Sex differences in ADHD: Conference summary

Clinical samples of attention deficit hyperactivity disorder (ADHD) have been dominated by males. Consequently, female manifestations and sex differences have been relatively neglected in the extensive ADHD research. Because ADHD is so common (3% to 5% of school children) and chronic (lifelong in many cases), even a small proportion of females multiplied by such a large base means hundreds of thousands of girls and women with ADHD, a significant public health problem. An NIMH conference concluded that research is needed not only on sex differences related to ADHD, but also on manifestations of ADHD in females as such. Areas of focus should include differences in life course (sex-differential age effects); effects of hormones; effects of ADHD parenting (in utero and postnatal) on the next generation; response to and implications for design of psychosocial treatment; effects of differential comorbidity; normative background sex differences that influence the manifestation of ADHD; differences in development of verbal fluency and social behavior; possible interactions of sex and ethnicity; a prospective study of both sex offspring of ADHD adults; and such methodological issues as appropriate instruments and diagnostic thresholds, power to prevent false negatives, valid impairment measures, validity and reliability of child self-reports, and more inclusive samples (all three subtypes: inattentive, hyperactive-impulsive, and combined).The following participants in the November 16–17, 1994, NIMH Conference on Sex Differences in ADHD may be considered ghost co-authors of the contents in this summary. Special thanks are due to Euthymia Hibbs, Ph.D., co-organizer of the conference; Peter Jensen, M.D., who suggested the successful format; Delores Parron, Ph.D., who gave much helpful advice on the conference arrangements; Emily Areia, Ph.D., who thoroughly critiqued the summary; Joan Cole, who helped abstract the recorded proceedings; and Jose Bauermeister, Ph. D., F. Xavier Castellanos, M.D., Stephen Hinshaw, Ph.D., and Mark Stein, Ph.D., who helped with referencing. Other participants, in alphabetical order, included Russell Barkley, Ph.D.; Joseph Biederman, M.D.; Caryn Carlson, Ph.D.; C. Keith Conners, Ph.D.; Monique Ernst, M.D.; Miranda Gaub; Jay N. Giedd, M.D.; Michael Gordon, Ph.D.; Jeffrey Halperin, Ph. D.; Betsy Hoza, Ph.D.; Hans Huessy, M.D.; Jean King, Ph.D.; Kathleen Kiely; Rachel Klein, Ph.D.; Benjamin Lahey, Ph.D.; Jan Loney, Ph.D.; Elizabeth Lorch, Ph.D.; Spero Manson, Ph.D.; Keith McBurnett, Ph.D.; Richard Milich, Ph.D.; Douglas Novins, M.D.; Daisy Pascualvaca, Ph.D.; Linda Pfiffner, Ph.D.; Jane Steinberg, Ph.D.; James Swanson, Ph.D.; Marcus Thomeer, Ph.D.; Lillie Williams, M.D.; Alan Zametkin, M.D.The opinions expressed herein are the views of the author and conference participants and do not necessarily reflect the official position of the National Institute of Mental Health or any other part of the U.S. Department of Health and Human Services.     

Support groups for medical caregivers of people with HIV diseases

As we enter the second decade of AIDS, medical caregivers are experiencing stress and burnout as a result of their work with people with HIV diseases. There are common themes to the stress, as well as differences in the experience of stress according to the characteristics of the healthcare setting. Caregiver support groups are a means of reducing this stress by helping medical caregivers cope better, manage difficult cases, normalize their feelings, put understanding and context to their experiences, decrease isolation, and instill meaning in their work. The use of support groups across various medical settings is presented.The author wishes to acknowledge the assistance of Nicholas Covino, Ph.D., Peter Kassel, Psy.D., Randall Paulsen, M.D., Veronica Rempusheski, Ph.D., Dan Silverman, M.D., and Susan Burns Tisdale, R.N., in ongoing research regarding caregiver support groups. The author also wishes to express gratitude to Genya Bernstein, Psy.D., for many editorial contributions.     

Book Reviews

Book review in this article.
M errill , H arwood F., and M arting , E lizabeth . (Eds.) Developing Executive Skills: New Patterns for Management Growth . New York: American Management Association, Inc., 1958. Pp. 431. $9.00.
L eavitt , H arold J. Managerial Psychology . Chicago: The University of Chicago Press, 1958. Pp. xi + 335. $5.00.
C alhoon , R ichard P., N oland , E. W illiam , and W hitehill , A rthur M., J r . Cases on Human Relations in Management . New York: McGraw-Hill Book Company, Inc., 1958. Pp. viii + 444. $6.00.
G ross , N eal , M ason , W ard S., and M c E achern , A lexander W. Explorations in Role Analysis: Studies of the School Superintendency Role . New York: John Wiley & Sons, Inc., 1958. Pp. xiv + 379. $8.75.
H eider , F ritz . The Psychology of Interpersonal Relations . New York: John Wiley & Sons, Inc., 1958. Pp. ix + 322. $6.25.
M c C ormick , E rnest , J. Human Engineering . New York: McGraw-Hill Book Company, Inc., 1957. Pp. xi + 467. $8.00.
B ellows , R oger , B ellows , C arol S., E step , M. F rances , R ush , C arl H., S choll , C harles E., and W ilson , R onald F. Workbook in Industrial Psychology and Personnel Management . Dubuque, Iowa: Wm. C. Brown Company, 1957. Pp. iv + 94. $2.40.
Y oder , D ale , H eneman , H. G., J r ., T urnbull , J ohn G., and S tone , C. H arold . Handbook of Personnel Management and Labor Relations . New York: McGraw-Hill Book Company, Inc., 1958. Pp. v + approximately 1200. $12.50.
C hamberlain , N eil W., P ierson , F rank C., and W olfson , T heresa . (Eds.) A Decade of Industrial Relations Research, 1946–1956: An Appraisal of the Literature in the Field . New York: Harper & Brothers, 1958. Pp. viii + 205. $3.50.     

Mind, Body, and Spirit: Family Physicians’ Beliefs, Attitudes, and Practices Regarding the Integration of Patient Spirituality into Medical Care

This study used a qualitative approach to explore family physicians’ beliefs, attitudes, and practices regarding the integration of patient spirituality into clinical care. Participants included family medicine residents completing training in the Southwest USA. The qualitative approach drew upon phenomenology and elements of grounded-theory. In-depth interviews were conducted with each participant. Interviews were recorded, transcribed and coded using grounded-theory techniques. Four main themes regarding physicians’ attitudes, beliefs, and practices were apparent from the analyses; (1) nature of spiritual assessment in practice, (2) experience connecting spirituality and medicine, (3) personal barriers to clinical practice, and (4) reflected strengths of an integrated approach. There was an almost unanimous conviction among respondents that openness to discussing spirituality contributes to better health and physician–patient relationships and addressing spiritual issues requires sensitivity, patience, tolerance for ambiguity, dealing with time constraints, and sensitivity to ones “own spiritual place.” The residents’ voices in this study reflect an awareness of religious diversity, a sensitivity to the degree to which their beliefs differ from those of their patients, and a deep respect for the individual beliefs of their patients. Implications for practice and education are discussed.Michael M. Olson, Ph.D., is a member of the Department of Family Medicine, University of Texas Medical Branch in Galveston.M. Kay Sandor, Ph.D., R.N., is in the School of Nursing.Victor Sierpina, M.D., is in the Department of Family Medicine.Harold Vanderpool, Ph.D., Th.M., represents the Institute for Medical Humanities at the university and Patricia Dayao, M.A., is a graduate student there.Funding for this study provided in part by the John G. and Marie Stella Kenedy Foundation and the George Washington Institute for Spirituality and Health/John Templeton Foundation. Correspondence to Michael M. Olson, mmolson@utmb.edu.     

Reviews

Books reviewed in this article.
The Spectrum of Ritual: A Biogenetic Structural Analysis. By E ugene G. D'A quili , C harles D. L aughlin , J r ., and J ohn M c M anus , with Tom Burns, Barbara Lex, G. Ronald Murphy, S.J., and W. John Smith.
Beginnings in Ritual Studies. By R onald L. G rimes .
Pluralism and Personality: William James and Some Contemporary Cultures & Psychology. By D on S. B rowning .
Primordiality, Science and Value. By R. M. M artin .
After Virtue, a Study an Moral Theory. By A lasdair M acintyre .     

The making of a group psychotherapist: Needs and goals for graduate and postgraduate training

Group therapy is a widely practiced, effective, but underrated specialty. Unfortunately, group therapy seems to be taught more haphazardly, with less attention to quality, than is individual therapy. Group therapy has a technique, history, and literature of its own and should be taught independently from individual psychotherapy. The training of psychiatric residents is particularly crucial for group therapy to prosper and be seen as more prestigious. A common core of experience is vital for training in group therapy, whether the trainee's background is psychiatry, psychology, social work, pastoral counseling, or nursing. This core consists of: 1) clinical experience doing group therapy; 2) supervision; 3) a professional training group experience; 4) observation of experienced group therapists; 5) exposure to current thinking in the field; 6) personal group therapy; and 7) a didactic course in theory and technique. Clinical experiences involving cotherapy and combined individual and group treatments are especially useful, both as training and as treatment modalities.He is on sabbatical leave from John Jay College of Criminal Justice where he is Professor of Psychology and was founding Chairman of the Psychology Department.The authors wish to thank Arnold Rachman, Ph.D., Michael Lapidus, M.D., Fayek Nakhla, M.D., Nyapati R. Rao, M.D., and Dorothy Gartner, Ph.D., for their helpful comments on earlier versions of this paper, and Ms. Deloris J. Johnson for her typing and editorial assistance.     

Group intervention for medical patients—A treatment for damaged self-esteem

There is a need to integrate our knowledge of psychoanalytic theory, group therapy and medical care delivery systems. Understanding the importance of selfesteem, based upon the study of psychoanalytic theory, can help to determine appropriate technique in medical groups as well as to add to our understanding of the profound importance of such groups in the delivery of medical care. Groups in hospitals help patients to get in touch with their strengths, feel less isolated, and be more active—all of which enhance selfesteem. As patients participate in groups, narcissistic defenses can be enhanced and the quality of life improved. When interdisciplinary teams participate in patient groups, delivery of medical care can be more comprehensive: The totality of the patient emerges more clearly and staff becomes more aware and sensitive to his/her emotional and physical needs.This paper was presented at Thirty-Sixth Annual Conference, American Group Psychotherapy Association, 1978. The author would like to acknowledge Hazel M. Halloran and Susanne A. Kohut, Director and Associate Director, Department of Social Work, who conceived of and supported the expansion of the group work program in the General Hospital Division of St. Vincent's Hospital and Medical Center of New York. The following professionals contributed clinical material used in this paper: Sara Bookbinder, M.S.W., Carol Coven, M.S.W., Linda Haselman, R.N., Barbara Horn, M.S.W., Kathleen McQuade, R.N., Ellen McGuire, M.S.W., Sister Marita Rose O'Brien, R.N., and Emile Powe, M.D.     

Book Review Section

Books reviewed in this article:
C ros , P ierre , E mmanuel , L ucas L., G amble , R obert B., E t A l . Imagination-Undeveloped Resource
R oe , A nne . The Psychology of Occupations
F raser , J ohn M unro . Psychology: General, Industrial, Social
M aier , N orman R. F., S olem , A llen R., AND M aier , A yesha A. Supervisory and Executive Development: A Manual for Role Playing
U rwick , L yndall F. The Pattern of Management
H emphill , J ohn K. Group Dzmensions: A Manual for Their Measurement
C ampbell , D onald T. Leadership and Its Egects Upon the Group
C alhoon , R ichard P., AND K irkpatrick , C. A. Influencing Employee Behavior
S priegel , W illiam R., S chulz , E dward , AND S priegel , W illiam B. Elements of Supervision
A bruzzi , A dam . Work, Workers, and Work Measurement
S togdill , R alph M., S cott , E llis L., AND J aynes , W illiam E. Leadership and Role Expectations
S elekman , S ylvia , AND S elekman , B enjamin . Power and Morality in a Business Society
S tunkel , E va R ussell , H eitman , S ara M., AND D avidoff , I sabel S. Improving Employment Reference Checks     

Self psychology and group therapy

This paper illustrates how the theories of Heinz Kohut elucidate the curative aspects of group treatment. Group therapy is an ideal milieu in which mirroring, idealizing and alterego transferences can be experienced and worked through. Transmuting internalizations, or psychic structure building, occur when optimal frustration of these needs can be provided by available selfobjects. In group therapy a patient can use the group-as-a-whole, the individual members as well as the leader as potential selfobjects. With the help of individual sessions to reflect on group encounters, a patient can gain a more fully integrated therapeutic experience.The author wishes to acknowledge Susan Sands, Ph.D., Jane Jordan, M.S.W., and Ruth White, Ph.D., for their help.     

Group psychology in the totalitarian system: A psychoanalytic view

The author discusses the ideas of three important psychoanalytic thinkers about group processes in large social groups: Sigmund Freud, Wilfred Bion, and Erich Fromm. Their ideas are developed and applied to analysis of group processes in totalitarian systems, as they were known to the author in Czechoslovakia and the Soviet Union. In conclusion, treatment considerations as they apply to patients who grew up in these regimes are developed and illustrated by clinical cases.This paper is dedicated to Dr. Alexander Wolf, who made his groups growth-promoting, free and holding environments.The author wants to thank Valerie Angel, M.S.W., Eva Papiasvili, Ph.D., Susan Kavaler, Ph.D., Maria Luisa Bastos, Ph.D., and Nancy Smith for their support, critical commentary, and helpful suggestions.     

Book Reviews Section

Book reviews in this article:
B urns , T homas J. (Editor) The Behavioral Aspects of Accounting Data for Performance Evaluation.
C ampbell , J ohn P., D unnette , M arvin D., L awler , E dward E., III, and W eick , K arl E., J r . Managerial Behavior, Performance, and Effectiveness.
K ast , F remont E. and R osenzweig , J ames E. Organization and Management: A Systems Approach.
P owell , R eed M. Race, Religion, and the Promotion of the American Executive.
W asmuth , W illiam J., S imonds , R ollin H., H ilgert , R aymond L., and L ee , H ak C hong . Human Resources Administration: Problems of Growth and Change.
M ueller , E va (with others). Technological Advance in an Expanding Economy: Its Impact on a Cross-section of the Labor Force.
B lake , R obert R. and M outon , J ane S rygley . The Grid for Sales Excellence: Benchmarks for Effective Salesmanship.
F rench , W endell . The Personnel Management Process: Human Resources Administration.
R eddin , W. J. Managerial Effectiveness.
B lack , J ames M. HOW to Get Results from Interviewing: A Practical Guide for Operating Management.
C ohen , J acob . Statistical Power Analysis for the Behavorial Sciences.
L ucas , R ex A. Men In Crisis:. A Study of a Mine Disaster.
G roff , G ene K. and M uth , J ohn F. (Editors) Operations Management: Selected Readings.
N i B hroin , N oirin . the motivation and Productivity of Young Women Workers.
E rdos , P aul L. Professional Mai Surveys.
A dams , S exton and F yffe , D on . The Corporate Promotables.
…Briefly Mentioned
Books and Materials Received     

BOOK REVIEWS

Book reviewed in this article: Frustration and Aggression: By John Dollard and others. Child Psychology: By Skinner and Harriman . The Psychology of Women: By Helene Deutsch , M.D. Rorschach's Test 1.—Basic Processes: By Samuel J. Beck , Ph.D. The Nature and Treatment of Mental Disorders: By Dom Thomas Verner Moore , O.S.B., Ph.D., M.D. Education for Democracy: By J. D. G. Medley . A Plan for Australia. The American Character: By Margaret Mead . Widening Horizons: By P. R. Morris and others.     

Book Reviews

Book Reviewed in this article:
The Fifth Conference on Human Relations in Industry
The Sixth Conference on Human Relations in Industry.
Selecting and Training Negroes for Managerial Positions. (Proceedings of The Executive Study Conference).
C ooper , W illiam W., L eavitt , H arold J., and S helly , M aynard W., II. (Eds.) New Perspectives in Organization Research.
R ichardson , S tephen A., D ohrenwend , B arbara S nell , and K lein , D avid . Interviewing: Its Forms and Functions.
M ott , P aul E., M ann , F loyd C., M c L oughlin , Q uin , and W arwick , D onald P. Shift Work: The Social, Psychological, and Physical Consequences.
The Obstinate Audience . (Report of a Seminar)
M aier , N orman R. F. Psychology in Industry (Third Edition).
T aylor , C alvin W. (Editor) Widening Horizons in Creativity .
K irsh , B enjamin S. Automation and Collective Bargaining .
V room , V ictor H. Motivation in Management.     

Scientific Meetings of The American Institute for Psychoanalysis

PSYCHIC TRAUMA AND ANNIHILATION ANXIETY, Presenter: Marvin Hurvich, Ph.D., Discussant: Martha Sermier, R.N., C.S., Date: October 16, 2003. DECEPTIVELY SIMPLE AND SIMPLY DECEPTIVE: SHAME AND DECEIT, Presenter: Benjamin Kilborne, Ph.D., Discussant: Janice Lieberman, Ph.D., Date: November 20, 2003     

A review of “Human ability”

By C. Spearman, Ph.D. (Leipzig), Hon. LL.D. (Wittenberg), F.R.S., and Ll. Wynn Jones, M.A. (Oxon.), Ph.D. (Leipzig), D.Sc. (Wales). London: Macmillan & Co., Ltd., 1950. Pp. vi + 198. 16s.     

Book Reviews

Books reviewed in this article:
S tagner , R oss . The Psychology of Industrial Conflict
F riedmann , G eorges . Industrial Society
F ryer , D ouglas H., F einberg , M ortimer R., AND Z alkind , S heldon S. Developing People in Industry: Principles and Methods of Training
E dwards , J oseph D ean . Executives: Making Them Click
W alker , C harles R., G uest , R obert H., AND T urner , A rthur N. The Foreman on the Assembly Line
M c M urry , R obert N., et al. Tested Techniques of Personnel Selection
G oldwag , E lliott M. A Survey on the Use of Psychlogical Tests in Selecting Salesmen
P igors , P aul , AND M yers , C harles A. Personnel Administration: A Point of View and a Method
L eonhard , D ietz L. Consumer Research with Projective Techniques
C hapanis , A lphonse . The Design and Conduct of Human Engineering Studies
G ilmour , R obert W. Industrial Wage and Salary Control
P hillipson , H erbert . The Object Relations Technique
C ornell , F rancis G. The Essentials of Educational Statistics
K ornhauser , A rthur , M ayer , A lbert J., AND S heppard , H arold L. When Labor Votes: A Study of Auto Workers
K nox , J ohn B. The Sociology of Industrial Relations
B rown , M ilon . Effective Supervision     

Book Review Section

Books reviewed in this article:
G uest , R obert H enry . Organizational Change: The Effect of Successful Leadership.
B ennis , W arren G., B enne , K enneth D., and C hin , R obert (Editors). The Planning of Change: Readings in the Applied Behavioral Sciences.
B lau , P eter M., and S cott , W. R ichard . Formal Organizations: A Comparative Approach.
E tzioni , A mitai . A Comparative Analysis of Complex Organizations: On Power, Involvement, and Their Correlates.
A rgyris , C hris , et al. Social Science Approaches to Business Behavior.
T annenbaum , R obert , W eschler , I rving R., and M assarik , F red . Leadership and Organization: A Behavioral Science Approach.
M aier , N orman R. F., and H ayes , J ohn J. Creative Management.
B aum , B ernard H. Decentralization of Authority in a Bureaucracy.
de M ontmollin , M. Nouvelles Perspectives dam L'Etude du Travail.
P atchen , M artin . The Choice of Wage Comparisons.
S inaiko , H. W allace . (Editor) Selected Papers on Human Factors in the Design and Use of Control Systems.     

Book Reviews

Book reviews in this article:
D onnette , M arvin D. Personnel Selection and Placement.
B ass , B ernard M., and V aughn , J ames A. Training in Industry : The Management of Learning.
H aire , M ason , G hiselli , E dwin E., and P orter , L yman W. Managerial Thinking: An International Study.
A ndrews , K enneth R. The Effectiveness of University Management Development Programs.
D ickson , W illiam J., and R oethlisberger , F. J. Counseling in an Organization: A Sequel to the Hawthorne Researches.
O ppenheim , A. N. Questionnaire Design and Attitude Measurement.
B eer , M ichael . Leadership, Employee Needs and Motivation.
F lippo , E dwin B. Principles of Personnel Management.
B ritt , S teuart H enderson (Editor). Consumer Behavior and the Behavioral Sciences: Theories and Applications.
B lack , J ames M enzies , and L ynch , E dith M. How to Move in Management: An Executive's Guide to Changing Jobs.
B ennis , W arren G., and S chein , E dgar H. with M c G regor , C aroline (Editors). Leadership and Motivation: Essays of Douglas McGregor.
K err , W illard A., and D unbar , F lorence W. Theory and Problems of Industrial Psychology.
Briefly Mentioned
Books and Materials Received     

Relationship: The bridge to the delinquent child

Summary We have attempted to isolate a crucial component in work with juvenile delinquents and their families. This component, defined as relationship, is felt to be the link between the disorganized, infantile, self-destructive world of the delinquent child, and the organized, productive world of society.We feel that those engaged in either individual or mass efforts to help delinquent children and their families are not operating in opposition to each other. We feel instead that these efforts can complement each other when they are organized, systematized, and utilized along a continuum that has meaning for each individual child and his family. We have expressed the idea that this crucial relationship or bridge can be established, nourished, and built skillfully under controlled conditions by many kinds of trained people.The concept of relationship which is developed in this article is very heavily based on the extensive work done in this area by the following persons: Irving Kaufman, M.D., Harry Durkin Jr., M.D., Thomas Frank, M.D., Lora W. Heims, Ph.D., Dorothea Jones, M.S.S., Joan Zilbach, M.D., and Joy Rabinowitz, M.S.S.The author gratefully acknowledges his long association with this group and the opportunities to crystallize and utilize the concept of relationship building in his work with the Massachusetts Society for the Prevention of Cruelty to Children, the Judge Baker Guidance Center, the Roxbury Chronic Problem Family Project, the Massachusetts Division of Legal Medicine, and the Massachusetts Youth Service Board.     

Little hans's transference

D. W. Winnicott: Playing and Reality. Tavistock Publications, London, 1971. Pp. xiii and 151. Price £2.10.

Louis Minski, M.D., F.R.C.P., D.P.M., and Margaret J. Shepperd, M.R.C.S., L.R.C.P., D.P.M.: Non-communicating Children. Butterworths, London, 1970. Price £2.50.

I. Salzberger-Wittenberg: Psycho-Analytic Insight and Relationships: A Kleinian Approach. Routledge and Kegan Paul, 1970. Price £1.50.

Ed. T. C. N. Gibbens and Robert H. Ahrenfeldt: Cultural Factors in Delinquency. Social Science Paperbacks, Tavistock Publications. Price 75p.