Projective methods have lost significance in child and adolescent psychiatric diagnostics. These methods allow access to important emotional and conflictual topics that can only be determined to a limited extent via diagnostic discussions and questionnaires. The Thematic Apperception Test (TAT-A) has been updated for use in adolescents. For this purpose, special image templates with new motifs were developed, which were redrawn photorealistically in color to increase ambiguity and stimulate imagination. To check the thematic valences, the panels were presented to 184 schoolgirls in Seoul, South Korea, for assessment. The practical suitability and acceptance of the image templates were evaluated on a small clinical German sample (N = 13), and the valences in terms of content were determined by two raters. The results clarify that photorealistic color representation is an appropriate method for this new concept of TAT. In particular, \"empty\" panels with landscape views initiate meaningful narratives, thereby enabling access to personal topics.
Zusammenfassung Projektive Verfahren haben in der kinder- und jugendpsychiatrischen Diagnostik an Bedeutung verloren. Dabei ermöglichen sie den Zugang zu wichtigen emotionalen und konflikthaften Themen, die im diagnostischen Gespräch und durch Fragebögen nur bedingt zu eruieren sind. Für den Einsatz bei Jugendlichen wurde eine Aktualisierung des Thematischen Apperzeptions-Tests (TAT-J) vorgenommen. Hierzu wurden spezielle Bildvorlagen mit neuen Motiven entwickelt, die fotorealistisch farbig nachgezeichnet wurden, um die Ambiguität zu erhöhen und die Fantasie anzuregen. Zur Überprüfung der thematischen Valenzen wurden die Tafeln 184 Schülerinnen in Seoul, Südkorea, zur Beurteilung vorgelegt. An einer kleinen klinischen deutschen Stichprobe (N = 13) wurden die Praxistauglichkeit und Akzeptanz des Materials überprüft sowie die inhaltlichen Valenzen mit Hilfe zweier Rater festgelegt. Die Ergebnisse verdeutlichen, dass die fotorealistische farbige Darstellung eine angemessene Methode für eine Neukonzeption des TAT ist. Es zeigt sich, dass insbesondere „inhaltsleere“ Tafeln mit Landschaftsansichten sinnstiftende Erzählungen anstoßen und damit einen Zugang zu persönlichen Themen ermöglichen.

OBJECTIVE: People with eating disorders (EDs) have difficulties understanding their own emotions and recognizing the emotions of others, especially in ambiguous settings. We examined the neuronal mechanisms underlying the emotion processing of ambiguous interpersonal stimuli in EDs and healthy controls (HCs).
METHODS: The fMRI data were acquired by a blocked experimental design with 28 women (14 EDs) during the visual presentation of a modified Thematic Apperception Test.
RESULTS: EDs showed very strong associations between experienced and inferred emotions evoked by the stimuli; no such relationship was found in HCs. HCs displayed elevated left anterior insula activity during the mentalizing condition; EDs showed increased activity in the right supramarginal gyrus and medial prefrontal cortex.
CONCLUSIONS: The two groups seem to apply different strategies for judging emotionally ambiguous stimuli, albeit resulting in equivalent judgments. We assume that activity in the supramarginal gyrus and insula in EDs is linked with suppressing their own perspective while considering emotional states, probably due to alexithymia and the lack of awareness of their own mental states. We hypothesize that the strong correlation between experienced and inferred emotions in EDs could reflect their tendency to use others as a reference point for perceiving themselves and gaining information about their affective state.
METHODS: No level of evidence, this is a basic science study.

Medical schools responding to challenges with fairness, equity, learning environments, and student wellness have reconsidered clerkship grades. This study used the Concerns-Based Adoption Model (CBAM) to explore how faculty responded to a change in the approach to assessment from focus on grades toward focus on feedback.
This qualitative study used an inductive approach to analyze data from semistructured interviews with teaching faculty and education leaders at University of California, San Francisco, School of Medicine 6 months following the elimination of traditional tiered clerkship grades. Participants were recruited in 2019 using purposive sampling. Interview questions addressed participants\' perceptions of the new approach to assessment and grading that emphasizes assessment for learning, including advantages and concerns. The authors analyzed data using thematic analysis informed by sensitizing concepts from CBAM.
Nineteen faculty participated (11 medicine, 8 surgery). Faculty expressed optimism about the impact of the change on their clinical educator roles and sought faculty development to enhance feedback and assessment skills. Perceived benefits to students addressed learning and wellness, with concern for students\' motivation and professional development. Faculty shared uncertainty about their roles and larger systemic consequences involving the residency match and institutional reputation. Participants acknowledged that traditional grading is imperfect, yet felt a departure from this system represented significant culture change.
Faculty perceptions of the assessment and grade change in 2 large departments demonstrated tensions around grading. Their descriptions of change as an ongoing process aligned with CBAM and required them to consider new approaches and perspectives. While discourse about assessment and grading frequently focuses on learners, these findings support institutional consideration of the impact of changes in assessment on teaching faculty.

To investigate women\'s understanding and attitudes towards the National Cervical Screening Program (NCSP) and to explore methods to improve screening participation.
Semi-structured face-to-face interviews were conducted through convenience and snowball sampling. Thematic analysis occurred using the interpretivist framework.
A private general practice in North Queensland.
Women between the ages of 18 and 74 who attended the general practice were eligible to participate. Fourteen women between 20 and 58 years old were interviewed.
Participants were concerned that the new NCSP would miss cancer due to longer screening intervals and reliance on primary human papilloma virus (HPV) testing. They believed that young women are at increased risk of cervical cancer, due to perceived HPV vaccine ineffectiveness and parent objection to vaccination. Most participants were not agreeable to self-sampling and preferred their doctor to perform screening. Personal and practitioner beliefs influenced a woman\'s screening participation. Personal factors include being healthy for themselves and their family, previous abnormal smears and family history of cancer. Emphasis was placed on feeling \'comfortable\' with their practitioner which included patient rapport and gender preference. Proposed methods to improve cervical screening included education programmes, advertising campaigns, general practitioner interventions and improving accessibility.
It is apparent that women are hesitant about the new NCSP. However, when provided with additional information they were more amenable to the changes. This highlights the need to improve awareness of cervical screening and the new NCSP.

Previous research has shown that stimulus pull is one of the contributory factors influencing Thematic Apperception Test (TAT) responses. In recent years, there has been a resurgence of studies examining this. In particular, the Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) has been employed to examine stimulus pull in adult clinical and nonclinical samples. The present study is the first attempt to examine this issue in a nonclinical sample of children. Ninety-eight children from Italian elementary (1st to 5th grade) and middle (6th to 8th grade) schools provided narratives to six TAT cards (1, 2, 3BM, 4, 8BM, and 16). Some important findings with regard to variance within scales replicate prior findings from other studies. Furthermore, some findings regarding the specific nature of pull for particular TAT cards (1, 2, 3BM, and 4) replicate prior work. Given that Cards 8BM and 16\'s SCORS-G stimulus properties have not been previously studied, the pull of these cards is explored. Last, SCORS-G differences/similarities across these two age groups are highlighted. Suggestions for further research in this field are also provided, particularly concerning the use of SCORS-G and TAT for clinical assessment.

Social cognition and its association with level of personality organization (PO) were examined in 163 patients with severe somatoform disorders (SFDs) and 151 psychiatric (PSA) control patients. Social cognition was measured with the Social Cognition and Object Relations Scale, which assessed both affective and cognitive facets of social cognition. Levels of PO were assessed using theory-driven profiles of the Dutch Short Form of the Minnesota Multiphasic Personality Inventory (MMPI). The SFD patients exhibited impairments in the cognitive facets of social cognition but not more so than the PSA controls. The results for the affective aspects indicated that the SFD patients exhibited lower levels of emotional investment yet higher affect tone in interactions than the PSA controls. In contrast to the control group, level of PO was not associated with social cognition in SFD. Together, the results indicated that impairments in complexity of mental representations are not specific to SFD patients, yet impairments in emotional investment may be specific to SFD.

This study reports on brain activity induced by picture-based personality tests. Near-infrared spectroscopy is a newly developed, noninvasive technology in neuroimaging that can measure brain activity through blood volume changes. We measure the prefrontal cortex (Brodmann Area 10 [BA10]) activities of adolescents during the Rorschach (1921), the Rosenzweig Picture-Frustration Study (PFS; Hayashi, 1964), and Thematic Apperception Test (TAT; Murray, 1943). BA10 showed that the PFS was left-hemisphere dominant and significantly different from the Rorschach and TAT, which showed a tendency to be right-hemisphere dominant. We believe that this tendency reflects emotion and sociality.

Given the trust the public places in the medical profession, the question of when it might be acceptable to minimally deceive patients, in their best interests, is a challenging one to answer. In this study, we explore neuro-oncology patients\' attitudes towards dilemmas in which they may feel deceived, and with that information make recommendations on what steps physicians can take to avoid breaking that trust. Qualitative case study methodology was used. Thirty-two face-to-face interviews with post-operative brain tumor patients were conducted and recorded. Interviews were transcribed and subjected to modified thematic analysis. The majority of patients had a postsecondary education, and there was substantial religious and ethnic diversity among them. Five prominent themes arose from the analysis: (1) patients are hesitant about trainees working on their case, but they are more open to it if they expect the occurrence ahead of time; (2) patients wish to know the exact details when an error has occurred, even if it is of inconsequential effect for them; (3) patients generally prefer to know exactly what the doctor knows, even if nothing can be changed; (4) patients expect physicians to provide them with all the options and resources available; and (5) there are special cases in which patients accept a delay in knowing. Most neuro-oncology patients trust their physicians to make the best decisions for them, but that does not mean they would accept subtle forms of deception. Patients prefer to have all the information necessary in order to make their own decision.

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