Family therapy alone is not enough or the dirty story of Dorian

When serious malfunctioning of an individual occurs in a secondary system (school, hospital, rehabilitation center, dormitory setting), the tendency often is to focus on the family as both the cause of the malfunctioning and the arena of intervention. Many times, family therapy alone is not enough because a parallel destructive constellation has formed around the Identified Patient in the secondary system as well and the symptoms catalyze that system's own maladaptive patterns. Often the IP is caught in the web of rigid pathological patterns of interactions between the two systems. A unique model of conjoined intersystemic intervention for dealing with such resistance to change is presented.     

The Measurement of Positive Attitudes: The Glass is Half Full

Positive thoughts play a significant role in the experience and recovery from depression. The Coping Attitudes Scale (CAS) is a rationally derived measure of positive cognitions. The CAS contains statements reflective of coping attitudes along five domains: life perspective, personal accomplishment, positive future, self-worth, and coping with problems. The current study examined the CAS in psychiatric outpatients and college students. Measures of depression, hopelessness, suicidal ideation and positive attitudes were administered to 82 adult psychiatric outpatients and 156 college students. Depression and hopelessness were strongly, negatively, partially correlated with each of the CAS factors, after controlling for age. Relationships among individual CAS factors and suicidal ideation demonstrated weak to moderate partial associations, after controlling for age. Depression was significantly associated with the coping with problems subscale (R ² = .530). Hopelessness was significantly related to the positive future subscale (R ² = .696). Further, the CAS demonstrated a significant relationship with depression and hopelessness, even after accounting for the Automatic Thoughts Questionnaire-Revised, Positive subscale. The CAS may be an improved measure of positive attitudes that could be useful in establishing a patient’s baseline of positive thinking, determining targets for therapy, and in monitoring progress in treatment.     

Adaptive memory: Stereotype activation is not enough

Studies have shown that survival processing leads to superior memorability. The aim of the present study was to examine whether this survival recall advantage might result from stereotype activation. To test this hypothesis, we conducted a pilot study and two experiments in which participants were primed with stereotypes (Experiment 1, professor and elderly person; Experiment 2, survival-stereotype). In Experiment 1, 120 undergraduates were randomly assigned to a survival, professor stereotype, elderly person stereotype, or moving scenario and rated words for their relevance to the imagined scenario. In Experiment 2, 75 undergraduates were given a survival, survival-stereotype (based on our pilot study), or moving scenario. Both experiments showed that survival processing leads to a greater recall advantage over the stereotype groups and control group. These data indicate that the mere activation of stereotypes cannot explain the survival recall advantage.     

Mere presence is not enough: Responsive support in a virtual world

When individuals are faced with novel or threatening situations, the presence of a trusted companion should reduce anxiety and promote feelings of security. Attachment theory assumes, however, that mere presence is not sufficient for establishing security; an attachment figure must also be attentive and emotionally responsive. To test this idea, participants came to the lab with their romantic partner and completed a threatening cliff-walking task in a digital immersive virtual environment. The presence and nonverbal support behavior (attentive vs. inattentive) of their partner was experimentally manipulated. Results indicated that participants in the attentive-partner condition experienced the task as less stressful than those who were alone; they also reported feeling more secure during the task and were less vigilant of their partner's behavior compared to those in the inattentive-partner condition. Those in the inattentive-partner condition felt less cared for and kept greater physical distance from their partner on a subsequent task. These findings suggest that human beings are predisposed to monitor their social environment for signs of responsiveness, and that perceived responsiveness, not mere presence, is the key modulator of emotional security.     

When accuracy is not enough: The moderating effect of perceived appraisal use

It is hypothesized that perceived appraisal use in making pay related decisions will moderate the relationship between instrumentality beliefs and appraisal accuracy related variables. Perceived appraisal use was found to moderate the relationship between instrumentality beliefs and perceived appraisal accuracy, supervisor appraisal behavior, and supervisor knowledge of performance.     

When murder is not enough: Toward a new definition of community violence

Homicide classification is classic criminological preoccupation, but criminology and criminal justice are only really ever concerned with the willful kind, which are murder and nonnegligent manslaughter. Other disciplines, such as epidemiology, do not operate such a differentiation and consider all homicides together, as one type of death, a violent one. This study adopts a broader, epidemiological approach to homicide, in order to understand classification effects at the death certification level. In order to achieve this goal, this article presents a procedural analysis of the classification of violent deaths based on systematic observations conducted in a medical examiner's office in an urban area. The ethnographic data show the many different procedural stages leading to death classification. They also uncover the complex web of informal rules, individual influences, institutional limitations, etc., making the classification system based more on “degrees of certainty” rather than a “true/false” statement.     

The story of a ghost

SUMMARY

This paper is concerned with the relationship between psychotherapy and general psychiatry. This relationship is examined from historical, clinical and theoretical perspectives. Psychotherapy is an integral part of psychiatric practice imparting to it a means of participating in, as well as observing, the patient's subjective experiences. Mental illnesses, whatever their nature have fundamental elements in common. This common ground is most apparent when mental illnesses are conceptualised in psychological terms. Such an approach in no way undervalues the importance of the hereditary and somatic influences which contribute to the predisposition to mental illnesses. Viewed in this psychobiological way it is not difficult to discern what is common to neuroses, psychoses and disturbances of the personality. The clinical phenomena provide the basis for a developmental theory which portrays the essential unity of mental illnesses. The paper concludes with a discussion of why psychotherapy is being gradually divorced from clinical psychiatry. The dangers which this separation hold for the clinical tradition in psychiatry are emphasised.     

The problem of parental nonadherence in clinical behavior analysis: effective treatment is not enough

Applied behavior analysts have developed many effective interventions for common childhood problems and have repeatedly demonstrated that childhood behavior responds to properly managed contingencies. The success of these interventions is dependent upon their basic effectiveness, as demonstrated in the literature, their precise delivery by the clinician to the parent, and adherence to or consistent implementation of the intervention. Unfortunately, arranging the consistent implementation of effective parenting strategies is a significant challenge for behavior analysts who work in homes, schools, and outpatient or primary care clinics. Much has been done to address issues of adherence or implementation in the clinic, but relatively little has been done to increase our understanding of the contingencies that affect parental adherence beyond the supervised clinic environment. An analysis of the contingencies that strengthen or weaken adherence might suggest strategies to improve implementation outside the clinic setting. What follows is an analysis of the variables associated with adherence by parents to recommendations designed to solve common childhood problems.     

The locus of the frequency effect in picture naming: When recognizing is not enough

The lexical frequency effect in picture naming is generally assumed to constitute a signature of lexical access. Lexical frequency, however, is correlated with other variables, like concept familiarity, that can produce effects similar to those of lexical frequency in picture naming tasks. In this study, a delayed picture naming task was employed to address the hypothesis that the frequency effect in picture naming is due to variables that affect processing in the perceptual and semantic identification stages (i.e., input stages). Despite the fact that all the input processing stages were completed prior to the presentation of the naming cue, a strong frequency effect was still obtained in this task. These results establish that the lexical frequency effect is independent of variables affecting the input stages of picture naming, and, hence, confirm the lexical frequency effect as a signature effect of lexical access.     

Hope and cardiovascular health-promoting behaviour: Education alone is not enough

We investigated hope’s ability to predict cardiovascular disease (CVD) knowledge and health-promoting behaviours. Snyder defined hope as the combination of goal-directed planning and motivation, and theorised that high-hope people seek knowledge relevant to goal pursuits. We surveyed 391 Latino and Asian participants undergoing CVD risk screening, nearly all immigrants to the USA. This was a particularly important sample because, in general, these populations are considered underserved and under-researched. Pre-screening hope levels were measured. After screening and education, participants rated perceived importance of behaviour change. Behaviour change (salt/fat intake, exercise, CVD information-seeking and visiting a physician) and CVD knowledge were assessed one month later by telephone. Unexpectedly, hope did not predict knowledge. However, hope predicted self-reported behaviour change, though results differed by ethnicity. Among Asian individuals, hope?×?knowledge predicted reduced salt/fat, CVD information-seeking and physician visits. Among Latino individuals, hope?×?perceived importance of diet change predicted reduced salt/fat and hope?×?perceived importance of exercise change predicted increased exercise.     

Language is never enough: memories are more than words reveal

In this commentary I discuss the work by Fivush and Schwarzmueller (1998) including some methodological limitations to their study. It is perhaps because of these limitations that the data do not provide support for their linguistic hypothesis concerning the onset of autobiographical memory. The data do, however, address important issues in the study of autobiographical memory, particularly in terms of very long-term retention and reconstruction of unique (and perhaps distinctive) events that are pleasant. This is a welcome change from the typical studies of recall of distinctive life events in which the target event is one that revolves around unpleasant medical procedures. Future research efforts should continue along these lines, although alternative suggestions are made for which theoretical issues need to be addressed and new measures developed. © 1998 John Wiley & Sons, Ltd.