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Frontiers in Human Neuroscience 2013A hypothesis about the neurobiological bases of drive, drive reduction and will in addictive illness is presented. Drive reduction seems to require both SEEKING and...
A hypothesis about the neurobiological bases of drive, drive reduction and will in addictive illness is presented. Drive reduction seems to require both SEEKING and gratification. Will is the everyday term for our experience of drives functioning within us. Addictive drugs take over the will by altering neurotransmission in the SEEKING system. As a result of this biological change, psychological defenses are arrayed that allow partial gratification and reduce anxiety about the consequences of drug use. Repeated partial gratification of the addictive drive creates a cathexis to the drug and the drug seller. It also keeps the addicted person in a permanent state of SEEKING. The cathexis to the drug and drug seller creates a difficult situation for psychoanalytic therapists. The actively addicted patient will have one set of feelings for the analyst, and a split off set of feelings for the drug dealer. Addictive neuroses, which feature a split transference, are contrasted with Freud's concept of transference and narcissistic neuroses. For treatment of an actively addicted patient, the treater must negotiate the split transference. By analyzing the denial system the relationship with the drug dealer ends and the hostility involved in addictive behavior enters the transference where it can be interpreted. Selling drugs that take over the will is a lucrative enterprise. The addictive drug industry, about the size of the oil and gas industry worldwide, produces many patients in need of treatment. The marketers of addictive drugs understand the psychology of inducing initial ingestion of the drugs, and of managing their addicted populations. The neuropsychoanalytic understanding of addiction might be used to create more effective public health interventions to combat this morbid and mortal illness.
PubMed: 24062657
DOI: 10.3389/fnhum.2013.00545 -
Journal of Neurosciences in Rural... Jan 2021Stroke results in functional dependence and poor quality of life. Body cathexis is a measure of one's perceived body image. Stroke survivors often experience stress,...
Stroke results in functional dependence and poor quality of life. Body cathexis is a measure of one's perceived body image. Stroke survivors often experience stress, anxiety, and disturbances in body image. The objective of the study was to explore the body cathexis of stroke survivors. The cross-sectional survey was conducted at two rural community settings of Kozhikode district, Kerala. Using a purposive sampling, 151 stroke survivors were recruited. The mean age of the participants was 64.58 years. About 53.6% participants were males and majority of the participants had ischemic stroke (76.2%). About one-third of participants had moderately severe disability. Among the participants, the body cathexis scale (BCS) ranged from 176 to 202. The overall mean (standard deviation) BCS score was 190.09 (5.04). Satisfaction or dissatisfaction toward each body part was analyzed and found that significant areas of dissatisfaction were energy level (98%), wrist (88.1%), elimination (86.1%), fingers (76.2%), and arms (73.5%). The BCS scores compared with the sides of lesion, gender differences, and duration of stroke showed no significant differences in the mean (p>0.05). Stroke survivors are found to experience disturbances in body image. Low energy level, poor functioning of upper extremities, and disturbed elimination patterns add primarily to body image disturbances. Body cathexis does not differ with side of lesion, gender differences, and duration of stroke.
PubMed: 33531757
DOI: 10.1055/s-0040-1716807 -
Eating and Weight Disorders : EWD Dec 2021Differentiating the concept of body satisfaction, especially the functional component, is important in clinical and research context. The aim of the present study is to...
PURPOSE
Differentiating the concept of body satisfaction, especially the functional component, is important in clinical and research context. The aim of the present study is to contribute to further refinement of the concept by evaluating the psychometric properties of the Dutch version of the Body Cathexis Scale (BCS). Differences in body satisfaction between clinical and non-clinical respondents are also explored.
METHOD
Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to investigate whether functional body satisfaction can be distinguished as a separate factor, using data from 238 adult female patients from a clinical sample and 1060 women from two non-clinical samples in the Netherlands. Univariate tests were used to identify differences between non-clinical and clinical samples.
RESULTS
EFA identified functionality as one of three factors, which was confirmed by CFA. CFA showed the best fit for a three-factor model, where functionality, non-weight, and weight were identified as separate factors in both populations. Internal consistency was good and correlations between factors were low. Women in the non-clinical sample scored significantly higher on the BCS than women with eating disorders on all three subscales, with high effect sizes.
CONCLUSIONS
The three factors of the BCS may be used as subscales, enabling researchers and practitioners to use one scale to measure different aspects of body satisfaction, including body functionality. Use of the BCS may help to achieve a more complete understanding of how people evaluate body satisfaction and contribute to further research on the effectiveness of interventions focussing on body functionality.
LEVEL OF EVIDENCE
Cross-sectional descriptive study, Level V.
Topics: Adult; Body Image; Cathexis; Cross-Sectional Studies; Factor Analysis, Statistical; Feeding and Eating Disorders; Female; Humans; Personal Satisfaction; Psychometrics; Reproducibility of Results; Surveys and Questionnaires
PubMed: 33591559
DOI: 10.1007/s40519-021-01120-9 -
Frontiers in Psychology 2021Addictive drugs are responsible for mass killing. Neither persons with addiction nor the general populace seem conscious of the malevolence of governments and drug...
Addictive drugs are responsible for mass killing. Neither persons with addiction nor the general populace seem conscious of the malevolence of governments and drug dealers working together. How could this be? What is the place of psychoanalysis in thinking about deaths from addiction and in responding to patients with addiction? To answer these questions, we revise concepts of SEEKING, drive, instinct, pleasure, and unpleasure as separable. We review the neurobiological mechanism of cathexis. We discuss how addictive drugs take over the will by changing the SEEKING system. We review how opioid tone in the central nervous system regulates human relationships and how this endogenous hormonal system is modified by external opioid administration. We differentiate the pleasure of relatedness from the unpleasure of urgent need including the urgent need for drugs. We show how addictive drug-induced changes in the SEEKING system diminish dopaminergic tone, reducing the motivation to engage in the pursuit of food, water, sex, sleep, and relationships in favor of addictive drugs. With this neuropsychoanalytic understanding of how drugs work, we become more confidently conscious of our ability to respond individually and socially.
PubMed: 34177709
DOI: 10.3389/fpsyg.2021.657944 -
Turkish Journal of Surgery Sep 2022Considering the effects of self-esteem, eating attitudes and body satisfaction on obesity and bariatric surgery outcomes, psychiatric evaluation is important for the...
OBJECTIVES
Considering the effects of self-esteem, eating attitudes and body satisfaction on obesity and bariatric surgery outcomes, psychiatric evaluation is important for the identification and treatment of psychopathology, improvement of self-esteem, eating attitudes and body satisfaction. In this study, it was aimed to determine the relation between eating behaviors, body dissatisfaction, self-esteem and psychological symptoms in patients seeking bariatric surgery. Our second aim was to determine whether depressive symptoms and anxiety had a mediating role in the relationship between body satisfaction and self-esteem and eating attitudes.
MATERIAL AND METHODS
The study included 200 patients. Patients' data were retrospectively evaluated. Psychometric evaluation performed during the preoperative period included psychiatric examination and administration of the Beck Depression Inventory, Beck Anxiety Inventory, Rosenberg SelfEsteem Scale, Body-Cathexis Scale, and Dutch Eating Behaviors Questionnaire.
RESULTS
There was a positive correlation between self-esteem and body satisfaction and a negative correlation between self-esteem and emotional eating (r= 0.160, p= 0.024; r= -0.261, p <0.001 respectively). Body satisfaction had an effect on emotional eating mediated by depression and an effect on external and restrictive eating mediated by anxiety. Furthermore, anxiety mediated the relations between self-esteem and external and restrictive eating behaviors.
CONCLUSION
Our finding indicating that depression and anxiety have mediator effects on the relation between self-esteem, body dissatisfaction, and eating attitudes is significant since screening for these entities and their treatment is relatively more practical in clinical settings.
PubMed: 36846062
DOI: 10.47717/turkjsurg.2022.5732 -
AIDS Care Oct 2020In the United States, youth aged 13-24 comprised approximately 21% of new HIV infections in 2017; 13% of these infections occurred among women, the majority of whom...
In the United States, youth aged 13-24 comprised approximately 21% of new HIV infections in 2017; 13% of these infections occurred among women, the majority of whom (86%) acquired HIV through heterosexual contact (Centers for Disease Control and Prevention. 2019a. . Retrieved from https://www.cdc.gov/hiv/group/age/youth/index.html, Centers for Disease Control and Prevention. 2019b. . Retrieved from https://www.cdc.gov/hiv/group/gender/women/index.html). We fit and validated a developmentally appropriate empirical model of Connell's Theory of Gender and Power (Connell, R. W. 1987. . Stanford, CA: Stanford University Press, Connell, R. W. 2013. . Hoboken, NJ: John Wiley & Sons) in a sample of young women and assessed whether gendered powerlessness reflected a multidimensional higher-order latent factor, as the theory implies. Anonymous computer-assisted interviews were administered to at-risk, sexually active young women ( = 1,101). Factor analyses and structural equation modeling were used to determine the dimensionality of gendered powerlessness. Associations with condom use were examined to validate the model. We fit a three-component model of gendered powerlessness, but not a higher-order latent factor. We observed that high scores on two dimensions of gendered powerlessness - cathexis and sexual division of power - were associated with lower likelihood of condom use. Our three-component model helps elucidate the role that components of gendered powerlessness play in young women's health behaviors and underscores the need for measures tailored to young women at high risk of contracting HIV.
Topics: Adolescent; Adult; Bayes Theorem; Condoms; Female; HIV Infections; Humans; Power, Psychological; Sexual Behavior; Sexual Partners; Sexual and Gender Minorities; Young Adult
PubMed: 32008352
DOI: 10.1080/09540121.2020.1724252 -
PloS One 2020After more than four decades of research and almost 100 attachment studies, the mechanisms of intergenerational transmission of attachment still remain unclear. To...
After more than four decades of research and almost 100 attachment studies, the mechanisms of intergenerational transmission of attachment still remain unclear. To better understand the mechanisms moderating the associations of attachment orientations from one generation to the next, this empirical study examined the roles of 1) shared and non-shared environmental factors that characterize critical events in adulthood such as career choice, income and child care; 2) gender differences in attachment between parents (Generation 1, G1) and their adult offspring (Generation 2, G2) and their possible interactions. A sample of 321 families with G2 adults aged 18 and over and two G1 parents up to the age of 81 took part in this study. Both generations completed the Experiences in Close Relationships attachment measure as well as a comprehensive detailed measure of current core characteristics in adulthood (e.g. employment status, income, whether they had children) and demographic variables (gender, age). The findings suggest that the associations between the attachment orientations of G1 and the attachment orientations of G2 were moderated by G2's income, their G1 paternal income and employment status, whether G2 had children (G3) of their own, and their family status after controlling for the age of G2, and the age of both paternal and maternal G1. When the associations for both paternal and maternal G1attachment orientation with both their male and female G2 was analyzed separately, this accounted for 35% of the variance of males' G2 attachment orientation. The discussion focuses on the contribution of these findings to attachment theory and draws clinical conclusions.
Topics: Adolescent; Adult; Adult Children; Aged; Aged, 80 and over; Avoidance Learning; Cathexis; Child; Family Relations; Female; Gender Identity; Grandparents; Humans; Intergenerational Relations; Male; Middle Aged; Parent-Child Relations; Parents; Social Environment; Socioeconomic Factors; Young Adult
PubMed: 32687501
DOI: 10.1371/journal.pone.0233906 -
Health Services Research Oct 2021To evaluate and compare approaches to estimating the service delivery cost of emergency department (ED) visits from total charge data only.
OBJECTIVE
To evaluate and compare approaches to estimating the service delivery cost of emergency department (ED) visits from total charge data only.
DATA SOURCES
The 2013-2017 Healthcare Cost and Utilization Project's (HCUP) State Emergency Department Databases (SEDD) and the Centers for Medicare and Medicaid Services Healthcare Cost Report Information System (HCRIS) public use files.
STUDY DESIGN
Compare a baseline approach (requiring cost-center-level charge detail) and four alternative methods (relying on total charges only) for estimating ED visit costs. Estimation errors are calculated after applying each method to a sample of ED visits, treating estimates from the baseline approach as the "true" cost. Performance metrics are calculated at the visit and hospital levels.
DATA COLLECTION/EXTRACTION METHODS
The charges, revenue center codes, and patient/hospital characteristics were extracted from the SEDD. Detailed costs and charges were extracted from HCRIS public use files.
PRINCIPAL FINDINGS
Baseline ("true") ED visit costs increased from $383 to $420 per visit between 2013 and 2017. Three methods performed comparatively well estimating mean cost per visit. The method using an overall cost-to-charge ratio (CCR) for all ancillary cost centers without regression adjustment (ANC-CCR) performed the worst, overestimating "true" costs by $63-$113 per visit. The other three methods, which used CCRs computed from selected cost centers, exhibited much smaller bias, with two of the methods yielding estimates within $2 of the "true" cost in 2017. Compared with ANC-CCR, the other three methods had more compact estimation error distributions. The estimated mean visit costs from all four methods have relatively small statistical variance, with 95% confidence intervals for mean cost in a hospital with 25,000 ED visits ranging between $4 and $7.
CONCLUSIONS
When cost-center-level charge detail for ED visits is unavailable, alternative methods relying on total ED charges can estimate ED service costs for patient and hospital segments.
Topics: Centers for Medicare and Medicaid Services, U.S.; Emergency Service, Hospital; Hospital Charges; Hospital Costs; Humans; Models, Economic; Research Design; United States
PubMed: 34350589
DOI: 10.1111/1475-6773.13709 -
European Journal of Breast Health Oct 2021Breast augmentation surgery is one of the most common cosmetic procedures among women. In the present study, we compared personality traits, self-esteem, and body...
OBJECTIVE
Breast augmentation surgery is one of the most common cosmetic procedures among women. In the present study, we compared personality traits, self-esteem, and body perception between women who had undergone breast augmentation surgery and a control group of women who had not. We hypothesized that the personality traits of women who had vs those who had not undergone breast augmentation surgery would differ.
MATERIALS AND METHODS
According to the inclusion and exclusion criteria, patients who had undergone breast augmentation surgery and age- and education-matched, healthy women were included in the present study. The breast augmentation group and control group were compared in terms of personality traits under the Basic Personality Traits Inventory. Additionally, self-esteem, which was assessed with the Rosenberg Self-Esteem Scale, and body perception, which was evaluated using the Body Cathexis Scale, were measured and compared between the two groups.
RESULTS
When the patients (n = 80) and the control group (n = 100) were compared, the Body Cathexis Scale, extroversion, and openness scores were statistically significant and were found to be higher in the breast augmentation group (p<0.05). In regression analysis, it was found that age, openness, and the Rosenberg Self-Esteem Scale score had statistically significant effects on extroversion.
CONCLUSION
We argue that there may be a presupposition, based on stigma, that women who undergo breast augmentation surgery are more neurotic than those who do not. Consequently, this may influence the outcomes of studies evaluating the personalities of these women. Our results indicate that women who had undergone breast augmentation had more positive personality traits than women in an un-operated control group.
PubMed: 34651108
DOI: 10.4274/ejbh.galenos.2020.6276 -
Canadian Urological Association Journal... 2016Our aim was to investigate the psychological and sexual effects of circumcision in adult men, and analyze these changes following circumcision.
INTRODUCTION
Our aim was to investigate the psychological and sexual effects of circumcision in adult men, and analyze these changes following circumcision.
METHODS
We included 37 adults who applied to our clinic for circumcision and who did not have any psychiatric or urologic disorders and age-matched 30 controls in our study. Body Cathexis Scale (BCS), Liebowitz Social Anxiety Scale (LSAS), and Premature Ejaculation Diagnostic Tool (PEDT) were applied to the study group twice, once before and once three months after circumcision, and only once in the control group. Also, intravaginal ejaculation latency time (IELT) was noted and premature ejaculation (PE) evaluation was done. Intra- and intergroup comparisons were performed.
RESULTS
The two groups were similar with regard to demographic data. Comparison of preoperative BCS and LSAS scores with the scores of the control group showed significant differences (p=0.003, p<0.001, and p<0.001, respectively). However, postoperative scores were similar to the scores obtained in the control group (p=0.768, p>0.05, and p>0.05, respectively). Scores of all scales showed significant improvements postoperatively. Also, PEDT scores and IELT changes before and after circumcision were significant in the study group, but not when compared to the control group.
CONCLUSIONS
Our results indicated that social anxiety and anxiety levels decreased after circumcision in adult Turkish men, and their body gratification increased. We found that not being circumcised might negatively affect individuals in adulthood when it comes to body image and sexual satisfaction, however, both improve after circumcision.
PubMed: 27790295
DOI: 10.5489/cuaj.3364