Observations with respect to the relationship between symptoms and diseases can seriously be biased by selection phenomena. This selection may occur from the general population, via consultation behavior, diagnostic and therapeutic activities of the general practitioner, and by referral.Relationships may be suggested and reproduced even if they do not exist in unselected populations, as a product of diagnostic routines. Correction for selection bias can only be achieved by choosing proper comparison groups. While this can be done in a general practice (...) setting, this is almost impossible after referral, as is demonstrated in this paper. Surprisingly, the most unbiased estimation of the relationship between symptoms and diseases after referral can be made from patient groups that are referred for reason unrelated to the disease under study. (shrink)

Avatar, le film de James Cameron (2009), aura ete un succes commercial d'une ampleur exceptionnelle, a considerer davantage comme le symptome d'une certaine societe en crise spirituelle, que comme l'expression personnelle d'un createur, fut-il exceptionnel. Sur cette base, Frank Pierobon, au terme d'une deconstruction tres poussee, en extrait l'embleme de notre postmodernite finissante: un Deus ex Fantasma, soit une derisoire redemption par le reve, faute de tout autre salut.

Since psychiatry remains a descriptive discipline, it is essential for its practitioners to understand how the language of psychiatry came to be formed. This important book, written by a psychiatrist-historian, traces the genesis of the descriptive categories of psychopathology and examines their interaction with the psychological and philosophical context within which they arose. The author explores particularly the language and ideas that have characterised descriptive psychopathology from the mid-nineteenth century to the present day. He presents a masterful survey of the (...) history of the main psychiatric symptoms, from the metaphysics of classical antiquity to the operational criteria of today. Tracing the evolution of concepts such as memory, consciousness, will and personality, and of symptoms ranging from catalepsy and aboulia to anxiety and self-harm, this book provides fascinating insights into the subjective nature of mental illness, and into the ideas of British, Continental and American authorities who sought to clarify and define it. (shrink)

Depressive symptoms are characterised by reduced cognitive control. However, whether depressive symptoms are linked to difficulty in exerting cognitive control in general or over emotional content specifically remains unclear. To better differentiate between affective interference or general cognitive control difficulties in people with depressive symptoms, we employed a non emotional (cold) and an emotional (hot) version of a task-switching paradigm in a nonclinical sample of young adults (N = 82) with varying levels of depressive symptoms. Depressive symptoms were linked to (...) greater difficulties in exerting cognitive control in complex situations (mixed-task blocks) compared to simple and semiautomatic situations (single-task blocks) in both task versions. Moreover, greater depressive symptoms were associated with longer latencies in the emotional version of the task across all trial types. Thus, the emotion-specific effect was not modulated by the degree of cognitive control required to perform the task. In sum, depressive symptoms were characterised by a general difficulty to exert cognitive control in both emotional and non emotional contexts and by greater difficulty in even simple attentional processing of emotional material. This study granted novel insights on the extent of cognitive control difficulties in emotional and non emotional contexts for people with depressive symptoms. (shrink)

In this paper, I want to make two main points. The first point is methodological: Instead of attempting to give a classical analysis or reductive definition of the term “expertise”, we should attempt an explication and look for what may be called symptoms of expertise. What this comes to will be explained in due course. My second point is substantial: I want to recommend understanding as an important symptom of expertise. In order to give this suggestion content, I begin to (...) develop an account of understanding. Finally, I will draw attention to some consequences of this approach. (shrink)

The symptom (which here refers to both the clinical or ‘objective’ sign, that is, the sign that physicians believe cannot lie, and the patient’s subjective revelation of disorder, which is always considered suspect) has been relegated by a number of semioticians to a category of signs often considered of little consequence, a ‘natural’ sign signaling some specific condition or state within the body whose object stands in a strictly biological and securely determined relationship to the symptom. I believe the symptom, (...) however, is deep, rich, and symbolic in every sense, signifying the misadventures of a body impaled by its perceptual skills and history within its own unique Umwelt or sign-world. Unfortunately, the notion of a sign which reflects biologically coded events alone suggests the body is without the ability to think, learn, and produce a story of unlimited semiosis. This should seem especially problematic to those biosemioticians who find analogic codes of much greater importance than the supposedly digital codes of DNA. I suggest that the disordered and disorderly body and the Umwelt within which it survives offer biosemioticians and those who pursue semiotic models in other disciplines an important opportunity to jointly and more fully explore the experienced world of health and illness, a world in which culture and nature are fully interpenetrated. (shrink)

Psychiatric researchers typically assume that the modelling of psychiatric symptoms is not influenced by psychiatric categories; symptoms are modelled and then grouped into a psychiatric category. I highlight this primarily through analysing research domain criteria. RDoC’s importance makes it worth scrutinizing, and this assessment also serves as a case study with relevance for other areas of psychiatry. RDoC takes inadequacies of existing psychiatric categories as holding back causal investigation. Consequently, RDoC aims to circumnavigate existing psychiatric categories by directly investigating the (...) causal basis of symptoms. The unique methodological approach of RDoC exploits the supposed lack of influence of psychiatric categories on symptom modelling, taking psychiatric symptoms as the same regardless of which psychiatric category is employed or if no psychiatric category is employed. But this supposition is not always true. I will show how psychiatric categories can influence symptom modelling, whereby identical behaviours can be considered as different symptoms based on an individual’s psychiatric diagnosis. If the modelling of symptoms is influenced by psychiatric categories, then psychiatric categories will still play a role, a situation which RDoC researchers explicitly aim to avoid. I discuss four ways RDoC could address this issue. This issue also has important implications for factor analysis, cluster analysis, modifying psychiatric categories, and symptom based approaches. (shrink)

There is one concept in medicine which is prominent, the symptom. The omnipresence of the symptom seems, however, not to be reflected by an equally prominent curiosity aimed at investigating this concept as a phenomenon. In classic, traditional or conventional medical diagnostics and treatment, the lack of distinction with respect to the symptom represents a minor problem. Faced with enigmatic conditions and their accompanying labels such as chronic fatigue syndrome, fibromyalgia, medically unexplained symptoms, and functional somatic syndromes, the contestation of (...) the symptom and its origin is immediate and obvious and calls for further exploration. Based on a description of the diagnostic framework encompassing medically unexplained conditions and a brief introduction to how such symptoms are managed both within and outside of the medical clinic, we argue on one hand how unexplained conditions invite us to reconsider and re-think the concept we call a “symptom” and on the other hand how the concept “symptom” is no longer an adequate and necessary fulcrum and must be enriched by socio-cultural, phenomenological and existential dimensions. Consequently, our main aim is to expand both our interpretative horizon and the linguistic repertoire in the face of those appearances we label medically unexplained symptoms. (shrink)

The main aim of this study is to explore the breadth of the inference field and the type of etiopathogenetic contents of symptom explanations provided by the client and therapist in the first two psychotherapy sessions conducted using a systemic approach. Does the therapist use triadic explanations of psychopathology as suggested by her approach? And do clients resort almost exclusively to monadic and dyadic explanations as did the university students in our previous study? What kind of explanations do they propose? (...) The coding system “1 to 3: from the monad to the triad” was applied to the transcripts of 25 individual systemic therapies conducted by the same therapist. This manual allows to code the inference field of symptom explanations according to three categories: monadic, dyadic and triadic. These three broad categories are also used to analyse the etiopathogenetic content of each explanation: traumatic, intrapersonal, and interpersonal. Our findings showed that clients and their therapist actually used different inference fields: clients resorted almost exclusively to monadic and dyadic explanations, whereas their therapist included the triadic explanatory level. Moreover, the therapist provided more interpersonal explanations than her clients. Hence, the dissonance between client and therapist about the inference fields¬–a crucial premise of one of the most accepted ideas of therapeutic change according to systemic therapies–is proved, at least among our participants. Thanks to this dissonance, clients and therapists can create a new story, potentially able to change clients’ feelings, without disconfirming their emotions. (shrink)

Following the declaration of the COVID-19 outbreak as a global pandemic in March 2020, a state of alarm was decreed in Spain. In this situation, healthcare workers experienced high levels of stress, anxiety and depression due to the heavy workload and working conditions. Although Spain experienced a progressive decline in the number of COVID-19 cases until the last week of May and the work overload among health workers was substantially reduced, several studies have shown that this work overload is associated (...) with the later emergence of psychological symptoms induced by stress. The aim of the present study was to evaluate the levels of stress, anxiety, depression, post-traumatic stress and compassionate fatigue in health professionals. The sample consisted of 973 health professionals 16.5% men, 82.9% women, and one non-binary person. The data were collected through an online questionnaire sent to the participants by e-mail. DASS-21 was used to measure anxiety, stress and depression, PCL-C to measure post-traumatic stress and ProQOL -vIV to measure compassion fatigue. In addition, other descriptive variables that could be related to these levels of psychological symptomatology were evaluated. The results reveal that after the work overload experienced during the COVID-19 pandemic, healthcare workers report psychological symptoms, post-traumatic stress and compassion fatigue. It is therefore recommended that these professionals be provided with psychological help in order to reduce the emotional impact of COVID-19, and consequently improve their mental health. (shrink)

Every statement about language is also a statement by and about psyche. Guided by this primary assumption, and inspired by the works of Carl Jung, in _Symptom, Symbol, and the Other of Language_, Bret Alderman delves deep into the symbolic and symptomatic dimensions of a deconstructive postmodernism infatuated with semiotics and the workings of linguistic signs. This book offers an important exploration of linguistic reference and representation through a Jungian understanding of symptom and symbol, using techniques including amplification, dream interpretation, (...) and symbolic attitude. Focusing on Ferdinand de Saussure, Jacques Derrida, Michel Foucault, and Richard Rorty, Alderman examines the common belief that words and their meaning are grounded purely in language, instead envisioning a symptomatic expression of alienation and collective dissociation. Drawing upon the nascent field of ecopsychology, the modern disciplines of phenomenology and depth psychology, and the ancient knowledge of myth and animistic cosmologies, Alderman dares us to re-imagine some of the more sacrosanct concepts of the contemporary intellectual milieu informed by semiotics and the linguistic turn. Symptom, Symbol, and the Other of Language is essential reading for academics and students engaged in the study of depth psychology. However, the interdisciplinary approach of the work ensures that it will also be of great interest to those researching and studying in the areas of ethology, ecopsychology, philosophy, linguistics and mythology. (shrink)

Les mémorialistes témoignent du ressentiment persistant qui accompagne les édits de pacification des années 1563 à 1598. Non publiés à cette époque, ils reflètent le mécontentement de voir les édits favoriser leurs adversaires, croient-ils, et les divers moyens par lesquels une population peut traduire la permanence des agressivités détournées, quelles que soient la date et les clauses d’oubli. Le peu de crédit apporté à la décision royale de coexistence pacifique ne construit, au delà des apparences disciplinées, que la perception d’une (...) régression à ce qui était l’origine des conflits. (shrink)

The concept of anxiety has long held a central place in psychoanalytic theories of mind and treatment. Yet, in recent years, data from the neurosciences and from pharmacological studies have posed a compelling challenge to psychoanalytic models of anxiety. One major outcome of these studies is the realization that anxiety both organizes and disorganizes, that it can be both symptom and signal. In _Anxiety as Symptom and Signal_, editors Steven Roose and Robert Glick have brought together distinguished contributors to address (...) these different dimensions of anxiety. A section of original papers on "Anxiety as Symptom" covers evolutionary, neuroanatomical, genetic, and developmental perspectives. A complementary section on "Anxiety as Signal" focuses on the meanings and functions of anxiety in the clinical process; contributions address anxiety in its ego-psychological, intersubjective, and relational dimensions. The illuminating, readable collection will broaden clinicians' awareness of the diverse research findings that now inform our understanding of anxiety. No less importantly, it will deepen their appreciation of the richly variegated ways that anxiety can shape, and be shaped by, the clinical process. (shrink)

Galen's treatises on the classification and causation of diseases and symptoms are an important component of his prodigious oeuvre, forming a bridge between his theoretical works and his practical, clinical writings. As such, they remained an integral component of the medical teaching curriculum well into the second millennium. This edition was originally published in 2006. In these four treatises, Galen not only provides a framework for the exhaustive classification of diseases and their symptoms as a prelude to his analysis of (...) their causation, but he also attempts to establish precise definitions of all the key terms involved. Unlike other of his works, these treatises are notably moderate in tone, taking into account different views on structure and causation in a relatively even-handed way. Nonetheless, they are a clear statement of the Dogmatic position on the theoretical foundations of medicine in his time. (shrink)

This article argues that Badiou's account of subjects of truth-procedures requires the Lacanian subject in order to be intelligible. Without an account of the Lacanian subject as void and precarious with respect to all identifications, Badiou is unable to explain how the subject of truth procedures is able to throw off its identifications and symbolic roles that characterize its existence as an individual or body in the situation, taking on, instead, fidelity to the truth that follows from an event.

Background: The classical symptom specificity hypothesis (Blatt, 1974) links obsessional symptoms to autonomous interpersonal behavior. Inconsistent findings from cross-sectional group studies on symptom specificity have previously been associated with several conceptual and methodological limitations intrinsic to nomothetic research. Previous empirical case research reported ambivalences between autonomous and dependent interpersonal behavior in obsessional pathology. Aim and Method: The present ‘theory-building’ case study specifically aims at further refinement of the classical symptom specificity hypothesis by testing specific operationalizations within an empirical single case (...) design. Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of a psychodynamic therapy. Interpersonal functioning is assessed by means of the Core Conflictual Relationship Theme method. The classical symptom specificity hypothesis is contrasted to an alternative hypothesis of interpersonal ambivalences as determinants of obsessional symptoms. Results: Close associations between obsessions and interpersonal dynamics are observed. Findings predominantly affirm the ambivalence hypothesis rather than the classical symptom specificity hypothesis. Psychodynamic interventions focusing on interpersonal conflicts are related to symptomatic changes. Conceptual and methodological considerations, limitations and future research indications are discussed. (shrink)

This book chapter is a short response to a paper by the psychiatrist Nicholas Kontos, on the phenomenon of psychological symptom amplification (PSA). PSA takes place when patients present symptoms to clinicians that they do not actually have, or, perhaps more commonly, they exaggerate symptoms they do have. Kontos argues that, because of modern medical training, it is very difficult for clinicians to recognize that the patient's presented symptoms are exaggerated or nonexistent. I argue that the hiddenness of PSA is (...) a result of far-reaching instutitional changes that took place in American psychiatry in the 1970s. In short, many psychiatrists went from seeing mental disorders as (unconscious) strategies to seeing them as dysfunctions, nothing more. Recognizing PSA involves adopting a perspective that has been effectively abolished in contemporary American psychiatry. (shrink)

The boundary between spiritual experience and mental disorder remains unclear and should invite collaboration between psychiatry and other disciplines, including theology. Jackson and Fulford (1997), using the tools of analytic philosophy, have proposed a model allowing principled differentiation between spiritual experience and psychotic symptoms based on the personal values of the subject, a cognitive problem-solving model. Spiritual experience is described as positively evaluated psychotic experience, which enables the subject to do more than he or she normally does. In the present (...) paper, it is claimed that values and actions cannot alone always discriminate between religious experience and psychopathology. With reference to three case studies, drawn from the practice of one of us, it is argued that spirituality is not all about experience and that it cannot be understood without reference to the subject's personal history and spiritual tradition, however implicit or fragmented. This approach would allow an account of ordinary religious experience in those who have suffered ego disablement during mental illness. Drawing primarily on the Christian tradition, we argue that the use of theological criteria may allow levels of discrimination between spiritual experience and mental disorder not allowed for by philosophical psychopathology. (shrink)

The first clinical symptoms focused on the presentation of coronavirus disease 2019 have been respiratory failure, however, accumulating evidence also points to its presentation with neuropsychiatric symptoms, the exact mechanisms of which are not well known. By using a computational methodology, we aimed to explain the molecular paths of COVID-19 associated neuropsychiatric symptoms, based on the mimicry of the human protein interactions with SARS-CoV-2 proteins.Methods: Available 11 of the 29 SARS-CoV-2 proteins’ structures have been extracted from Protein Data Bank. HMI-PRED, (...) a recently developed web server for structural PREDiction of protein-protein interactions between host and any microbial species, was used to find the “interface mimicry” through which the microbial proteins hijack host binding surfaces. Classification of the found interactions was conducted using the PANTHER Classification System.Results: Predicted Human-SARS-CoV-2 protein interactions have been extensively compared with the literature. Based on the analysis of the molecular functions, cellular localizations and pathways related to human proteins, SARS-CoV-2 proteins are found to possibly interact with human proteins linked to synaptic vesicle trafficking, endocytosis, axonal transport, neurotransmission, growth factors, mitochondrial and blood-brain barrier elements, in addition to its peripheral interactions with proteins linked to thrombosis, inflammation and metabolic control.Conclusion: SARS-CoV-2-human protein interactions may lead to the development of delirium, psychosis, seizures, encephalitis, stroke, sensory impairments, peripheral nerve diseases, and autoimmune disorders. Our findings are also supported by the previous in vivo and in vitro studies from other viruses. Further in vivo and in vitro studies using the proteins that are pointed here, could pave new targets both for avoiding and reversing neuropsychiatric presentations. (shrink)

This study reviews the existing literature on psychiatric interventions for individuals affected by the COVID-19 epidemic. My article cumulates previous research on how extreme stressors associated with COVID-19 may aggravate or cause psychiatric problems. The unpredictability of the COVID-19 epidemic progression may result in significant psychological pressure on vulnerable populations. Persons with psychiatric illnesses may experience worsening symptoms or may develop an altered mental state related to an increased suicide risk. The inspected findings prove that psychological intervention measures for patients (...) affected by the epidemic should be designed and personalized adequately. Preventive measures seek to decrease infection rates and cut down the risk of the public healthcare system to eventually be overburdened. Throughout the COVID-19 crisis, people with psychiatric illnesses may confront a decrease in mental health services. As limitations in the current review, by focusing only on articles published in journals indexed in Web of Science, Scopus, and ProQuest, I inevitably disregarded other valuable sources. Subsequent research directions should clarify the effectiveness of online mental health services in providing remote psychiatric interventions to individuals affected by the COVID-19 epidemic. (shrink)

Psychoanalytic practice and theory do not map together in any seamless ways. Nevertheless, the creative tension between the two is essential in the production of psychoanalytic knowledge. In this paper, I recount Emma’s psychoanalytic journey using a series of five vignettes from her four-year psychotherapy. When I met Emma, she had been unable to walk for six months. The reasons for her affliction were, at this time, mysterious. During her therapy, a transformative process took place reflecting a movement from symptom (...) to the symbolization of an inner receptive space. The insights that emerged from this psychic journey challenge the conceptualization of a simple linear progression from the pre-Oedipal to the Oedipal moment which is seen to structure subjectivity. I argue that the representation of a receptive inner space is a necessary precondition for thought – and this is especially so for women’s development of mind. This argument calls into question the centrality given to the Oedipus complex and the associated paternal function in the structuring of subjectivity in some psychoanalytic models of mind. I suggest these models sit too closely to patriarchal fantasies which underestimate the complex processes involved in entering the symbolic realm. (shrink)

Abstract:Most mental health conditions, though appropriate targets of treatment, do not generate a moral obligation to seek treatment. Trauma, in contrast, is caused (at least in part) by an external event that can happen at any point in the individual’s life. Survivors often experience diverse and enduring symptoms that adversely affect their cognitive, social, emotional, and physical functioning (American Psychiatric Association, 2013). These global impairments diminish an individual’s ability to respond appropriately to morally relevant reasons and stimuli. Fortunately, symptoms of (...) trauma respond well to treatment (Bradley, Greene, Russ, Dutra, & Westen, 2005). The external etiology and effectiveness of treatment allows us examine the moral duties of someone with impaired moral faculties due to trauma within a Kantian framework. The symptoms of trauma interfere with their ability to cultivate what Kant calls “natural powers” of spirit, soul, and body (DoV 6:444–6:445). Kant’s discussion of the natural powers implies that we must possess a baseline level of functioning in these areas in order to fulfill our moral duties (DoV 6:444–446). By Kant’s own reasoning it seems that individuals who experience impairments in any of the three powers are morally obligated to cultivate these capacities. Using Johnson’s (2011) discussion of Kant’s duties to self and careful analysis of available treatments for trauma, I argue that individuals who experience symptoms of trauma and suffer from impairments in Kantian natural powers have an imperfect duty to themselves to repair these powers through empirically informed trauma treatment. (shrink)

Boldly focusing on sexuality as a crucial definer of social order, Being and Symptom argues that there is an "M theory" -- a master theory of theories -- not only in Quantum Physics, but also in Continental Philosophy, Psychoanalysis, and Sociology, disclosing how the ontological structure of the "fantastic four" ingredients of metaphysics (potentiality, impotentiality, actuality, completion) has recurred through time. Öğüt also seeks to turn Thomas Hobbes's political philosophy into a social theory within the fields of sexuality and sovereignty (...) and to locate parallels among Aristotle, Ibn Khaldun, Kant, Hegel, Heidegger, Foucault, Lacan, Agamben, Nash, Derrida, Girard, Kristeva, and Žižek, with a special emphasis on how Žižek has adapted Lacanian psychoanalysis into social theory. Öğüt conveys a highly original analysis of the unconscious of our social (sexual) relations, subjectivities, and politics. (shrink)

The concept of anxiety has long held a central place in psychoanalytic theories of mind and treatment. Yet, in recent years, data from the neurosciences and from pharmacological studies have posed a compelling challenge to psychoanalytic models of anxiety. One major outcome of these studies is the realization that anxiety both organizes and disorganizes, that it can be both symptom and signal. In _Anxiety as Symptom and Signal_, editors Steven Roose and Robert Glick have brought together distinguished contributors to address (...) these different dimensions of anxiety. A section of original papers on "Anxiety as Symptom" covers evolutionary, neuroanatomical, genetic, and developmental perspectives. A complementary section on "Anxiety as Signal" focuses on the meanings and functions of anxiety in the clinical process; contributions address anxiety in its ego-psychological, intersubjective, and relational dimensions. The illuminating, readable collection will broaden clinicians' awareness of the diverse research findings that now inform our understanding of anxiety. No less importantly, it will deepen their appreciation of the richly variegated ways that anxiety can shape, and be shaped by, the clinical process. (shrink)

Trolley dilemmas have been used to justify the intuitive appeal of the doctrine of double effect. According to this doctrine, if a good action has a harmful side effect, it is morally acceptable to do it, provided the harmful effect is not intended. However, in some variants of the dilemma, most people are willing to forego this doctrine, thus making responses inconsistent. In this study, 404 university students from the United Arab Emirates (UAE) were presented with 4 versions of the (...) trolley dilemma. Results came out showing that higher levels of depressive symptoms predict greater consistency in adherence (or rejection) to the doctrine of double effect. Likewise, higher levels of depressive symptom predict utilitarian responses to trolley dilemmas. Anxiety symptoms had similar effects, but more moderate. Demographic variables (age, gender) were also assessed as predictors of responses and consistency to trolley scenarios, but no significant effects were found. (shrink)

Individuals with idiopathic environmental illness with attribution to electromagnetic fields (IEI-EMF) claim they experience adverse symptoms when exposed to electromagnetic fields (EMFs) from mobile telecommunication devices. However, research has consistently reported no relationship between exposure to EMFs and symptoms in IEI-EMF individuals. The current study investigated whether presence of symptoms in IEI-EMF individuals were associated with a nocebo effect. Data from two previous double-blind provocation studies were re-analyzed based on participants’ judgments as to whether or not they believed a telecommunication (...) base station was “on” or “off.” Experiment 1 examined data in which participants were exposed to EMFs from Global System for Mobile Communication, Universal Mobile Telecommunications System, and sham base station signals. In Experiment 2, participants were exposed to EMFs from Terrestrial Trunked Radio Telecommunications System and sham base station signals. Our measures of subjective well-being indicated IEI-EMF participants consistently reported significantly lower levels of well-being, when they believed the base station was “on” compared to “off.” Interestingly, control participants also reported experiencing more symptoms and greater symptom severity when they too believed the base station was “on” compared to “off.” Thus, a nocebo effect provides a reasonable explanation for the presence of symptoms in IEI-EMF and control participants. (shrink)

In the target article, Cramer et al. suggest that diagnostic classification is improved by modeling the relationship between manifest variables (i.e., symptoms) rather than modeling unobservable latent variables (i.e., diagnostic categories such as Generalized Anxiety Disorder). This commentary discusses whether symptoms represent manifest or latent variables and the implications of this distinction for diagnosis and treatment.

Religious leaders face numerous mental health challenges, and prior research suggests that some experience symptoms of post-traumatic stress disorder due to work-related experiences. This study employed a diverse sample of 274 religious leaders to qualitatively describe the types of work-related experiences they identify as particularly stressful or overwhelming, assess the prevalence of PTSD symptoms associated with these experiences, and test hypothesized associations between PTSD symptoms and narcissism. The study found that the stressful experiences reported typically involved relational conflict, having limited (...) resources, or caring for people suffering. Over half of the sample endorsed symptoms that were above the cutoff for a clinical concern for PTSD, and PTSD symptoms were significantly associated with symptoms of both vulnerable narcissism and grandiose narcissism. Practical implications for the ongoing formation and support of religious leaders are discussed. (shrink)

Traditionally, psychoanalytically oriented clinicians have eschewed a direct focus on symptoms, viewing it as superficial turning away from underlying psychopathology. But this assumption is an artifact of a dated classical approach; it should be reexamined in the light of contemporary relational thinking. So argues Mary Connors in _Symptom-Focused Dynamic Psychotherapy_, an integrative project that describes cognitive-behavioral techniques that have been demonstrated to be empirically effective and may be productively assimilated into dynamic psychotherapy. What is the warrant for symptom-focused interventions in (...) psychodynamic treatment? Connors argues that the deleterious impact of symptoms on the patient's physical and emotional well being often impedes psychodynamic engagement. Symptoms associated with addictive disorders, eating disorders, OCD, and posttraumatic stress receive special attention. With patients suffering from these and other symptoms, Connors finds, specific cognitive-behavior techniques may relieve symptomatic distress and facilitate a psychodynamic treatment process, with its attentiveness to the therapeutic relationship and the analysis of transference-countertransference. Connors' model of integrative psychotherapy, which makes cognitive-behavioral techniques responsive to a comprehensive understanding of symptom etiology, offers a balanced perspective that attends to the relational embeddedness of symptoms without skirting the therapeutic obligation to alleviate symptomatic distress. In fact, Connors shows, active techniques of symptom management are frequently facilitative of treatment goals formulated in terms of relational psychoanalysis, self psychology, intersubjectivity theory, and attachment research. A discerning effort to enrich psychodynamic treatment without subverting its conceptual ground, _Symptom-Focused Dynamic Psychotherapy_ is a bracing antidote to the timeworn mindset that makes a virtue of symptomatic suffering. (shrink)

The practice of the Western medicine often identifies the symptom with the disease itself, but a current of thought and medical practice considers it as the important message of an organic imbalance. In fact, in standard therapies symptoms are usually suppressed, thus interrupting a normal physiological process and risking severe reactions due to the organic imbalance. Dr. Hahnemann, the father of homeopathy, founded his diagnostic and therapeutic model on the interpretation of the symptoms and maintained that symptoms are an expression (...) of altered physiology. The same concept is to be found in Dr. Reckeweg's “reactivity” and homotoxicology; he believed that diseases are the expression of the struggle of the body against toxins. Reckeweg's contribution was particularly important in considering the inflammation process as a biologic process through which the body restores its health. Also PNEI proposes a model where the symptom is interpreted as information and as the res... (shrink)

Considerable heterogeneity among pediatric chronic pain patients may at least partially explain the variability seen in the response to behavioral therapies. The current study tested whether autistic traits and attention-deficit/hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain are associated with socioemotional and functional impairments and response to acceptance and commitment therapy treatment, which has increased psychological flexibility as its core target for coping with pain and pain-related distress. Children and adolescents aged 8–18 years were (...) recruited. Patients and their parents completed questionnaires pre- and post-ACT of 17 sessions. Correlational analyses and mixed-effects models were used to assess the role of autistic traits and ADHD symptoms in pretreatment functioning and ACT-treatment response. Outcome variables were degree to which pain interfered with daily activities, socioemotional functioning, psychological inflexibility, and pain intensity. Autistic traits and ADHD symptoms, pain frequency, and pain duration were measured at pretreatment only. Higher autistic traits were associated with greater pain interference, higher depression, and greater psychological inflexibility. Higher ADHD symptomatology was associated with greater pretreatment pain interference, lower emotional functioning, greater depression, and longer duration of pain. Across patients, all outcome variables, except for sleep disturbances and school functioning, significantly improved from pre- to post-ACT. Higher autistic traits were associated with greater pre- to post-ACT improvements in emotional functioning and sleep disturbance and non-significant improvements in pain interference. ADHD symptomatology was not associated with treatment outcome. The current results showed that neuropsychiatric symptoms in pediatric chronic pain patients are associated with lower functioning, particularly pain interfering with daily life and lower socioemotional functioning. The results suggest that not only pediatric chronic pain patients low in neuropsychiatric symptoms may benefit from ACT, but also those high in autism traits and ADHD symptoms. With the present results in mind, pediatric chronic pain patients higher in autistic traits may actually derive extra benefit from ACT. Future research could assess whether increased psychological flexibility, the core focus of ACT, enabled those higher in autism traits to cope relatively better with pain-related distress and thus to gain more from the treatment, as compared to those lower in autism traits. Moreover, to address specific effects of ACT, inclusion of an appropriate control group is key. (shrink)

The aim of this article is to present a conceptual review and analysis of symptom understanding. Subjective bodily sensations occur abundantly in the normal population and dialogues about symptoms take place in a broad range of contexts, not only in the doctor’s office. Our review of symptom understanding proceeds from an initial subliminal awareness by way of attribution of meaning and subsequent management, with and without professional involvement. We introduce theoretical perspectives from phenomenology, semiotics, social interactionism, and discourse analysis. Drew (...) Leder’s phenomenological perspectives deal with how symptom perception occurs when any kind of altered balance brings forward a bodily attention. Corporeality is brought to explicit awareness and perceived as sensations. Jesper Hoffmeyer’s biosemiotic perspectives provide access to how signs are interpreted to attribute meaning to the bodily messages. Symptom management is then determined by the meaning of a symptom. Dorte E. Gannik’s concept “situational disease” explains how situations can be reviewed not just in terms of their potential to produce signs or symptoms, but also in terms of their capacity to contain symptoms. Disease is a social and relational phenomenon of containment, and regulating the situation where the symptoms originate implies adjusting containment. Discourse analysis, as presented by Jonathan Potter and Margaret Wetherell, provides a tool to notice the subtle ways in which language orders perceptions and how language constructs social interaction. Symptoms are situated in culture and context, and trends in modern everyday life modify symptom understanding continuously. Our analysis suggests that a symptom can only be understood by attention to the social context in which the symptom emerges and the dialogue through which it is negotiated. (shrink)

The recent changes in COVID-19 symptoms suggest convergent evolution of respiratory diseases. This process is analogous to the emergence of animal mimetic complexes and complements previously identified types of mimicry. A novel pathogen might go unnoticed or insufficiently counteracted if it resembles a disease that the host already faced on multiple occasions, which creates a selective pressure towards a typical symptomic phonotype. In short, the reason why so many unrelated pathogens cause similar symptoms may correspond to the reasons that drove (...) the evolution of the ‘warning’ wasp-like colouration in various insect species. (shrink)