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Biomedical subjects

S B Tuber

Publications and source records attributed to S B Tuber.

10 recordsLinked to original sources
PubMed1998

Knowing the unspeakable: somatization as an expression of disruptions in affective-relational functioning.

Somatization has been repeatedly associated with disturbances in either affectivity or object relatedness. The authors take an integrative approach to understanding somatization based on the theory that affectivity and relatedness are inextricably linked. An extended clinical vignette illustrates the idea that it may be the inability to effectively tolerate and express the affective dimension of relational challenges that drives the course of somatic distress for many somatizing patients. Treatment implications are discussed.

Adult↗
PubMed1996

Multifetal pregnancy reduction: psychodynamic implications.

New reproductive technologies, such as advanced infertility treatments, may have significant implications for women's psychological experience of pregnancy and motherhood. This paper examines some of the psychodynamic implications of multifetal pregnancy reduction, a medical procedure in which some of the fetuses in a multiple pregnancy are aborted while other fetuses are carried to term. Forty-four women who had undergone pregnancy reductions were interviewed about their emotional experience of this medical intervention and their subsequent pregnancies. A qualitative analysis of their experience was conducted from five psychoanalytically-informed vantage points: drive theory, ego psychology, object relations theory, self psychology and a developmental perspective. Women experienced having to abort some of their fetuses as a stressful and distressing life event, and a fourth of the women experienced bereavement reactions which impaired their functioning for at least two weeks. Conscious and unconscious responses to the procedure included ambivalence, guilt, and a sense of narcissistic injury, increasing the complexity of their attachment to the remaining babies. However, the achievement of the developmental goal of parenting healthy birth children helped most women feel that they had made the right decision for themselves and their families. Further research is indicated, including interviews before the reduction and long-term follow-up of mothers and surviving children.

Adaptation, Psychological↗
PubMed1995

The impact of homelessness on children's level of aspiration.

In a sample of 39 school-age homeless children, their length of stay in shelters for the homeless was significantly correlated with an index of their level of aspiration. This correlation remained significant even when the effects of the children's intelligence and their performance on a related cognitive task were partialed out. Stories given in response to two Thematic Apperception Test cards by a small sample of these children illustrate the potentially traumatic consequences of homelessness on children's hopes and aspirations.

Adolescent↗
PubMed1993

Rorschach adaptive fantasy images and coping in children under severe environmental stress.

We measured the relationship between the capacity of a group of inner-city, homeless children to produce adaptive fantasy images, as assessed by the Rorschach M+ score and their performance on the Fruit Distraction Test of selective attention and Rorschach measures of reality testing (extended F+ percentage) and object relations (Mutuality of Autonomy [MOA] Scale, Urist, 1977). The sample included 46 Black and Hispanic children (24 boys and 22 girls) who ranged in age from 5 to 13 years. Results from multiple regression analyses that also included age, intelligence, and gender as independent variables indicated that the M+ score accounted for the largest portion of the variance in the Fruit Distraction and MOA scores. The M+ score was also significantly positively correlated with the extended F+ percentage. The results suggest that children's capacity to withstand severe environmental stressors is linked to their ability to produce adaptive fantasy images on the Rorschach.

Adaptation, Psychological↗
PubMed1993

Measures of mental representation: clinical and theoretical considerations.

The authors explored the strengths and limitations of measures of mental representation from attachment theory and object relations theory. Using a study of adolescent mothers' mental representations while pregnant and their association to later mother-infant attachment (Levine, Tuber, Slade, & Ward, 1991), they compared the Adult Attachment Interview (AAI) (George, Kaplan, & Main, 1985) and the Krohn Object Representation Scale (KORS) (Krohn & Mayman, 1974) in terms of their clinical and theoretical utility. The authors argue that the AAI does not sufficiently explicate less adaptive object-representations, and that attachment research must address a broader clinical population to have a greater heuristic impact on clinical theory and practice. The AAI relies less on clinical inference than the KORS, however, thus providing a more viable mechanism for predicting parent-child relationship patterns. Clinical examples are provided to illustrate the process and content of the two scoring systems.

Adolescent↗
PubMed1991

Mothers' mental representations and their relationship to mother-infant attachment.

The association between the constructs of mental representation posited by object relations theory and attachment theory was studied through an assessment of adolescent mothers' mental representations and their infants' security of attachment. Forty-two pregnant adolescents were given the Adult Attachment Interview (George, Kaplan, & Main, 1985) to assess their modes of attachment, and the Krohn Object Representation Scale for Dreams (Krohn & Mayman, 1974) to assess object-representations. When the 42 infants were 15 months old, they were videotaped in the Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978) with their mothers. Subjects were primarily low-income African-American and Hispanic mothers and infants. As measured by the significant association between classifications on the Adult Attachment Interview and the Krohn scale (p less than .001), the adolescents' attachment and object-representations were highly related. Both attachment and object relations were also significantly related to infant attachment (p less than .001 and p less than .01, respectively). Results suggest that the concepts of mental representation proposed by object relations theory and attachment theory overlap and that mothers' mental representations have heuristic value in predicting mother-infant attachment.

Adolescent↗
PubMed1990

Representation of interpersonal interactions on the Rorschach and level of psychopathology.

Recent theoretical formulations emphasize the importance of the quality of interpersonal relationships in personality development and psychopathology and have resulted in the construction of methods for assessing the representation of interpersonal experiences. The Urist Mutuality of Autonomy (MOA) Scale is one of the most frequently used methods for assessing the quality of interpersonal relationships by evaluating interactions portrayed on the Rorschach between people, animals, and/or things. This study of the relationship of the MOA scale to independent assessments of interpersonal relationships and clinical symptoms in a group of seriously disturbed adolescents and young adults recently admitted to a long-term, open, residential treatment facility revealed that the average quality of interactions portrayed on the Rorschach relates significantly to the severity of clinical symptoms and the presence of thought disorder, but not to the quality of interpersonal relations. In addition, the portrayal of at least one intensively malevolent and destructive interaction on the Rorschach is correlated primarily with measures of thought disorder and impaired reality testing, whereas not giving at least one mutual and benevolent interaction response is correlated with impaired capacity for social adaptation (e.g., inappropriate interpersonal behavior and unmodulated affect). The relative failure to give at least one mutual and benevolent response is also correlated with the severity of clinical symptoms. Though the MOA scale was developed to assess object relations, it seems more consistently to assess aspects of psychopathology, such as the severity of clinical symptoms and the extent of thought disorder, and only secondarily the quality of interpersonal relationships.

Adolescent↗
PubMed1989

Assessment of children's object-representations with the Rorschach.

The recent emphasis on object relations theory as an explanatory model for personality development has been paralleled in the psychological test literature by measures that assess the quality of object-representations. The author reviews one such measure--the Mutuality of Autonomy (MOA) scale--in its research applications with adults and children. He then extends the scale to the psychotherapy of children and suggests that Rorschach object-representation scores can be of heuristic value in understanding the treatment process.

Adolescent↗
PubMed1989

Children's anticipation of impending surgery. Shifts in object-representational paradigms.

The authors used Rorschach assessments of the quality of object-representations to measure psychological shifts in children facing surgery. Fifteen children, ages 7 to 11, were given the Rorschach test three times: one week prior to elective hernia surgery, the day before the surgery, and 3 weeks after hospitalization. These children were compared with a nonsurgical group of 13 children matched for age and IQ and tested at the same time intervals. The authors hypothesized that the two groups would have similar Rorschach Mutuality of Autonomy (MOA) scale scores at Times 1 and 3, but would differ substantially at Time 2. This hypothesis was confirmed using the Mann-Whitney U test. Within the surgical group, there was an overall significant difference in MOA scores over time, and, as hypothesized, these children's scores at Time 2 were significantly more malevolent than at Time 1 (p less than .003). The effects of surgery were somewhat attenuated by Time 3, but the Time 3 MOA scores were still more malevolent than at Time 1 (p = .05) and were not significantly different from those at Time 2 (p = .18). The authors highlight the need to amply prepare children for even minor surgical procedures.

Child↗