Occupational Therapy Intervention in the Treatment of Alcoholics

The first section of this article will provide the rationale for all occupational therapists to learn extensively about the isease of alcoholism regardless of area of practice or type of agency where employed. It will offer su estions on how this learning can take place. The second section will take an historic look at occupational therapy literature documenting the use of occupational therapy in alcoholism rehabilitation from 1941 to the present. It will describe modalities currently being used by occupational therapists in alcoholism rehabilitation and discuss expansion of occupational therapy in this practice area.     

Modifications of Yalom's interactional group therapy model as a mode of treatment for alcoholism

As a result of a review of the literature and especially Brown and Yalom's (1977) clinical report, it is suggested that the preferred mode of treatment for alcoholism is group psychotherapy. The group's ability to provide support, structure and reinforcement for abstinence make it a powerful catalyst in the recovery process. In measures of time, efficacy and recovery, group psychotherapy generally succeeds where other treatment modalities frequently fail.     

Leisure Activity Profile Measuring Use of Leisure Time by Persons with Alcoholism

Use of leisure time by persons with alcoholism differs from that of non-alcoholics. Some leisure activities may even contribute to a pattern of heavy drinking. The Leisure Activity Profile (LAP) was designed to identify dysfunctional leisure activity patterns, specifically those activity patterns associated with high levels of alcohol consumption. The initial developmental work on the LAP is described in this article. The LAP includes a list of 38 activities, half of which were selected for their association with alcohol consumption. Respondents indicate the activities in which they participate, and the level of alcohol consumption with each activity. Respondents also indicate if they complete the activity alone or with close friends or relatives. The LAP should prove useful to occupational therapists who treat persons with alcoholism, both in identifying dysfunctional leisure activity patterns and in developing and measuring treatment approaches.     

New perspectives in temperament/personality research: The “Behavioral” model of the Warsaw group

This paper reviews the theory and research of the Warsaw school of differential psychophysiology, which has modified and extended the typologic model constructed by Teplov and Nebylitsyn. While Soviet theory still favors a relatively inflexible structure of nervous system properties as the biologic basis of individual differences in personality, Strelau and colleagues, in line with the action/activity model of Vygotsky and Tomaszewski, begin with the premise that for every individual there is a specific, genetically determined optimal level of arousal, a necessary background for fullest emotional and intellectual development. The person strives to create this optimal climate through an active process of stimulation control, achieved primarily through enhancement or dampening of reactivity—which describes innate responsivity in the reacting systems to both sensory and emotional stimuli—through various hormonal ‘tuning’ mechanisms and through “appropriate” activity, reflected in different cognitive styles and preference for certain work conditions. Such activities aim to ensure comfortable physical and psychologic environments, in which the individual can avoid conflict and stress. The system regulating and integrating such control mechanisms is the core of personality. Investigations of the Warsaw group on relationships between reactivity and different forms of stimulation seeking/control—risk-taking, work style preferences, cognitive style, defense mechanisms, for example—and between reactivity and tolerance of stress and conflict and their speculations about the neurophysiologic and endocrinologic mechanisms of stimulation control are described, as are a number of questionnaires developed by this group to measure reactivity, the temporal parameters of response, and stimulation-seeking in a variety of occupational and social contexts.     

Defense mechanisms in alcoholics attending outpatient treatment. Results from the MCT-test (Meta-Contrast Technique)

Defensive strategies were studied in 72 alcoholics participating in outpatient treatment by using, before the treatment started, the Meta-Contrast Technique, MCT, a percept-genetic method. Alcoholics had less often adaptive strategies than controls. A lack of adaptive defense strategies was related to a more impaired psychic status, more psychological benefits from drinking, and more psychiatric symptoms but not to severity of alcoholism or results of psychometric tests (intellectual level, field-dependence, spatial performance). It does not seem inconceivable that the MCT could be used as a diagnostic tool in treatment planning.     

Distinctive self and occupational member concepts in different occupational preference groups

This investigation attempted to test and extend selected aspects of Super's self-concept theory of career development. Four hundred twenty-eight male college student subjects, representing 39 college majors, selected their most-preferred occupational interest areas from a list of 14 factorially separable areas. The students described both themselves and their most-preferred occupational member concepts with Adjective Check List items. Individuals with demonstrably different self-concepts and occupational preferences displayed differences in the concepts that they held of members of their preferred occupational areas. Relatively distinct dimensions of similarity of self and occupational member concepts among students who preferred the same occupational area were also found.     

Searching for the self: an identity control theory approach to triggers of occupational exploration

Identity control theory researchers have found evidence for two processes of identity development (identity defense and identity change) and have theorized a third process (identity exploration). College students (N = 123) self-rated as high or low in occupational identity certainty and importance received self-discrepant feedback to induce identity disturbance, and dependent measures of identity defense, identity change, and identity exploration were obtained. As predicted, high certainty about identity standards led to identity defense, while low certainty led to identity change. Although an interaction between certainty and importance was hypothesized to predict identity exploration, results showed that the two operated independently. Low certainty predicted exploration of additional occupational areas, whereas high importance predicted exploration of self, environment, and additional occupational areas.     

Alcoholism,Aging, and Cognition: A Review of Evidence for Shared or Independent Impairments

Little is known about the combined effects of aging and alcoholism on cognitive function, in spite of the potential importance of this knowledge. Studies reported to date have focused on whether aging and alcoholism have shared mechanisms (i.e., the premature aging hypothesis) or independent mechanisms. Most have concluded that the effects of aging and alcoholism on cognition operate through independent mechanisms. However, there are reasons to doubt this conclusion. Many of the studies were not optimally designed to discover shared mechanisms because they used a limited range of ages, included several different groups in their analyses, or had low statistical power. Furthermore, interpretation of the patterns of main effects and interactions between aging and alcoholism is not straightforward. Assumptions must be made about the nature of the impairments in order to interpret the data. This review uses several theories of cognitive aging as an organizing heuristic for interpreting the extant data on aging, cognition, and alcoholism. Some potential shared mechanisms for cognitive deficits in aging and alcoholism are identified, such as information processing speed and proactive interference in working memory. In contrast, some potential independent mechanisms are also identified, such as decay from working and long-term memory. These mechanisms should be used as a base to guide necessary further research.     

Searching for the Self: An Identity Control Theory Approach to Triggers of Occupational Exploration

Identity control theory researchers have found evidence for two processes of identity development (identity defense and identity change) and have theorized a third process (identity exploration). College students (N = 123) self-rated as high or low in occupational identity certainty and importance received self-discrepant feedback to induce identity disturbance, and dependent measures of identity defense, identity change, and identity exploration were obtained. As predicted, high certainty about identity standards led to identity defense, while low certainty led to identity change. Although an interaction between certainty and importance was hypothesized to predict identity exploration, results showed that the two operated independently. Low certainty predicted exploration of additional occupational areas, whereas high importance predicted exploration of self, environment, and additional occupational areas.     

Towards a model of female occupational behavior: a human development approach

Substantial evidence suggests that women have added the role of worker to their characteristic adult roles of wife and mother. The inclusion of a work cycle in the female life course is a significant alteration of traditional roles, and is likely to have a major impact on both individual lives and the social structure. However, little has been done to incorporate these changes into theoretical perspectives on occupational development. This paper examines the literature on women and work by reviewing, at the societal level, the trends in female labor force activity since 1900 and, at the individual level, theories of the development of occupational behavior. An integration of these two areas is then suggested through an evaluation of their relevance to the human development paradigm.     

Anger and the Use of Defense Mechanisms in College Students

ABSTRACT It was hypothesized that experimentally induced anger would result in an increased use of defense mechanisms in college students. As predicted from the theory of defense mechanism development, the Thematic Apperception Test (TAT) stories of angered students showed a higher level of use of projection and identification, and the use of these defenses was significantly correlated with the presence of aggressive content in the stories. The results were consistent with previous studies in showing that the predominant defenses of late adolescents are projection and identification, and that men use more projection than women.     

Defense Mechanisms in Mania,Bipolar Depression and Unipolar Depression

The present study compared the use of defense mechanisms in ten bipolar manic, ten bipolar depressed and ten unipolar depressed patients. The defense mechanisms were assessed by two methods: TAT stories scored by Defense Mechanism Manual and Defense Mechanism Rating Scale ratings of psychodynamic interviews. The severity of symptoms was assessed by Beck Depression Inventory for depressed patients and Young’s Manic Rating Scale for manic patients. Both bipolar manic and depressed groups used the defense mechanism of denial, borderline level defenses and immature defenses significantly more than the unipolar depression group. The manic group showed greater dependence on narcissistic level defenses as compared to the other two groups. Positive relationships were found between severity of manic symptoms and the defense mechanisms of denial as well as the narcissistic level defenses. The bipolar depression group also used more action level defenses as compared to the unipolar depression group. The unipolar depression group scored higher on the defense mechanism of identification and adaptive level defenses as compared to the manic group. A negative correlation was found between the severity of depressive symptoms for unipolar depression group and the defense mechanism of identification. The neurotic level defenses were used most frequently by unipolar depression group, followed by the bipolar depression group and manic group. Some of these findings are in consonance with the psychoanalytic understanding of mania and depression.     

Defense Mechanisms in Rational Emotive Cognitive Behavior Therapy Personality Theory

It has been argued that if rational emotive cognitive behavior therapy (RECBT) is to survive and prosper in the present century, the personality theory underlying it requires further development, greater clarification, and more comprehensiveness. In this article it is argued that RECBT personality theory could be further broadened and strengthened by attempting to incorporate the classic defense mechanisms of psychoanalytic theory via stripping them away from Freud’s hypothetical dynamic unconscious and instead resting them on Ellis’s concept of the unconscious. First, to provide proper context, the unconscious and the defense mechanisms are briefly discussed. Then attention is turned to the 10 classic defense mechanisms, discussed one by one. In each described mechanism, the mechanism in question is defined, then placed in the framework of RECBT personality theory along with ample examples. Then the clinical implications of each mechanism are briefly explored, with RECBT practitioners in mind. It is hoped that this discussion will, in some way, help to broaden and strengthen RECBT theory and practice.     

Psychological maturity and change in adult defense mechanisms

Change in the use of defense mechanisms between late adolescence and adulthood was assessed in two different longitudinal studies from the Institute of Human Development. The results were virtually identical: the use of Identification decreased, the use of Denial increased, and there was little change in the use of Projection. Both the use of Identification at adolescence, and its subsequent decrease in adulthood were found to be predicted by ego strength and committed Identity - that is, by evidence of developmental maturity at late adolescence. The decrease in Identification is consistent with predictions from the theory of defense mechanism development: defenses are related to developmental period; once that period is concluded, the use of the related defense declines.     

Seven Pillars of Defense Mechanism Theory

Defense mechanisms are cognitive processes that function to protect the individual from excessive anxiety or other negative emotions. They also protect the person from loss of self‐esteem and, in the extreme, the loss of self‐integration. Although past critics questioned the existence of defense mechanisms, recent research has supported seven basic tenets regarding defenses. These include: (1) defenses function outside of awareness; (2) there is a chronology of defense development; (3) defenses are present in the normal personality; (4) defense use increases under conditions of stress; (5) defense use reduces the conscious experience of negative emotions; (6) defense function is connected to the autonomic nervous system; (7) excessive use of defenses is associated with psychopathology. Research supporting the seven pillars of defense mechanism theory is described in this essay.     

职业可续视角下的工作重塑行为研究：动力、路径及干预机制

社会经济高质量、可持续发展的实现, 须依托具备可持续职业能力的人才来引领、支撑和保障。鉴于此, 本研究考虑职业与日间工作行为的联动效应, 探究个体于工作中实现持续竞争优势的潜在动力、路径及干预机制。首先, 确定职业可持续力的概念界定与结构测量, 并揭示其潜在的影响因素、动态发展机理以及对职业主动行为的作用路径。其次, 结合资源保存理论和社会认知理论, 探究职业可持续力与员工工作重塑行为的动态交互作用机制。最后基于职业可持续视角, 探讨组织层面对个体工作重塑行为的纵向干预机制。本研究将为个体实现职业可持续发展以及组织开展共赢的职业管理支持提供策略依据。     

Defenses, Personality Structure, and Development: Integrating Psychodynamic Theory Into a Typological Approach to Personality

Psychodynamic theory does not conceptualize motivated unconscious defenses primarily in terms of individual traits. Rather, a person's mechanisms of defense are understood in terms of his or her personality structure and level of psychological development. This paper outlines the way in which this perspective has been integrated into a configural approach to personality assessment. The six-group typology based on the Weinberger Adjustment Inventory (WAI) identifies higher-order personality organization through the intersection of self-reported high/low distress and high/moderate/low self-restraint. The framework incorporates a developmental perspective by assessing affect regulation in conjunction with the internalization of self-regulatory controls. The primary defenses of prototypic members of each of the six groups are highlighted, and hypothesized links to personality traits, stages of ego development, attachment styles, and proneness to specific personality disorders are discussed.     

Home,school, and playroom: Training grounds for adult gender roles

Gender differences in children's play activities, preferred school subjects, and occupational goals were examined in relation to such parental variables as toy-giving and chore assignment. Subjects were 245 children in grades K, 3, 6, and 8. Subjects completed questionnaires before and after Christmas asking what gifts they wanted, asked for, received, and liked best. They also were asked to name their friends and play activities, favorite and least-liked school subjects, occupational aspirations, and chores at home. Children generally wanted, asked for, received, and most-liked gender-typical toys. They were less likely to receive requested gender-atypical toys. Children's preferred activities, job aspirations and assigned chores were along gender-typical lines. Girls preferred masculine toys and jobs more than boys preferred feminine ones. With increasing age, both girls and boys increasingly preferred masculine toys and male friends. No gender differences in favorite or least-liked school subjects were found. School subject preference was related to gender-typing of occupational choice for girls but not boys.An earlier version of this paper was presented at the annual meeting of the American Psychological Association, Anaheim, California, 1983.     

“What shall we do with the inebriate?” asylum treatment and the disease concept of alcoholism in the late nineteenth century

During the late nineteenth century a number of physicians, sometimes called inebriety specialists, combined a narrowly physicalistic disease concept of alcoholism with a high regard for the curative power of asylum treatment to advocate the development of specialized asylums for the treatment of alcoholism. Central to the idea of such an inebriate asylum was the belief that the power to detain the alcoholic was necessary to cure his disease. This article considers why inebriety specialists held this belief as well as why others opposed it. It also describes alternative approaches to alcoholism and the fate of efforts, during this period, to treat the alcoholic by confining him.