Measurement of interleukin 3 and other hematopoietic cytokines, such as GM-CSF, G-CSF, M-CSF, erythropoietin, steel factor, and Flt-3 ligand.

Detection and quantitation of IL-3 and other hematopoietic cytokines in serum samples and culture supernatants has played an important role in understanding their function and pleiotropic properties during the process of hematopoiesis. Several methods for detecting and quantitating cytokines--such as the colony-stimulating factors granulocyte/macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF), macrophage colony-stimulating factor (M-CSF, also called CSF-1), interleukin 3 (IL-3), and erythropoietin (Epo), as well as two potent costimulating cytokines steel factor (SLF) and Flt3/Flk-2 ligand (Flt3-L)--are described in this unit.

Effects of CC, CXC, C, and CX3C chemokines on proliferation of myeloid progenitor cells, and insights into SDF-1-induced chemotaxis of progenitors.

Chemokines have been implicated in the regulation of stem/progenitor cell proliferation and movement. The purpose of the present study was to assess a number of new chemokines for suppressive activity and to delve further into SDF-1-mediated chemotaxis of progenitor cells. This report extends the list of chemokines that have suppressive activity against immature subsets of myeloid progenitors stimulated to proliferate by multiple growth factors to include: MCP-4/CK beta-10, MIP-4/CK beta-7, I-309, TECK, GCP-2, MIG and lymphotactin. The suppressive activity of a number of other chemokines was confirmed. Additionally, pretreatment of the active chemokines with an acetylnitrile solution enhanced specific activity of a number of these chemokines. The new chemokines found to be lacking suppressive activity include: MCP-2, MCP-3, eotaxin-1, MCIF/HCC-1/CK beta-1, TARC, MDC, MPIF-2/eotaxin-2/CK beta-6, SDF-1 and fractalkine/neurotactin. Overall, 19 chemokines, crossing the CC, CXC, and C subgroups, have now been found to be myelosuppressive, and 14 chemokines crossing the CC, CXC and CX3C subgroups have been found to lack myelosuppressive activity under the culture conditions of our assays. Because of the redundancy in chemokine/chemokine receptor interactions, it is not yet clear through which chemokine receptors many of these chemokines signal to elicit suppressive activities. It was also found that SDF-1-induced chemotaxis of progenitors can occur in the presence of fibronectin (FN) and extracellular matrix components and that FN effects involve activation of beta 1-, and possibly alpha 4-, integrins.

Analyst subjectivity, analyst disclosure, and the aims of psychoanalysis.

It is preferable to think of what we directly disclose to our patients as "analyst disclosure" rather than as the commonly used "self-disclosure." The author suggests this change because, to some extent, we have equated the analyst's subjectivity with the self-concept in ways that fail to distinguish how disclosure both overlaps and is distinct from other forms of interpretation. What distinguishes the analysts's subjectivity in disclosure is her or his deliberate attempt to reveal a construction of the self to the patient so that something new can be explored. This paper elaborates these issues by examining some of the therapeutic aims of analyst disclosure.

Countertransference disclosure and the conceptualization of analytic technique.

Most discussions of countertransference disclosure have focused on points of impasse. Here, I will discuss countertransference disclosure in which the analyst attempts to make explicit to the patient how the analyst experiences something during an analytic session that differs from the way the patient experiences the same moment. The analyst presents his observation as something for the patient and analyst to work on together, with the aim of arriving at further understanding. In a clinical example, I suggest a way of comparing uses of countertransference that relate to other approaches in analytic technique. Since the analyst's disclosure evokes questions regarding asymmetry and anonymity in the analytic process, I will briefly elaborate these dimensions.

Interpretation and the psychic future.

The author applies the analyst's multi-faceted awareness of his or her view of the patient's psychic future to analytic process. Loewald's (1960) interest in the way in which the analyst anticipates the future of the patient was linked to his epistemological assumptions about the analyst's superior objectivity and maturity relative to the patient. The elucidation of the authority of the analyst (e.g. Hoffman, 1991, 1994) allows us to begin to disentangle the analyst's view of the patient's psychic future from some of these epistemological assumptions. Clinical illustrations attempt to show how the analyst's awareness of this aspect of the interpretive process is often deconstructed over time and can help to understand aspects of resistance from both analyst and patient. This perspective may provide one more avenue for understanding our various modes of influence through interpretive process.

Facts all come with a point of view: some reflections on fact and formulation from the 75th anniversary edition of the International Journal of Psycho-Analysis.

In this paper the author examines some of the varieties of definitions of fact and formulation within contemporary psychoanalytic perspectives. A common thread running throughout various definitions of fact is the way in which fact is never theory-free. An attempt is made to compare and contrast the ways in which fact and formulation are contextually bound to theory. Questions are raised about the extent to which we can claim evidential status of propositions versus viewing formulations as useful illustrations of our work. Implicit in this paper is the current tension in psychoanalytic theory between psychoanalysis as a theory of motivation and meaning.

Interpretive fallibility and the psychoanalytic dialogue.

The concept of the analyst's interpretive fallibility is utilized to understand and organize the ways in which contemporary psychoanalytic theory has expanded on Freud's notions regarding the hypothetical nature of interpretation. This expansion involves a particular axis regarding the analyst's stance, an axis that cuts across theoretical scaffolding to include the analyst's view of symmetry and asymmetry in the analytic setting and the epistemological positions and preferences accorded to analyst and analysand. The ways in which the analyst constructs and imposes meaning are examined more specifically in the theories of Roy Schafer and Ernest S. Wolf. The benefits and problems of constructivism in analytic stance are evaluated and illustrated through a case example. Finally, the notion of psychoanalytic neurality is reconsidered with regard to a series of tensions between the construction and foreclosure of meaning in the analytic situation.

Mast cell growth factor (c-kit ligand) supports the growth of human multipotential progenitor cells with a high replating potential.

The replating capability of human multipotential (colony-forming unit-granulocyte-erythrocyte-macrophage-megakaryocyte [CFU-GEMM]) and erythroid (burst-forming unit-erythroid [BFU-E]) progenitors was assessed in vitro as a potential measure of self-renewal using purified, recombinant (r) human (hu) or murine (mu) mast cell growth factor (MGF), a ligand for the c-kit proto-oncogene receptor. Primary cultures of human umbilical cord blood or adult human bone marrow cells were initiated in methylcellulose with erythropoietin (Epo) alone or in combination with rhu interleukin-3 (IL-3) or MGF. Individual day 14 to 18 CFU-GEMM or BFU-E colonies were removed from primary cultures and reseeded into secondary methylcellulose cultures containing a combination of Epo, MGF, and rhu granulocyte-macrophage colony-stimulating factor (GM-CSF). The data showed a high replating efficiency of cord blood and bone marrow CFU-GEMM in response to Epo + MGF in terms of the percentage of colonies that could be replated and the number of secondary colonies formed per replated primary colony. The average number of hematopoietic colonies and clusters apparent from replated cultures of cord blood or bone marrow CFU-GEMM stimulated by Epo + MGF was greater than with Epo + rhuIL-3 or Epo alone. Replated cord blood CFU-GEMM gave rise to CFU-GEMM, BFU-E, and GM colony-forming units (CFU-GM) in secondary cultures. Replated bone marrow CFU-GEMM gave rise mainly to CFU-GM in secondary cultures. A more limited capacity for replating of cord blood and bone marrow BFU-E was observed. These studies show that CFU-GEMM responding to MGF have an enhanced replating potential, which may be promoted by MGF. These studies also support the concept that MGF acts on more primitive progenitors than IL-3.

The Rorschach Defense Scales: II. Longitudinal perspectives.

We investigated the ability of defenses assessed from the Rorschach test to predict future levels of depression, anxiety, and psychosocial role functioning in a sample of adults with personality and affective disorder. In general, defenses were less powerful predictors than a descriptively oriented assessment done at the beginning of the study. However, certain defenses did have predictive value. Devaluation and, to a lesser degree, projection were associated with poor outcome in areas of affective disturbance and social relations, whereas intellectualization, isolation, reaction formation, and pollyannish denial were associated with better outcome on these measures.

Assessing psychodynamic conflicts: I. Reliability of the idiographic conflict formulation method.

Recent years have seen increasing interest in devising methods of studying psychodynamic phenomena. These efforts have had confront difficulties, first, in specifying the data, the observation language, and rules of inference for psychodynamic propositions, and second, in determining the reliability and validity of the measures used. Given how "fuzzy" traditional psychodynamic concepts are, it is no wonder that psychodynamic clinicians from Freud onward have achieved more success in generating new hypotheses than in testing their validity. As Reichenbach (1938) has observed, science requires that discovery be followed by systematic validation of all new propositions, regardless of their degree of popular acceptance. At the core of efforts to study psychodynamics have been methods to study ego functioning (Bellak and Goldsmith 1984), defense mechanisms (Perry and Copper 1988), and psychodynamic conflicts. This paper reports on the reliability of the Idiographic Conflict Formulation (ICF), a guided method for formulating an individual's psychodynamic conflicts.

An empirical study of defense mechanisms. I. Clinical interview and life vignette ratings.

The Defense Mechanism Rating Scales (DMRS) measure the use of defense mechanisms based on clinical interview or life vignette data. Using nonprofessional raters observing videotaped psychodynamic interviews of individuals with personality and affective disorders, the median intraclass interrater reliability (IR) of the defense scales was .36 but was .57 for group consensus ratings and .74 when related defenses were grouped into defense summary scales. When follow-up data on life vignettes were rated, the median interrater IR was .55 for those defenses occurring at least 5% of the time and .66 for the defense summary scales. In relation to follow-up data, so-called immature defenses (denial, projection, acting out, hypochondriasis, passive-aggression) were associated with higher levels of symptoms, poorer global functioning, and higher proportion of time impaired in psychosocial role functioning. Borderline defenses (splitting, projective identification) displayed a similar pattern. Among narcissistic and neurotic defenses, only devaluation was associated with poorer functioning, whereas intellectualization was associated with higher functioning. Finally, action and borderline defenses demonstrated significant correlations across methods and across time (video vs life vignettes), whereas obsessional, disavowal, and narcissistic defenses showed nonsignificant trends. Overall, these results support the model of a hierarchy of defenses.

Recent contributions to the theory of defense mechanisms: a comparative view.

Some of the most recent contributions to the theory of defense mechanisms are critically reviewed including theories of complex motivational properties of the ego (Schafer, 1968; Kris, 1984), a functional theory of defense (Brenner, 1982), an object-representational theory of defense (Kernberg, 1976), a "two-person" theory of defense (Modell, 1984) and a self-psychologically based theory of defense (Kohut, 1984). These recently proposed theories of defense mechanisms utilize differing levels of analytic observation and theoretical discourse. One of the major differences among theorists involves the variety of referents of defense mechanisms (i.e., what is being defended against) including impulse, drive derivative, object loss, or environmental failure. Another fundamental difference involves the variety of ways theorists regard the relation between internal homeostasis and the external world. Questions are raised about the recent tendency in psychoanalytic theory to develop or invoke different theories of defense to explain a broad range of clinical phenomena.

An empirical approach to the study of defense mechanisms: I. Reliability and preliminary validity of the Rorschach Defense scales.

Despite widespread use of the Rorschach for the study of defense mechanisms, few recent Rorschach scales have been developed for the study of defensive functioning. We critically review previous empirical research and describe the Rorschach Defense scales. These scales provide criteria for rating both lower level defense mechanisms, such as splitting and primitive idealization, as well as higher level defenses, such as intellectualization and isolation. The scales utilize a broad range of content including all Rorschach responses, associative content, and verbalization of the tester-patient relationship. Data on interrater reliability and preliminary validity are presented.

A preliminary report on defenses and conflicts associated with borderline personality disorder.

The authors present preliminary psychodynamic findings from a naturalistic study of borderline personality disorder compared to antisocial personality disorder and bipolar type II (depression with hypomania) affective disorder. An independent psychodynamic interview of each subject was videotaped from which ratings were made of the presence of 22 defense mechanisms and 11 psychodynamic conflicts. A factor analysis of ratings from 81 subjects supported the separation of borderline (splitting, projective identification) from narcissistic defenses (devaluation, omnipotence, idealization, mood-incongruent denial). While certain groups of defenses were associated with each diagnosis, defense ratings did not significantly discriminate the three diagnostic groups, suggesting a limit to their diagnostic value. Among 27 subjects rated, borderline personality was strongly associated with two conflicts: separation-abandonment, and a global conflict over the experience and expression of emotional needs and anger. Antisocial personality was psychodynamically distinct and more heterogeneous. Bipolar type II was associated with two hypothesized depressive conflicts: dominant other and dominant goal. Chronic depression, which was more common in both personality disorder groups than in bipolar type II, was associated with a third depressive conflict, overall gratification inhibition. Overall, conflicts were powerful discriminators of the three diagnostic groups. The heuristic value of these findings is discussed.