and of defensive transformations.

Child↗
PubMed1986

Identification processes and denial in the shadow of Nazism.

This paper presents an analysis of the vicissitudes of individual and group identification processes during and after the Holocaust. We also examine denial as a defence mechanism when confronted with massive traumatization, and in the period of readaptation and reintegration to life. Identification with (idealized) lost objects and with group myths, in fantasy as well as in action, and denial sustained by fantasy, words and acts, were connected to mourning processes which helped to initiate the re-individuation process developing in face of danger. We consider some of the basic problems of survivors of the Holocaust such as avoidance of mourning and rebuilding of self-structure with reemergence of superego, in connexion to various processes of identification and denial. We focus on the 'Mythos of Survival' which reveals a special way of coping with life and death problems, and attempt to show how processes of identification connected with it, influence the survivors' way of mourning up to the second and third generation. The aim of therapy with children of survivors is to aid the process of mourning for lost objects, to free them from the burden of the past, by differentiating between their own experiences and that of their parents, thus helping them in the process of re-individuation.

Adult↗
PubMed1986

Identification and its vicissitudes in relation to the Nazi phenomenon.

The author has developed the following theoretical models: autistic encapsulation, loss of identifications under the effect of terror, the logical-pragmatic paradox, which can be applied to other similar ones, but taking into account that it is not an exhaustive mechanism to be applied in all cases. Carrying out an in-depth study of the subject, we would find two systems, one which we might define as the detachment-withdrawal model (loss) and the other, the model of autistic encapsulation. Part of the material seems to point to the former. In the encapsulation model, there is a shielding of early identifications which are later found fairly well preserved (Inge's language and grandparents, the name of Moshe and Judaism). As an explanatory model, I would suggest that there is a dialectic interplay between two systems: one aiming at encapsulating (which does not mean integration but preservation) and thus shielding identifications, and another which, in spite of everything, loses valuable identifications as a consequence of terror. The inner drama develops between these two mechanisms.

Adult↗
PubMed1986

Identification and its vicissitudes as observed in psychosis.

I have described the mechanisms that operate in psychotic identification. One mechanism is psychotic introjection, characterized by a refusion of 'all good' self and object representations. This re-fusion threatens the destruction of the self as a consequence of the defensive blurring of these self and object representations. The second operative mechanism is projective identification, which I have defined in comparison with and in contrast to projection. Projective identification threatens the destruction of the relation with the object. The case I have described in detail illustrates these psychotic identifications, the development of psychotic transferences wherein the patient cannot differentiate herself and her thinking from the therapist and his thinking, and the struggle around a sense of personal identity at a point of resolution of the psychotic transference. This case also illustrates that an integrated self includes two types of self-representations: those centred on self differentiation and those which reflect the observing functions of the parental images internalized into the self.

Adult↗
PubMed1986

Vicissitudes of identification as observed in character pathology.

This paper deals with identification and its vicissitudes as observed in character pathology. A clinical case of character neurosis is presented to demonstrate that it is possible, through transference analysis and especially through countertransference, to observe in character traits the vicissitudes of identification with an object. In this context it was possible to observe how painful affects, pathological narcissism, excessive use of defence mechanisms such as splitting, denial, repression, projective identification, all activated by primitive object relations determine specific unconscious fantasies. They also distort and cause difficulties in identification. It is also pointed out that failures in the external object strengthen the defensive processes which determines the formation of the character trait enclosing the history of primitive object relations.

Adult↗
PubMed1986

Positive projective identification.

This paper suggests that literature concerning projective identification has excessively focused on the projection of unwanted aspects of the self without giving adequate consideration to projective identification involving good qualities. It is proposed that clinical advantages may derive from dividing projective identification into positive and negative components. This division allows a more ready emphasis on the capacity for beneficial object relations which even psychotic individuals retain despite their obvious hostility. Case vignettes are provided to demonstrate positive projective identification and to emphasize the clinical usefulness of this concept.

Adult↗
PubMedDate not supplied

Experiences of identification and differentiation as functions of leprosy, personality and age.

It is a study of sociogenic need satisfactions that determines the homeostasis of 'being' by remaining contingent conditions of perpetuation or debasement of the social 'self'. The paper has a focus on identification satisfaction and differentiation experience of patients of the highly stigmatized leprosy. The study proceeds with an 'Experimental Group--Control-Group' randomized design. Experimental Groups are two, viz., those of Lepromatous and Non-lepromatous patients. 'Control Group' consists of 'disease-free' normal people. The three independent variables are disease types, age, personality factors. The dependent variables are two, viz., score of identification satisfaction and differentiation experience, measured by standardized tools. Each dependent variable has four '3 X 3 X 2' factorial experiments to test 56 'Null Hypotheses'. The sample consists of 360 elements for each one of the eight experiments. Leprosy elements are drawn from the Central JALMA Institute for Leprosy and the 'Kushta Seva Sadan' (Agra). The 'F' test is run for statistical verification of 'Null hypotheses'. Results show presence of 'role-reversion' and 'role negation' of age and personality factors. The disease possesses 'anti-roles'. It does not allow age and personality factors to promote identification satisfaction and to demote differentiation and experience. The disease actively promotes differentiation and demotes identification through its own 'alien system'. The senescents are the greatest sufferers. 'Social Stigma' works a 'social thanatos' and exposes senescents to substantial 'self-erosion'.

Adolescent↗
PubMed1983

Pathological identification in twins.

In summary, in addition to the cultural, parental, developmental, and dynamic factors which support mutual identification and/or failure of separation between twins, it is my thesis that the basic early identifications between twins rely heavily on relatively conflict-free perceptual modes (visual, auditory, kinesthetic, etc.) quite different from the conflict-laden drive modes we usually think of when considering identification. Furthermore, identification based on perceptual modes, which are relatively free of conflict in early development, become extremely difficult to analyze, as analytic progress depends on conflict.

Adult↗
PubMed2001

Identification and management of psychosocial problems by preventive child health care.

OBJECTIVES: To assess the degree to which physicians and nurses working in preventive child health care (child health professionals [CHPs]) identify and manage psychosocial problems in children, and to determine its association with parent-reported behavioral and emotional problems, sociodemographic factors, and general and mental health history of children. DESIGN: The CHPs examined the child and interviewed parents and child during their routine health assessments. The parents completed the Child Behavior Checklist. SETTING: Nineteen child health care services across the Netherlands, serving nearly all school-aged children routinely. SUBJECTS: Of 4970 children aged 5 through 15 years, eligible for a routine health assessment, 4480 (90.1%) participated. MAIN OUTCOME MEASURES: Identification and management of psychosocial problems by CHPs. RESULTS: In 25% of all children, CHPs identified 1 or more psychosocial problems. One in 5 identified children were referred for further diagnosis and treatment. Identification of psychosocial problems and subsequent referral were 6 times more likely in children with serious parent-reported problem behavior according to the Child Behavior Checklist total problem score (8% of total sample). However, CHPs identified no psychosocial problems in 43% of these children and therefore undertook no action. Other child factors associated with CHPs' identification and referral were past treatment for psychosocial problems, life events, and academic problems. After adjustment for these, sociodemographic characteristics did not predict referral. CONCLUSIONS: The CHPs identify psychosocial problems in school-aged children frequently and undertake actions for most of them. Screening for psychosocial problems may be a promising option to reduce these problems, but accurate identification should be enhanced.

Adolescent↗
PubMed2004

Identification and management of psychosocial problems among toddlers in Dutch preventive child health care.

OBJECTIVES: To assess the degree to which preventive child health professionals (CHPs) identify and manage psychosocial problems among preschool children in the general population and to determine the association with parent-reported behavioral and emotional problems, sociodemographic factors, and mental health history of children. DESIGN: The CHPs examined the child and interviewed the parents and child during their routine health assessments. The Child Behavior Checklist (CBCL) was completed by the parents. SETTING: Sixteen child health care services across the Netherlands that routinely provided well-child care to nearly all preschool children. PATIENTS: Of 2354 children aged 21 months to 4 years who were eligible for a routine health assessment, 2229 (94.7%) participated. MAIN OUTCOME MEASURES: Identification and management of psychosocial problems by CHPs. RESULTS: In 9.4% of all children, CHPs identified psychosocial problems. Two in 5 of the CHP-identified children were referred for additional diagnosis and treatment. Identification of psychosocial problems and subsequent referral were much more likely in children with a clinical CBCL total problems score than in others (identification: 29% vs 7%; odds ratio [95% confidence interval], 5.40 [3.45-8.47]; referral: 15% vs 3%; odds ratio [95% confidence interval], 6.50 [3.69-11.46]). CONCLUSIONS: The CHPs frequently identify psychosocial problems in preschool children, although less than among school-aged children, but they miss many cases of parent-reported problems as measured by a clinical CBCL score. This general population study shows substantial room for improvement in the early identification of psychosocial problems.

Affective Symptoms↗
PubMed1999

Improving protein identification from peptide mass fingerprinting through a parameterized multi-level scoring algorithm and an optimized peak detection.

We have developed a new algorithm to identify proteins by means of peptide mass fingerprinting. Starting from the matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF) spectra and environmental data such as species, isoelectric point and molecular weight, as well as chemical modifications or number of missed cleavages of a protein, the program performs a fully automated identification of the protein. The first step is a peak detection algorithm, which allows precise and fast determination of peptide masses, even if the peaks are of low intensity or they overlap. In the second step the masses and environmental data are used by the identification algorithm to search in protein sequence databases (SWISS-PROT and/or TrEMBL) for protein entries that match the input data. Consequently, a list of candidate proteins is selected from the database, and a score calculation provides a ranking according to the quality of the match. To define the most discriminating scoring calculation we analyzed the respective role of each parameter in two directions. The first one is based on filtering and exploratory effects, while the second direction focuses on the levels where the parameters intervene in the identification process. Thus, according to our analysis, all input parameters contribute to the score, however with different weights. Since it is difficult to estimate the weights in advance, they have been computed with a generic algorithm, using a training set of 91 protein spectra with their environmental data. We tested the resulting scoring calculation on a test set of ten proteins and compared the identification results with those of other peptide mass fingerprinting programs.

Algorithms↗
PubMed2000

Electrospray tandem mass spectrometry in the rapid identification of alpha-chain haemoglobin variants.

The potential use of electrospray tandem mass spectrometry in the rapid characterisation of haemoglobin variants found in the Swedish population has been assessed. Analysis times of the order of 5 -10 min were routinely achieved, and identification of variants using mass spectrometry as the sole analytical technique was possible. However, additional information, readily available from isoelectric focusing experiments, made identification simpler and more secure. In the present communication we report on the identification of the alpha-chain variants, Hb Russ, Hb Le Lamentin and Hb Q-Iran. The identifications were confirmed by the use of nucleotide sequencing techniques.

Genetic Variation↗
PubMed2000

Automatic poisson peak harvesting for high throughput protein identification.

High throughput identification of proteins by peptide mass fingerprinting requires an efficient means of picking peaks from mass spectra. Here, we report the development of a peak harvester to automatically pick monoisotopic peaks from spectra generated on matrix-assisted laser desorption/ionisation time of flight (MALDI-TOF) mass spectrometers. The peak harvester uses advanced mathematical morphology and watershed algorithms to first process spectra to stick representations. Subsequently, Poisson modelling is applied to determine which peak in an isotopically resolved group represents the monoisotopic mass of a peptide. We illustrate the features of the peak harvester with mass spectra of standard peptides, digests of gel-separated bovine serum albumin, and with Escherictia coli proteins prepared by two-dimensional polyacrylamide gel electrophoresis. In all cases, the peak harvester proved effective in its ability to pick similar monoisotopic peaks as an experienced human operator, and also proved effective in the identification of monoisotopic masses in cases where isotopic distributions of peptides were overlapping. The peak harvester can be operated in an interactive mode, or can be completely automated and linked through to peptide mass fingerprinting protein identification tools to achieve high throughput automated protein identification.

Animals↗
PubMed2001

Sequential electroelution and mass spectroscopic identification of intact sodium dodecyl sulfate-proteins labeled with 5(6)-carboxyfluorescein-N-hydroxysuccinimide ester.

A gel electrophoresis apparatus capable of scanning the migration path fluorometrically and of computer-directed electroelution of bands was applied to the mass spectrometric identification of sequentially electroeluted 5(6)-carboxyfluorescein-N-hydrosuccinimide ester (FLUOS)-labeled sodium dodedyl sulfate (SDS)-proteins. The masses of four electroeluted SDS-proteins under study determined by matrix assisted laser desorption/ionization-time of flight (MALDI-TOF) spectrometry are changed by 1% due to their reaction with FLUOS in a 1:5 molar ratio of protein:label, allowing for the identification of the labeled intact proteins on the basis of mass. More importantly, the partial (10 or 50%) derivatization of proteins with FLUOS does not preclude their tryptic hydrolysis, and identification of the protein on the basis of the mass spectrometric analysis of its tryptic peptides. Potentially, the procedure allows for the automated mass spectrometric identification of SDS-proteins globally labeled with FLUOS and electrophoretically separated, without need for any gel sectioning.

Animals↗