The Brief Version of the Mentalization Scale (MentS-12): Evidence-Based Assessment of Mentalizing Capacity.

Recognizing the need for a concise self-report measure of mentalizing capacity, we developed a 12-item iteration of the well-established Mentalization Scale (MentS). Using college student and community samples of Serbian adults (N = 566), we performed a precise selection of items and then examined the psychometric attributes of the shortened scale (MentS-12). The new scale maintains the original three-dimensional structure: self-related mentalization, other-related mentalization, and motivation to mentalize. MentS-12 proves to be both reliable and structurally consistent. To improve its utility in therapeutic contexts, we determined clinical change thresholds for both the complete and abbreviated forms. We hope that its feasibility stimulates the integration of the MentS-12 in longitudinal research projects and real-world clinical settings.

Onset of Inattention and Hyperactivity in Children and Adolescents With Epilepsy 6 months After the Diagnosis.

OBJECTIVE: Complete or major symptoms of ADHD are often present in epilepsy. This study evaluated inattention and hyperactivity symptoms over the first 6 months in newly diagnosed pediatric epilepsy without comorbid ADHD. METHOD: Children and adolescents with newly diagnosed epilepsy were followed for 6 months after starting antiseizure medications. The Nisonger Child Behavior Rating Form (NCBRF), Adverse Event Profile (AEP), and the Revised Wechsler Intelligence Scale for Children were used. RESULTS: There was a marked increase in attention difficulties while a moderate increase in hyperactivity levels. AEP scores, changes in non-verbal aspects of intelligence, levels of hyperactivity at the follow-up, and attention at baseline were significant predictors for inattention. In contrast, only levels of hyperactivity at the baseline and inattention at the follow-up were significant predictors for hyperactivity. CONCLUSION: Significant inattention and hyperactivity levels originated 6 months after the diagnosis of epilepsy and starting antiseizure medication.

Raised in the world of psychoanalysis: an interview with Judith Dupont.

This interview with Dr. Judith Dupont contains her reminiscences and thoughts about two topics of importance for the historiography of psychoanalysis. First, Dr. Dupont recalls her growing up among and meeting with pioneers, such as Vilma Kovács, Alice and Michael Balint, Melanie Klein, Imre Hermann and others. Second, Dr. Dupont reconstructs the chronicle of Ferenczi's manuscripts: how they were entrusted to Michael Balint by Ferenczi's widow, the complex reasons Balint could not publish them for more than 30 years, and finally, how Dr. Dupont succeeded in bringing the Clinical Diary to the public, and thus enriched contemporary psychoanalysis with the presence of Ferenczi after more than 50 years of silence and censorship.

"Death drive" scientifically reconsidered: Not a drive but a collection of trauma-induced auto-addictive diseases.

Over the last 102 years, a lot of discussion was being held about the psychoanalytic conception of the "death drive," but still with inconclusive results. In this paper, we start with a brief review of Freud's conception, followed by a comprised overview of its subsequent support or criticisms. The core of our argument is a systematic review of current biochemical research about two proposed manifestations of the "death drive," which could hopefully move the discussion to the realm of science. It was already established that drive satisfaction leads to the secretion of beta-endorphins, and research evidence also shows that the same biochemical mechanisms get activated in the case of masochism and the gambling disorder but only if they are preceded by chronic frustration of the essential drives. We conclude that the actual situation is more complex than Freud hypothesized, and that a fundamental revision of the psychoanalytic drive theory is necessary.

Cognitive profile, psychopathological symptoms, and quality of life in newly diagnosed pediatric epilepsy: A six-month, naturalistic follow-up study.

Long-term studies indicated changes in aspects of cognition, psychopathology, and quality of life (QOL) in children and adolescents followed up after the diagnosis of epilepsy. However, evidence is limited regarding what happens during the first few months after epilepsy is diagnosed because at this phase is possible to adjust and/or change an AED regimen or add other treatment interventions, if needed. This is a naturalistic, six months follow-up study that evaluated changes in overall cognitive profiles, levels of psychopathological symptoms, and quality of life (QOL) in newly diagnosed, uncomplicated pediatric epilepsy. In total, 61 (35 [57.4%] males) children and adolescents aged 7-18 years were assessed at the time of diagnosis and the initiation of antiepileptic drug (AED) treatment and six months afterward. The Revised Wechsler Intelligence Scale for Children, the Revised Child Anxiety and Depression Scale (RCADS), Nisonger Child Behavior Rating Form for typically developing children and adolescents (NCBRF), KIDSCREEN-10 Quality of Life Measure, and Adverse Event Profile (AEP) were used. The RCADS and NCBRF scores significantly increased over time, while the KIDSCREEN-10 scores significantly decreased. The most significant increases were observed in scores measuring social phobia and depressive symptoms and inattentiveness. Verbal cognitive abilities and full-scale intelligence scores changed slightly, while more changes were found in aspects of non-verbal cognitive abilities. This study showed that six months after epilepsy diagnosis and AED initiation, there were marked increases in anxiety levels, depressive symptoms, and behavioral problems, with deteriorations in QOL, while cognitive changes were relatively minimal. Therefore, monitoring levels of psychopathological symptoms and QOL in newly diagnosed epilepsy is highly recommended.

Psychometric properties and validity of the German version of the Post-Traumatic Diagnostic Scale for DSM-5 (PDS-5).

Background: The availability of psychometrically sound instruments for the assessment of Post-Traumatic Stress Disorder (PTSD) is indispensable for clinical and scientific work with individuals suffering from trauma-related distress. Objective: The aim of the present study was to translate the Post-Traumatic Diagnostic Scale for DSM-5 (PDS-5) into German and to evaluate its psychometric properties as well as convergent, discriminant, and factorial validity. Method: The authorized German translation of the PDS-5 was completed by 270 patients admitted to specialized outpatient trauma clinics. Of these, 57.8% completed the PDS for a second time (mean time between assessments was 12.0 days). In order to examine convergent and discriminant validity of the PDS-5, the Post-traumatic Stress Disorder Checklist for DSM-5 as well as Patient Health Questionnaire subscales assessing depression (PHQ-9), somatization (PHQ-15), and Generalized Anxiety Disorder (GAD-7) were applied. Results: The PDS-5 total score showed excellent internal consistency (α = .91) and re-test reliability (rho = .84). Convergent validity was supported by a strong correlation with the total score of the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5; rho = .91). Correlations with Patient Health Questionnaire subscales of depression (rho = .81), anxiety (rho = .72), and somatization (rho = .65) were significantly lower (all p < .001) indicating discriminant validity of the PDS-5. Confirmative Factor Analysis did not result in a clear preference for one of the tested models. Defining a diagnostic cut-off value of ≥36 based on ROC analysis resulted in high sensitivity (.92) and specificity (.96) compared to a probable PTSD diagnosis according to the PCL-5. Conclusions: In summary, our results indicate that the German PDS-5 translation provides valid and reliable information concerning both PTSD severity and diagnosis.

Antecedentes: La disponibilidad de instrumentos psicométricamente sólidos para la evaluación del trastorno de estrés postraumático (TEPT) es indispensable para el trabajo clínico y científico con personas que sufren angustia relacionada con el trauma.Objetivo: El objetivo del presente estudio fue traducir la Escala de Diagnóstico Postraumático del DSM-5 (PDS-5) al alemán y evaluar sus propiedades psicométricas, así como su validez convergente, discriminante y factorial.Método: La traducción al alemán autorizada del PDS-5 fue completada por 270 pacientes ingresados en clínicas de trauma ambulatorias especializadas. De estos, el 57,8% completó la PDS por segunda vez (el tiempo medio entre evaluaciones fue de 12,0 días). Con el fin de examinar la validez convergente y discriminante del PDS-5, la lista de verificación del trastorno de estrés postraumático para el DSM-5, así como las subescalas de depresión del Cuestionario de salud del paciente (PHQ-9), de somatización (PHQ-15) y de trastorno de ansiedad generalizada (GAD-7) fueron aplicadas.Resultados: La puntuación total del PDS-5 mostró una excelente consistencia interna (α = .91) y confiabilidad al reaplicar (rho = .84). La validez convergente fue apoyada por una fuerte correlación con la puntuación total de la lista de verificación de trastorno de estrés postraumático para el DSM-5 (PCL-5; rho = .91). Las correlaciones con las subescalas del Cuestionario de Salud del Paciente de depresión (rho = .81), ansiedad (rho = .72) y somatización (rho = .65) fueron significativamente más bajas (todas p <.001) lindicando validez discriminante del PDS-5. El Análisis Factorial Confirmativo no resultó en una preferencia clara por uno de los modelos probados. La definición de un valour de corte de diagnóstico de ≥36 basado en el análisis ROC resultó en una alta sensibilidad (.92) y especificidad (.96) en comparación con un diagnóstico de TEPT probable según el PCL-5.Conclusiones: En resumen, nuestros resultados indican que la traducción al alemán PDS-5 proporciona información válida y confiable sobre la severidad y diagnóstico del TEPT.

Differences in attachment dimensions and reflective functioning between traumatized juvenile offenders and maltreated non-delinquent adolescents from care services.

BACKGROUND: Adverse childhood experiences, especially maltreatment, are regarded as significant risk factors for the development of antisocial behavior in adolescence. However, possible correlates are still to be investigated after considering the history of criminal records and the experience of institutionalization. OBJECTIVE: In this study, differences in attachment anxiety and avoidance, and reflective functioning (RF) between traumatized incarcerated juvenile offenders and non-delinquent adolescents institutionalized in child services because of domestic violence were examined. PARTICIPANTS, SETTING AND METHOD: Forty-two juvenile offenders (Nfemale = 19) and 43 inmates of institutions for adolescents without parental care (Nfemale = 20) with the history of trauma filled in the childhood trauma and attachment dimensions questionnaires, and were scored on the Reflective Functioning Scale. Groups were matched on age and education. RESULTS: Results indicate that both groups reported equally high levels of attachment anxiety and avoidance. Male juvenile offenders had lower scores on reflective functioning than both female convicted minors (B = 1.06; Odds Ratio = 2.88; Nagelkerkes R2 = 45) and non-delinquent adolescents of both genders (B = -.65; Odds Ratio = .52; Nagelkerkes R2 = 42). In comparison to non-convicted males, male offenders also had higher scores on the control scale of idealization (B = .35; Odds Ratio = 1.42; Nagelkerkes R2 = 42). No differences between females with and without a history of crimes were found. CONCLUSIONS: Results indicate a need for building RF in both traumatized samples, especially in male delinquents, and encourage further research in females.

The Mentalization Scale (MentS): A Self-Report Measure for the Assessment of Mentalizing Capacity.

The psychometric properties of a new 28-item self-report measure of mentalization, the Mentalization Scale (MentS), were examined in 2 studies: with a sample of employed adults and university students (N1 = 288 + 278) and with a sample of persons with borderline personality disorder (BPD) and matched controls (N2 = 62 + 62). Besides the MentS, both studies employed measures of attachment and the Big Five; Study 1 also included assessments of empathy and emotional intelligence. MentS whole-scale internal consistency was good in the community and acceptable in the clinical sample (α = .84 and .75, respectively). A principal components analysis of Study 1 data yielded 3 interpretable factors, or subscales: Self-Related Mentalization (MentS-S), Other-Related Mentalization (MentS-O), and Motivation to Mentalize (MentS-M). These showed acceptable reliabilities (α = .74-.79), except for MentS-M in the clinical sample (α = .60). MentS scores further exhibited a coherent pattern of correlations with cognate constructs and the Big Five, relating positively to empathy, trait and ability emotional intelligence, openness, extraversion, and conscientiousness, and negatively to attachment avoidance and anxiety, and neuroticism. Persons with BPD scored significantly lower on MentS total and MentS-S. The proposed scale is thus deemed suitable for quick, yet meaningful, assessments of mentalization in both individual differences research and clinical contexts.

Being Mad in Early Modern England.

It has become almost a rule that the birth of scientific psychiatry and what we today term clinical psychology took place in the short period between the last decade of the XVIII century and the 1820s. Everything that happened before that period-every description, diagnosis, and therapy-has been considered "pre-scientific," outdated, in a way worthless. In this paper, however, I am providing the argument that, first, the roots of contemporary psychiatry reach at least to England of the early modern period, and that, second, it may still turn out that in the field of mental health care historical continuities are more numerous and persistent than discontinuities. Thus, I briefly review the most important surviving documents about the treatment of mental disorders in England of Elizabethan and Jacobian period, organizing the argument around the well-known markers: diagnostics and etiology, therapy, organization of the asylum, the public image of the mentally ill.

Academic model of trauma healing in post-war societies.

OBJECTIVE: The aim of this paper is to examine the implications for healing in a contemporary Balkan post-war context, and to provide a bridge-building model of trauma transformation, reconciliation and recovery through academic reconstruction and cross-border dialogue. Post-war societies are marked by the effects of massive, large group traumatization, and if not properly dealt with, long-term rehabilitation and social recovery cannot be expected. Unprocessed cumulative trauma that has become deeply embedded in the collective memory of the Balkan peoples over centuries, "chosen trauma", its trans-generational transmission and periodical reactivations across the Balkan have often been addressed in recent literature, in ethno-psychology, psychoanalysis, psychiatry, sociology and anthropology. In order to deepen our understanding of the roots of collective (social) trauma and the specific traumatic experiences of different groups, and to offer different perspectives and information on how trauma can be dealt with, the "Trauma Trust Memory" multinational interdisciplinary research network is being established, and a groundbreaking workshop was held in May 2013 in Tuzla, Bosnia-Herzegovina. CONCLUSION: The Tuzla Workshop showed that the active participation of affected groups in adequate coping with the past is required for post-conflict reconstruction, trauma healing and peacebuilding in the long run.

Wiskott-Aldrich syndrome with macrothrombocytopenia.

BACKGROUND: Wiskott-Aldrich syndrome is a rare X-linked immunodeficiency disorder with a variable phenotype. CASE CHARACTERISTICS: 3.5-year-old boy diagnosed with Wiskott-Aldrich syndrome. OBSERVATION: Unusual and persistent thrombocytopenia with increased platelet volume (>10fL). He did not exhibit characteristic clinical and laboratory finding for the syndrome. OUTCOME: Maternally inherited causative mutation in the exon 2 of the WAS gene was disclosed. MESSAGE: This is a need for multidisciplinary assessment of patients with congenital or early infantile thrombocytopenia, including testing for mutations of the WAS gene in all unexplained cases even in the absence of characteristic microthrombocytopenia.

Case report of acute vitamin D intoxication in an infant.

INTRODUCTION: Vitamin D intoxication represents a rare and potentially serious pathological condition caused by the excess of calcium and phosphorus. We are presenting an infant with vitamin D intoxication due to excessive daily administration, as well as therapeutic procedures that prevented its adverse effects. CASE OUTLINE: A 1.5-month-old female infant, born at term, exclusively breastfed and without any complaints and abnormalities of physical findings, was observed due to the data that during the preceding month, by her mother's mistake, she had received about 200,000 IU of vitamin D3. Laboratory analyses showed a high serum level of 25(OH)D (>400 nmol/L) and calcium (2.72 mmol/L), lowered PTH (6.6 pg/ml) and high urinary calcium/creatinine ratio (1.6), while other findings, including urotract ultrasonography image, were within normal limits. Treatment based on the discontinuation of vitamin D administration, infant's forced water intake, as well as the application of 2-month prednisolone and 4-month phenobarbitone and furosemide, resulted in complete normalization of the laboratory indicators of vitamin D overdose, as well as the prevention of its adverse effects. CONCLUSION: By timely recognition and adequate treatment, including triple therapy with prednisolone, phenobarbitone and furosemide, adverse effects of acute vitamin D intoxication can be prevented.

A Serbian version of modified and revised Experiences in Close Relationships scale (SM-ECR-R).

We present details about the validation of the Serbian version of the Experiences in Close Relationships-Revised questionnaire modified to measure attachment in close relationships in general (SM-ECR-R). Its psychometric features were examined with 2 samples of students (N = 719 and N = 91) and 1 group of employed adults (N = 259). The results obtained in the student sample were equivalent to those obtained in validation studies worldwide, whereas in the more heterogeneous sample of employed adults, internal consistency of both avoidance and anxiety was lower and their intercorrelation was higher. Test-retest reliability was satisfactory, and relations with measures of attachment, empathy, and personality structure were meaningful. The results support the SM-ECR-R as a reliable and valid research instrument, but its internal structure and consistency might vary in different samples, depending on age, education, gender, and culture.

Early presentation of neuromyelitis optica.

Neuromyelitis optica is a rare autoimmune demyelinating disease of the central nervous system in childhood. Its relapsing form is usually reported in adults. We report a 3-year-old girl with relapsing, IgG seropositive neuromyelitis optica. Initially she presented with optic neuritis, followed by three relapses with deterioration of optic neuritis and developing transverse myelitis. With each relapse, the treatment was less effective. Four years after the onset of the disease, the patient was blind, had paraplegia associated with urinary and bowel incontinence and short stature.

Epilepsy in a child with Wolf-Hirschhorn syndrome.

INTRODUCTION: Wolf-Hirschhorn syndrome (WHS) is a rare chromosomal disorder characterized by facial dismorphy, multiple congenital anomalies, delayed psychomotor development and pharmaco-resistant epilepsy. CASE OUTLINE: We present a 5-year-old girl with severe delay in growth and development, microcephaly, mild facial dismorphy and epilepsy. The pregnancy was complicated by intrauterine growth retardation. Generalized muscle hypotonia was observed at birth. First seizures started at age of 9 months as unilateral convulsive status epilepticus (SE), sometimes with bilateral generalization. Seizures were often triggered by fever and were resistant to antiepileptic treatment. Introduction of lamotrigine and valproate therapy led to complete seizure control at the age of 33 months. Electroencephalographic (EEG) finding was typical at the beginning. After transitory improvement between age four and five years, epileptiform EEG activity appeared again at the age of five years, without observed clinical seizures. Magnetic resonance imaging showed diffuse brain atrophy and delay in myelination. Using Multiplex ligation-dependent probe amplification (MLPA) method, we disclosed heterozygote microdeletation of the distal part of the short arm of chromosome 4 (4p16). CONCLUSION: We present a clinical course of epilepsy in a patient with Wolf-Hirschhorn syndrome. The diagnosis was verified by modern molecular technique. This is the first molecular characterization of a patient with WHS performed in our country.

Definition, foundation and meaning of illness: locating Georg Groddeck in the history of medicine.

The paper reviews and discusses Groddeck's conception of illness. I first argue that Groddeck was a late Romanticist as much as he was a "wild" psychoanalyst. Then I use Groddeck's scattered formulations regarding definition, foundation, and meaning of illness in order to articulate them in the form of more explicit scientific statements. Finally, I suggest that Groddeck's theory of illness is fundamentally different from current medical conceptions, which, nevertheless, does not make our dialogue with him either less useful or indeed less necessary. It is through an investigation of Groddeck's therapeutic attitude and the spirit of his work that psychoanalysis and medicine can build foundations of bold, innovative, and healing future.

An attempt at unmasking Eugene O'Neill.

Masks appear in several of Eugene O'Neill's early plays, serving not as a mere technical innovation, but rather as a way to explore "hidden conflicts" of human nature. This article explores three factors that could have provoked this sensitivity to the motif of masking. First is the influence of Greek tragedy--itself a domain of "the masked God"--which O'Neill tried to restore through several of his plays. Second is O'Neill's insight into the connection between modern man's selfhood and the process of masking, several decades before psychoanalysts have approached it scientifically, in complete accordance with Kohut's hypothesis about the "anticipatory function of art". The final factor consists of both his early development and his later life--especially his three marriages--as revealed through extensive biographies, correspondence, and plays. The article suggests that the most important influence on O'Neill's sensitivity to motif of masking was his mother's morphine addiction.