How to study the ‘quality of psychoanalytic treatments’ and their long‐term effects on patients' well‐being: A representative,multi‐perspective follow‐up study3

How can we study the ‘quality of psychoanalytic treatments’? The authors attempt to answer this question by discussing a naturalistic, multi‐perspective and representative follow‐up study of psychoanalyses and long‐term psychoanalytic psychotherapies. We studied a representative sample (n = 401) of all the patients who had terminated their psychoanalytic treatments with members of the German Psychoanalytical Association (DPV) between 1990 and 1993. Between 70 and 80 per cent of the patients achieved (average 6.5 years after the end of treatment) good and stable psychic changes according to the evaluations of the patients themselves, their analysts, independent psychoanalytic and non‐psychoanalytic experts, and questionnaires commonly applied in psychotherapy research. The evaluation of mental health costs showed a cost reduction through fewer days of sick leave during the seven years following the end of long‐term psychoanalytic treatments. The results achieved using non‐psychoanalytical instruments are complemented by the richness of the idiosyncratic findings, gained by the psychoanalytic research instruments.     

Individual distress and dyadic adjustment over a three‐year follow‐up period in couple therapy: a bi‐directional relationship?

This study examined the relationship between depressive symptoms and dyadic adjustment, as well as between interpersonal problems and dyadic adjustment, during residential couple therapy and at a three‐year follow‐up (N=106). Mixed models were used in the analyses. Significant improvement (p<.001) occurred on all measures from admission to discharge (effect sizes .27?.83) and from admission to three‐year follow‐up (effect sizes .52?.79). During the observation period, improvement in depressive symptoms at the first time point predicted improvement in dyadic adjustment at the subsequent time point. Furthermore, the dyadic adjustment level at discharge predicted improvement in depressive symptoms in the follow‐up period. There were only modest associations between personality variables and dyadic adjustment. The clinical implication is that in couples suffering from co‐existing relational and symptomatic distress, couple therapy should include the aim of lowering depressive symptoms.     

Adolescents born extremely preterm: behavioral outcomes and quality of life

Fifty-two extremely premature born and 54 full-term controls were assessed regarding behavioral outcomes, risk-taking and self-perceived quality of life. Behavioral outcomes were assessed with the Achenbach Youth Self Report; risk-taking was estimated regarding alcohol and nicotine use; self-perceived quality of life and future expectations were rated; and attention and hyperactivity problems were surveyed retrospectively with the Wender Utah Rating Scale. The prematurely born reported fewer problems than full-term born on the externalizing scale (delinquent behavior and aggressive behaviour); and they reported less alcohol consumption. No difference was observed between the two groups concerning nicotine use, views about quality of life and expectations for the future or in the retrospective assessment of attention and hyper-activity problems. Conclusively, the prematurely born adolescents described a quality of life and future expectations comparable to full-term born controls. They also reported fewer behavioral problems and less risk-taking behavior.     

研究性访谈及其应用现状和展望

在科学研究中,研究性访谈作为一种定性研究方法得到了广泛的应用,然而这种定性方法在当前的研究领域中并没有受到足够的重视。本文立足于研究性访谈这种重要的研究方法,着重讨论三个问题：一是研究性访谈的概念、分类和程序;二是目前关于研究性访谈的方法论研究;最后对研究性访谈的应用和发展进行了评价和展望。作者认为结构因素可能是影响访谈效度的主要因素;而信度与结构化、标准化、主试培训等因素有关;社会背景和访谈情境的交互作用将成为未来访谈研究的新趋势;研究性访谈在我国的应用存在一定的文化适应问题,并有待加强和科学化。     

Can the Dead be Brought into Disrepute?

Queen Christina of Sweden was unconventional in her time, leading to hypotheses on her gender and possible hermaphroditic nature. If genetic analysis can substantiate the latter claim, could this bring the queen into disrepute 300 years after her death? Joan C. Callahan has argued that if a reputation changes, this constitutes a change only in the group of people changing their views and not in the person whose reputation it is. Is this so? This paper analyses what constitutes change and draws out the implications to the reputation of the dead. It is argued that a reputation is a relational property which can go through changes. The change is “real” for the group changing their views on Queen Christina and of a Cambridge kind for the long dead queen herself. Cambridge changes result in new properties being acquired, some of which can be of significance. Although the dead cannot go through any non-relational changes, it is possible for the dead to change properties through Cambridge changes. In this sense changes in reputation do affect the dead, and thus Queen Christina can acquire a new property, in this case possibly a worse reputation.     

Are waves of relational assumptions eroding traditional analysis?

The author designates as ‘traditional’ those elements of psychoanalytic presumption and practice that have, in the wake of Fordham's legacy, helped to inform analytical psychology and expand our capacity to integrate the shadow. It is argued that this element of the broad spectrum of Jungian practice is in danger of erosion by the underlying assumptions of the relational approach, which is fast becoming the new establishment. If the maps of the traditional landscape of symbolic reference (primal scene, Oedipus et al.) are disregarded, analysts are left with only their own self‐appointed authority with which to orientate themselves. This self‐centric epistemological basis of the relationalists leads to a revision of ‘analytic attitude’ that may be therapeutic but is not essentially analytic. This theme is linked to the perennial challenge of balancing differentiation and merger and traced back, through Chasseguet‐Smirgel, to its roots in Genesis. An endeavour is made to illustrate this within the Journal convention of clinically based discussion through a commentary on Colman's (2013) avowedly relational treatment of the case material presented in his recent Journal paper ‘Reflections on knowledge and experience’ and through an assessment of Jessica Benjamin's (2004) relational critique of Ron Britton's (1989) transference embodied approach.     

Explaining the procedural justice–perceived legitimacy relationship: Relying on relational concern or instrumental concern?

People can extract relational information (i.e., relational concern) as well as instrumental information (i.e., instrumental concern) from decision‐making procedures. Thus, both instrumental and relational concerns are assumed to influence the procedural justice–perceived legitimacy relationship. Drawing from social exchange theory, the different kinds of concerns may lead to form different exchange relationships (social exchange relationship vs. economic relationship), which can be indicated by two forms of trust (affect‐based trust vs. cognition‐based trust). We built a model of trust mediation in which procedural justice predicted affect‐based and cognition‐based trust. Further, we also tested the hypothesis that high (compared with low) group identification individuals are more likely to rely on relational concern to construct procedural justice and judge legitimacy of authority, because they use procedural fairness information to infer the quality of their relationships with the authority. The results of an experiment (Study 1) demonstrated that both affect‐based trust and cognition‐based trust mediated the procedural justice–perceived legitimacy relationship. Moreover, a field study (Study 2) showed that affect‐based trust mediated the relationship between procedural justice and perceived legitimacy primarily among individuals with high group identification whereas cognition‐based trust mediated this relationship primarily among those with low group identification.