Developing culturally sensitive psychodynamic case formulations: The effects of Asian cultural elements on psychoanalytic control-mastery theory.

Examined the effects of traditional Asian cultural norms, family roles, and values upon the psychodynamic formulation of a 25-yr-old Asian American man. The main tenets of control-mastery theory (CMT; J. Weiss et al [1986]), a cognitive approach to psychoanalytic psychotherapy, are presented, and its plan formulation method is discussed. The need for a more comprehensive consideration of Asian culture, Asian-American identity formation, and acculturative stress in clinical case formulations is presented. Theory modifications are discussed that should help to reconcile differences between the Western values inherent in CMT and traditional Asian approaches to psychotherapy and mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Percutaneous large-core biopsy of papillary breast lesions

Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae possess the ability to cleave human IgA1 antibodies, and all successfully colonize and occasionally invade the human upper respiratory tract. N. meningitidis invades the bloodstream after a period of nasopharyngeal colonization. We directly compared levels of IgA1 protease activity in strains (n=52) derived from the cerebrospinal fluid or blood of patients with meningococcal disease with strains of N. meningitidis obtained from asymptomatic carriers (n=25). IgA1 protease activity was determined by a sensitive semiquantitative ELISA assay. Levels of IgA1 protease activity were significantly higher (P<0.0001) in strains associated with invasive meningococcal disease (98% with detectable activity, mean = 580 mU) than with those obtained from asymptomatic carriers (76% with detectable activity, mean = 280 mU). Despite marked variation in enzyme activity, almost all strains (96%) possessed the gene for IgA1 protease. Given the panmictic population structure of the bacterial isolates investigated, these data, obtained from two groups infected with N. meningitidis, but with markedly different clinical outcomes, provide the first quantitative evidence that IgA1 protease activity is a virulence determinant that contributes to the pathogenic phenotype, and suggest IgA1 protease as a potential target for prophylaxis.     

Ancestral voices: Narrative and multicultural perspectives with an Asian schizophrenic.

Explores the effects of traditional Asian cultural values, family roles, and behavioral norms upon the psychodynamic formulation and treatment of the case of a 36-yr-old female Chinese immigrant schizophrenic. The main principles of Control Mastery theory, a cognitive approach to psychoanalytic psychotherapy, are presented and its Plan Formulation Method is reviewed, from the perspective of post-modern theories of life-narrative transformations and relational theories of mind. Culturally sensitive modifications of psychodynamic theory are introduced, and implications of the hierarchical transference and therapist "gift" giving are discussed, with emphasis on story telling and role modeling interventions/parameters effectively used to address issues of acculturation conflicts, gender issues, and Asian-American identity formation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intimidades: confianza, gender, and hierarchy in the construction of Latino-Latina therapeutic relationships

The intimate nature of psychotherapy requires psychotherapists be educated to deal with the sexualization of the sharing of intimate feelings and interpersonal closeness. Latino cultures have relatively rigid sex role expectations and norms that privilege men at the expense of women. Experiences of emotional intimacy threaten this Latino cultural discourse of boundaries between men and women and may lead to impasses in therapy and enactments of pathogenic aspects of machismo and marianismo in the therapeutic relationship. Clinical vignettes illustrating the embeddedness of such gender discourses within therapeutic conversations between a Latino therapist and his Latina clients are presented, with discussion of how an intersubjective--relational approach can be used to deconstruct oppressive machista metaphors and cultural narratives and then aid in the coconstruction of reparative narratives within a context of intergender mutuality.