Myositis mimics in scleroderma: A case series of neuromuscular diseases that can co-exist in scleroderma.

We present a case series of four patients with systemic sclerosis and skeletal myopathy. While idiopathic inflammatory myopathies, or myositis, are thought to be the most common type of muscle disease seen in systemic sclerosis, we highlight four cases where unique clinical findings and careful assessment ruled out myositis mimics. Key diagnostic tools that can be helpful for clinicians to diagnose a neuromuscular disease are also detailed in this report.

Toward an Integrative Approach to the Study of Positive-Affect-Related Aggression.

Research on aggression usually aims at gaining a better understanding of its more negative aspects, such as the role and effects of aversive social interactions, hostile cognitions, or negative affect. However, there are conditions under which an act of aggression can elicit a positive affective response, even among the most nonviolent of individuals. One might experience the "sweetness of revenge" on reacting aggressively to a betrayal or social rejection. A soldier may feel elated after "shooting to kill" in the name of the flag. There are many factors that contribute to the appeal of aggression, but despite growing interest in researching these phenomena, there is still no unitary framework that organizes existing theories and empirical findings and can be applied to a model to generate testable hypotheses. This article presents a narrative review of the literature on positive-affect-related forms of aggression and explores the role of aggression in eliciting positive affect across diverse social situations and relational contexts. An integrative model that unifies existing theories and findings is proposed, with the objective to inspire and inform future research.

Is Splitting Related to Resistance to Proactive Interference? A Process-Oriented Study of Kernberg's Conceptualization of Splitting.

INTRODUCTION: Splitting, as a defense mechanism in Kernberg's theory, plays a significant role in the development and maintenance of polarized and oscillating representations of self/other characteristics of borderline personality disorder (BPD). Although the notion of splitting can be considered from a structural and a functional point of view, almost all empirical studies to date have focused on the former elements to the detriment of related cognitive processes. METHODS: To further investigate the cognitive processes related to splitting, 60 participants were administered the Splitting Index and indexes of resistance to proactive interference (PI) using the interpersonal recent negative task with words that reflect negative or positive interactions compared to neutral words. RESULTS: The use of splitting was uniquely and significantly predicted by a higher capacity to resist PI and a lower capacity to consistently maintain this resistance when presented with negative words, above and beyond BPD traits, primitive defenses, and the presentation of neutral words. Results showed no evidence of a relationship between splitting and resistance to PI with positive words. CONCLUSION: Results appear compatible with Kernberg's conceptualization of splitting as an active defense process that relates to an unstable capacity to inhibit negative representations of the object from entering working memory.

Cognitive Control Processes and Defense Mechanisms That Influence Aggressive Reactions: Toward an Integration of Socio-Cognitive and Psychodynamic Models of Aggression.

Research on cognitive processes has primarily focused on cognitive control and inhibitory processes to the detriment of other psychological processes, such as defense mechanisms (DMs), which can be used to modify aggressive impulses as well as self/other images during interpersonal conflicts. First, we conducted an in-depth theoretical analysis of three socio-cognitive models and three psychodynamic models and compared main propositions regarding the source of aggression and processes that influence its enactment. Second, 32 participants completed the Hostile Expectancy Violation Paradigm (HEVP) in which scenarios describe a hostile vs. non-hostile social context followed by a character's ambiguous aversive behavior. The N400 effect to critical words that violate expected hostile vs. non-hostile intent of the behavior was analyzed. Prepotent response inhibition was measured using a Stop Signal task (SST) and DMs were assessed with the Defense Style Questionnaire (DSQ-60). Results showed that reactive aggression and HIA were not significantly correlated with response inhibition but were significantly positively and negatively correlated with image distorting defense style and adaptive defense style, respectively. The present article has highlighted the importance of integrating socio-cognitive and psychodynamic models to account for the full complexity underlying psychological processes that influence reactive aggressive behavior.