INVESTIGATING PSYCHOLOGICAL CORRELATES OF EMOTION-BASED DECISION-MAKING

David Younger and Michael Garfinkle

Bechara, Damasio, Damasio, & Anderson (1994) created the Iowa Gambling Task (IGT) to “produce [a] task which simulates in real time, personal real-life decision-making relative to the way it factors uncertainty of premises and outcomes, as well as reward and punishment” (p. 8). The Iowa Gambling Task has proven to be a useful tool in differentiating between risky and non-risky decision makers both in subjects with brain lesions and in samples that are traditionally considered to be bigger risk takers including gamblers, alcoholics, drug users and people who are HIV + (e.g., Hardy, Hinkin, Levine, Castellon, & Lam, 2006).

While a substantial amount has been done with the IGT and clinical populations, relatively little has been done to investigate emotion-based decision-making in normative samples. Bechara et al. (2001) found that 33% of neurologically normal individuals performed within the range of those with lesions in the ventromedial prefrontal cortex on the IGT. Bechara and Damasio (2002) found that 37% of neurologically normal individuals performed within the range of lesioned individuals. Evans, Bowman, and Turnbull (2004) claim that “potential sources of such variation have yet to be properly explored” (241).

The present study sought to explain some of the aforementioned variability through developmental, psychoanalytically-oriented, constructs. Attachment security (George, Kaplan, & Main, 1985) and reflective function (Fonagy, Target, Steele, & Steele, 1998) were investigated as mediators of performance on the IGT with a normative sample. It has been demonstrated that the development of the ability to mentalize is not universal, “but rather a developmental achievement” (Fonagy & Target, 1996). It is connected with interactions and processes in early relationships, primarily that of the child with her primary caregiver. Mentalization, or the reflective mode, comes when the child is able to integrate her internal world with external reality.

Secure attachment provides the child with the foundation for understanding the complexity of the relationship between her internal world and external reality. This is reflected in the child’s ability to mentalize, to understand that her parent’s thoughts do not mirror her own thoughts, and that predicting parental behavior will involve more than thinking about how she would think or act in a given situation. It is assumed that the developmental trajectory as it relates to secure attachment is directly comparable to the sensitivity to somatic feedback required to succeed on the IGT. Since both require an awareness of internal and external factors, it was further assumed that securely attached individuals would meet with greater success on the IGT.

This study is underway utilizing a college sample from a New York area private university. In addition to completing the Iowa Gambling Task, subjects complete the Affective Neuroscience Personality Scales (ANPS; Davis, Panksepp, & Normansell, 2003), Beck Anxiety Inventory (BAI; Beck & Steer, 1990), Beck Depression Inventory, Second Edition (BDI-II; Beck, Steer, & Brown, 1996), and the Sentence Completion Test. Galvanic skin response (GSR) is also monitored over the course of the administration. Twenty high scorers and twenty low scorers on the IGT will be recruited to complete the Adult Attachment Interview (AAI). AAIs will be coded both for attachment security and reflective function.

References

Bechara, A., Damasio, A.R., Damasio, H., & Anderson, S.W. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50, 7-15.
Bechara, A., Dolan, S., Denburg, N., Hindes, A., Anderson, S. W., & Nathan, P. E. (2001). Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers. Neuropsychologia, 39, 376–389.

Bechara, A., & Damasio, H. (2002). Decision-making and addiction (part I): Impaired activation of somatic states in substance dependent individuals when pondering decisions with negative future consequences. Neuropsychologia, 40, 1675–1689.

Beck, A. T., & Steer, R. A. (1990). Manual for the Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation.

Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.

Davis, K.L., Panksepp, J., & Normansell, L. (2003). The Affective Neuroscience Personality Scales: Normative data and implications. Neuro-Psychoanalysis, 5: 57-70.

Evans, C. E. Y., Bowman, C. H., & Turnbull, O. H. (under review). Subjective experience on the Iowa Gambling Task: Preserved performance in schizophrenia.
Brain and Cognition.

Fonagy, P., & Target, M. (1996). Playing with reality: Theory of mind and the normal development of psychic reality. International Journal of Psychoanalysis, 76, 487-502.

Fonagy, P., Target, M., Steele, H., & Steele, M. (1998). Reflective-Functioning Manual, version 5.0, for Application to Adult Attachment Interviews. London: University College London.

George, C., Kaplan, N., & Main, M. (1985). The Berkeley Adult Attachment Interview. Unpublished protocol, University of California, Berkeley.

Hardy, D. J., Hinkin, C. H., Levine, A. J., Castellon, S. A., & Lam, M. N. (2006). Risky decision making assessed with the Gambling Task in Adults with HIV. Neuropsychology, 20(3), 355-360.

ADULT CHILDREN OF HOLOCAUST SURVIVORS, TRANSLATIONAL PROCESSES, MENTALIZATION AND AFFILIATIVE BEHAVIOUR: A Neuro-psychoanalytical Case Study

Andrei Novac, MD, FAPA
Clinical Professor of Psychiatry,Director Traumatic Stress Program,
University of California, Irvine School of Medicine

A large body of literature on offspring of Holocaust survivors, covering intergenerational transmission of trauma has emerged over the past five decades (1). Early psychoanalytical contributions did pioneer the notion that many children of Holocaust survivors born after World War II have carried the burden of traumatic experiences of their parents. These were followed by more recent quantitative research contributions that revealed patterns of trauma response, comorbidity, propensity to the development of PTSD and changes in salivary cortisol levels in individuals who were raised by parents afflicted by PTSD. However, little is known about the mechanisms of transmission of trauma between generations. The most comprehensive understanding has been offered by Attachment Theory, but the question still remains whether intergenerational transmission of Holocaust trauma follows the patterns of attachment modeled by Bowlby, Ainsworth & Main. Specifically, do previously healthy adults, victims of massive psychic trauma, regress to functional levels that later promote insecure and disorganized attachment? By introducing the notion of translational neural mechanisms, the author will explore aspects of brain functions that create a link between information processed from the external world and internal experiences from memories, fantasies and internalized objects. Such translational functions are strongly at play in deteriming a person’s social affiliative behavior.

The case of a long-term treatment of female adult offspring of Holocaust survivors will be presented. The complexity of the case consists in the co-existence of borderline personality features in addition to complex comorbid psychopathology (Bipolar Type II, Social Phobia, Substance Abuse, Panic Attacks, Explosive Anger, features of OCD). Progress in modified psychoanalytical psychotherapy with features of “interpersonal therapy,” and later exploration of mentalization, will be presented.

The case material will follow the steps of progress during which acquired skills of mentalization are converted from explicit episodic mental functions to implicit procedural skills used in redefining her social universe.

The presentation will then review neuro-anatomical structures that could explain the mediation of the selective recruitment, according to needs, of appropriate implicit information/memories. The role of the striatal-palidal system, the extended amygdala, the substantia innominata into the cortico-subcortical re-entrant circuits, as proposed by the late Lennart Heimer (2), will be discussed. More recent neuroimaging studies support the top-down process of a gradual conversion of explicit cortical tasks into implicit information, and at the same time, the bottom-up process of deeply sub-cortically engrained information to shape and bias cognitive processes of the prefrontal cortex. The presentation will conclude with a proposed neuro-psychoanalytical formulation of the described clinical case based on the numerous transformations seen in a treatment that has lasted for over a decade.

References

1. Novac A & Huber-Schneider S. Comorbidity in a patient population of adult offspring of Holocaust survivors. Am J Forensic Psychiatry, 1998; 19:45-58.
2. Heimer L. A new anatomical framework for nuropsychiatric disorders and drug abuse. Am J Psychiatry, 2003; 160: 1726-1739.

INTRODUCTORY REMARKS ON NEUROFEEDBACK AND NEUROPSYCHOANALYSIS

Dirce M Navas Perissinotti, Sonia Pinto Alves Soussumi, Elko Perissinotti and Yussako Soussumi

Introduction: Neurofeedback (NBT), when associated with psychoanalytical treatment, becomes more effective because executive functions are stimulated. The symbolic access is facilitated leading to better mental fluency, to dreamlike contents and to unconscious traumatic memories. The results of this present research aim at opening a closer relationship between both fields of this research in order to ensure better psychological rehabilitation efficacy. The Neuropsychoanalysis concept, which is the combination and the integration of Psychoanalysis and Neurosciencies, was adopted as an approach. This study intended NBT training applied to six patients to try attentional process increase (executive function ↑ SMR e ↑ Beta in Fp1-Fp2 bipolar).

Method: Neurofeedback training method was applied to patients who were already in psychoanalytical treatment that continued according to pre-established patterns, at least for three times a week with another professional (professor psychoanalyst). It was established through protocol planned to improve inhibitory response process, affect regulation, and mental organization. During initial evaluation, everybody showed high scores in frontal (Fp1-Fp2 bipolar) for Delta and Theta waves, and accented decrease for SMR and Beta waves. 30 sections of NBT were carried on, twice a week. The protocol was used for SMR and Beta score pattern increase, because the purpose of the research was attentional capacity improvement and global reasoning development.

Results: EEG wave report measures confirmed that NBT was effective in inducing gain in attentional process and improvement in the patterns (e.g., ↓ Theta/ ↑ SMR) that were translated into electric pattern reorganization. Furthermore, patients that previously showed limited capacity of inner verbal expression content, started to better integrate their real-life conditions with their own wishes and necessities.

Discussion: Improvement of insights and outputs of past memory flashes (early childhood and sensorial) were observed. It seems that NBT contributed to establish integrated reconnections between external and internal reality and it could also perform as wider support to what Freud would call unconscious system. As being used two attentional concepts, from one side the neurological point of view, which is considered the modulatory influence of sensorial information process, and from the other side, the psychological point of view, which is the process where we concentrate our mental activity according to the stimuli (sensation, perception, representation, affect or desire) to fix, define, and select representations and draw the reasoning, NBT has allowed the secondary process operation, as concluded. It was also observed that studied patients, who previously showed limited capacity of verbal expression privileging internal psychic reality (primary process), started to integrate external reality with their desires, aspirations and necessities (second process) after undergoing NBT.

NEUROPSYCHOANALYSIS IN THE FLOW OF CONTEMPORARY SCIENCE

Sébastien Adam
Ph.D candidate, Département de psychologie,Université de Montréal

Neuropsychoanalysis’ claims of relevance rest, at least partly, on the idea that psychoanalysis developed a unique body of knowledge on certain psychological phenomena. It is assumed that it stands in a privileged relation with neuroscience, as far as these areas of inquiry are concerned. Our opinion is that as a consequence of this belief, neuropsychoanalysts neglect the fact that rival psychological paradigms could take over its traditional areas of inquiry. Discussing theories of reference, we will argue that neuropsychoanalysis should not insist solely on its coherence with neuroscience, but also demonstrate that this coherence cannot be matched by rival paradigms.

Psychoanalysis is said to have authority on certain phenomena. Can other paradigms in psychology attend to those while disrespecting psychoanalysis’ authority? Neuropsychoanalysts seem to believe that no. This opinion appears to rest on a misconception of what ″phenomena″ are. Here is my description of the neuropsychoanalytic understanding of this notion. Phenomena are stable and relatively well delineated entities. What they refer to stays the same across time, while only their meaning is allowed to change. This corresponds to the causal-historical theory of reference (H. Putnam). It allows us to conclude that psychoanalysis can indeed attend to the same phenomena as neuroscience. Since it is assumed that psychoanalysis holds a huge sum of valid knowledge on certain phenomena, it is concluded that it cannot be ignored. Psychoanalysis contributes valid and unique meaning to phenomena also considered by neuroscience. It therefore stands in a privileged relation to neuroscience.

In our opinion, this is an inappropriate way of understanding the situation of psychoanalysis. An analysis of the interactions between psychoanalysis and neuroscience demands a subtler handling of the question of co-reference (i.e. the idea of « same phenomenon »). Using the work of T. Kuhn, W.O. Quine and I. Lakatos, we will argue that psychoanalysis’ position in contemporary science is more fragile than what is assumed by the neuropsychoanalytic discourse. More specifically, it appears to us that neuropsychoanalysts exclusively consider the dual relation between psychoanalysis and neuroscience, while neglecting the evolving interests and ″borders″ of other paradigms in psychology. The descriptive theory of reference (T. Kuhn and P.S. Feyerabend) asserts that the phenomena referred to by the concepts of various paradigms are less stable than what is assumed by the causal-historical theory of reference. The phenomena (objects, processes, etc.) constituting the world are the theoretical entities of the paradigms. In a way, we can say that the world changes with the evolution of the theoretical apparatus of the various paradigms. What are the consequences for neuropsychoanalysis? Our opinion is that other psychological paradigms, for example cognitive psychology, could develop their own interactions with neuroscience, while refusing to acknowledge the existence of phenomena postulated by psychoanalysis. They could nonetheless investigate areas of interest to psychoanalysis by using their own theoretical network, i.e. by reinterpreting psychoanalytic observations in the light of their own paradigm. In other words, psychoanalytic phenomena could be replaced by new entities postulated by rival paradigms, without considering whatever coherence may exist between psychoanalysis and neuroscience. Neuropsychoanalysts should therefore make more efforts to show that rival paradigms are incapable of matching psychoanalytic contributions.