bluuebunny/crossref_metadata_2025 huggingface dataset:
Stroke Awareness in Two Estonian Cities: Better Knowledge in Subjects with Advanced Age and Higher Education
Authors: Vibo Riina , Kõrv Liisa , Väli Merle , Tomson Kadi , Piirsoo Erika , Schneider Siim , Kõrv Janika
Published: November 2012

Objectives: This study was undertaken to assess stroke awareness of the Estonian population. Methods: Investigators were asked to fill in an original, closed-ended multiple-choice questionnaire about the definition, risk factors, symptoms and behavior at the onset of stroke by randomly selected subjects in public places of the two biggest cities in Estonia (Tallinn and Tartu). Results: The study included 355 persons. Most of the respondents knew that stroke is an acute disease and that one should call the ambulance at the onset of a stroke. Speech disorder and paresis were the best known symptoms, while hypertension was the best known risk factor. There were no differences between the sexes, but advanced age and higher level of education were related to higher awareness. Conclusions: The overall knowledge was better compared to many other studies. Future awareness campaigns should be addressed to younger subjects with lower education.
Uremia Suppresses Immune Signal-Induced CYP27B1 Expression in Human Monocytes
Authors: Viaene Liesbeth , Evenepoel Pieter , Meijers Björn , Vanderschueren Dirk , Overbergh Lut , Mathieu Chantal
Published: November 2012

Background: Local production of 1,25-dihydroxyvitamin D (1,25(OH)2D) regulated by the CYP27B1 enzyme in monocytes contributes to the immunomodulatory effects of vitamin D. Uremia suppresses renal CYP27B1, but its impact on monocytic CYP27B1 is incompletely understood. The present study aimed to elucidate this issue and to define the pathogenic role of p-cresyl sulfate (PCS), indoxyl sulfate (IndS), and fibroblast growth factor 23 (FGF23). Methods: Resting or immune (interferon-γ + lipopolysaccharide)-stimulated THP1 cells and monocytes, isolated from healthy donors, were cultured in the presence of either healthy serum, uremic serum, PCS, IndS or FGF23. RNA expression levels for CYP27B1 and cytokines were quantified by RT-PCR and enzymatic CYP27B1 activity was measured 24 h after incubation. Results: Culturing THP1 cells or human monocytes in the presence of uremic serum led to higher inflammatory cytokine and CYP27B1 expression. Immune signal-induced CYP27B1 expression and activity, conversely, was impaired in the presence of uremic serum. Similar effects were observed in the presence of FGF23, although significance was reached in immune-stimulated cells only. PCS and IndS failed to show any effect. Conclusions: Monocytic baseline CYP27B1 expression is increased in uremia, probably reflecting the microinflammatory state. Immune signal-induced CYP27B1 expression, conversely, is impaired in uremic conditions. Elevated FGF23 levels, but not PCS and IndS, may account, at least partly, for the dysregulation of monocytic CYP27B1 in uremia and, as such, may contribute to the high cardiovascular and infectious burden in chronic kidney disease.
Oral Health-Related Quality of Life among Parents and Teachers of Disabled Schoolchildren in Kuwait
Authors: Shyama Maddi , Honkala Sisko , Al-Mutawa Sabiha A. , Honkala Eino
Published: November 2012

Objective: The objective of this study was to assess the oral health-related quality of life between the parents and the teachers of disabled schoolchildren in Kuwait. Subjects and Methods: The three category response version of the General Oral Health Assessment Index (GOHAI) (12 questions, always, sometimes, never) was used in the questionnaires in Kuwait. Three hundred and eight (308) parents and 112 teachers were enrolled in this study. Results: The mean age of the parents was 45 ± 9.9 years and of the teachers 38 ± 8.4 years. The mean GOHAI was 27.2 ± 3.5 among the parents and 27.8 ± 3.3 among the teachers (p = 0.091). GOHAI was higher in the older age groups (p = 0.002) and among the parents with a university education (p < 0.001). GOHAI was also higher with increasing toothbrushing frequency among the parents (p = 0.047) and the teachers (p = 0.003). Altogether, 203 (66%) of the parents and 85 (76%) of the teachers were always able to swallow comfortably; 123 (40%) of the parents and 41 (37%) of the teachers were able to eat without discomfort. Overall, 132 (43%) of the parents and 41 (37%) of the teachers were always pleased and happy with the looks of their teeth and gums, or dentures. The Cronbach's alpha (0.83) indicated a high degree of internal consistency between different GOHAI items. Conclusion: There seemed to be no difference in the impact of oral health on the quality of life between the parents and the teachers of disabled schoolchildren. Oral health had a relatively weak impact on the quality of life of these adults.
Ghrelin and Obestatin in Human Neuroendocrine Tumors: Expression and Effect on Obestatin Levels after Food Intake
Authors: Grönberg Malin , Tsolakis Apostolos V. , Holmbäck Ulf , Stridsberg Mats , Grimelius Lars , Janson Eva T.
Published: November 2012

Background: Ghrelin and obestatin are derived from the same peptide hormone precursor and are mainly produced by the gastric mucosa. Ghrelin is involved in many biological processes, whereas the physiological function of obestatin needs further investigation. The aims of the present study were to establish the incidence of ghrelin- and obestatin-immunoreactive cells in a comprehensive panel of human neuroendocrine tumors (NETs) and to investigate if blood obestatin concentrations are influenced during a standardized meal stimulation test in healthy individuals and patients with NETs. Materials and Methods: The expression of ghrelin and obestatin was investigated in NETs (n = 149) and other endocrine-related disorders (n = 3) using immunohistochemistry with specific polyclonal antibodies. Coexpression of the peptides was evaluated by double immunofluorescence. Concentrations of obestatin in blood were measured during a meal test in 6 healthy individuals and 5 patients with pancreatic NETs. Results: Ghrelin and obestatin were expressed in 14/152 and 19/152 tumor tissues, respectively, mainly representing NETs of foregut origin and in pancreatic tissue from a nesidioblastosis patient. Double immunofluorescence staining showed colocalization of the peptides. During the meal test, obestatin levels in blood were unchanged in all patients but decreased significantly in the healthy individuals. Conclusion: Only a minority of NETs express ghrelin and obestatin. However, analysis of patients with tumors originating from tissues that express the peptides in normal conditions could be of importance. The results from the meal test indicate that the hormone levels are affected by food intake in healthy individuals, whereas obestatin levels remained unchanged in pancreatic NET patients.
Measuring Word Meaning in Context
Authors: Erk Katrin , McCarthy Diana , Gaylord Nicholas
Published: November 2012

Word sense disambiguation (WSD) is an old and important task in computational linguistics that still remains challenging, to machines as well as to human annotators. Recently there have been several proposals for representing word meaning in context that diverge from the traditional use of a single best sense for each occurrence. They represent word meaning in context through multiple paraphrases, as points in vector space, or as distributions over latent senses. New methods of evaluating and comparing these different representations are needed.

In this paper we propose two novel annotation schemes that characterize word meaning in context in a graded fashion. In WSsim annotation, the applicability of each dictionary sense is rated on an ordinal scale. Usim annotation directly rates the similarity of pairs of usages of the same lemma, again on a scale. We find that the novel annotation schemes show good inter-annotator agreement, as well as a strong correlation with traditional single-sense annotation and with annotation of multiple lexical paraphrases. Annotators make use of the whole ordinal scale, and give very fine-grained judgments that “mix and match” senses for each individual usage. We also find that the Usim ratings obey the triangle inequality, justifying models that treat usage similarity as metric.

There has recently been much work on grouping senses into coarse-grained groups. We demonstrate that graded WSsim and Usim ratings can be used to analyze existing coarse-grained sense groupings to identify sense groups that may not match intuitions of untrained native speakers. In the course of the comparison, we also show that the WSsim ratings are not subsumed by any static sense grouping.
Computing Lexical Contrast
Authors: Mohammad Saif M. , Dorr Bonnie J. , Hirst Graeme , Turney Peter D.
Published: November 2012

Knowing the degree of semantic contrast between words has widespread application in natural language processing, including machine translation, information retrieval, and dialogue systems. Manually created lexicons focus on opposites, such as hot and cold. Opposites are of many kinds such as antipodals, complementaries, and gradable. Existing lexicons often do not classify opposites into the different kinds, however. They also do not explicitly list word pairs that are not opposites but yet have some degree of contrast in meaning, such as warm and cold or tropical and freezing. We propose an automatic method to identify contrasting word pairs that is based on the hypothesis that if a pair of words, A and B, are contrasting, then there is a pair of opposites, C and D, such that A and C are strongly related and B and D are strongly related. (For example, there exists the pair of opposites hot and cold such that tropical is related to hot, and freezing is related to cold.) We will call this the contrast hypothesis.

We begin with a large crowdsourcing experiment to determine the amount of human agreement on the concept of oppositeness and its different kinds. In the process, we flesh out key features of different kinds of opposites. We then present an automatic and empirical measure of lexical contrast that relies on the contrast hypothesis, corpus statistics, and the structure of a Roget-like thesaurus. We show how, using four different data sets, we evaluated our approach on two different tasks, solving “most contrasting word” questions and distinguishing synonyms from opposites. The results are analyzed across four parts of speech and across five different kinds of opposites. We show that the proposed measure of lexical contrast obtains high precision and large coverage, outperforming existing methods.
Clustering and Diversifying Web Search Results with Graph-Based Word Sense Induction
Authors: Di Marco Antonio , Navigli Roberto
Published: November 2012

Web search result clustering aims to facilitate information search on the Web. Rather than the results of a query being presented as a flat list, they are grouped on the basis of their similarity and subsequently shown to the user as a list of clusters. Each cluster is intended to represent a different meaning of the input query, thus taking into account the lexical ambiguity (i.e., polysemy) issue. Existing Web clustering methods typically rely on some shallow notion of textual similarity between search result snippets, however. As a result, text snippets with no word in common tend to be clustered separately even if they share the same meaning, whereas snippets with words in common may be grouped together even if they refer to different meanings of the input query.

In this article we present a novel approach to Web search result clustering based on the automatic discovery of word senses from raw text, a task referred to as Word Sense Induction. Key to our approach is to first acquire the various senses (i.e., meanings) of an ambiguous query and then cluster the search results based on their semantic similarity to the word senses induced. Our experiments, conducted on data sets of ambiguous queries, show that our approach outperforms both Web clustering and search engines.
Making a “Popular Slave Society” in Colonial British America
Authors: Menard Russell R.
Published: November 2012

Evidence from probate inventories in St. Mary's County, Maryland, suggests that the transition from servants to slaves in colonial British America was not the sole mechanism by which the Chesapeake transformed into a fully developed slave society. Rather, this transition was only the first step in a century-long process by which slavery gradually took root, until, by the eve of the Revolution, the Chesapeake finally bore the imprint of slavery in every avenue of its activity.
Living Standards in Nineteenth-Century Russia
Authors: Dennison Tracy , Nafziger Steven
Published: November 2012

Most of the studies of living standards in pre-revolutionary Russia by economic historians have focused on a narrow range of measures for predominantly urban areas. A micro-level analysis that employs a broader set of measures of well-being for a small rural region in central Russia suggests that, contrary to previous findings, living standards were improving throughout the nineteenth century, even in seemingly less dynamic rural areas. Moreover, the variation in income and consumption patterns, human-capital development, and the distribution of resources in the countryside was greater than typically assumed. Since state and local institutions might be able to account for it, these determinants should be emphasized in future analyses of rural living standards in pre-Soviet Russia.
Evaluation of Several A-Train Ice Cloud Retrieval Products with In Situ Measurements Collected during the SPARTICUS Campaign
Authors: Deng Min , Mace Gerald G. , Wang Zhien , Lawson R. Paul
Published: November 2012

In this study several ice cloud retrieval products that utilize active and passive A-Train measurements are evaluated using in situ data collected during the Small Particles in Cirrus (SPARTICUS) field campaign. The retrieval datasets include ice water content (IWC), effective radius re, and visible extinction σ from CloudSat level-2C ice cloud property product (2C-ICE), CloudSat level-2B radar-visible optical depth cloud water content product (2B-CWC-RVOD), radar–lidar (DARDAR), and σ from Cloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO). When the discrepancies between the radar reflectivity Ze derived from 2D stereo probe (2D-S) in situ measurements and Ze measured by the CloudSat radar are less than 10 dBZe, the flight mean ratios of the retrieved IWC to the IWC estimated from in situ data are 1.12, 1.59, and 1.02, respectively for 2C-ICE, DARDAR, and 2B-CWC-RVOD. For re, the flight mean ratios are 1.05, 1.18, and 1.61, respectively. For σ, the flight mean ratios for 2C-ICE, DARDAR, and CALIPSO are 1.03, 1.42, and 0.97, respectively. The CloudSat 2C-ICE and DARDAR retrieval products are typically in close agreement. However, the use of parameterized radar signals in ice cloud volumes that are below the detection threshold of the CloudSat radar in the 2C-ICE algorithm provides an extra constraint that leads to slightly better agreement with in situ data. The differences in assumed mass–size and area–size relations between CloudSat 2C-ICE and DARDAR also contribute to some subtle difference between the datasets: re from the 2B-CWC-RVOD dataset is biased more than the other retrieval products and in situ measurements by about 40%. A slight low (negative) bias in CALIPSO σ may be due to 5-km averaging in situations in which the cirrus layers have significant horizontal gradients in σ.
Numerical Simulations of Waves over Large Crater Topography in the Atmosphere
Authors: Soontiens Nancy , Stastna Marek , Waite Michael L.
Published: November 2012

Numerical simulations are used to investigate waves generated by flow over crater topography of diameter 100 km in an idealized atmosphere. The atmosphere is stratified with a constant buoyancy frequency profile and the background wind is constant. This study describes the development of a low-level jet along the upstream crater slope and its interaction with the cooler air within the crater valley. This interaction results in a hydraulic jump–like structure that acts as a modified topography, forcing a beam of secondary waves. The hydraulic jump is formed by a retreating gravity current as the cool air within the crater readjusts after the initial tilting of potential temperature contours. A two-dimensional simulation is used to compare features such as wave overturning in two and three dimensions. Several variations on the atmosphere’s profile are considered, including an atmosphere with reduced constant stratification and an atmosphere that is unstratified within the crater. These results indicate that the stratification within the crater is an important component in the development of the hydraulic jump. Also, several topographic modifications are included, such as a crater with no rims and a crater with reduced diameter. These comparisons reveal that the crater rims have little impact on the general wave pattern and that the crater curvature can influence wave breaking and lateral deflections. In addition, cases with rotation break the symmetry and induce more overturning in one-half of the crater.
Projected Increases in North Atlantic Tropical Cyclone Intensity from CMIP5 Models
Authors: Villarini Gabriele , Vecchi Gabriel A.
Published: November 2012

Tropical cyclones—particularly intense ones—are a hazard to life and property, so an assessment of the changes in North Atlantic tropical cyclone intensity has important socioeconomic implications. In this study, the authors focus on the seasonally integrated power dissipation index (PDI) as a metric to project changes in tropical cyclone intensity. Based on a recently developed statistical model, this study examines projections in North Atlantic PDI using output from 17 state-of-the-art global climate models and three radiative forcing scenarios. Overall, the authors find that North Atlantic PDI is projected to increase with respect to the 1986–2005 period across all scenarios. The difference between the PDI projections and those of the number of North Atlantic tropical cyclones, which are not projected to increase significantly, indicates an intensification of North Atlantic tropical cyclones in response to both greenhouse gas (GHG) increases and aerosol changes over the current century. At the end of the twenty-first century, the magnitude of these increases shows a positive dependence on projected GHG forcing. The projected intensification is significantly enhanced by non-GHG (primarily aerosol) forcing in the first half of the twenty-first century.
Multiseason Lead Forecast of the North Atlantic Power Dissipation Index (PDI) and Accumulated Cyclone Energy (ACE)
Authors: Villarini Gabriele , Vecchi Gabriel A.
Published: November 2012

By considering the intensity, duration, and frequency of tropical cyclones, the power dissipation index (PDI) and accumulated cyclone energy (ACE) are concise metrics routinely used to assess tropical storm activity. This study focuses on the development of a hybrid statistical–dynamical seasonal forecasting system for the North Atlantic Ocean’s PDI and ACE over the period 1982–2011. The statistical model uses only tropical Atlantic and tropical mean sea surface temperatures (SSTs) to describe the variability exhibited by the observational record, reflecting the role of both local and nonlocal effects on the genesis and development of tropical cyclones in the North Atlantic basin. SSTs are predicted using a 10-member ensemble of the Geophysical Fluid Dynamics Laboratory Climate Model, version 2.1 (GFDL CM2.1), an experimental dynamical seasonal-to-interannual prediction system. To assess prediction skill, a set of retrospective predictions is initialized for each month from November to April, over the years 1981–2011. The skill assessment indicates that it is possible to make skillful predictions of ACE and PDI starting from November of the previous year: skillful predictions of the seasonally integrated North Atlantic tropical cyclone activity for the coming season could be made even while the current one is still under way. Probabilistic predictions for the 2012 North Atlantic tropical cyclone season are presented.
The Elusive Concept of the Psychoanalytic Process
Authors: Ornstein Paul H.
Published: November 2012

Although the term psychoanalytic process is frequently used, there is no consensual definition of its meaning. Some authors use it to designate a recognizable set of experiences within psychoanalysis. Others, a majority, use it as a synonym for the entire psychoanalytic experience, describing in detail what analysts do to achieve their goals. A range of views may be found between these extremes. A distinction is drawn here between the structure and content of the psychoanalytic process, which is regarded as a specific, definable entity—a red thread—within the psychoanalytic treatment experience as a whole, consisting of a microprocess and a macroprocess. The former is predominantly an amalgam of the patient's and the analyst's highly subjective experiences and entanglements, while the latter is predominantly an amalgam of the infantile and childhood origin of the patient's difficulties, as well as the analyst's conception of these difficulties based on a preferred theory. These ideas are used to formulate a definition of the psychoanalytic process based on clinical experience and are traced here primarily through lessons learned from a patient, Mr. K, over the course of a long and arduous analysis.
Analytic Neutrality, Anonymity, Abstinence, and Elective Self-Disclosure
Authors: Shill Merton A.
Published: November 2012

Recent contributions to the psychoanalytic literature propose new ways of understanding analytic neutrality, anonymity, abstinence, and self-disclosure. They advocate elective self-disclosure by the analyst as an antidote to the allegedly game-playing quality of transference and resistance analysis. The analytic relationship, they assert, becomes unreal when attempts are made to observe the principles of neutrality and abstinence. Both are seen as ill-conceived because of the irreducible subjectivity and unwarranted authority of the analyst. These relational and interactional views are criticized because (1) they ignore the fact that transference and resistance analysis have from Freud onward been accepted as minimal criteria qualifying a clinical process as psychoanalytic; (2) elective self-disclosure carries metapsychological implications dismissing not only Freud's theory of motivation but motivation as a basic feature of human personality; (3) they do not recognize interpersonal relations as mental events and so do not consider the ego's ability to create intrapsychic representations of object relations; (4) elective self-disclosures within the empathic parameters of the analytic situation are themselves unreal compared to the reality of the patient's experience with other objects. Abstinence and neutrality as ideals facilitate maintenance of an internal holding environment or container for the analyst's countertransference.
Psychoanalysis—With Whom, for What, and How? Comparisons With Psychotherapy
Authors: Blatt Sidney J. , Shahar Golan
Published: November 2012

If psychoanalytic treatment is to survive in the era of evidence-based medicine and managed care systems, empirical evidence is needed to demonstrate its unique nature and effectiveness. To address this need, comprehensive analyses were conducted of data from the Menninger Psychotherapy Research Project (Wallerstein 1986). These analyses addressed three questions: (1) What are the differences in outcome between psychoanalysis (PSA) and supportive-expressive psychotherapy (SEP)? (2) With what types of patient, and in what ways, are these two psychodynamic treatments differentially effective? (3) Are these differences in outcome the consequence of possibly different mechanisms of therapeutic action? PSA was found to contribute significantly to the development of adaptive interpersonal capacities and to the reduction of maladaptive interpersonal tendencies, especially with more ruminative, self-reflective, introjective patients, possibly by extending their associative capacities. SEP, by contrast, was effective only in reducing maladaptive interpersonal tendencies and only with dependent, unreflective, more affectively labile anaclitic patients, possibly by containing or limiting their associative capacities.
John Bowlby and Margaret S. Mahler: Their Lives and Theories
Authors: Coates Susan W.
Published: November 2012

Traumatic aspects of the lives of John Bowlby and Margaret Mahler can be seen to inform their intellectual careers, a perspective that suggests that attachment theory and separation-individuation theory are far more consonant with one another than otherwise. Articulating the domains of convergence between the two theories reveals the essential complementarity of the special strengths of each. Both theories were attempts to understand the role of experience in the development of mental representations. Mahler paid close clinical attention to inner mental states and their evolution, while Bowlby searched for behavioral correlates that could lend themselves to empirical observation and inferences about internal representations.
How Can We Know What We Need To Know? Reflections On Clinical Judgment Formation
Authors: Schmidt-Hellerau Cordelia , Busch Fred
Published: November 2012

What distinguishes a psychoanalyst from any other psychologically minded, empathic human being? This seemingly simple question goes to the heart of our profession, the way we see ourselves as competent clinicians. To understand a patient`s material beyond ordinary empathy—that is, to come to a clinical judgment—we need to step out of the dyadic, countertransference situation and reflect what we've experienced in reference to our clinical theories. An analytic vignette shows how a theoretical background can be used to understand and interpret to a patient in a way that is deeply meaningful.
Gender On the Modern-Postmodern and Classical-Relational Divide: Untangling History and Epistemology
Authors: Chodorow Nancy J.
Published: November 2012

This essay considers the historical periodization and epistemology of psychoanalytic thinking about gender. Overlapping historically with feminism itself, psychoanalytic thinking about gender has two periods of efflorescence, the 1920s and 1930s, and the contemporary period beginning in the 1970s. Two divides have characterized our gender thinking, the modern-postmodern and the classical-relational. From the early theorizing of the 1920s and 1930s until around the early 1990s, most psychoanalytic thinking about gender should be considered modernist, as it draws on traditional views of scientific evidence and holds more universalistic and dichotomized conceptions of men and women. In the contemporary period, although postmodernism tends to be associated with relational psychoanalysts and modernist thinking with classical analysts, the divisions overlap. The author argues that considering any psychoanalytic theory as “premodern” is misleading: from its inception, psychoanalysis formed part of modernism.
A Developmental Perspective On the Ideal of Reason in American Constitutional Law
Authors: Dailey Anne C.
Published: November 2012

The ideal of reason is central to contemporary accounts of citizenship in American constitutional law. The individual capacity for reasoned choice lies closely aligned with the constitutional values of personal liberty and democratic self-government as they have evolved in Supreme Court decisions over the past century. Yet as presently conceived, the ideal of reason in constitutional law overlooks the process by which individuals actually acquire the capacity to choose their own values and commitments or to engage in reasoned thinking about collective ends. This paper argues that we cannot hope to sustain and foster a constitutional polity committed to the principles of individual liberty and democratic self-government without knowing something about how individual citizens come to possess this requisite skill of mind. A developmental perspective on reason in constitutional law provides a framework for examining the source and contours of the psychological skills that make it possible to lead an autonomous, self-directed life and to participate meaningfully in the processes of democratic self-government. Developmental psychology, together with research in related fields, provides empirical support for the proposition that the psychological capacity for reasoned thinking has its roots in the early caregiving relationship. Thus, a comprehensive and integrated constitutional family law must recognize the role of early caregiving in the political socialization of children. This developmental approach offers a substantial reworking of constitutional doctrine in the areas of family privacy, parental rights, congressional power, and affirmative welfare rights.
Premodern, Modern, and Postmodern Perspectives On Sex and Gender Mixes
Authors: Gediman Helen K.
Published: November 2012

Postmodern sensibilities, generally associated with relational psychoanalysis, are applicable also in traditional and contemporary Freudian psychoanalytic contexts. Historically speaking, views of femininity and female sexuality may be ordered according to positions designated as premodern, modern, and postmodern. This temporal continuum provides a basis for incorporating aspects of postmodern feminist approaches to deconstructing gender into a more traditional yet contemporary psychoanalytic framework. The postmodern “crisis of category” is addressed through a critique from a modern psychoanalytic point of view of the gender stereotyping inherent in certain false binaries and either/or thinking of premodern psychoanalytic thinking regarding female (as well as male) sex and gender. The cultural changes brought about by the consciousness-raising of postmodern feminist and contemporary psychoanalytic thinking contribute significantly to evolutionary changes in the understanding of gender that are further internalized and represented intrapsychically. That is, sequential transformations in the internalization of new cultural norms influence the development of still more new cultural norms, so that progression in these identificatory markers of gender can be observed over successive generations.
Autistic Defenses in Agoraphobic Syndrome: “Flat” Objects and the Retardation of Projective Identification
Authors: Cartwright Duncan
Published: November 2012

The function of autistic defenses in the generation of agoraphobic symptoms is explored in the case of a patient treated in psychoanalytic psychotherapy. The therapist's growing awareness of autistic modes of relating in the case facilitated various changes in the transference relationship. Although oedipal concerns are seen as important, a formulation is presented whereby autistic modes of generating experience are viewed as fundamental to an understanding of agoraphobic experience. Clinical findings in the transference-countertransference relationship led to the additional observation that the retardation of defensive forms of projective identification further contributed to the patient's agoraphobic difficulties. This formulation is tied theoretically to the idea that agoraphobic experience occurs when the dialectic between paranoid-schizoid and autistic-contiguous modes of generating experience collapses. The treatment implications of these observations are briefly explored.
A Fear of Trying: Dysfunctional Conservatism
Authors: Fischer Newell
Published: November 2012

As the American Psychoanalytic Association faces mounting external pressures that threaten its very survival, its leadership and members appear increasingly preoccupied with issues of internal governance and training standards. This inward gazing, though in keeping with analysts' personality and occupational traits, serves to obscure and defend against the anxieties associated with threats from the surround. Such maladaptive defensive activity contributes to organizational stagnation, dysfunctional conservatism, and a “fear of trying.” Suggestions to combat this self-defeating behavior are offered.
How Do We Evaluate Learning From the Curriculum? Thirty Phone Interviews With Institutes of the American Psychoanalytic Association
Authors: Jordan Leslie , Emde Robert N.
Published: November 2012

A telephone survey of curriculum directors of the thirty institutes of the American Psychoanalytic Association revealed that 75 percent of institutes highly value the importance of evaluating what candidates learn from the curriculum. Paradoxically, however, most institutes do not do evaluations in this area. Typically, institutes evaluate candidates' satisfaction with courses, or their attendance and conduct in classes, rather than learning per se. Some institutes have more rigorous evaluation methods, including oral exams. Objections to evaluating what candidates learn included (1) evaluations involve too much work; (2) evaluations of learning are considered inappropriate or invalid; (3) evaluations would hurt candidates, faculty, the learning process, and the institute. Some curriculum directors dismissed these objections, contending that it is the responsibility of psychoanalytic educators to set teaching goals and evaluate learning.
Paul Gray's narrowing Scope: A “Developmental Lag” in His Theory and Technique
Authors: Phillips Sidney H.
Published: November 2012

A cental thesis of Paul Gray's work is that a “developmental lag” pervades modern psychoanalysis in its failure to assimilate and apply knowledge gained about the role of the unconscious ego in intrapsychic life. But Gray himself, it is proposed, has become a victim of a new “developmental lag,” of his own construction. As he somewhat single-mindedly pursued the ramifications of his “developmental lag” concept, Gray may have foreclosed on some noteworthy ideas developing around him. The most important example is his claim—herein refuted—that proper interpretive technique can avoid being infused with transference. He also seems to have rejected the theoretical importance of the internalization of the analyst and the clinical usefulness of countertransference. While emphasizing defense analysis, he ignores defenses such as splitting, denial, and disavowal as substantive problems for his technique of close-process attention. Gray's “undoing” of the rapprochement between “ego analysis” and “id analysis” by viewing the matter as an either-or proposition undermines the very real value of his contribution to the field.
Minding the Gap Between Positivism and Hermeneutics in Psychoanalytic Research
Authors: Blatt Sidney J. , Corveleyn Jozef , Luyten Patrick
Published: November 2012

Two quite different cultures are to be found within psychoanalysis, one more clinical in orientation, more focused on meaning and interpretation, and relying primarily on the traditional case study method, the other more research-oriented, focused on cause-and-effect relationships, and relying primarily on methods borrowed from the natural and social sciences. The history of this divide is reviewed and arguments, pro and con, about the potential contributions of specific types of empirical investigation are discussed. Increasingly, it seems, criticisms concerning the scientific status of psychoanalysis are being responded to by empirical research. This has contributed to a growing recognition within the scientific community of the credibility of aspects of psychoanalytic theories and of the effectiveness of psychodynamic treatment. However, some segments of the psychoanalytic community are concerned that this increase in the quantity and quality of empirical research on psychoanalytic concepts risks creating an empirical one-sidedness, while other segments are concerned that not engaging in systematic empirical research can lead to intellectual isolation, fragmentation, stagnation, and orthodoxy. To counter this polarizing tendency, a recommendation is made for methodological pluralism. Adopting this stance could contribute to an enriched understanding of the clinical process and to the development of new research methodologies to investigate complex psychodynamic hypotheses, thus bridging the gap between the two psychoanalytic cultures, as well as the gap between research and clinical practice.
“Nothing Could Be Further From the Truth”: The Role of Lack in the Analytic Process
Authors: Wilson Mitchell
Published: November 2012

It is an oft-noted clinical phenomenon that the analyst's mistakes are beneficial to the analytic process. Although the analyst's mistakes, misunderstandings, and faulty functioning have been described by psychoanalysts of various theoretical persuasions, no overall theory has been advanced to account for this clinical phenomenon. To address this theoretical lacuna the central Lacanian notions of lack and desire are brought to bear. In particular, lack, or nothing, is presented as an essential working condition of the analyst, one that if understood, recognized, and tolerated can positively inform the analyst's attitude. By contrast, theoretical biases that privilege presence can obscure lack as an important contributor to the analyst's attitude. A clinical case demonstrates that both analyst and patient struggle with deep anxieties generated by lack, and that both are repeatedly tempted to solve these struggles by settling for obsessional solutions.
What's in a nAme: What Analyst and Patient Call Each Other
Authors: Barron Grace Caroline
Published: November 2012

Awkward moments often arise between patient and analyst involving the question, “What do we call each other?” The manner in which the dyad address each other contains material central to the patient's inner life. Names, like dreams, deserve a privileged status as providing a royal road into the paradoxical analytic relationship and the unconscious conflicts that feed it. Whether an analyst addresses the patient formally, informally, or not at all, awareness of the issues surrounding names is important.
Friedman's corpus Since His Anatomy: A Psychoanalytic Odyssey
Authors: Kravis Nathan
Published: November 2012

Lawrence Friedman is a preeminent theorist, critic, and commentator in American psychoanalysis today. The major themes of his work, beginning with his magnum opus, The Anatomy of Psychotherapy (1988), are examined in an effort to identify conceptual shifts and problems in contemporary psychoanalysis. In the years since publication of that work, Friedman's texts have increasingly focused on the epistemological controversies faced by contemporary psychoanalysts. He has become a vocal critic of recent developments in relational psychoanalysis, advancing views that are explored here and subjected to critical appraisal. To better understand Friedman's ideas, areas of disagreement with other authors, including Schafer, Renik, Hoffman, Mitchell, Rorty, and Michels, are explored. Finally, Friedman is presented as a cryptointersubjectivist whose work effects a realignment of theory with practice.
The Threat of Male-To-Female Erotic Transference
Authors: Celenza Andrea
Published: November 2012

Vignettes from an ongoing psychoanalysis with a patient, Michael, are presented to illustrate the various dimensions of the erotic transference at different phases of the treatment. The relation to power, the experience and expression of aggression, how these may be organized by gender, and the female analyst's countertransference are discussed as potentially fostering or inhibitory in the development of an erotic transference. Traditional sociocultural gender stereotypes kept alive in fantasy can cause female analysts to subtly foreclose the impending threat of an intense erotic transference with male analysands due to a fear of outwardly directed male aggression. It is suggested that the maternal/containing transference can be unconsciously fostered by both analyst and analysand to defensively avoid expression of the aggressivized erotic transference in its full intensity. Similarities and differences in cases of sexual boundary violations with opposite-gender pairings are discussed.
Masculinities, Plural
Authors: Spector Person Ethel
Published: November 2012

Masculinity cannot be regarded as a single entity. Both within Western culture and across cultures, a wide variety of masculinities are easily observable. Yet masculinity is so often contrasted with femininity that the many differences among men are at times obscured. To in part correct this deficiency, various “psychologies” of men are explored, as well as the cultural components that shape a society's ideas of what constitutes masculinity. Male heterosexuality and homosexuality are also examined, as are a number of the fantasies and fears that men typically experience. What cannot be left out of any exploration of male psychology are those sources of strength that permit so many men to fiercely protect their families and, when called upon, to fight their country's wars. Nonetheless, the differences between individual men are significant and can even be said to be vast.
A Contemporary Integration of Modern and Postmodern Trends in Psychoanalysis
Authors: Leffert Mark
Published: November 2012

Postmodernism has appeared on the psychoanalytic horizon and with it brought change and some confusion. Although many link or even conflate it with relational and intersubjectivity theory, those views are as subject to a postmodernist critique as other analytic orientations. Postmodernism can also be seen as usefully informing the concepts of psychoanalytic narrative and psychoanalytic space. It should not be viewed as an organized theory or movement that would entirely replace modernist ideas in psychoanalysis. Indeed, valid critiques of both modern and postmodern psychoanalytic positions have been advanced. In this climate the need for a viable integration remains urgent. Bruno Latour's development of the concept of hybrid structure as a way of dealing with the same kind of impasse in the field of science studies is presented, along with its applicability to the dilemma faced by psychoanalysis.
Nothing But the Truth: Self-Disclosure, Self-Revelation, and the Persona of the Analyst
Authors: Levine Susan S.
Published: November 2012

The question of the analyst's self-disclosure and self-revelation inhabits every moment of every psychoanalytic treatment. All self-disclosures and revelations, however, are not equivalent, and differentiating among them allows us to define a construct that can be called the analytic persona. Analysts already rely on an unarticulated concept of an analytic persona that guides them, for instance, as they decide what constitutes appropriate boundaries. Clinical examples illustrate how self-disclosures and revelations from within and without the analytic persona feel different, for both patient and analyst. The analyst plays a specific role for each patient and is both purposefully and unconsciously different in this context than in other settings. To a great degree, the self is a relational phenomenon. Our ethics call for us to tell nothing but the truth and simultaneously for us not to tell the whole truth. The unarticulated working concept of an analytic persona that many analysts have refers to the self we step out of at the close of each session and the self we step into as the patient enters the room. Attitudes toward self-disclosure and self-revelation can be considered reflections of how we conceptualize this persona.
The Rooting of the Mind in the Body: New Links Between Attachment Theory and Psychoanalytic Thought
Authors: Fonagy Peter , Target Mary
Published: November 2012

The relationship between psychoanalysis and attachment theory is complex indeed. A brief review of the psychoanalytic literature as it concerns attachment theory and research, and of the attachment literature as it pertains to psychoanalytic ideas, demonstrates an increasing interest in attachment theory within psychoanalysis. Some of the difficulties that attachment theory faces in relation to psychoanalytic ideas are traced to its links to the now dated cognitive science of the 1960s and 1970s. Today, however, a second-generation cognitive neuroscience seeks neurobiologically plausible accounts in which links with brain and body are seen as shaping mind and consciousness, which increasingly are seen as “embodied,” as emerging from or serving the needs of a physical being located in a specific time, place, and social context. This idea has also been at the core of much psychoanalytic thinking, which has historically affirmed the rootedness of symbolic thought in sensory, emotional, and enacted experience with objects. Now neurobiological advances supporting the concept of embodied cognition offer an opportunity to forge powerful links between the hitherto separate domains of attachment theory and psychoanalysis. Speculations about the nature of language are presented that emphasize the origin of internal working models (and of representations in general) in early sensorimotor and emotional experiences with a caregiver. It is argued that language and symbolic thought may be phylogenetically and ontogenetically embodied, built on a foundation of gestures and actions, and are thus profoundly influenced by the experience of early physical interaction with the primary object. Finally, the clinical and research implications of these ideas are discussed.
The Almost Untreatable Narcissistic Patient
Authors: Kernberg Otto F.
Published: November 2012

Clinical experience in the Personality Disorders Institute at Weill Cornell Medical College suggests that patients with borderline personality organization and a narcissistic personality disorder have a more serious prognosis than all other personality disorders functioning at the borderline level, and that those who in addition present significant antisocial behavior have an even worse prognosis (Clarkin, Yeomans, and Kernberg 1999; Stone 1990). This negative trend culminates in a group of practically untreatable patients with antisocial personality disorder, who represent the most severe cases of pathological narcissism. There are also patients with severe narcissistic personality disorder, functioning at an overt borderline level with significant antisocial features, but not presenting an antisocial personality disorder proper, who at times respond to treatment, while others do not. These patients are explored here, with a focus on particular psychotherapeutic techniques that have proven helpful, as well as on the limits of these technical approaches.
What If There Is an Ethical Dimension in Psychoanalysis?
Authors: Meissner W.W.
Published: November 2012

The implications of an ethical dimension in psychoanalysis are explored, together with the questions whether and in what sense analysis has anything to contribute to ethical reflection, and whether and in what sense ethical considerations can play a role in analytic theory and process. As regards theory, analytic construction of an ethical agent would require a refocusing of structural and dynamic considerations in order to provide an integrative source of decision-making capacity to serve as the responsible agent in ethical deliberation, choice, and action. Suggestions are made for formulating the nature of the ethical agent in terms of a theory of motivation rather than of drive, and in terms of an integrative theory of the self. To the extent that analysis involves ethical considerations, the way lies open for dialogue and mutually enriching contributions of analysis to ethics and vice versa. Various aspects of the analytic perspective are explored that in themselves carry ethical implications or can be enriched by ethical reflection. Beyond theoretical considerations, the interaction between ethical factors and genetic, structural, and dynamic issues in clinical psychoanalysis loom as matters for future exploration.