Semantic aphasia: A neglected entity

Three cases of semantic aphasia are reported. Computerized brain tomography showed bilateral temporo-parieto-occipital junction hemorrhages in one patient, and left parieto-occipital junction infarctions in the other two patients. The auditory comprehension defect of the three patients was characterized by preserved understanding of single words and impaired understanding of grammatically complex constructions. It is suggested that this comprehension defect reflects an inability to fully grasp the meaning of words and grammatical constructions imbued with spatial or quasi-spatial significance. Each of the three patients showed a complex spatial disorder that included constructional apraxia, spatial agnosia, and elements of Gerstmann's syndrome. The aphasic as well as the spatial disorder of semantic aphasics may be manifestations of a common defect in the perception of spatial relationships produced by left temporo-parieto-occipital region damage.     

Unexplained chest pain: a review of psychological conceptualizations and treatment efficacy

This review critically considers psychological theories and models used to understand unexplained chest pain, and efficacy of treatment strategies. It discusses the strengths and limitations of current perspectives, and highlights implications for future research and interventions. A comprehensive range of literature examining unexplained chest pain, and published over the last three decades, was thus reviewed finding that, although unexplained chest pain has been examined as a psychological phenomenon for over 100 years, explanatory models have emerged only in the last two decades. Neither psychophysiological nor psychodynamic models have been significantly advanced. Only cognitive-behavioural models have been explicitly derived to explain and manage the condition, and require further refinement to address conceptual and methodological limitations. Studies assessing treatment efficacy suggest cognitive-behavioural therapy as a first-line therapy, but have failed to establish whether the approach is acceptable and effective in routine care. Comprehensive psychological understanding of unexplained chest pain, and its management, is therefore developing but is far from complete. Cognitive-behavioural interventions show promise but are likely to be enhanced by greater theoretical clarity and understanding of resistance to their implementation.     

Sexual asphyxia: A neglected area of study

Sexual asphyxia, a solitary autoerotic activity practiced almost exclusively by males, is examined in this paper. The self‐induced asphyxia may be either chemical or mechanical, and its purpose it to heighten the sexual pleasure. The practice of sexual asphyxia can result in death; however, many such deaths may erroneously be viewed as suicides or homicides as a result of the lack of knowledge of the practice. Sixteen sexual asphyxiai deaths, reported in Dade County (Miami), Florida, are examined in detail. These data confirm that practitioners are overwhelmingly young, white, middle‐class, unmarried males. When the practice is fatal among older practitioners, the data show that some complicating factor, such as the use of alcohol or other drugs, may have contributed to the accident. The most frequent method of inducing the asphyxia was simple hanging by rope and in most cases there was no indication nor suspicion of suicidal intent     

Pastoral care and miscarriage: A ministry long neglected

Ministers often are estranged from the loss experience of women who miscarry. This paper gives medical information about such spontaneous abortions, describes several factors that shape the woman's experience, and explores possible pastoral response.Swanee Hunt is a candidate for Th.D. in pastoral care and counseling at Iliff School of Theology, Denver, Colorado. She is part of an ecumenical ministry team that serves both a Presbyterian church community and a Catholic church community.     

A neglected triangle: Grandmother,mother, and daughter

This paper reports on exploratory research and therapeutic work with a neglected but highly important family triangle, the grandmother-mother-daughter triangle. Some characteristic relationships are described from a clinical sample of 18 daughters for whom such a triangle was important. The triangle may signal both problems and strengths for therapy and the daughters.     

Cardiophobia: a paradigmatic behavioural model of heart-focused anxiety and non-anginal chest pain.

Cardiophobia is defined as an anxiety disorder of persons characterized by repeated complaints of chest pain, heart palpitations, and other somatic sensations accompanied by fears of having a heart attack and of dying. Persons with cardiophobia focus attention on their heart when experiencing stress and arousal, perceive its function in a phobic manner, and continue to believe that they suffer from an organic heart problem despite repeated negative medical tests. In order to reduce anxiety, they seek continuous reassurance, make excessive use of medical facilities, and avoid activities believed to elicit symptoms. The relationship of cardiophobia to illness phobia, health anxiety, and panic disorder is discussed. An integrative psychobiological model of cardiophobia is presented which includes previous learning conditions relating to experiences of separation and cardiac disease; deficient and inappropriate behavioural repertoires which constitute a psychological vulnerability for cardiophobic problems; negative life events, stressors, and conflicts in the person's present situation that trigger and contribute to the symptoms; current affective, cognitive, and behavioural symptoms and their stimulus properties; and genetic and acquired biological vulnerability factors. Finally, recommendations for the treatment of cardiophobia are derived from the model and areas of future research are outlined.     

Payoff: A neglected factor in reaction time measurement

The aim of this paper is to point out some implications of implicit or explicit payoffs in reaction time experiments. In any psychophysical task the subject is given a set of instructions which define the desired performance, as it were the rules of the game. Instructions may be supplemented by knowledge of results which further define the required performance. When performance admits of being “good” or “bad,” however wide these limits, the instructions may be said to define, explicitly or implicitly, a system of payoffs. In reaction time experiments the subject is instructed, amongst other things, to respond as soon as possible after the stimulus but never before it. These instructions could equally well be represented by a system of payoffs and Figure 1 illustrates the kind of payoff system normally implied in these instructions. If S represents the time at which the physical stimulus occurs the graph shows a fixed penalty for anticipations (response before S), maximum positive score for responses immediately following S declining at an arbitrary rate as a function of elapsed time between S and the response until an unacceptably long time involves a constant maximum penalty. Some experimenters choose to treat very short RT's as anticipations. This is represented by the dashed line in Figure 1, but it should be clear that payoff values are, to a certain extent, arbitrary.     

The context of counselling: A neglected dimension of trainings research and practice

The context of counselling includes such factors as the physical environment of the counselling room, the emotional climate of the counselling agency, the relationship between the agency and the community it serves, and the cultural beliefs and values which inform both counsellor and client. It is argued that these factors can make a difference to the relationship between counsellor and client, and the process and outcome of counselling. It is suggested that contextual issues have been largely ignored in counselling theory, research and practice, and that increased attention to context has the potential to contribute to the creation of more responsive and effective counselling services.     

Categories and causality: the neglected direction

The standard approach guiding research on the relationship between categories and causality views categories as reflecting causal relations in the world. We provide evidence that the opposite direction also holds: categories that have been acquired in previous learning contexts may influence subsequent causal learning. In three experiments we show that identical causal learning input yields different attributions of causal capacity depending on the pre-existing categories to which the learning exemplars are assigned. There is a strong tendency to continue to use old conceptual schemes rather than switch to new ones even when the old categories are not optimal for predicting the new effect, and when they were motivated by goals that differed from the present context of causal discovery. However, we also found that the use of prior categories is dependent on the match between categories and causal effect. Whenever the category labels suggest natural kinds which can be plausibly related to the causal effects, transfer was observed. When the categories were arbitrary, or could not be plausibly related to the causal effect learners abandoned the categories, and used different categories to predict the causal effect.     

Quantification and Chicago Social Science in the 1920s: A neglected tradition

This paper discusses the development of quantitative methods by social scientists at the University of Chicago in the 1920s. Chicago sociology, in particular, is frequently characterized by its emphasis upon using field research and personal documents to elicit the actor's definition of the situation. The important developments in quantitative methods in sociology, political science, and psychology at the time are discussed with reference to Ernest Burgess, William F. Ogburn, L. L. Thurstone, Samuel Stouffer, and others. In addition, the contribution made by the institutionalization of social research in the Local Community Research Committee is examined.     

Buddhism: Mistranslations,misconceptions and neglected territory

Ajaan Sujin, a prominent Thai lay teacher of Theravada Buddhism, interprets abhidhammic theory in a manner that, in my view, approaches the teachings of Emptiness as presented in the Prajñā-pāramitā-sūtras and in the Madhyamaka-kārikā. This paper presents an overview of Ajaan Sujin's teachings and compares them with Emptiness as expressed in the Diamond Sūtra, the Heart Sūtra, and the Madhyamaka-kārikā, as well as from a few well-known secondary sources. Core distinctions between the two theories do remain, primarily that for Ajaan Sujin dhammas do have characteristics and nibbāna is distinct from samsāra; thus I have termed Ajaan Sujin's teachings ‘Theravada Emptiness’. While it may seem that these distinctions are too great to overcome in bridging the gap between abhidhammic theory and Emptiness, a direct comparison between the wording of certain sections and the overall correspondence of vocabulary, practice, and other conceptions, serves to narrow the divide created by these distinctions.     

Playing and working through: a neglected analogy

The author proposes an analogy between certain features of playing and aspects of working through. Conceptualizing psychoanalysis as the process whereby unconscious fantasy is uncovered and then subjected to rigorous scrutiny, and building on Freud's (1908) insight that play is the same as fantasy--with the essential difference that fantasy links itself to real objects in play, such as toys and playthings--the author proposes that play can be thought of as not merely symbolic, as a fantasy bearer, so to speak, but as a fantasy tester as well. In the process of working through, some analysands attach their unconscious fantasies not only to a transference object, a primary libidinal object, or a significant loved one, but also to actual props within the analytic setting (a Kleenex box, for example), making the analogy with play even more obvious and palpable.     

Existentialism and family therapy: a neglected perspective

This article describes an approach to therapeutic work with families based more on a value-system about persons in relationship than on an objectively validated scientific view and makes a claim for the contribution of existential philosophy to such endeavour.     

Termination of parental rights: A neglected side effect of infant intervention programs

A significant proportion of infants receiving treatment in programs designed to prevent abuse and psychosocial disorders may be removed from the custody of their parents by social service agencies. In an effort to help distinguish those cases at risk for termination of parental rights (TPR), seven such cases were analyzed and compared to seven similar cases where TPR did not occur. All 14 cases were referred because of abuse/neglect, and were at risk for continued abuse. Results showed that TPR was most likely in families where the parents were viewed as being unpleasant, as having a poor relationship with their child, were seen as retarded by the social service agency, and whose infants showed large gains in developmental level, especially during foster placement. These findings were interpreted as indicating a mixture of actual lack of progress in treatment and a negative attitudinal set about these clients.