Challenging Case: New-Onset Hallucinations and Developmental Regression in a Child with Autism Spectrum Disorder.

CASE: Nick is a 5-year-old boy who began displaying self-stimulating behaviors and decreased social interactions shortly before turning 3 years. At the age of 3.5 years, he was diagnosed with autism spectrum disorder by a local developmental-behavioral pediatrician. His parents recall that the physician described Nick to be "high functioning" and encouraged them to expect that he would attend college and live independently as an adult. Upon receiving the diagnosis, intervention was initiated using an applied behavioral analysis (ABA) approach. With this intervention, he demonstrated initial gains in the use of complex language and improved social interactions.Concerns regarding suspected psychosis emerged just before starting kindergarten when Nick began experiencing ego-dystonic visual and auditory hallucinations. Initially, Nick verbally responded to the hallucinations and vividly described what he was experiencing. Shortly after the onset of these hallucinations, Nick experienced a significant decrease in the frequency and complexity of his expressive language and became more withdrawn. Over time, his hallucinations intensified, and his parents became increasingly fearful for his safety. Various antipsychotic and mood-stabilizing medications, steroids, and immunotherapy have been trialed with limited improvement of his symptoms.An extensive medical evaluation yielded the following:1. Magnetic resonance imaging of the brain: dilated perivascular spaces.2. Urine organic acids: ketosis and increased lactic acid.3. Antinuclear antibody: minimally positive.4. Vitamin B12: elevated.All other studies, including lumbar puncture, electroencephalogram (awake and asleep), genetic studies (chromosomal microarray, fragile X testing, and whole exome sequencing), metabolic studies, inflammatory markers, and thyroid panel, were negative/normal.Nick is enrolled in a special education classroom within a school that utilizes an ABA-based approach for all students. As part of his educational programming, he receives 25 hours of ABA in a 1:1 setting, 2 hours of speech therapy, 3 hours of occupational therapy, 1 hour of physical therapy, and 30 minutes of music therapy weekly. Current concerns include significant head-banging and thrashing before falling asleep, hyperactivity, unsafe behaviors (e.g., banging on windows, climbing high to reach desired items), aggression toward caregivers, limited ability to complete self-care tasks (e.g., personal hygiene, toileting), significant decline in expressive language, and continued response to internal stimuli.Nick's parents now present to a multidisciplinary center seeking guidance regarding additional therapies/interventions to assist in management of his current developmental and behavioral challenges as well as information regarding his expected developmental trajectory as he reaches adulthood.

Uncertainty and bank risk in an emerging market: The moderating role of business models.

The paper explores the role of business models in the link between uncertainty and bank risk. From the perspective of banks, given that future outcomes tend to be less predictable if banking uncertainty rises, we highlight a framework that a larger dispersion of bank shocks to bank-specific variables might mirror such decreased predictability as a consequence of increasing uncertainty. To compensate for the persistence of bank risk and address the endogeneity issue, we applied the system generalized method of moments (GMM) estimator as the main regressions. Analyzing a panel of commercial banks from Vietnam between 2007 and 2019, we find that higher levels of banking uncertainty may increase bank risk, as gauged by banks' credit risk (loan loss reverses and non-performing loans) and default risk (Z-score index). This detrimental influence of uncertainty appears to be most pronounced with banks relying on pure lending, and it decreases with more non-interest income. A deeper investigation after estimating the marginal effects with plots reveals an asymmetric pattern that bank risk is immune to uncertainty in banks with the highest level of income diversification. Interestingly, we also provide evidence that uncertainty may lower the default risk level when income diversification exceeds a sufficiently high level. Our findings demonstrate that diversified business models are an efficient buffer against higher bank risk in times of increased uncertainty.

Fixação e regressão como conceitos fundamentais da filosofia psicanalítica declinista da história de Freud / Fixation and Regression as fundamental concepts of the declinist psychoanalytic philosophy of Freud's history / Fijación y Regresión como conceptos fundamentales de la filosofía psicoanalítica declinista de la historia de Freud / Fixation et régression comme des concepts fondamentaux de la philosophie psychanalytique décliniste de l'histoire de Freud

Resumo Este artigo reflete sobre a noção antropológica de animatismo, um estádio pré-animista da humanidade, à qual Freud recorreu em Totem e tabu. Com ela, ampliou seu objetivo de revelar a origem da religião e da moralidade, estendendo-o à origem e ao destino da humanidade. Objetivo que também perseguiu em interlocução com as teorias psiquiátricas da hereditariedade e da degeneração dos séculos XVIII e XIX. Teorias concebidas por Tissot, Pinel, Lucas, Morel, Esquirol, Magnan, Legrain, Charcot, entre outros, sumariamente apresentadas neste artigo. Por fim, este artigo também apresenta e põe em discussão algumas obras de Freud, nas quais as teorias da hereditariedade e da degeneração foram ressignificadas sob as de fixação e regressão, ampliando os fundamentos do que seria sua filosofia psicanalítica declinista da história, reveladora de um novo sentido e direção tanto para a origem, quanto para o destino da humanidade.

Abstract This article reflects on the anthropological notion of animatism, a pre-animist stage of humanity, to which Freud resorted in Totem and Taboo. With it he broadened his aim of revealing the origin of religion and morality, extending it to the origin and destiny of humanity. An objective that he also pursued in dialogue with the psychiatric theories of heredity and degeneration of the 18th and 19th centuries. Theories conceived by Tissot, Pinel, Lucas, Morel, Esquirol, Magnan, Legrain, Charcot, among others, are briefly presented in this article. Finally, this article also presents and discusses some works by Freud, in which the theories of heredity and degeneration were resignified under those of fixation and regression, expanding the foundations of what would be his declinist psychoanalytic philosophy of history, revealing a new meaning and direction for both the origin and the destiny of humanity.

Resumen Este artículo reflexiona sobre la noción antropológica de animatismo, etapa preanimista de la humanidad, a la que recurrió Freud en Tótem y tabú. Con ella amplió su objetivo de revelar el origen de la religión y la moral, extendiéndolo al origen y destino de la humanidad. Un objetivo que también persiguió en diálogo con las teorías psiquiátricas de la herencia y la degeneración de los siglos XVIII y XIX. En este artículo se presentan brevemente las teorías concebidas por Tissot, Pinel, Lucas, Morel, Esquirol, Magnan, Legrain, Charcot, entre otros. Finalmente, este artículo también presenta y discute algunos trabajos de Freud, en los que las teorías de la herencia y la degeneración fueron resignificadas bajo las de la fijación y la regresión, ampliando los fundamentos de lo que sería su filosofía psicoanalítica declinista de la historia, revelando un nuevo sentido y dirección tanto para el origen como para el destino de la humanidad.

Résumé Cet article reflète sur la notion anthropologique d'animatisme, un stade préanimiste de l'humanité auquel Freud a fait recours dans son texte Totem et Tabu. Avec cette notion, il amplifie son objectif de révéler l'origine de la religion et de la moralité afin d'aussi aborder l'origine et le destin de l'humanité. Cet objectif a été poursuivi dans un dialogue constant avec les théories psychiatriques de l'hérédité et de la dégénérescence du XVIIIe et du XIXe siècle. Les théories conçues par Tissot, Pine, Lucas, Morel, Esquirol, Magnan, Legrain, Charcot, entre autres, seront brièvement présentées dans cet article. Enfin, cet article propose aussi de présenter et mettre en débat quelques travaux de Freud, où les théories de l'hérédité et de la dégénération ont été resignifiées pour ce qui est des concepts de fixation et de régression, élargissant ainsi les fondements de ce qu'on pourrait appeler sa philosophie psychanalytique décliniste de l'histoire, une philosophie révélatrice d'un nouveau sens et d'une nouvelle direction concernant l'origine et le destin de l'humanité.

Fetichismo e regressão em Freud e Adorno: da psicanálise à teoria social / Fetishism and regression in Freud and Adorno: from psychoanalysis to social theory / Fétichisme et régression chez Freud et Adorno: de la psychanalyse à la théorie sociale / Fetichismo y regresión en Freud y Adorno: del psicoanálisis a la teoría social

Resumo: Nas "Conferências introdutórias à psicanálise" (1916-1917), Freud argumenta pela participação fundamental da regressão na etiologia tanto da neurose, quanto da perversão. Em "O fetichismo" ( 1927 ), o autor formula uma nova versão desse conceito, de modo que as características do fetichismo passam a representar a estrutura geral de todas as perversões. Em 1938, Adorno, filósofo e sociólogo da Escola de Frankfurt, publica o ensaio "O fetichismo na música e a regressão da audição", no qual ele aborda ambos os conceitos em uma perspectiva sociológica. Nosso objetivo aqui é analisar comparativamente como os conceitos de fetichismo e regressão são definidos e empregados pelos dois autores, assim como examinar a influência da teoria freudiana sobre Adorno, a partir dos textos mencionados. Esse é um tema muito pouco explorado na literatura da área, de modo que sua discussão pode contribuir para uma melhor compreensão dos conceitos e do impacto de suas diferentes interpretações.

Abstract: In the "Introductory Lectures on Psychoanalysis" (1916-1917), Freud argues for the fundamental participation of regression in the etiology of both neurosis and perversion. In "Fetishism" ( 1927 ), the author formulates a new version of this concept, so that the characteristics of fetishism came to represent the general structure of all perversions. In 1938, Adorno, a philosopher and sociologist from the Frankfurt school, published his essay "On the Fetish-Character in Music and the Regression of Listening," in which he approaches both concepts from a sociological perspective. Our objective here is to comparatively analyze how the concepts of fetishism and regression are defined and employed by the two authors and to discuss the influence of Freud's theory on Adorno, based on the texts mentioned above. This subject is rarely explored in the literature of the field, thus its discussion can contribute to a better understanding of the concepts and the impact of their different interpretations.

Résumé : Dans les « Conférences d'introduction à la psychanalyse ¼ (1916-1917), Freud soutient la participation fondamentale de la régression dans l'étiologie de la névrose et de la perversion. Dans « Le fétichisme ¼ ( 1927 ), l'auteur formule une nouvelle version de ce concept, de sorte que les caractéristiques du fétichisme en viennent à représenter la structure générale de toutes les perversions. En 1938, Adorno, philosophe et sociologue de l'école de Francfort, publie l'essai « Le caractère fétiche dans la musique et la régression de l'écoute ¼, dans lequel il aborde les deux concepts d'un point de vue sociologique. Notre objectif ici est d'analyser comparativement comment les concepts de fétichisme et de régression sont définis et employés par les deux auteurs, ainsi que d'examiner l'influence de la théorie freudienne sur Adorno à partir des textes mentionnés. Il s'agit d'un thème très peu exploré dans la littérature du domaine, de sorte que sa discussion peut contribuer à une meilleure compréhension des concepts et de l'impact de leurs différentes interprétations.

Resumen: En las Conferencias de introducción al psicoanálisis (1916-1917), Freud sostiene la participación fundamental de la regresión en la etiología tanto de la neurosis como de la perversión. En "Fetichismo" ( 1927 ), el autor formula una nueva versión de este concepto, de modo que las características del fetichismo pasan a representar la estructura general de todas las perversiones. En 1938, Adorno, filósofo y sociólogo de la Escuela de Fráncfort, publicó el ensayo "Sobre el carácter fetichista en la música y la regresión de la escucha" en el que aborda ambos conceptos desde una perspectiva sociológica. El objetivo de este artículo es analizar comparativamente cómo los conceptos de fetichismo y regresión son definidos y empleados por los dos autores, así como examinar la influencia de la teoría freudiana en Adorno a partir de los textos mencionados. Este es un tema muy poco explorado en la literatura del área, por lo que su discusión puede contribuir a una mejor comprensión de los conceptos y del impacto de sus diferentes interpretaciones.

El malestar a través de la voz y la forma subjetiva del saber hacer con el conflicto. Un estudio de caso / Discomfort through the voice and the subjective form of knowing do with the conflicto. A case study

La voz es un elemento particular de los primeros años de vida en el sujeto debido a que es una de las formas de manifestar su necesidad, un deseo, u otro, por lo cual se adopta como una herramienta que se vincula a los procesos anímicos; puede ser una forma de ver síntomas o malestares que el paciente no quiere ni confesarse, ni confesar en una consulta. Objetivo: Comprender la manifestación del malestar a través de la voz del sujeto y la forma subjetiva del saber hacer con el conflicto, que apertura la importancia de la voz en el proceso psicoterapéutico. Materiales y métodos: Se enmarcó en un paradigma fenomenológico, es una investigación de campo con enfoque cualitativo mediante un estudio de caso. Resultados: A partir de este estudio se pudo determinar que el malestar incide en la voz del sujeto cuando no puede ser expresado con anterioridad, por tanto, la voz es una forma de expresión inconsciente que en ocasiones no es percibida por el sujeto que manifiesta un malestar. Conclusiones: El fenómeno de la voz está presente en los sujetos que formaron parte de esta investigación, pero cada uno de ellos lo formula de manera distinta, haciendo del malestar un saber hacer individual; por medio de la voz se manifiestan los silencios, el grito, el llanto y variadas formas orales que indican que hay asuntos pendientes, reflejando el conflicto que tiene el individuo con lo que está refiriendo, así deja huellas fonéticas en todo lo que nos relata(AU)

The voice is a particular element of the first years of life in the subject due to which is one of the ways to express their need, a desire, or another, for which it is adopted as a tool that is linked to psychic processes; it may be a way of seeing symptoms or discomforts that the patient does not want to confess or confess in a consultation. Objective:Understand the manifestation of discomfort through the voice of the subject and the subjective form of knowing how to deal with conflict, which opens up the importance of the voice in the psychotherapeutic process. Materials and methods:It was framed in a phenomenological paradigm, it is an investigation of field with a qualitative approach through a case study. Results:From this study it was possible to determine that discomfort affects the voice of the subject when it cannot be expressed with previously, therefore, the voice is a form of unconscious expression that sometimes is not perceived by the subject who manifests discomfort. Conclusions:The phenomenon of the voice is present in the subjects who were part of this investigation, but each one of them formulates it in a different way, making discomfort an individual know-how; through the voice silences, screaming, crying and various oral forms that indicate thatthere are issues pending, reflecting the conflict that the individual has with what he is referring to, thus leaving traces phonetics in everything he tells us(AU)

A falha básica: alguns aspectos sobre a teoria da técnica em Michael Balint / La falla básica: algunos aspectos de la teoría de la técnica en Michael Balint

O artigo aborda alguns pontos teóricos sobre a técnica, pontos estes relacionados aos pacientes que funcionam de forma ao nível da falha básica, como descreve o psicanalista Michael Balint. O objetivo é trazer reflexões para o atendimento dos pacientes que apresentam quadros regressivos, no sentido de permitir a vivência do novo começo. O texto discute algumas ideias da teoria balintiana sobre a questão da regressão em psicanálise (Au)

The article addresses some theoretical points about the technique related to patients who function more at the level of basic failure, as described by psychoanalyst Michael Balint. The objective is to bring reflections for the care of patients who present regressive conditions in order to allow the experience of the new beginning. The text discusses some ideas of the Balintian theory on the issue of regression in psychoanalysis.

El artículo aborda algunos puntos teóricos sobre la técnica, puntos que se relacionan con pacientes que funcionan en el nivel de falla básica, como lo describe el psicoanalista Michael Balint. El objetivo es traer reflexiones para el cuidado de los pacientes que presentan condiciones regresivas, a fin de permitir la experiencia de un nuevo comienzo. El texto analiza algunas ideas de la teoría balintiana sobre el tema de la regresión en psicoanálisis

Mapping brain-behavior space relationships along the psychosis spectrum.

Difficulties in advancing effective patient-specific therapies for psychiatric disorders highlight a need to develop a stable neurobiologically grounded mapping between neural and symptom variation. This gap is particularly acute for psychosis-spectrum disorders (PSD). Here, in a sample of 436 PSD patients spanning several diagnoses, we derived and replicated a dimensionality-reduced symptom space across hallmark psychopathology symptoms and cognitive deficits. In turn, these symptom axes mapped onto distinct, reproducible brain maps. Critically, we found that multivariate brain-behavior mapping techniques (e.g. canonical correlation analysis) do not produce stable results with current sample sizes. However, we show that a univariate brain-behavioral space (BBS) can resolve stable individualized prediction. Finally, we show a proof-of-principle framework for relating personalized BBS metrics with molecular targets via serotonin and glutamate receptor manipulations and neural gene expression maps derived from the Allen Human Brain Atlas. Collectively, these results highlight a stable and data-driven BBS mapping across PSD, which offers an actionable path that can be iteratively optimized for personalized clinical biomarker endpoints.

Regressões em análise: contribuições de Ferenczi e Balint para a técnica psicanalítica / Regressions in psychoanalysis: Ferenczi's and Balint's contributions to the psychoanalytic technique / Regresiones en análisis: contribuciones de Ferenczi y Balint a la técnica psicoanalítica

Na clínica psicanalítica contemporânea temos nos defrontado, cada vez mais, com impasses técnicos que nos exigem repensar a teoria sobre a técnica psicanalítica. Essa revisão teórica se justifica a partir de uma maior incidência de quadros clínicos cujo dinamismo psíquico não se encontra balizado hegemonicamente pela lógica do recalque, mas pela predominância de outros mecanismos defensivos, como a clivagem/splitting do eu, e formas de expressão não verbais como passagens ao ato e acting outs. Diante da necessidade de reconfigurar alguns parâmetros da técnica psicanalítica, delimitamos como objetivo deste artigo a investigação do tema do manejo clínico das regressões em análise a partir das contribuições teórico-clínicas de Sándor Ferenczi e de seus desdobramentos e avanços propostos Michael Balint. Assim, pretendemos extrair das modificações no dispositivo analítico propostas por esses autores, elementos que nos ajudem a pensar o manejo clínico com pacientes cujo sofrimento remete às falhas traumáticas dos primórdios da constituição subjetiva.

In contemporary psychoanalytic clinic we have faced increasingly technical deadlocks that require to rethink the psychoanalytic technique theory. This situation requires a revision of psychoanalysis technical theory. This theoretical revision is justified by a higher incidence of clinical conditions whose psychic dynamic is not hegemonic marked by the logic of repression, but the predominance of other defensive mechanisms, e.g. splitting, and non-verbal forms of expression such as acting out. Given the need to reconfigure some parameters of the psychoanalytic technique, we set as the objective of this article the investigation of clinical management of regressions under analysis from the theoretical and clinical contributions of Sándor Ferenczi and from developments and advances by Michael Balint. Therefore, from the changes proposed by these authors, we will attempt to extract elements that will help us think different clinical management of patients whose suffering refers to traumatic failures in the early stages of development, in an analytical setting.

En la clínica psicoanalítica contemporánea nos hemos enfrentado, cada vez más, con impases técnicos que nos obligan a repensar la teoría sobre la técnica psicoanalítica. Esta revisión teórica se justifica por una mayor incidencia de cuadros clínicos cuyo dinamismo psíquico no responde a la lógica de la represión, sino por el predominio de otros mecanismos defensivos, como el clivaje / escisión del yo, y formas de expresión no verbal como pasajes al acto y "acting outs". Ante la necesidad de reconfigurar algunos parámetros de la técnica psicoanalítica, el objetivo de este artículo es delinear la investigación del tema del manejo clínico de las regresiones en análisis, a partir de las contribuciones teórico-clínicas de Sándor Ferenczi y sus desdoblamientos y avances en la teoría de Michael Balint. Así, pretendemos extraer, de las modificaciones en el dispositivo analítico propuestas por esos autores, elementos que nos ayuden a pensar sobre el manejo clínico con pacientes cuyo sufrimiento remite a los fracasos traumáticas de los primordios de la constitución subjetiva.

Phelan McDermid Syndrome: Multiple Sclerosis as a Rare but Treatable Cause for Regression-A Case Report.

Phelan McDermid syndrome (PMcD) is a neurogenetic disease associated with haploinsufficiency of the SHANK3 gene due to a spectrum of anomalies in the terminal region of the long arm of chromosome 22. SHANK3 is the abbreviation for SH3 domain and ankyrin repeat-containing protein, a gene that encodes for proteins of the postsynaptic density (PSD) of excitatory synapses. This PSD is relevant for the induction and plasticity of spine and synapse formation as a basis for learning processes and long-term potentiation. Individuals with PMcD present with intellectual disability, muscular hypotonia, and severely delayed or absent speech. Further neuropsychiatric manifestations cover symptoms of the autism spectrum, epilepsy, bipolar disorders, schizophrenia, and regression. Regression is one of the most feared syndromes by relatives of PMcD patients. Current scientific evidence indicates that the onset of regression is variable and affects language, motor skills, activities of daily living and cognition. In the case of regression, patients normally undergo further diagnostics to exclude treatable reasons such as complex-focal seizures or psychiatric comorbidities. Here, we report, for the first time, the case of a young female who developed progressive symptoms of regression and a dystonic-spastic hemiparesis that could be traced back to a comorbid multiple sclerosis and that improved after treatment with methylprednisolone.

Decreasing cerebral palsy prevalence in multiple births in the modern era: a population cohort study of European data.

Multiple births (twins or higher order multiples) are increasing in developed countries and may present higher risk for cerebral palsy (CP). However, few studies can reliably investigate trends over time because these outcomes are relatively rare. OBJECTIVE: We pooled data from European CP registers to investigate CP birth prevalence and its trends among single and multiple births born between 1990 and 2008. DESIGN: Population cohort study. SETTING: 12 population-based registers from the Surveillance of Cerebral Palsy in Europe collaboration. PARTICIPANTS: 4 446 125 single and multiple live births, of whom 8416 (0.19%) had CP of prenatal or perinatal origin. MAIN OUTCOMES: CP diagnosis ascertained in childhood using harmonised methods; CP subtype; Motor impairment severity among CP cases. RESULTS: The rate of multiple births increased from 1990. Multiples displayed higher risk for CP (RR=4.27, 95% CI 4.00 to 4.57). For singletons and multiples alike, risk for CP was higher among births of lower gestational age (GA) or birth weight (BW). However, CP birth prevalence declined significantly among very preterm (<32 weeks) and very low BW (<1500 g) multiples. Singletons and multiples with CP displayed similar severity of motor impairment. CONCLUSIONS: Between 1990 and 2008, CP birth prevalence decreased steadily among multiples with low GA or BW. Furthermore, multiples with CP display similar profiles of severe motor impairment compared with CP singletons. Improvements in management of preterm birth since the 1990s may also have been responsible for providing better prospects for multiples.

Regression II. Development through regression.

As shown in our previous paper ('Regression I. Experimental approaches to regression', JAP, 65, 2, 345-65), the common mechanism of regression can be described as reversible dedifferentiation, which is understood as a relative increase of the proportion of low-differentiated (older) systems in actualized experience. Experimental data show that regression following disease (chronic tension headache) is followed by adaptation and an increase in system differentiation in that experience domain which contains systems responsible for that adaptation. The results of mathematical modelling support the idea that reversible dedifferentiation can be one of the mechanisms for increasing the effectiveness of adaptation through learning. Reversible dedifferentiation, which is phenomenologically described as regression, is a general mechanism for restructuring the organism-environment interactions in situations where behaviours that were effective in the past become ineffective. Reversible dedifferentiation has evolved as a component of adaptation when new behaviours are formed and large-scale modifications in the existing behaviours are required in the face of changes in the external and/or internal environment. Thus, the authors believe that this article provides evidence for Jung's view that regression is not only a 'return' to past forms of thinking, affects and behaviour, but that regressive processes provide a significant impetus for psychological growth and development.

Comme nous l'avons montré dans notre article précédent (« Régression I. Les approches expérimentales de la régression ¼), le mécanisme propre à la régression peut être décrit en tant que dé-différentiation réversible, ce que l'on peut comprendre comme une hausse relative de la proportion de systèmes peu différentiés (plus vieux) dans l'expérience actualisée. Les données expérimentales montrent que la régression suite à une maladie (mal de tête de tension chronique) est suivie par une adaptation et un accroissement dans la différentiation des systèmes dans le domaine d'expérience qui contient les systèmes responsables de cette adaptation. Les résultats de la modélisation mathématique soutiennent l'idée que la dé-différentiation réversible peut être l'un des mécanismes pour accroitre l'efficacité de l'adaptation par l'apprentissage. La dé-différentiation réversible, qui est décrite phénoménologiquement comme régression, est un mécanisme général pour restructurer les interactions organisme-environnement dans des situations où les comportements qui fonctionnaient par le passé sont devenus inefficaces. La dé-différentiation réversible a évolué comme un élément de l'adaptation quand de nouveaux comportements se développent et que des changements dans l'environnement extérieur ou intérieur requièrent des modifications à grande échelle dans les comportements existants. Ainsi, les auteurs pensent que cet article apporte un soutien à la perspective de Jung selon laquelle la régression n'est pas seulement un « retour ¼ à des formes anciennes de fonctionnement, d'affects et de comportement, mais que les processus régressifs fournissent un élan significatif pour la croissance et le développement psychologiques.

Como hemos mostrado en nuestros trabajos previos ('Regresión I. Abordajes experimentales hacia la regresión'), el mecanismo común de la regresión puede ser descripto como desdiferenciación reversible, el cual es comprendido como un relativo incremento en la proporción de sistemas de baja-diferenciación en la experiencia actual. Data experimental muestra que la regresión luego de una enfermedad (tensión de cabeza crónica) es seguida por la adaptación y por un incremento en la diferenciación de sistemas en aquel dominio de la experiencia, que contiene sistemas responsables para tal adaptación. Los resultados del modelo matemático sostienen la idea de que la desdiferenciación reversible puede ser uno de los mecanismos para incrementar la efectividad de la adaptación a través del aprendizaje. La desdiferenciación reversible, la cual fenomenológicamente se describe como regresión, es un mecanismo general para restructurar las interacciones entre el organismo y el medio ambiente, en situaciones en las que las conductas que eran efectivas en el pasado se vuelven ineficaces. La desdiferenciación reversible ha evolucionado como un componente de la adaptación cuando se forman nuevas conductas y se requieren modificaciones a gran escala en las conductas existentes frente a los cambios en el medio ambiente externo y/o interno. Así, los autores consideran que el artículo proporciona evidencia a la perspectiva de Jung sobre la regresión, no solamente como un 'retorno' a formas de pensar, sentir y actuar del pasado sino que los procesos regresivos proveen un estímulo significativo para el desarrollo y el crecimiento psicológico.

Reconsidering Regression in Psychoanalysis: Notes on a Central Yet Controversial Concept and Its Relation to Free Association.

The concept of regression is schematically reviewed, focusing on the complexities and confusions that have surrounded this contested notion in the course of psychoanalytic history. Clinical illustrations are used to suggest descriptive differences in regressive functioning occurring in the course of psychoanalysis. It is argued that there may be an important distinction between the sense-making (adaptational, maturational, and integrative) aims of therapeutic discourse and the distinctively deconstructive conditions of a psychoanalytic process. In this context, the "regressive" impact of the free-associative method is illustrated, and on this basis, it is suggested that there is a significant and profound difference between "free association" conceived simply as uncensored storytelling and "full-on free association" as closer to the babbling of a stream of consciousness.

El Leonardo de Freud: notas cruzadas sobre la interpretación en la cura y fuera de la cura / Freud's Leonardo. Cross notes on interpretation in the cure and outside the cure

La posteridad de Un recuerdo infantil de Leonardo da Vinci de Sigmund Freud (1910) se ha centrado en el error de traducción del psicoanalista, del italiano al alemán, de un recuerdo del artista (buitre en lugar de milano). Al releer este texto y volver a ciertas etapas de su posteridad, el artículo ofrece una reflexión sobre los desafíos de la interpretación, tanto en la cura como fuera de ella. El carácter abierto y fundamentalmente inscrito en un entresujetos de la interpretación resulta fructífera para los teóricos del arte

The posterity of Sigmund Freud's Leonardo da Vinci.A Memory of His Childhood (1910) emphasized the translation error by the psychoanalyst from Italian to German of a memory of the artist (vulture instead milan). By rereading this text and returning to certain steps of its posterity, the article offers a reflection on the challenges of interpretation, both in psychoanalytical treatment and outside. The open and fundamentally intersubjective nature of psychoanalytical interpretation proves fruitful for art theorists

Psychiatric illness and regression in individuals with Phelan-McDermid syndrome.

BACKGROUND: Phelan-McDermid syndrome (PMS) is a genetic condition characterized by intellectual disability, speech and language deficits, hypotonia, autism spectrum disorder, and epilepsy. PMS is caused by 22q13.33 deletions or mutations affecting SHANK3, which codes for a critical scaffolding protein in excitatory synapses. SHANK3 variants are also known to be associated with an increased risk for regression, as well as for psychiatric disorders, including bipolar disorder and catatonia. This study aimed to further describe these phenomena in PMS and to explore any relationship between psychiatric illness and regression after early childhood. METHODS: Thirty-eight people with PMS were recruited to this study through the Phelan-McDermid Syndrome Foundation based on caregiver report of distinct development of psychiatric symptoms. Caregivers completed a clinician-administered semi-structured interview focused on eliciting psychiatric symptomatology. Data from the PMS International Registry were used to confirm genetic diagnoses of participants and to provide a larger sample for comparison. RESULTS: The mean age of the 38 participants was 24.7 years (range = 13 to 50; SD = 10.06). Females (31 of 38 cases; 82%) and sequence variants (15 of 38 cases; 39%) were over-represented in this sample, compared to base rates in the PMS International Registry. Onset of psychiatric symptoms occurred at a mean age of 15.4 years (range = 7 to 32), with presentations marked by prominent disturbances of mood. Enduring substantial loss of functional skills after onset of psychiatric changes was seen in 25 cases (66%). Symptomst indicative of catatonia occurred in 20 cases (53%). Triggers included infections, changes in hormonal status, and stressful life events. CONCLUSIONS: This study confirms that individuals with PMS are at risk of developing severe neuropsychiatric illness in adolescence or early adulthood, including bipolar disorder, catatonia, and lasting regression of skills. These findings should increase the awareness of these phenotypes and lead to earlier diagnosis and the implementation of appropriate interventions. Our findings also highlight the importance of genetic testing in the work-up of individuals with intellectual disability and acute psychiatric illness or regression. Future research is needed to clarify the prevalence and nature of psychiatric disorders and regression among larger unbiased samples of individuals with PMS.

Reading Winnicott: return to the concept of regression to dependence.

Drawing on Winnicott's renowned concept of regression to dependence, the author elaborates on both the creative potential and limitations of this notion, examining some theoretical and clinical contributions from his own psychoanalytic practice with neurotic and psychotic children. First, the author questions and discusses the theoretical difficulties that arise in the conception of regression to dependence. In particular, he analyses the matter of psychic temporality and passivity. Second, the author considers how analysts can receive and foster the regression to dependence, and examines the use of limited physical contact in the treatment of severely disturbed children.

Characteristics, Early Development and Outcome of Parent-Reported Regression in Autism Spectrum Disorder.

This study explored regression patterns in 100 children with ASD (3-11 years) using several approaches to enhance the validity of retrospective parent report. Both early development and outcome were examined in regression groups defined by 36 months age cut-off and two underlying empirical patterns based on type and onset age. Results over regression groups were generally consistent. During early development, children with regression showed a similar amount of social atypicalities and stereotyped behaviour as compared to children without regression. However, parents indicated less communication skills which could be a valuable predictor of regression. Development after regression was characterised by early language delay and more restricted and repetitive behaviour. The findings provide insight into the diagnosis and prognosis of regression in ASD.

A pulsão de morte no primeiro Ferenczi: quietude, regressão e os primórdios da vida psíquica / La pulsión de muerte en el primer Ferenczi: quietud, regresión y los primordios de la vida psíquica / Death drive in the first Ferenczi: a quiet state, regression, and the beginnings of psychic life

Este artigo procura expor e discutir o uso que Ferenczi faz da ideia de pulsão de morte, ainda na década de 1910. Apresentamos a história e o contexto da utilização da ideia entre os primeiros psicanalistas e, em seguida, argumentamos que a primeira hipótese do analista húngaro sobre a pulsão de morte procurava relacionar um estágio de onipotência incondicional, característico, a seu ver, da vida intrauterina, com um estado de quietude originário, uma tendência à regressão e uma concepção do narcisismo primitivo. Cada um desses aspectos é problematizado junto à teoria freudiana. Ao final, fazemos uma análise crítica da hipótese à luz das postulações de outros autores.

Este artículo busca exponer y discutir el uso que Ferenczi hace de la idea de pulsión de muerte, aún en la década de 1910. Presentamos la historia y el contexto de la utilización de la idea entre los primeros psicoanalistas y, a continuación, argumentamos que la primera hipótesis del analista húngaro sobre la pulsión de muerte buscaba relacionar una etapa de omnipotencia incondicional, característico, a su ver, de la vida intrauterina, con un estado de quietud originario, una tendencia a la regresión y una concepción del narcisismo primitivo. Cada uno de estos aspectos es problematizado junto a la teoría freudiana. Al final, hacemos un análisis crítico de la hipótesis a la luz de las postulaciones de otros autores

This article seeks to present and discuss Ferenczi's use of the idea of a death drive in the 1910s. We present the history and context of the use of the idea among the first psychoanalysts, and then argue that Ferenczi's first hypothesis on the death instinct sought to relate a stage of unconditional omnipotence, characteristic, in his view, of intrauterine life, with an original state of quietness, a tendency to regression and a conception of primitive narcissism. We then compare each one of these aspects with the Freudian theory. In conclusion, we make a critical analysis of the hypothesis using the ideas of other authors.

Effect of modulating braille dot height on reading regressions.

It is well known that people who read print or braille sometimes make eye or finger movements against the reading direction. The way these regressions are elicited has been studied in detail by manipulating linguistic aspects of the reading material. Actually, it has been shown that reducing the physical intensity or clarity of the visual input signal can also lead to increased regressions during reading. We asked whether the same might be true in the haptic realm while reading braille. We set the height of braille dots at three different levels (high, medium, and low) and asked adult blind, practiced braille readers to read standardized texts without any repetition of content. The results show that setting the braille dot height near the tactile threshold significantly increased the frequency of regressive finger movements. Additionally, at the lowest braille dot height, braille reading speed significantly diminished. These effects did not occur at braille dot heights that were closer to the height of standard braille (medium and high). We tentatively conclude that this effect may be due to a heightened sense of uncertainty elicited by perception near the threshold that seems to be common to the reading process, independent of the sensory input modality. Furthermore, the described effect may be a feature of a brain area that contributes to the reading process mediated by vision as well as touch.

Changing conceptualizations of regression: What prospective studies reveal about the onset of autism spectrum disorder.

Until the last decade, studies of the timing of early symptom emergence in autism spectrum disorder (ASD) relied upon retrospective methods. Recent investigations, however, are raising significant questions about the accuracy and validity of such data. Questions about when and how behavioral signs of autism emerge may be better answered through prospective studies, in which infants are enrolled near birth and followed longitudinally until the age at which ASD can be confidently diagnosed or ruled out. This review summarizes the results of recent studies that utilized prospective methods to study infants at high risk of developing ASD due to family history. Collectively, prospective studies demonstrate that the onset of ASD involves declines in the rates of key social and communication behaviors during the first years of life for most children. This corpus of literature suggests that regressive onset patterns occur much more frequently than previously recognized and may be the rule rather than the exception.