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Harmful drinking is associated with significant negative health and social outcomes, but drinkers are reticent to recognise personal drinking problems, hindering natural recovery or help-seeking. Recent evidence suggests that social identity as a drinker is associated with various drinking-related factors but has not been examined in relation to likelihood of problem recognition. In a group of ninety-six harmful drinkers (61 females, M age = 34 years) we explored how identity components associated with ingroup self-investment and ingroup self-definition in combination with implicit identity as a drinker accounted for degrees of problem recognition. In addition to demographic information, addiction experience and drinking behaviour (AUDIT), respondents completed measures of ingroup self-investment (identity centrality, solidarity, and satisfaction), ingroup self-definition (ingroup homogeneity and self-stereotyping), a "self as drinker" identity implicit association test and problem recognition (four items from the Stages of Change Readiness and Treatment Eagerness Scale). After controlling for possible covariates (age, gender and alcohol addiction experience) increased problem recognition was accounted for by explicit and not implicit identity components. More specifically, increasing perceived chronic saliency of one's drinker identity (self-investment in the drinker ingroup) and not an implicit association between the self and being a drinker was related to increased likelihood of problem recognition. This suggests that how chronically and explicitly accessible the identity of the drinker is for individuals might operate to stimulate the willingness or motivation to recognise potential drinking related harm.

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BACKGROUND: The prevalence of mental disorders and global burden of disease increases and need an integrated psychiatric treatment at the best point of service. Severe mental disorders have medical consequences and solid psychiatric interventions are necessary. Research is required to be conducted along the bio-psycho-social paradigm. AIM: Based on the dynamics of memory and mentalization theory this paper presents clinical and therapeutic considerations for change. RESULTS: Mentalization is influenced by patterns of parental rearing styles, attachment, and traumatic incidents. In psychoanalytic theory, unconscious memory contents are enacted in the patient-therapist relationship. This editorial gives a review and intends to bridge the gap between psychiatry, the neurosciences, psychoanalysis and other sciences concerned with the study and processing of memory and its associated psychological, cognitive, and affective functions. The role of memory and related abilities and factors affecting psychological functioning are outlined. Research findings on memory dynamics and vulnerability as well as insights that are relevant to bridge the gap to related sciences are highlighted. CONCLUSIONS: For treatment, a dynamic view of long-term memory with a plasticity of states of memories when they are reactivated is supported. For intervention technique, affect-related therapist-centered interpretations and a sound working through of such enacted states in the interpersonal environment of the treatment is essential.

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This study examined the sexual orientation of 30 young adult children of lesbian and gay parents, analyzing three dimensions (sexual behavior, sexual attraction and sexual self-identification), their evolution over time and the possible influence of gender (19 women and 11 men). Sexual orientation was measured using KSOG. The results revealed that most participants defined themselves as heterosexual only, although percentages varied between 87% for sexual behavior to 67% for sexual attraction and 60% for sexual self-identification. Gender differences were found for sexual attraction and self-identification, with men having a polarized profile (responses at both ends of the scale) and women reporting a less exclusive and more fluid sexuality. These findings are discussed in light of the complex nature of sexual orientation, the freedom of these young adults for defining their sexual orientation, and the role played by gender and family experiences.

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Perfectionism has been the object of many disputes. One such debate pertains to the nature of perfectionistic strivings. Whereas perfectionistic concerns (PC) have been shown to correlate with negative outcomes, perfectionistic strivings (PS) have been associated with mixed outcomes. This view of perfectionism assumes a motivational perspective; however, commonly used questionnaires assess motivation only implicitly. To create a more explicit measure of motivation as regard perfectionism, we aimed to assess perfectionism in post-secondary education based on Deci and Ryan's self-determination continuum. We posit that introjected motivation represents the variance common to both dimensions of perfectionism. External motivation is considered to be specific to PC and identified motivation to PS. Amotivation represents a lack of meaningful striving. Intrinsic motivation, lacking perfectionism's pressure, is conceptualized to be a self-determined form of striving for excellence. We further posited that this continuum is implicitly underlain by a continuum of self-definition as defined by Blatt. The resulting questionnaire showed an adequate structure with ESEM, followed a simplex structure, and had adequate reliabilities (Study 1a/Study 2). It also showed adequate convergent validity (Study 1b/Study 2). Finally, the questionnaire proved to be invariant over a 6-week period (Study 2). Results suggest that the degree of active goal pursuit, in addition to standards setting, could be a distinguishing characteristic between dimensions of perfectionism as well as striving for excellence.

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O movimento woke tomou conta das universidades americanas e também das brasileiras. Com origem no pós-modernismo dos anos setenta, inspira-se na genealogia do saber de Michel Foucault e na recente evolução das ciências sociais rumo à redução do universal, do simbólico, da linguagem e da cultura a uma mera construção social. Tudo é relativo e pode ser definido contratualmente nas relações intersubjetivas ou os indivíduos podem autodefinir-se. Precisaremos de comitês de ética, como observou Miller (1996), para estabelecer a verdade, a norma, o protocolo e as convenções de acordo com os diferentes indivíduos e grupos sociais. Queremos avaliar se essa tendência pós-moderna coincide com uma radicalização da lógica feminina da sexuação, a lógica do não-todo. Qual o papel dos movimentos feministas no advento da tese de que "não há universal pois o Outro não existe!".

Le mouvement woke a également pris le contrôle des universités américaines et brésiliennes. Issu dupost-modernisme des années 70, il s'inspire de la généalogie des savoirs de Michel Foucault et de l'évolution récente des sciences sociales vers la réduction de l'universel, du symbolique, du langage et de la culture, à une simple construction sociale. Tout est relatif et peut être contractuellement défini dans des relations intersubjectives et les individus peuvent se définir eux-mêmes. Nous aurons besoin de comités d'éthique, comme le notait Miller (1996), pour établir la vérité, la norme, le protocole, les conventions selon les différents individus et groupes sociaux. Nous voulons évaluer si cette tendance postmoderne coïncide avec une radicalisation de la logique féminine de la sexuation, la logique du pas-tout. Quel est le rôle des mouvements féministes dans l'avènement de la thèse selon laquelle "il n'y a pas d'universel parce que l'Autre n'existe pas."

The woke movement took over American and Brazilian universities as well. Originating in the post-modernism of the seventies, it is inspired by the genealogy of knowledge by Michel Foucault and the recent evolution of the social sciences towards the reduction of the universal, the symbolic, language and culture, to a mere social construction. Everything is relative and can be contractually defined in intersubjective relationships or individuals can define themselves. We will need ethics committees, as Miller (1996) noted to establish the truth, the norm, the protocol, the conventions according to different individuals and social groups. We want to assess if this postmodern trend coincides with a radicalization of the feminine logic of sexuation, the logic of not-all. What is the role of feminist movements in the advent of the thesis that "there is no universal because the Other does not exist.".

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Background: Psychopathological models of adolescent borderline personality disorder (BPD) suggest that non-suicidal self-injuring (NSSI)-a particularly frequent symptom in girls-may constitute a way of coping with distress resulting from interpersonal concerns they typically experience as a developmental psychopathological feature. Objectives: Our objective was to investigate the relationship in BPD female adolescents between NSSI and the Sidney Blatt two-polarities model of personality development, which focuses on the psychological processes of interpersonal relatedness and self-definition. Methods: The study was conducted within the European Research Network on Borderline Personality Disorder in Adolescence, using the Depressive Experience Questionnaire (DEQ). Results: BPD patients (n = 59; mean age = 16.6 ± 1.3) scored significantly higher than healthy controls on the two DEQ sub-factors assessing the more immature forms of Interpersonal Relatedness (Neediness) and Self-definition (Self-criticism) and significantly lower on the more mature form of Self-definition (Efficacy). BPD adolescents with NSSI showed significantly higher scores on both mature and immature forms of Interpersonal Relatedness (Neediness and Connectedness) compared to BPD adolescents without NSSI. A logistic regression analysis showed that the subfactor Neediness of the DEQ was the only significant predictor of the presence of NSSI among BPD adolescents. Conclusions: The preliminary results of this study suggests that NSSI in adolescents with BPD is developmentally linked to high developmental concerns in the domain of interpersonal relatedness, which may be taken into consideration in clinical practice. More studies are necessary to better understand the relationships between NSSI and developmental psychopathology in borderline adolescents.

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Despite evidence of increasing prevalence of depression in university students, few studies investigated how depression evolves over the first months at university. We investigate severity of depression among first-year university students during their first semester at university, and whether it was associated with impairments in personality, mentalizing (or reflective functioning), and social and academic integration. Participants in this two-wave prospective study were 377 Belgian first-year students in 2018 and 2019. Results showed that maladaptive interpersonal relatedness and self-definition at the start of the first semester (T1) were prospectively associated with increases in the prevalence and severity of depression at the end of the semester (T2). Uncertainty, but not certainty, with regard to mentalizing was positively associated with severity of depression at T2 and mediated the association between personality dimensions and severity of depression. The implications of these findings for depression prevention and intervention strategies in first-year university students are discussed.

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This study examined associations between child sexual abuse (CSA) survivors' self-definition status (i.e., whether or not survivors self-identified as sexually abused) and multiple measures of psychopathology, self-system functioning, and risk behaviors. We evaluated the hypothesis that survivors with concordant abuse perceptions (i.e., individuals who reported objective CSA and self-defined as sexually abused) would evidence more pronounced adjustment difficulties in young adulthood than survivors with discordant perceptions (i.e., individuals who reported objective CSA but did not self-define as sexually abused). In this large and ethnically diverse college student sample (N = 2,195; 63.8% female, 36.2% male; 83.3% nonwhite), objective experiences of CSA were associated with increased psychopathology, decreased self-system functioning, and increased risk behaviors, but the magnitude of these effects varied by survivors' self-definition status. Relative to their nonmaltreated peers, survivors with concordant abuse perceptions evidenced the largest elevations in psychopathology and risk behaviors, whereas survivors with discordant abuse perceptions evidenced the largest deficits in self-system functioning. These findings indicate that standard screening criteria may misidentify a sizable group of CSA survivors because these individuals do not perceive their experiences as "abuse." Efforts to understand the meaning ascribed to CSA experiences may profitably guide clinical interventions to enhance specific domains of functioning.

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We review theory and research pertaining to psychodynamic, social, humanistic, and ethological models of the self and depression and examine research into the neurobiological bases of the self and depression. We provide a narrative review of classic and recent empirical evidence pertaining to these four models of the relation of the self to depression as well as exemplar relevant neurobiological research. Evidence stemming from each of the four theories reviewed here shows a robust relationship between deficits in the sense of self and depressive symptoms, as well as increases in depressive symptoms over time. A smaller body of literature has linked one's sense of self to onsets of depressive episodes. A growing body of literature has linked self-relevant variables to functioning in various prefrontal and cortical midline brain regions as well as emotion and reward processing brain regions which have in turn been linked to depression. Evidence has therefore converged across all four theories and confirmed that a deficit in one's sense of self confers risk for depression and that there is substantial overlap in the brain areas associated with one's sense of self and depression.

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Only some individuals who have the medically defined condition 'infertility' adopt a self-definition as having a fertility problem, which has implications for social and behavioural responses, yet there is no clear consensus on why some people and not others adopt a medical label. We use interview data from 28 women and men who sought medical infertility treatment to understand variations in self-identification. Results highlight the importance of identity disruption for understanding the dialectical relationship between medical contact and self-identification, as well as how diagnosis acts both as a category and a process. Simultaneously integrating new medical knowledge from testing and treatment with previous fertility self-perceptions created difficulty for settling on an infertility self-perception. Four response categories emerged for adopting a self-perception of having a fertility problem: (i) the non-adopters - never adopting the self-perception pre- or post-medical contact; (ii) uncertain - not being fully committed to the self-perception pre- or post-medical contact; (iii) assuming the label - not having prior fertility concerns but adopting the self-perception post-medical contact; and (iv) solidifying a tentative identity - not being fully committed to a self-perception pre-medical contact, but fully committed post-medical contact. (A virtual abstract of this paper can be viewed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA).

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Sidney Blatt's seminal contributions in the domain of personality development, psychopathology, and health rank among the best researched and most empirically supported theories in psychoanalysis. Blatt is known primarily for his two-polarities model of personality development, which he viewed as evolving through a dialectical, synergistic interaction between two fundamental processes across the lifespan: the development of interpersonal relatedness on the one hand, and of self-definition on the other. In this model, psychopathology is viewed as an attempt to find a balance, however distorted, between relatedness and self-definition. Neurobiological research has confirmed the intrinsic dialectical relationship between these two processes in the development of the neural circuits subserving these capacities, a finding with important implications for physical health. Research relevant to these ideas is reviewed, and the influence that Blatt's approach has had in reintroducing psychodynamic factors into contemporary psychology and psychiatry, as reflected in DSM-5, is discussed.

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Treatment goals in psychoanalytic psychotherapy often include changes in underlying psychological structures, rather than only symptom reduction. This study examines changes in the anaclitic-introjective personality configurations following psychoanalytic psychotherapy with young adults in relation to outcomes. Thirty-three patients were interviewed pretreatment and at termination using the Object Relations Inventory (ORI). Prototype Matching of Anaclitic-Introjective Personality Configuration (PMAI) was applied to the ORI material by two independent judges (intraclass correlation coefficient=0.73). The patients were classified pretreatment as predominately anaclitic (n=13) or introjective (n=20). Outcome measures included the Symptom Checklist-90-R (SCL-90) and Differentiation-Relatedness scale (D-R) pretreatment, at termination, at the 1.5-year and three-year follow-up. Both groups improved post-treatment in terms of symptoms and developmental levels of representations of self, mother, and father. No significant differences between the anaclitic and the introjective group were found in this respect, and could not be expected due to the low power (0.27). The anaclitic group showed better balance between relatedness and self-definition post-treatment, while this improvement was not significant in the introjective group. Further and larger studies are needed to draw more far-reaching conclusions about the relations between changes in personality configurations over the course of treatment and the treatment efficacy. The clinical implications of this approach to underlying dynamic psychological structures are discussed.

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This article reviews the theoretical and empirical contributions of Blatt's two-polarities model of personality development and psychopathology to the second edition of the Psychodynamic Diagnostic Manual (PDM-2). First, we briefly provide an overview of the manual's main features and describe the guiding principles of the revision process. We then discuss in more detail how Blatt's model, which is focused on the dialectic interaction between anaclitic-introjective and relatedness vs self-definition dimensions in both normal and disrupted personality development, increases the PDM-2's theoretical and empirical comprehensiveness and clinical utility, especially concerning the classification and assessment of personality and overall mental functioning in adult populations. Finally, we address the implications for the therapeutic process, showing how anaclitic and introjective patients may be differentially responsive to different psychodynamic techniques (e.g., supportive or expressive interventions). Taken together, these considerations demonstrate the importance of a more theory-driven and empirically informed diagnostic system that embraces, in accordance with Sidney Blatt's empirically supported and psychoanalytically-oriented ideas, the complexities of human experience (both normal and pathological) and captures the subjective and underlying dynamics of psychological symptoms and syndromes.

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It is well known that politicized identities are especially good predictors of collective action, but very little is known about what these identities are. We propose that moral identity content plays a central role in politicized identities. We examined this among (un)politicized Americans in the 2012 US Presidential Elections. In a longitudinal community sample of US citizens (N = 760), we tracked personal (i.e., unique) and politicized (i.e., party activist) identity content: before, during, and after the election. We compared identity content of individuals who self-labelled as politicized (i.e., active party promoters) or unpoliticized (i.e., passive party supporters): (1) Democrats (n = 69) longitudinally and (2) Republicans (n = 69) cross-sectionally to examine three hypotheses: Moral identity content (e.g., trustworthy) would be more prominent in politicized (vs. unpoliticized) identities (H1); moral identity content overlapping politicized and personal identities predict seeing the self as politicized (H2) and engaging in party activism (H3). Results largely supported H1 and H2, but only weakly supported H3. We conclude that politicized identities are moralized identities that have a self-evaluative, but not strongly action-motivation, function. We discuss the implications of our findings and method for politicization research.

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Among individuals defined as having been sexually abused based on legal criteria, some will self-report having been abused and some will not. Yet, the empirical correlates of self-definition status are not well studied. Different definitions of abuse may lead to varying prevalence rates and contradictory findings regarding psychological outcomes. The present study examined whether, among legally defined sexual abuse survivors, identifying oneself as having experienced childhood sexual abuse (CSA) was associated with more severe abuse, negative emotional reactions toward the abuse, and current sexual reactions. A convenience sample of 1,021 French-speaking Canadians completed self-report questionnaires online. The prevalence of legally defined CSA was 21.3% in women and 19.6% in men, as compared to 7.1% in women and 3.8% in men for self-defined CSA. Among legally defined sexual abuse survivors, those who identified themselves as CSA survivors had been abused more frequently, were more likely to report a male aggressor, and more often described abuse by a parental figure than those who did not self-identify as abused. Further, self-defined CSA was associated with more negative postabuse reactions and sexual avoidance, whereas those not identifying as sexually abused were more likely to report sexual compulsion.

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RATIONALE, AIMS AND OBJECTIVES: There has been inadequate philosophical attention to the claims of psychiatric user/survivor activist groups, although these groups represent a significant social justice movement. Many of the core concerns and claims emerging from this activism can be found in disability activism. A first step that must be taken is to question how mental illnesses are modelled. Biomedical modelling is heavily criticized by psychiatric users/survivors for being reductionistic and for perpetuating damaging presumptions about decline and pathology. Social constructionist modelling, on the other hand, tends to be overly dismissive of biological factors that are often at play with these sorts of impairments. A middle-ground approach, interactionist modelling, promises to be responsive to demands for recognition from psychiatric users/survivors. METHOD: I will first outline the core commitments of psychiatric users/survivors. Next, I will evaluate different models for mental illness by bringing together insights from user/survivor and disability activism. CONCLUSIONS: I conclude that interactionist modelling holds the best hope for supporting shared decision making. This type of model braids together the expertise of patients and medical professionals.

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