Countertransference as a guideline in the treatment of a psychotic patient

Presenting vignettes from a long analysis, the author describes many varieties of rage provoked in her by Meagan, a 29-year-old schizophrenic woman, and shows how the countertransference was the primary tool in helping to distinguish among the states, understand their origin, and work them through in the transference.     

Sex differences in feelings attributed to a woman in situations involving coercion and sexual advances.

This study investigated sex differences of feelings attributed to a woman in situations involving varying degrees of coercion and sexual advances. Sixteen vignettes (12 dealing with sex and coercion, 4 dealing with coercion only) were rated on 17 semantic differential scales by 59 undergraduates (44 females, 15 males) and 45 graduate students (18 females, 27 males). The 16 vignettes yielded factors of Sexual Flattery/Overtures, Sexual Aggressiveness, and Violence. Factor analyses of the 17 semantic differential scales yielded factors of Helplessness, Aversiveness, and Threat. High agreement was found between males and females in both the graduate and undergraduate samples on the relative intensity of feelings attributed to the woman across the sex/coercion vignettes for the three dimensions of Helplessness, Aversiveness, and Threat. Even more importantly, systematic differences between males and females on intensity of attributed feelings across the semantic differential factors were independently replicated using the graduate and undergraduate samples. Analyses of variance revealed that males showed significantly greater attributions on the factors Helplessness and Threat on scenes mainly dealing with sexual flattery/overtures, whereas they showed significantly less attributions on the factor Aversiveness on scenes dealing with sexual aggressiveness and rape. In short, while there was strong agreement between men and women, there were also replicated significant systematic differences with men overestimating the psychological impact of less intense incidents and underestimating the psychological impact on women of more intense incidents.     

Perceptions about fleeing religious persecution and entrance to the US

Using four vignettes to study attitudes toward religious persecution, a woman or man aged 22 or 68 came to the US with no supporting documentation. A General Linear Model analysed the 12 items for each vignette. Three items were significant among the vignettes: “All immigration policies and laws should be observed even if it means that M may not be granted permission to stay”; “M’s gender might be an indicator that M wishes to do harm to the US and its citizens” and “M should be deported because s/he entered the country illegally.” Gender and age impact these perceptions.     

Self-Other Perspective and Sexual Attitudes Affect Estimates of Sexual Risk

This study evaluated the effects of self-other perspective, sexual attitudes, and a sexual victimization history on women’s estimates of sexual risk for a set of vignettes describing situations that they may face when interacting socially with men. One hundred and twenty-four women from a medium sized southwestern university in the US were assigned to two different conditions (imagine self vs. an anonymous woman) and asked to rate how risky the situations described were in terms of having an unwanted sexual experience. Results revealed that participants asked to imagine an anonymous woman estimated sexual risk as higher than participants asked to imagine themselves, and that participants reporting liberal sexual attitudes estimated sexual risk as lower than participants reporting more conservative attitudes.     

Treating Adults With Complex Trauma: An Evidence‐Based Case Study

This article presents an overview of complex trauma and a case study describing the evidence‐informed treatment of a 25‐year‐old woman with chronic complex trauma symptoms resulting from childhood sexual, physical, and psychological abuse from a caregiver. Treatment followed a relationship‐based, cognitive behavior therapy model across 3 treatment phases. Significant reductions in trauma and general distress symptoms occurred from pre‐ to posttreatment, although firm conclusions about cause cannot be drawn from case studies. Verbatim vignettes illustrate specific interactions.     

How Do Geneticists and Genetic Counselors Counsel Women from High-Risk Breast Cancer Families?

This qualitative study asked Australian Genetic Counselors and Clinical Geneticists working in cancer genetics to describe their practice when a woman attends a consultation about her family history and her risk of developing breast cancer. Twenty-nine out of 36 Clinical Geneticists/Genetic Counselors returned the questionnaire (82%). Participants identified the key goals of the consultation as (a) identifying the individual needs and concerns of the woman, (b) providing information on genes and chromosomes, (c) giving an individual risk assessment in the context of supportive interaction, and (d) discussing the pros and cons of genetic testing and putting a surveillance plan into place. Respondents emphasized the dual importance of counseling/support and information provision in this setting, suggesting that one could not be given without the other. Implications for clinical practice are discussed.     

Teachers' and education students' perceptions of and reactions to children with and without the diagnostic label "ADHD"

Thirty-four elementary school teachers and 32 education students from Canada rated their reactions towards vignettes describing children who met attention-deficit/hyperactivity disorder (ADHD) symptom criteria that included or did not include the label “ADHD.” “ADHD”-labeled vignettes elicited greater perceptions of the child's impairment as well as more negative emotions and less confidence in the participants, although it also increased participants' willingness to implement treatment interventions. Ratings were similar to vignettes of boys versus girls; however, important differences in ratings between teachers and education students emerged and are discussed. Finally, we investigated the degree to which teachers' professional backgrounds influenced bias based on the label “ADHD.” Training specific to ADHD consistently predicted label bias, whereas teachers' experience working with children with ADHD did not.     

Collected Stories: Play in Four Acts

This article evolved from a group process where members of a psychoanalytic institute were faced with planning workshops for a professional weekend around the theme of “play.” The workshop that evolved consisted of four vignettes of play taking place in the therapeutic sessions of a child, an adolescent, an adult, and an elderly woman. The discussion of these vignettes that began at the conference and then was developed for this article focuses on tracing the development of play from childhood into adulthood (Mayes & Cohen, 1996; Russ, 2004) and on the relationship between play and the development of reflective functioning (Fonagy & Target, 1996). One area of particular interest that was focused upon was the use of play with adults who are described as “concrete,” people who function, at times, at a level of differentiation more typical of a young child. Play is described as being particularly helpful in facilitating a more differentiated and, thus, more reflective mode of psychic functioning for this group of individuals as well as for people at all levels of development.     

Confirmation Bias and the Sexual Double Standard

In contemporary Western societies it is widely believed that there is a sexual double standard such that men are rewarded for sexual activity, whereas women are derogated for sexual activity. This pervasive belief may result in a confirmation bias such that people tend to notice information that confirms the double standard and fail to notice information that refutes it. Two studies were conducted to test this hypothesis. In both studies, participants read vignettes about a target man or a woman that contained an equal number of positive and negative comments regarding the target's sexuality. Participants recalled more information consistent with the double standard than inconsistent with it.     

Psychological self-defense jury instructions: Influence on verdicts for battered women defendants

Ewing (1987) has proposed a new legal doctrine called ‘Psychological Self-Defense,’ which is intended to provide a legal justification for a killing committed under the threat of extremely serious psychological injury. This study examines the effect of such an affirmative defense on the verdict in two vignette cases in which a battered woman killed her abuser. One-hundred ninety-six subjects issued verdicts after reading the case vignettes and a series of jury instructions which varied by self-defense instruction (Psychological Self-Defense Only, Physical Self-Defense Only, Psychological and Physical Self-Defense, or none of these). Only Psychological Self-Defense instructions significantly influenced verdict patterns, primarily by shifting would-be voluntary manslaughter convictions to acquittals.     

Visibility and the Stigmatization of Cancer: Context Matters1

Few experimental studies have been conducted to investigate the effect of disease characteristics, such as visibility, on the stigmatization of cancer. The current study tested the reactions of undergraduates to vignettes that manipulated the visibility of cancer and the context in which help was needed by an individual with cancer. Results showed that participants were less willing to help the target individual when the cancer was visible and the context allowed stigmatization to be subtle. Further research should consider the relationships among disease attributes, the specific context where help is needed, and the stigmatization of individuals with cancer.     

Male honor and female fidelity: implicit cultural scripts that perpetuate domestic violence

Two studies explored how domestic violence may be implicitly or explicitly sanctioned and reinforced in cultures where honor is a salient organizing theme. Three general predictions were supported: (a) female infidelity damages a man's reputation, particularly in honor cultures; (b) this reputation can be partially restored through the use of violence; and (c) women in honor cultures are expected to remain loyal in the face of jealousy-related violence. Study 1 involved participants from Brazil (an honor culture) and the United States responding to written vignettes involving infidelity and violence in response to infidelity. Study 2 involved southern Anglo, Latino, and northern Anglo participants witnessing a "live" incident of aggression against a woman (actually a confederate) and subsequently interacting with her.     

Do adapted vignettes improve medical decision‐making capacity for individuals with Alzheimer's disease?

Medical decision‐making capacity (MDC) is known to decline in individuals with Alzheimer's disease (AD). The vignette method uses hypothetical information as a prerequisite for measuring the capacity to make well‐informed decisions to clinical trials. Our aim was to investigate if adapted vignettes can help individuals with mild AD to assimilate information, make decisions and express them in an understandable way, compared to corresponding decisions based on linguistically more demanding vignettes, as measured by the Swedish Linguistic Instrument for Medical Decision‐making (LIMD). Two vignettes from LIMD were altered linguistically with the aim to facilitate understanding for individuals with AD. An experimental within‐subject design was used to study the influence on MDC of readability (original/adapted vignettes) and content (two different clinical trials). We included 24 patients with mild AD in this prospective study, which read all four vignettes along with a few other tests. This allowed us to investigate the association between MDC and cognitive function. Adapted vignettes did not yield significant differences regarding MDC as compared with original vignettes using a two‐way repeated measures analysis of variance. A difference was found between the two clinical trials where LIMD score was significantly higher for Kidney disease than hypertension vignettes. Our results indicate that adapted vignettes may not improve MDC for individuals with mild AD. MDC was affected by which clinical trial the vignettes regarded, which implies that other factors affecting MDC need to be investigated, like length of text and vocabulary used.     

Truthiness and law: Nonprobative photos bias perceived credibility in forensic contexts

Nonprobative but related photos can increase the perceived truth value of statements relative to when no photo is presented (truthiness). In two experiments, we tested whether truthiness generalizes to credibility judgments in a forensic context. Participants read short vignettes in which a witness viewed an offence. The vignettes were presented with or without a nonprobative, but related photo. In both experiments, participants gave higher witness credibility ratings to photo-present vignettes compared to photo-absent vignettes. In Experiment 2, half the vignettes included additional nonprobative information in the form of text. We replicated the photo presence effect in Experiment 2, but the nonprobative text did not significantly alter witness credibility. The results suggest that nonprobative photos can increase the perceived credibility of witnesses in legal contexts.     

Transitioning from the Battlefield to Home: An Innovative Program for Israeli Soldiers

Soldiers moving from the army to civilian life encounter significant challenges during this time of transition, both in Israel and internationally. Identifying this period of time as a critical one, the Peace of Mind program is an innovative intervention designed specifically to address the issues occurring therein. This unique model focuses on mental health and normalization of responses, as well as on the processing of traumatic experiences. It is based on the considerable experience at the Israel Center for the Treatment of Psychotrauma in the fields of resilience building and trauma treatment. After reviewing the literature on returning soldiers, the model is described and several vignettes are presented.     

Gender bias and individualism: Responses to case vignettes among psychologists, professors, and students

This study examined the extent to which psychologists, when compared to university professors and evening school students, employ individualist values differentially in their responses to vignettes describing males and females. The participants responded to 6 vignettes by choosing initial hypotheses that reflected either utilitarian (tradition-ally masculine) or expressive (traditionally feminine) themes. Two vignettes involved a sex of client manipulation, but neither resulted in a sex of client effect. An analysis of the responses to the remaining 4 vignettes indicated a marked preference for the masculine form of individualism for males, but were evenly divided for females in all three groups. These results suggest that psychologists were just as likely to engage in bias as others.     

Gender bias and individualism: Responses to case vignettes among psychologists, professors, and students

This study examined the extent to which psychologists, when compared to university professors and evening school students, employ individualist values differentially in their responses to vignettes describing males and females. The participants responded to 6 vignettes by choosing initial hypotheses that reflected either utilitarian (tradition-ally masculine) or expressive (traditionally feminine) themes. Two vignettes involved a sex of client manipulation, but neither resulted in a sex of client effect. An analysis of the responses to the remaining 4 vignettes indicated a marked preference for the masculine form of individualism for males, but were evenly divided for females in all three groups. These results suggest that psychologists were just as likely to engage in bias as others.     

Student gender and the probability of referral for counselling in a college of further education

A small pilot study was carried out to investigate whether college tutors' perceptions of students' counselling needs were dependent on the gender of the student. Twenty-five tutors were asked to read six vignettes describing composite case-studies of students showing overt distress. The vignettes were constructed to represent two of each of three types of problem (anxiety, depression and aggression). One of each clinical type depicted a female student and the other a male. The tutors were asked to evaluate each of the six vignettes along a visual analogue scale, according to the perceived urgency of the problem and its long-term nature. The results were then analysed using two-factor within-subjects anovas and unplanned multiple pairwise comparisons to establish whether there existed any differences on these dimensions. Of the analyses computed, it was found that depressive vignettes were considered to be in more urgent need of referral than were anxious or aggressive vignettes; that males were generally considered to have a more urgent need for referral than were females; that anxiety was construed as a less enduring problem than was depression or aggression; and that male aggressive vignettes were considered to be a longer-term problem than were females, anxious or depressive clients. These results indicate that some sex-role stereotyping exists with respect to psychological problems. This is discussed in terms of equal opportunities and access to student support systems.