Noradrenergic neuromodulation in ageing and disease.

The locus coeruleus (LC) is a small brainstem structure located in the lower pons and is the main source of noradrenaline (NA) in the brain. Via its phasic and tonic firing, it modulates cognition and autonomic functions and is involved in the brain's immune response. The extent of degeneration to the LC in healthy ageing remains unclear, however, noradrenergic dysfunction may contribute to the pathogenesis of Alzheimer's (AD) and Parkinson's disease (PD).

Priorities for research on neuromodulatory subcortical systems in Alzheimer's disease: Position paper from the NSS PIA of ISTAART.

The neuromodulatory subcortical system (NSS) nuclei are critical hubs for survival, hedonic tone, and homeostasis. Tau-associated NSS degeneration occurs early in Alzheimer's disease (AD) pathogenesis, long before the emergence of pathognomonic memory dysfunction and cortical lesions. Accumulating evidence supports the role of NSS dysfunction and degeneration in the behavioral and neuropsychiatric manifestations featured early in AD.

Offering patients opportunities to reveal their subjective experiences in psychiatric assessment interviews.

Objective: With the intention of understanding the dynamics of psychiatric interviews, we investigated the usual (DSM/ICD-based) psychiatric assessment process and an alternative assessment process based on a case formulation method. We compared the two different approaches in terms of the clinicians' practices for offering patients opportunities to reveal their subjective experiences.

Methods: Using qualitative and quantitative applications of conversation analysis, we compared patient-clinician interaction in five usual psychiatric assessments (AAU) with five assessment interviews based on dialogical sequence analysis (DSA).

Zone of proximal development (ZPD) as an ability to play in psychotherapy: a theory-building case study of very brief therapy.

Objectives: This theory-building case study examined the zone of proximal development (ZPD) in psychotherapy within the assimilation model. Theoretically, the ZPD is the segment of the continuum of therapeutic development within which assimilation of problematic experiences can take place. Work within a problem's current ZPD may be manifested as a Winnicottian ability to play, that is, an ability to adopt a flexible reflexive stance to the presenting problem and be involved in joint examination of possible alternatives.

Achieving an empathic stance: dialogical sequence analysis of a change episode.

Abstract This study examined a client's therapeutic progress within one session of an 18-session child neurological assessment. The analysis focused on a parent-psychologist dialogue in one session of the assessment process. Dialogical sequence analysis (DSA; Leiman, 2004, 2012) was used as a micro-analytic method to examine the developing discourse.

Parent development in clinical child neurological assessment process: encounters with the assimilation model.

Child neurological diagnostic procedures involve extensive encounters with a multi-professional team and may have therapeutic effects. This study explored the therapeutic potential of the diagnostic process using the assimilation model as the conceptual frame of reference. The process of assimilation was tracked across nine consecutive encounters during the assessment of a 4-year-old girl who was referred to the child neurological team due to contact and communication problems.

Patient-nurse-doctor interaction in general practice teleconsultations--a qualitative analysis.

We analysed the interaction in doctor-nurse-patient teleconsultations in primary care. A qualitative analysis was performed of 30 primary care teleconsultations in northeastern Finland. The male doctor was the same in all consultations.

Medicine and the humanities--theoretical and methodological issues.

Engel's biopsychosocial model, Cassell's promotion of the concept "person" in medical thinking and Pellegrino's and Thomasma's philosophy of medicine are attempts to widen current biomedical theory of disease and to approach medicine as a form of human activity in pursuit of healing. To develop this approach further we would like to propose activity theory as a possible means for understanding the nature of medical practice. By "activity theory" we refer to developments which have evolved from Vygotsky's research on socially mediated mental functions and processes.

Ogden's matrix of transference and the concept of sign.

Ogden's concept of the matrix of transference as the inter-subjective basis in psychotherapy and psychoanalysis is examined by using the notion of sign-mediated activity. After an introduction to the concept of activity, Ogden's account of the autistic-contiguous position and his restatement of the Kleinian paranoid-schizoid and depressive positions as the three fundamental modes of generating psychic content are presented. Each is then examined as a specific kind of sign-mediated activity where the semiotic register that mediates the ways events are construed determines the particular qualities of the position.

Procedures as dialogical sequences: a revised version of the fundamental concept in cognitive analytic therapy.

Problematic action patterns that patients are unable to abandon or modify are important treatment targets in cognitive analytic therapy. They are called procedural sequences in the conceptual model underlying the approach. Interpersonal events in the patients' lives, and in the consulting room as well, frequently display such patterns.

Projective identification as early joint action sequences: a Vygotskian addendum to the Procedural Sequence Object Relations Model.

Some phenomena of projective identification, as examined by Ryle on the basis of the Procedural Sequence Object Relations Model, are readdressed by using the Vygotskian notion of joint sign-mediated activity as the earliest form of psychological process. This notion is elaborated by presenting Clark's empirical studies of the emergence of gestural communication.

The concept of sign in the work of Vygotsky, Winnicott and Bakhtin: further integration of object relations theory and activity theory.

In a recent paper Ryle introduced the idea of integrating object relations theory and activity theory, a conceptual tradition originated by Vygotsky and developed by a number of Soviet psychologists during the previous decades. A specific aspect of this integrative perspective will be examined, implied in Ryle's paper but not elaborated by him. It is the issue of sign mediation which was Vygotsky's primary contribution to the methodological problems of modern psychology.