Redemptive Experience in Relational Family Therapy: A Christian Perspective

We all long for relationships with others, because only in connecting with others can we develop our intrapsychic structure and become functional adults. We are psychologically predisposed to have a constant connection with others and are driven toward relationships with others. Our deepest yearnings are therefore devoted to building solid dialogue as the means of becoming fully human. We, therefore, consciously or unconsciously, long for a relationship where we can experience happiness, satisfaction and, above all, redemption or salvation from our dreads, miseries and unhappiness. In this article we presuppose that a therapeutic relationship, demonstrated in a psychoanalytic setting, namely in relational family therapy, can contain redemptive dimensions in which the inextinguishable longing for salvation is always present.

Relational Psychoanalysis: A Review

Relational psychoanalysis, a relatively new and evolving school of psychoanalytic thought, is considered by its founders to represent a “paradigm shift” in psychoanalysis. The relational approach, initiated by the publication of Jay Greenberg and Stephen Mitchell's book, Object Relations in Psychoanalytic Theory in 1983, has developed into a movement with its own substantially separate literature. This paper reviews both the history and theoretical origins of the relational movement, as well as important theoretical premises and viewpoints now associated with the relational school.     

A Test of Contextual Theory: The Relationship Among Relational Ethics,Marital Satisfaction,Health Problems,and Depression

Few studies have examined the theoretical underpinning of contextual theory. Using structural equation modeling, the relationship among relational ethics (recognized as the most important aspect of contextual theory), marital satisfaction, depression, and illness was examined. Data came from a national sample of 632 mid-life, married individuals. Results supported Nagy’s contextual theory. The total score of the Relational Ethics Scale was a significant predictor of marital satisfaction, and marital satisfaction was significantly associated with depression and health problems. Vertical and horizontal subscales of relational ethics also were significant predictors of depression and health problems through the mediating variable of marital satisfaction.     

Continuum between Relational and Therapeutic Models of Self-help in Mental Health: A Qualitative Approach

Self-help groups are generally described as “group[s] composed of individuals who meet on a regular basis to help one another cope with a life problem” (APA, 2019). Yet, it is challenging to find a univocal definition of self-help groups. Scholars usually use different labels to highlight various features of self-help groups, suggesting the need for further inquiry regarding commonalities and differences. The level of professional involvement is one of the most disputed factors influencing whether a group is considered to belong to the “self-help family.” The present qualitative study aimed to understand how professional support in Tuscany, Italy can influence the organizational choices of these groups (place for meetings, admission criteria, timing, etc.), as well as the personal beliefs of members. The study included 17 self-help groups. During 13 focus groups meetings, 92 participants were interviewed; then, we individually interviewed 19 facilitators and six additional key informants from mental health settings. We used a grounded theory approach, and we discussed the emerging models with participants at a public event. Results show the emergence of two theoretical models to define self-help groups, not to be interpreted as mutually exclusive. The “relational model” refers to self-help groups whose main feature is to guarantee the acquisition of specific skills (social comparison skills, active listening, and empathy), while the “therapeutic model” seems to represent a kind of assimilation of other types of interventions.     

Sex bias in the diagnosis of personality disorders: A different approach

There has been considerable controversy regarding a possible sex bias in the diagnosis of personality disorders (PDs). However, prior research has at times confused a bias within clinicians who fail to adhere to the diagnostic criteria with a bias within the diagnostic criteria. Rather than assess whether females are more likely than males to be diagnosed with a respective disorder, the current study assesses whether the thresholds for the diagnosis of female-typed PDs are lower than the thresholds for male-typed PDs. Subjects completed two self-report inventories for the DSM-III-R personality disorders, and three inventories that assessed 30 aspects of personality dysfunction organized with respect to social dysfunction, occupational dysfunction, and personal distress. There was no indication that the diagnostic thresholds for personality disorders that occur more often in females is lower than the thresholds for the personality disorders that occur more often in males. The implications of these findings for the issue of sex biased diagnoses are discussed.     

A Relational Psychoanalytic Model for Case Management: A Literature Review

Abstract

Relationship building is critical in case management with the seriously mentally ill. A theoretical framework, such as relational psychoanalytic theory, with a strong integrative emphasis provides a structure for the complex interplay of internal and external factors/forces in case management. The purpose of this paper is to provide a literature review in the area of case management: relational psychoanalytic theory, relationship building and psychodynamic theory. The review concludes outlining the appropriateness of this theoretical framework for case management.     

Betrayal: A psychological analysis

Betrayal is the sense of being harmed by the intentional actions or omissions of a trusted person. The most common forms of betrayal are harmful disclosures of confidential information, disloyalty, infidelity, dishonesty. They can be traumatic and cause considerable distress. The effects of betrayal include shock, loss and grief, morbid pre-occupation, damaged self-esteem, self-doubting, anger. Not infrequently they produce life-altering changes. The effects of a catastrophic betrayal are most relevant for anxiety disorders, and OC D and PTSD in particular.Betrayal can cause mental contamination, and the betrayer commonly becomes a source of contamination. In a series of experiments it was demonstrated that feelings of mental contamination can be aroused by imagining unacceptable non-consensual acts. The magnitude of the mental contamination was boosted by the introduction of betrayal themes. Feelings of mental contamination can also be aroused in some ‘perpetrators’ of non-consensual acts involving betrayal. The psychological significance of acts of betrayal is discussed.     

Diverse multi-week physical activity programs reduce ADHD symptoms: A systematic review and meta-analysis

ObjectivePhysical activity (PA) has been proposed as an adjunct treatment and secondary prevention intervention for attention-deficit hyperactivity/impulsivity disorder (ADHD) and oppositional defiant disorder (ODD). However, meta-analyses testing effects on symptoms and functional impairment have yielded conflicting results.MethodsA systematic search of eight databases yielded 15 randomized controlled trial and 2 quasi-experimental design studies—including N = 881 youth (M = 9.75 years, 71% male)—that tested the effects of multi-week PA programs on symptoms and impairment of children with [or at-risk for] ADHD and/or ODD.ResultsRandom effects meta-analyses favored PA groups on omnibus ADHD measures (g = −0.42, 95%CI[-0.62;-0.21]), combined ADHD symptoms (g = −0.50, 95%CI[-0.82;-0.17]), inattention (g = −0.41,95%CI[-0.82; 0.00]), and hyperactivity/impulsivity (g = −0.30, 95%CI[-0.56;-0.04]). Heterogeneity was moderate across studies (I² = 49%, 95%CI[12%-to-70%]). Significant differences favored PA programs whether inclusion required diagnosis, programs augmented frontline treatments, and active or passive comparison groups were utilized.ConclusionDiverse PA programs can reduce ADHD symptoms, especially where they intentionally pursue this end.     

一种多策略认知诊断方法:MSCD方法的开发

当前国内外开发的认知诊断模型基本上只能处理单策略的测验情景,并假设所有被试均采用同一种加工策略/解题策略,从而忽视了加工策略的多样性及差异性.本研究根据de la Torre和Douglas (2008)采用多个Q矩阵来表征多个加工策略的思想,并结合使用丁树良等(2009)修正的Q矩阵理论及孙佳楠,张淑梅、辛涛和包珏(2011)的广义距离判别法,开发了一种新的多策略认知诊断方法——MSCD方法.Monte Carlo模拟研究结果表明:在单策略测验情景下,传统的单策略认知诊断方法与采用MSCD方法的诊断正确率均比较理想,且差异不大;但在多策略测验情景时,传统的单策略认知诊断方法诊断正确率较低,而MSCD方法的诊断正确率却仍较理想;当加工策略增至5种时,MSCD方法仍有较高的边际判准率、模式判准率以及加工策略判准率.研究表明MSCD方法基本合理、可行.这为实现对加工策略的诊断提供了方法学支持,有利于拓展认知诊断在实际中的应用.     

Knowledge and Beliefs about Bulimia Nervosa and its Treatment: A Comparative Study of Three Disciplines

Poor Mental Health Literacy (MHL), i.e. knowledge and beliefs about bulimia nervosa (BN), among health professionals may contribute to low rates of recognition and less optimal management. The aim of this study was to investigate the BN-MHL of health professionals. A total of 534 professionals selected randomly from Internet based lists were surveyed with a MHL questionnaire regarding a fictional vignette of a woman with BN. One hundred and thirty-six dieticians, 68 psychologists and 97 counselors, total 56% (n = 301) responded. The majority of respondents indicated the woman in the vignette suffered from BN (49%) or an eating disorder (20%) and endorsed evidenced based approaches. On post hoc between group analyses there was a trend (p = .02) for dieticians and psychologists to be more likely than counselors to accurately identify the diagnosis of BN. Dieticians and psychologists were also more likely than counselors to endorse a psychologist as the most helpful treatment provider (p<.001) and to be more likely to endorse cognitive behavioral therapy as the most helpful treatment (p<.001). These results indicate a need for greater training and support for non specialist primary care health professionals.     

A Psychometric Analysis of the Child Behavior Checklist DSM-Oriented Scales

The Child Behavior Checklist for Ages 6–18 (CBCL/6-18) possesses newly developed DSM-Oriented Scales, constructed through expert clinical judgment to match selected categories for behavioral/emotional problems as described in the DSM-IV. The present investigation examined the basic psychometric properties for all six DSM-Oriented Scales (i.e., Affective, Anxiety, Somatic, Attention-Deficit/Hyperactivity, Oppositional, and Conduct Scales) in a large clinical sample of children and adolescents (N = 673). Findings from the present study provide strong evidence for the reliability, as well as convergent and discriminative validity, of these scales. It appears that the DSM-Oriented Scales may provide accurate supplementary information that may be considered when formulating clinical diagnoses.

Expectations of Psychotherapy Duration by Disorder: A Comparison Between Professional and Young Adult Expectations

Using more precise methodology, the current study investigated expectations of psychotherapy duration for specific disorders. Duration expectations were obtained for young adults and compared to those obtained from psychotherapists as reported by Lowry and Ross (Psychotherapy: Theory, Research, Practice, Training 34:272–277, 1997). Results revealed that expected duration for young adults by disorder was quite similar to the psychotherapists, where less severe psychological disorders and problems were expected to require shorter treatment durations than moderate and severe disorders and problems. For disorders and problems with which young adults were familiar, their expectations were essentially the same as psychotherapists. A meaningful difference was found for suicidal ideation, with young adults expecting significantly longer treatment duration.     

暴食症的诊断、治疗及其疗效

暴食症已成为目前世界上广泛流行的三大进食障碍之一,我国患者亦不在少数并有增加之势,但对暴食症的研究与治疗尚属起步阶段。文章回顾了暴食症的表征及其诊断技术,简要介绍了常见的三种治疗方法（即行为疗法、认知疗法及伴随症状改善法）,并讨论了影响暴食症疗效的诸个体因素。暴食症的诊断主要是根据美国精神疾病诊断与统计手册第四版（DSM-IV）、进食障碍检测评估表（EDE）（治疗者用）和患者用进食障碍检测问卷（EDE-Q）（患者用）,并结合过往病史和伴随症状。三类治疗方法在理论与操作层面各有倚重,均可收到一定治疗效果。但各疗法的效果与预后会因患者而异甚或迥乎相异,这是因为暴食症疗效还受到患者自身人格、社会和认知诸因素的影响,治疗者应根据特定患者选择适合该患者的疗法。     

The Experience of the Holy: A Relational Psychoanalytic Analysis

The title of this paper, The Experience of the Holy is a direct reference to Rudolf Otto's book Das Heilige. The paper begins with Otto because he lays out many of the important issues involved in a psychological investigation of the experience of the holy, especially the question of whether the sacred is a unique object of experience, or a characteristic of our experience of ordinary objects. The paper then discusses three contemporary relational psychoanalysts (D.W. Winnicott, Hans Loewald, and Christopher Bollas), and the ways in which their theorizing illuminates the psychology of the sacred.     

Human‐Animal Bonds I: The Relational Significance of Companion Animals

The importance of human‐animal bonds has been documented throughout history, across cultures, and in recent research. However, attachments with companion animals have been undervalued and even pathologized in the field of mental health. This article briefly surveys the evolution of human‐animal bonds, reviews research on their health and mental health benefits, and examines their profound relational significance across the life course. Finally, the emerging field of animal‐assisted interventions is described, noting applications in hospital and eldercare settings, and in innovative school, prison, farm, and community programs. The aim of this overview paper is to stimulate more attention to these vital bonds in systems‐oriented theory, practice, and research. A companion paper in this issue focuses on the role of pets and relational dynamics in family systems and family therapy ( Walsh, 2009a ).     

一种多级评分的认知诊断模型：P-DINA模型的开发

当前绝大多数认知诊断计量模型仅适用于0-1评分数据资料, 大大限制了认知诊断在实际中的应用, 也限制了认知诊断的进一步推广和发展。本文对具有较好发展前景的DINA模型进行拓展, 开发出适合多种评分(含0-1二级评分和多级评分)数据资料的P-DINA模型, 同时采用MCMC算法实现模型参数的估计, 并对该模型性能进行研究。结果表明：(1)本文开发的P-DINA模型无论是在无结构型属性层级关系下还是在结构型属性层级关系下, 参数估计的精度均较高, 参数估计的稳健性较强, 说明开发的P-DINA模型基本合理、可行。(2)P-DINA模型可采用MCMC算法实现参数估计, 且参数估计的精度较高。(3)整体来看, 无结构型属性层级关系和结构型属性层级关系下, P-DINA模型在项目参数的估计精度上两者基本相当; 但在被试属性判准率(MMR和PMR)上无结构型属性层级关系表现的稍差一些。(4)无结构型属性阶层关系下：模型诊断的属性个数越多, 参数 估计的精度越差、属性诊断的正确率(MMR和PMR)越低, 但参数 的估计精度越好; 若想保证属性模式判准率在80%以上, 建议诊断的属性个数不宜超过7个。总之, 本研究为拓展认知诊断在教育学和心理学中的应用提供了一种新方法、新模型。     

Assessment and Diagnosis of Eating Disorders: A Guide for Professional Counselors

Despite the prevalence of and risk associated with disordered eating, there are few guidelines for counselors on how to conduct an eating disorder assessment. Given the importance of the clinical interview, the purpose of this article is to provide recommendations for the assessment and diagnosis of eating disorders that (a) specifically focus on assessment in the context of a clinical interview and (b) can be used by counselors whether or not they specialize in eating disorder treatment.     

Disability Rights,Prenatal Diagnosis and Eugenics: A Cross-Cultural View

This paper considers the disability rights critique of genetic testing in the context of different communities and the issue of nondirectiveness. Despite the wide usage of genetic diagnosis in Israel, no public debate has emerged there concerning disability rights and prenatal testing. The common attitude that emerged from interviews with Israeli representatives of organizations “of’’ and “for’’ people with genetic diseases and congenital disabilities can be described as a two-fold view of disability: support of genetic testing during pregnancy, and support of the disabled person after birth. This two-fold view is explained as a secular construction situated in legal, economic and cultural contexts. The paper concludes by considering the implications of the “two-fold view’’ of disability for the profession of genetic counseling. It is argued that awareness of the existence of conflicting views among clients—such as the view of the ‘disability critique’ as well as of the “two-fold view of disability’’—should strengthen the significance of nondirectiveness.     

医患共同决策的具象问题思考——以肺结节诊疗为例

随着健康体检观念的深入及低剂量CT的广泛开展,肺结节的检出率大大提高,而对于其诊断及治疗方案的选择则具有较多的争议,过度诊疗或重视不足都会对患者造成伤害,如何做到正确的诊治从而保证患者的权益,患者的参与及接受程度显得十分重要,医患共同决策(shared decision making,SDM)这一方式在肺结节诊疗过程中的作用不言而喻。通过相关案例初步探索SDM在肺结节诊疗过程中的应用及效果,从而为临床医生及肺结节患者在诊疗过程中提供一种新的思路,也期望这种模式能够得到医患双方的共同认可,减少临床决策中的医患冲突,取得更佳的治疗方案。     

一种应用于中医阴阳五行诊断学说的次协调逻辑(英文)

中医阴阳五行学说博大情深,是中医辨证论治的理论基础,也是指导中医临床诊断与治疗的基本原理,因此对于中医的理论与实践都有着十分重要的价值。但长期以来,一直缺乏对该学说进行严格的形式化研究,使之难以与不断发展中的中医现代化进程相适应。本文就是在这一学说核心内容的基础上,介绍引入次协调逻辑、缺省推理逻辑等先进逻辑来与中医诊断学结合的思想和方法,这样的目的是为今后构造一种符合中医诊断原则的中医阴阳五行推演逻辑系统作准备,该逻辑系统将用来描述基本的中医辨证推演过程。