Assessment of Parents,Couples, and Families in Dialectical Behavior Therapy

Family intervention in Dialectical Behavior Therapy (DBT) is a core part of multiple required functions of DBT, providing opportunities for skill training (including relationship-specific skills that are not covered in individual DBT), skill generalization, and direct intervention into the social and family environment. In order to intervene with parents, partners and other family members efficiently and effectively, therapists must first conduct a careful assessment. The core relationship transaction of emotion vulnerability/dysregulation and inaccurate expression leading to invalidating responses (and vice versa) is highlighted, as are the treatment targets in DBT with families, which inform assessment targets. Then, two core assessment procedures are explored, with clinical examples: (a) conducting “double chain” analyses, demonstrating how one person’s social or relationship responses affect the other’s emotional arousal (and vice versa); and (b) direct behavior observation of family interactions, which allow treatment targets to be identified efficiently. These two assessment strategies may also be combined. Implications for family interventions are discussed.     

The elusive tradeoff: Speed vs accuracy in visual discrimination tasks

Theoretical models for choice reaction time and discrimination under time pressure must account for Ss’ ability to trade accuracy for increased speed. The fast guess model views these tradeoffs as different mixtures of “all-or-none” strategies, while incremental models assume they reflect different degrees of thoroughness in processing the stimulus. Three experiments sought tradeoffs for difficult visual discriminations, using explicit payoffs to control and manipulate pressures for speed and accuracy. Although guessing was pervasive, the simple fast guess model could be rejected; Experiments II and III obtained tradeoffs even when fast guesses were purged from Ss’ data. Tradeoff functions fit by several formulations revealed: (1) slower rates of increase in accuracy for more similar stimuli, and (2) substantial “dead times” (80–100 msec slower than detection times) before discrimination responses could exceed chance accuracy. Errors were sometimes faster and sometimes slower than correct responses (depending on S’s speed-accuracy trade); the latter effect may reflect a ceiling on S’s achievable accuracy. A final discussion examines implications of the results for models of discrimination under time pressure; it suggests modifications in present models, focusing on the random walk model, and describes an alternative “deadline” model.     

Enhancing the Cognitive Vitality of Older Adults

Aging is associated with decline in a multitude of cognitive processes and brain functions. However, a growing body of literature suggests that age-related decline in cognition can sometimes be reduced through experience, cognitive training, and other interventions such as fitness training. Research on cognitive training and expertise has suggested that age-related cognitive sparing is often quite narrow, being observed only on tasks and skills similar to those on which individuals have been trained. Furthermore, training and expertise benefits are often realized only after extensive practice with specific training strategies. Like cognitive training, fitness training has narrow effects on cognitive processes, but in the case of fitness training, the most substantial effects are observed for executive-control processes.     

Mixed-modality psychophysical scaling: Double cross-modality matching for “difficult” continua

In mixed-modality psychophysical scaling, stimuli from different modalities are presented alternately for judgment on the same scale. The usual purpose is to produce cross-modality matching functions without actually doing cross-modality matches. This paper reports the results of two experiments that extend the method to situations in which the responses, themselves crossmodality matches on an easy-to-control continuum (duration), are used to derive matching functions for two difficult-to-control continua (here loudness and brightness). Derived cross-modality matching functions are highly similar to those obtained from magnitude estimation or category judgment responses. First- and second-order sequential dependencies also closely resemble those found in data from the methods that employ numerical response scales, with one exception. For the first time in these studies of mixed-modality scaling, current responses sometimes were found to be weakly contrasted to the values of previous stimuli of different modality from the current stimulus. The various sequential dependencies found may arise from different levels of processing, with intramodal response-stimulus contrast arising from sensory differentiation, inter- and intramodality response-response assimilation from perceptual categorization processes, and intermodality response-stimulus contrast from cognitive expectancies.     

Intermanual interactions during programming of aimed movements: Converging evidence on common and specific parameters of control

Summary Reaction time for choice between left-hand and right-hand responses sometimes depends on whether the responses assigned to the two hands are the same or different, but sometimes it does not. It has been suggested that the result obtained indicates whether the variable on which the responses differ is determined by common or specific parameters of control. Common parameters apply to movements of both hands, but specific parameters can be set independently for left-hand and right-hand responses. The interpretation of choice RT in terms of intermanual interactions requires that the conclusions converge with conclusions that are based on studies of simultaneous movements, provided that interactions can indeed be attributed to common parameters. Results from the latter type of experiment suggest that duration of aimed movements is determined by common parameters, but amplitude is determined by specific parameters. In two experiments it is shown that the choice-task results are consistent with this conclusion: Choice RT increases when the choice is between aimed movements that differ in duration, but not if the choice is between movements of different amplitudes. Further, an assimilation of responses is found in the former case but not in the latter. These findings are taken as further support for the notion of intermanual interactions during motor programming.     

Two types of pigeon key pecking: suppression of long- but not short-duration key pecks by duration-dependent shock

The key pecking of eight pigeons was maintained on a variable-interval 1-minute schedule of food reinforcement. Sometimes, all responses between 35 and 50 milliseconds in duration produced a shock; sometimes, all responses between 10 and 25 milliseconds produced a shock; sometimes, shocks were produced by pecks without regard to duration (nondifferential punishment), and sometimes shocks were delivered independently of responding. Punishment of 35- to 50-millisecond responses selectively suppressed those responses, while punishment of 10- to 25-millisecond responses and nondifferential punishment suppressed responding overall but did not suppress responses of particular duration. Punishment of 35- to 50-millisecond responses suppressed key pecking slightly less than did nondifferential punishment. Punishment of 10- to 25-millisecond responses and response-independent shock produced roughly equal amounts of suppression, substantially less than the other punishment procedures. The data support the view that there are at least two kinds of key peck, identifiable on the basis of duration, one of which (short duration) is insensitive to its consequences.     

Criminal Rehabilitation Through Medical Intervention: Moral Liability and the Right to Bodily Integrity

Criminal offenders are sometimes required, by the institutions of criminal justice, to undergo medical interventions intended to promote rehabilitation. Ethical debate regarding this practice has largely proceeded on the assumption that medical interventions may only permissibly be administered to criminal offenders with their consent. In this article I challenge this assumption by suggesting that committing a crime might render one morally liable to certain forms of medical intervention. I then consider whether it is possible to respond persuasively to this challenge by invoking the right to bodily integrity. I argue that it is not.     

Some technical problems of countertransference

There are several aspects of the psychoanalytic interaction that foster the emergence of countertransference. First is a persistent identification with the patient, based primarily on the sharing of unconscious fantasies. Then there is the evocative power the patient's material may have upon latent unresolved conflicts in the analyst. Finally, the analytic setting itself may evoke a broad range of countertransference responses. Particular attention must be paid to those interventions of the analyst which represent attempts to divert his own and the patient's attention from emerging derivatives of the conflicts. There are many clues that should alert the analyst to the possibility of interfering countertransference.     

IS MY FEELING YOUR PAIN BAD FOR OTHERS? EMPATHY AS VIRTUE VERSUS EMPATHY AS FIXED TRAIT

The purpose of this article is to (1) critique the primary arguments given by Paul Bloom and Jesse Prinz against empathy, and (2) to argue instead that empathy is best understood as a virtue that plays an important but complicated role in the moral life. That it is a virtue does not mean that it always functions well, and empathy sometimes contributes to behavior that is partial and unfair. In some of their writings, both Bloom and Prinz endorse the view that empathy is a fixed trait, but there is little reason to think this, and the studies that they cite do not support this view. Further, a number of recent studies suggest the opposite: our empathic reactions are malleable and subject to environmental effects and learning. Although our capacities for cognitive and emotional empathy are clearly not sufficient for being moral, I argue that they are functionally necessary traits that, like other virtues, must be cultivated correctly.     

Some Thoughts on Supervision

Quite often we have the experience that adolescents do not accept an offer of treatment, in spite of the fact that they feel miserable. Or, that they do start in treatment and then change their minds and break off contact. The author reflects about factors and conditions contributing to these analytic failures. He discusses elements of analytic method, setting, neutral position, analytic relationship, and how the frames are put under pressure in work with adolescents. He thereafter presents some vignettes and examples of analytic work, where intuitive interventions and interpretations appear against a background of ordinary psychoanalytic method. For the analyst, these interventions can feel unexpected, incidental, like ideas out of the blue. On second thoughts, we may sometimes be able to trace and understand how these intuitions are based on non-conscious processes, like counter-transference feelings, an understanding of the patient still unclear and unarticulated for the analyst or perhaps a last desperate attempt to reach the patient and get in contact at a decisive or critical moment. Finally, the author reflects on the double face of psychoanalysis: both a contemplated, carefully described and systematic method and a craft with elements of intuition, creativity and, sometimes, inspiration.     

Considering olfactory stimulation for adults with age-related dementia.

Behavioral interventions and activities for adults with age-related dementias sometimes use olfactory stimulation; however, limitations to the usefulness of such stimulation are suggested by both neurological studies which show a large amount of degeneration in the cells of the olfactory bulb and studies of perception which indicate that adults with Alzheimer's disease and related dementias perform poorly on tests of smell identification and detection. Current approaches to using olfactory stimulation as a component of interventions for adults with age-related dementia may need to be either abandoned or reassessed.     

Opening the black box: Presenting a model for evaluating organizational-level interventions

Organizational-level occupational health interventions are often recommended when improvements in working conditions, employee health, and well-being are sought within organizations. Research has revealed that these interventions result in inconsistent effects despite being based on theoretical frameworks. This inconsistency indicates that intervention studies need to be designed to examine directly how and why such interventions bring about change and why they sometimes fail. We argue that intervention studies should include a process evaluation that includes a close examination of the psychological and organizational mechanisms that hinder and facilitate desired intervention outcomes. By drawing on existing intervention literature we present an evidence-based model containing three levels of elements that appear to be crucial in process evaluation. We describe how this model may be applied and developed in future research to identify better the mechanisms that link intervention processes to intervention outcomes.     

Is cognitive therapy consistent with what we know about emotions?

The cognitive perspective has been a dominant force in psychology and psychotherapy since the 1970s. Cognitive therapies share an emphasis on the priority of changing cognition as the key to bringing about changes in patterns of dysfunctional emotional reactions and symptomatic behaviors. In this article, the author examined the basis for the assumptions of cognitive therapy in the context of recent evidence of the long-term effects of stressful experiences. This evidence contradicts the assumption of many cognitive therapists that changing cognition is prior to and necessary to changing emotional reactions. Neurobiological evidence indicates that emotions can be experienced without cortical interpretations of stimuli, and clinical evidence indicates that experiences can be stored as isolated affective fragments that function later to distort cognition. This suggests that cognitive therapies are based on a limited model of mental functions that sometimes must be supplemented by broader psychodynamic concepts if lasting changes are to occur.     

Does The Necessity of Mathematical Truths Imply Their Apriority?

It is sometimes argued that mathematical knowledge must be a priori, since mathematical truths are necessary, and experience tells us only what is true, not what must be true. This argument can be undermined either by showing that experience can yield knowledge of the necessity of some truths, or by arguing that mathematical theorems are contingent. Recent work by Albert Casullo and Timothy Williamson argues (or can be used to argue) the first of these lines; W. V. Quine and Hartry Field take the latter line. I defend a version of the argument against these, and other objections.     

Response competition and stimulus preference in the treatment of automatically reinforced behavior: a comparison

Clinicians are particularly challenged by the development of interventions for behavior maintained by automatic reinforcement because reinforcers that maintain the responses often cannot be directly observed or manipulated. Researchers have conducted either preference assessments or competing items assessments when developing effective treatments for behavior maintained by automatic reinforcement. However, interventions based on these assessments have not been directly compared. The current study evaluated procedures to make such a comparison. High-competition items resulted in greater reductions in vocal stereotypy than did high-preference items for a preschool boy with autism.     

Homeless youths and HIV infection.

Risk of human immunodeficiency virus (HIV) infection exacerbates the already difficult lives of 1.5 million homeless adolescents in the United States. Homeless youths engage in sexual and substance-abuse behaviors that place them at increased risk of contracting HIV, and they demonstrate other problem behaviors that reduce their coping responses. Model HIV prevention programs and interventions for HIV-positive youths, implemented for homeless adolescents, need to be disseminated on a national level. Social policies must recognize adolescents' rights to satisfaction of basic survival needs; comprehensively address the needs of dysfunctional, disenfranchised, and single-parent families; and provide continuity of care for adolescents to facilitate independent living. Special provisions must be made when designing programs for gay, sexually abused, and substance-abusing youths.     

ESCHATOLOGY IN THE POLITICAL THEORY OF MICHAEL WALZER

This essay examines the relevance of eschatological themes to the political theory of Michael Walzer. A distinctive eschatological hope is identified, which functions as a guide to thought throughout Walzer's writings, even though he seldom expresses it (and sometimes denies it). This analysis of Walzer's work demonstrates that eschatology is relevant to the contemporary discussion of justice, and conversely, that contemporary political theory can be a guide for the construction and evaluation of theological doctrines of eschatology. Any eschatology that enters into political debate in a modern, pluralistic society like the United States, however, must have at least one important characteristic: it must be informed by a profound sense of limitation.