projective testing and lateralization

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  • 8/2/2019 Projective Testing and Lateralization

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    LETTERS

    23 2 VOLUM E 8 #{149}UM BER 2 #{149}PR ING 1996

    Pro j ective T estin g an dLatera l i za t ionSIR : I fo und the article T he C ogn i-tive B ias T ask an d L a te ra l ized F ron -tal Lo be Func tion s in M ales1 to bem ost in te re st ing , h av in g been fa sc i-na ted b y the con fus in g li tera tu re onla te ra lizatio n fo r yea rs . Th e con-cep ts o f con tex t-depend en t andcon tex t- ind ep en den t a s pa ra-d igm s fo r le ft and righ t fro n ta l p ro c-ess ing a re com pe lling ly re sea rch edand v ery w ell p re sen ted . I on lyw ish th at the a rtic le had add ressedadd itiona l pu b lished w o rk relevan tto la te ra lizatio n of the fron tal lob es.

    T he re w ere a lso som e in he ren tlyp rob lem a tic con cep ts co ncernedw ith th e n atu re o f execu tive fun c -tio ns , su ch as the su gg es tion tha tthe re a re con tex t- inv arian t re -sp onses. Im no t rea lly su re w h a tsuch re spo nse s w ou ld be , o th erthan d eep tendon ref lexes an d th elik e . I do ub t tha t com plex behav io r,ou tside o f ic ta l even ts and a fewo th e r ex cep tio ns, can eve r b estr ipp ed o f a co nn ec tion to m atr iceso f in te rna l rep re sen ta tion s, inc lud -in g rep re sen ta tion s o f ad ap tive con -tex t. T h e q uestion s a re abo u t thed ifferen tia l na tu re o f th ose rep re -s en tatio ns in each hem isph ere -w h at n eu ra l ne tw o rk th eo ry w ou ldte rm the sta te space o f the ir ac tiva -tio n -an d how th ese d ifferen tia lty pes o f co nstruc tions com e to be .

    Th e no tion of a co n tex t-in va ri-an t re spo nse m ay be a co n trad ic-tio n in te rm s, g iven m uch ev id en ceth a t con tex t m us t c r itic a lly m ed ia teal l ou tpu t. B y con tex t h ere I m eanp e rce ived o r rep re sen ted con tex t, re -g a rd le ss o f w he the r th ose co n tex trep resen tatio ns are fu lly con sc iouslyav ailab le o r p o ten tia lly co ded in lan -g uage . Th ere a re tim es w hen theau tho rs appea r to b e u sing the te rmcon tex t a s th ough it m eans therea l co n tex t (w ha tev e r tha t m ig h tbe ) in stead of the rep re sen ted con -tex t, w h ich in fact is a ll tha t w e

    eve r have to w ork w ith . It is p ro b -ab ly no t accu ra te a t a neu ra l ne t-w ork leve l to th ink in te rm s ofbehav io ra l o u tpu ts a s s tem m ingfrom s in g le rep re sen ta tion s o f adap-tive co n tex t , as op po sed to beingcom plex am a lgam s o f m ultip le com -pe ting , va riab ly in te rd ig ita ting , an dp ara lle l re pr es en ta tio ns .

    In th is sense , th e con tex t-in de -pend en t re spo nse s seem to reflec tsenso ry b iase s ( like s and d islike s)tha t p robab ly h av e im po rtan t lim b icand pa ra lim bic a sp ects , and I w on-de r if th ey m ig h t be m ore accu ra te lyte rm ed m ore id iosy nc ra tically pe r-son al o r le ss con strain ed as o p-po sed to con tex t- ind ep enden t. I tis cu rious th a t th e au th o rs have hap-pened upon a po ten tia lly ve ry u se -fu l pa rad igm , p erson al re s pons eb ias to am big uous ta sk s , th at h as along h isto ry in psy ch iatry , w itho u tthat conn ec tio n hav in g b ecom e ap-pa ren t to the au tho rs . T h is pa ra-d igm -p ro jec tive te sting -isg en era lly a ssum ed , e rron eo us ly inm y ju dgm en t, to have n o th ing to o f-fe r c lin ic al neu ro science (P . M alloy ,p erso na l com m un ica tio n o n a ssess -in g C apg ra s p atien ts by R o rsch achv ersu s o th er p ro je ctive tes ts , 19 92 ).B u t th is w o rk on the C ogn itiv e B iasT ask sug ge s ts tha t p ro jec tiv e te s tssho u ld ge t a seco nd lo ok in te rm so f the ir func tio na l va lu e a s p ro be so f la tera liz ed o r reg io ns-o f-in te res tact ivat ion.

    M y ow n th in k in g h as a lw ay sbeen tha t te s ts su ch a s th e R o r-schach and the T hem atic A ppe rcep -tio n T es t tap p ara lim bic an drigh t-hem isp he re rep re sen ta tion a ls ys t ems -bu t on ly w hen th e p e rso nm ov es aw ay from the popu lar o rconven t iona l safe, m ore con tex t-d ep en den t resp onse . W hole sco ringsys tem s in dun ical p sy cho log y a re infa ct ba sed o n th is distinction be -tw een co nv en tio na l and id io syn -c ra t ic re spo nse s . T h is hyp o the sis isen tire ly co ns is ten t with th e au th ors f ind ings. P erh ap s from this pe rs pec -

    tiv e , the con tex t-depend en t (con -ven tio na l? ) resp on se is le ss p er-sona l, m ore gu arded , le ss free lyassocia t ive , an d th us le ss m ed ia tedby rig h t-hem isp he re an d pa ra lim b icac tiv atio ns . G iv en m uch empir icalev idence th at righ t-h em isphe re ac ti-va tion is m ore in trin sically and c riti-ca lly tied in to lim bic /p a ra lim bicactivat ion, th is po ten tial co nnec tionof the C ogn itive B ia s T ask w ith p ro -je c tive te sting cou ld b e w orth pursu -ing em pir ically in a m uch m oresys tem atic w ay .

    A gulf con tinues to sep ara te tw olite ra tu re s tha t have lo oked at rep re -sen ta tion from disp ara te, a lm ost im -m iscib le, pe rspec tive s: on th e on ehan d , p sycho an aly sis and o the rp sy ch odyn am ic psych o lo g ie s , and ,on the o the r , va riou s cogn itivepsycho log ie s , especial ly t hos egrounded in cogn itive psych om e tricm eth odo log ie s w ith a strong beh av -io ra l ben t. O ne p e rsp ec tive ten ds toa ssum e th at a ll o f th e re al ly im por-tan t rep resen tatio na l schem es a re(most ly ) uncon sc io us . F rom th is pe r-sp ectiv e w e have re la tive ly o b tuseno tion s such a s in te rn alized o b jec tre la tio ns in psy ch oana lysis (w h atneu ral ne tw o rk theo ry w ou ld n owca ll non ve rb al m ap s o f the p o ten -t ia l i n te r p er s on a l- a ff e c ti v e s ta tesp ace ). T he o th e r pe rsp ectiv e as -sum es the o ppo site n o tion , tha t allo f the rea lly im portan t cogn itio nsth at d rive b eh av io r a re cons c ious ,abo ve the w a te r lin e, an d fa ir lyea s ily cod ed in lan gu ag e (a t le as t p o -ten tia lly ). O bv iou s ly , w h en s ta ted insu ch te rm s, b o th a ssum p tio ns loo kshaky . I do th ink , h ow ev e r, th at it isa se r ious m istak e to assum e tha t a llo f the c ritic a l rep resen tatio ns gu id -ing com plex behav io r, e sp ec ia llyw h en dea ling w ith a ffectiv e issu es ,can be seen ab ove th e w a te r line o fco nsc iou sness. C e rta in ly n o onetra ined in exp lo ra to ry psycho th er-ap y wou ld be lieve th a t.

    T he a rtic le un fo rtu na tely refe r-ence s on ly tw o of the m any dozens

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    L E T T E R S

    JOU RNAL O F N EUROPSY CH IA TRY 23 3

    of m a jo r theo retica l ove rv iew s o f la t-e ra lizatio n of the b ra in , o ne b y G old -b erg an d C osta , o u tlin ing ev idenceof a ro u tin ized v ersus nov el p ro c-es sing d is tinc tion , an o the r b yTuck er and W illiam son , o u tlin in gneurom odu la to ry d iffe ren ces, andthe au tho rs do n o t in teg ra te the irow n v iew po in t on la te ra lity w ithideas in th ese o th er m a jo r rev iew s.R ev iew s of la tera liza tion , even ifthey a re on ly exam in in g p re fro n ta lfu nc tions , p rob ab ly need to addre ssheu ris tic ally seve ra l b asic ideas andfin d ing s ab ou t late rality . O r if thissyn the s is is bey ond the cu rren t stateo f the a rt, one m ust at lea st pu t thefo llow ing p ieces on the tab le fo rev en tua l syn th esis :

    1 . C om plem en ta tion o f an opposedsyn tact ical-phono log ical-seman tican aly ze r and a G esta lt sy n thesize r.2

    2 . D ig ita l v ersus ana lo gue encod in gparad igms that m ust re flec t d iffe ren tty pes o f recu rren t co rtical ne tworks .3

    3. Rout in ized (le f t) ve rsu s n ov el(righ t) p roces sing lo ads.4

    4. D iffe ren tia l affec tive v alences- ther igh t m ore d ysp horic , th e le ftm ore euphoric in va lence .

    5 . A th eo re tical in teg ra tion o f th e a f-fectiv e va lence issues and th e p roc -ess ing m oda lity is sues, w h ich a retw o questio ns o ften app ro achedqu ite sepa ra te ly w ith little g ood re-su lt. W hy is the G esta lt syn th e -size r /an alo g ica l p rocesso r/no ve lev en tlcon tex t-in depend en t p ro c -esso r m o re invo lved in the activ a -tio n of nega tive a ffect, w h ile th ed ig i tal l rou t in ized /seman tical lybased /con tex t-d ep en den t p roce s-so r is m ore invo lved in the ac tiva -tion of po sitive o r a t lea st ben ignaffec tive sta te s? (The re is on lysom e in te res tin g specu la tiv e w orkon th is: Joseph s ex trap o la tion5 ofG alin s h yp oth es is .6 )

    6 . The rig h t h em isphe res b e ing bo thon to gene tica lly and phy log en eti-ca lly th e m ore p rim itiv e system .

    7. A ffec tive p ro cessin g an d the m o re

    fun dam en tal a spec ts o f a tten tionbe ing in tr in sica lly tied to th e rig h them isp he re , w ith the neurod e-ve lopm en ta l basis fo r th is alm ostto ta lly u nkn ow n.7

    8 . Th e n eu rom odu la to ry d iffe ren cesno ted in the au tho rs litera tu re re -v iew (no rep in ep hrine and se ro to -nm m ore righ t, do pam ine m orele ft) ; neu roana tom ica l d ifferencestha t w ere no t no ted (large r lef tp lanum tem po ra le , la rg er rig h t p a-ne ta l and pre fron ta l reg ionsam ong o the rs); and th e pos sib ilityo f cy toa rch itec ton ic d iffe ren ces,co rtica lly and subco rtica lly .

    9 . Th e curious re la tive absen ce ofconsc io us d iv ision in bo th in tac tand comm is su ro tom ized p atien ts ,ev idence tha t e ithe r o f the tw o th a-lam o co rtic a l sy stem s ap pears ab leto susta in h ig he r o rde r conscio us-ness an d a sense o f self , how eve rd iffe ren t they m ay be in affec tiveton e and m oda l sty le o f p ro cess ing .

    Th is is clea rly a v ast lite ra tu re fo ran y rev iew o f la te ra liza tion of ex ecu-tiv e fu nc tions to d igest, bu t it m eritsatten tio n . O n e hopes tha t a rtif icia ln eu ra l n etw ork m ode ls o f la te ra liza -tio n w ill em erge from artific ia l n eu -ra l n etw ork -conn ec tion ist w ork th a tm ay he lp in teg ra te all o f the se fea -tu re s in to on e heuris tic exp lana t ion .But th at seem s no t to b e a nea r p ro s-pect, s ince I k now o f no t on e s ing lecurren t ANN m ode l fo r la tera liza -tio n , desp ite d is cu ssion of th is w ithseve ra l lead ing neura l n etw ork th eo -rists (J . G . T ay lo r , p erso na l com m u-n icatio n , 199 5).

    DOUGLA S F. WAI -F , Pi- i .D .N euro psych o lo gy D epa rtm en t,Quincy H osp ita l, Q u incy , M A

    Referen ces1. Pode ll K , L o v e ll M , Z imm erm an M , Go ld -

    b erg E : T h e C ognitive B ias Task an d later-a lized fron ta l lob e fu nc tion s in m ales.J Neuropsych iatry C liii N eu rosci 1 995 ;7 :491-501

    2 . L evy J: P sychob io log ical im plicatio ns o fb ilate ra l asymm etry , in H em isp here D is -

    con nec tion and C ereb ra l Function , ed i tedby D im ond S J, B eaum ont JG . L ondon ,E le k S ci en ce , 1974 , p p 167 -1 83

    3. Wat t D F: H ighe r c or ti ca l f un ct io ns an dth e ego : exp lora tio ns of th e bo und ary be -tw ee n b eh av io ra l neuro log y, neuropsy-c ho lo gy , a nd p sy ch oa na ly sis.P sych oana ly tic Psycho log y 1990 ; 7 :48 7-52 7

    4 . G old berg E , Costa LD : H em ispheric d if -fe ren ces in the a cqu isi tion an d use o f de-scriptive system s. B ra in L ang 1981 ;14 :144-173

    5 . Joseph R : N eu ro psy cho log y , N eu rop sy-ch iatry , an d B ehavio ral N euro lo gy . N ewY ork , P len um , 1990

    6. G alin D : Implicat ions f or p sy ch ia tr y ofle ft a n d r ig h t cereb ra l spec ia l iza t ion .A rch G en P syc hia try 1974 ; 31 :572-583

    7 . M esu lam M -M : Pa tte rns in behav io raln euro an atom y : a sso cia tion are as, the lim -b ic sy stem , and hem isphe ric sp ec ializa-tion , in Pr inc ip les o f B eh av io ra lN euro lo gy , ed ited by M esulam M -M .Phi lade lph ia , FA D avis, 19 85 , pp 1-70

    In R ep lySIR : The le tte r b y D r. D oug las F .W att in resp on se to ou r recen t a r ti-c le tou ch es on a n um be r o f pert i -nen t, bu t n o t d irec tly in te rre lated ,issu es: th e p ro jectiv e n atu re o fou r task ; th e n o tion of co n tex t in -va rian ce ; the neural n et m ode lsof h em isph e ric sp ec ia liz a tio n ; andthe m ultitu de o f th eo rie s o f hem i-sph e ric specia liza tion . W e w ill ad -d re ss th em in tu rn .

    T he C ogn itive B ias T ask is p ro jec-tive in th e sense th at the su b jectm u st d is am bigu ate an inhe ren tlyam big uou s ta sk b y in trod uc ing h iso r he r ow n prefe rence . W e be liev etha t th is p rop erty o f th e ta sk cap -tu re s a fun dam en ta l a spec t o f th efron tal lo be func tion . If free w illcan b e an ch ored anyw here in p ar-ticu la r in the b ra in (a p rop ositionw e do no t neces sar ily adv ocateo th er than a fte r som e red w ine ) , itis a ssu red ly in the fron ta l lob es.T he neuropsy ch o log y of the fron tallob es sho u ld then , a t leas t in p art,b ecom e the neuropsycho lo gy offree w ill. Y et th ere is no th ing in theins trum en ta rium of cogn itive p sy -cho logy tha t w ou ld pe rm it su ch in -