A Sensory Integrative Approach to the Psychotic Child

Current knowledge provides ample evidence of widespread neurological and developmental impairments underlying the behavior of psychotic youngsters. Occupational Therapy can now assess, treat, and make "sense" of the psychotic child's disturbed systems. A case study of a severely disturbed, self-abusing, childhood schizophrenic patient is presented. The treatment process and behavioral changes are discussed and augmented with statistical analysis.     

Toward a construct validation of the Rorschach

The debate over the validity of the Rorschach has been lengthy but unresolved. Major reasons for the lack of consensus and conclusion are the absence of agreement about, how validation research should be conducted and the failure to identify appropriate criteria for subsequent evaluation. A construct validation model for the Rorschach is presented, with guidelines for proper implementation. The difficulties in establishing the optimal relationship between theory, research design, and clinical practice arc discussed. Recommendations for a resolution of these difficulties are presented.     

Child Sexual Abuse: A Multidisciplinary Approach to Case Management

Treatment for child victims of sexual abuse is a complex and sometimes lengthy process involving members of numerous social service agencies. Coordination of services can be accomplished through the use of a multidisciplinary team approach to case management. The author provides information about the roles of various team members as well as suggestions for organizing a child sexual abuse multidisciplinary team.     

Toward a synthetic approach to the Rorschach: the case of a psychotic child.

Much Rorschach research on case material focuses on the utility of a single scoring system, set of variables, or scale in isolation from other systems, scales, or perspectives. This approach fails to acknowledge the complexity of the Rorschach and to reflect the manner in which sophisticated clinicians select and synthesize various perspectives during the clinical inference and decision-making process. A case of a psychotic child is presented to illustrate the utility of a synthetic approach to the Rorschach. The strengths and weaknesses of various Rorschach perspectives in addressing specific diagnostic issues is explored through the case material.     

Severe Disturbance or Trauma-Induced Adaptive Reaction: A Rorschach Child Case Study

In interpreting children's Rorschachs, it is often difficult to discriminate between a severe disturbance and an adaptive reaction to a trauma. To explore this difficult differential diagnostic issue, a child was tested three times. It was suggested that complexity, references to the trauma, and evidence of psychological disturbance are associated with an attempt to master the trauma. Rorschach data were presented and were found to be consistent with these speculations. The author concluded that such "openness" to an environmental stress may allow an adaptive reaction and that understanding Rorschach data in context helps to reduce ambiguity and to recognize the test's limitations.     

Differentiation of Psychotic From Nonpsychotic Psychiatric Inpatients: The Rorschach Perceptual Thinking Index

The aim of the study was to investigate the validity of the Rorschach Perceptual Thinking Index (PTI) to detect psychotic perceptual and thought disturbance in a sample of Slovene psychiatric inpatients. Using a sample of 275 adult psychiatric inpatients of both sexes, we examined the differences between patients with psychosis (PP) and patients with no psychotic features (NP) from various diagnostic groups on the global PTI and its subcomponent variables. PPs obtained significantly higher PTI scores, indicating more disturbed perception and more thinking disturbance, than NPs. No differences were found for diagnostic differences within the PP and NP groups. Results are in accordance with previous studies of the PTI as a valid cross-cultural index of perceptual and thinking disturbance.     

The Rorschach and MMPI: Toward a More Scientifically Differentiated Understanding of Cross-Method Assessment

Reasons for Minnesota Multiphasic Personality Inventory (MMPI) and Rorschach disagreement at the nomothetic level are explored. Building on an understanding of measurement distinctions from other sciences, it is proposed that the Rorschach and MMPI procedures are differentially sensitive to unique manifestations of personality. By necessity, each method is then also recognized as having a limited scope of effectiveness, such that neither can provide a complete picture of personality in its full complexity. Drawing on the more extensive self-report literature, the idiosyncracies and limited scope of the self-report method are documented. Finally, an ideographically rooted, cross-method, configural model is proposed for validation research in personality assessment. Several examples consistent with this approach are drawn from the assessment literature and discussed.     

Toward a Psychodynamic Approach to Bioethics

Although many first-generation bioethicists were psychiatrists and some received psychoanalytic training, the field of bioethics has developed largely in isolation from psychodynamic theory. While much has been written regarding the ethics of psychoanalysis, only a few scholars have attempted to explain bioethical phenomena in psychodynamic terms. This paper argues for the development of a comprehensive theory of "psychodynamic bioethics" that attempts to explain individual and collective attitudes toward bioethical controversy in psychodynamic terms.     

An Approach to Standardization of Rorschach Form-level

The Rorschachs of three cases of ambulatory anorexia nervosa patients showed striking quantitative and qualitative similarities. Analysis of the patterning prompted a diagnosis of conversion hysteria with repressed orality as the suspected dynamism. It was suggested that the Rorschach might prove useful for diagnosing this hysteroid subgroup of patients for the purpose of differential treatment.     

Continued Longitudinal Rorschach Study of a Child for Years Three to Five

The present study was designed to assess whether induced behavioral similarity is reinforcing and, if so, whether it leads to increased subsequent imitation, or whether the increased imitation is a function of the predictability of the observer's responses. Sixty Dutch school age boys and girls participated. The experiment consisted of a modeling-only condition and three (i.e., contingent, noncontingent, and consistent) imitation conditions. All conditions consisted of 15 or less induction trials and 18 modeling trials. Except for the consistent imitation condition, none of the conditions allowed perfect predictability of the observer's responses during induction trials. The results revealed that the contingent imitation of the children's target response did not cause them to demonstrate that response more often and that it did not lead to increased imitations on subsequent modeling trials. By contrast, increased imitation was observed for the one condition suggesting perfect predictability of the observer's imitations.     

From Waiting Room to Mother's Lap: Parameters in Testing a Psychotic,School-Phobic Child

In this article, I discuss the challenging experience of testing a child with severe separation anxiety and school refusal, which reached psychotic-level proportions. Unusual parameters are necessary to provide assessments with severely compromised children. In cases such as these, the goal should be to gather as much useful information as possible, paying particular attention to the conditions, which allow testing to take place. Such information will afford clues to the necessary conditions for providing required therapeutic and educational support.     

Rorschach Content as a Means of Studying Child Development

The qualitative aspects of the content of Rorschach responses of normal 10-and 13-year-old boys have been analysed in order to determine whether significant changes occur between the two age levels. The results show that such changes do occur, and an attempt was made to relate the changes in response content to theories of child development. It was argued that the material is of value not only in corroborating present theory, but also in illustrating areas of development which have so far received limited attention.     

The Relationship Between Rorschach Responses and Attitudes Toward Parents

Effects of self-ideal discrepancy and favorability of content on subjects' acceptance of personality interpretations were studied. Subjects accepted more favorable than neutral statements and more neutral than unfavorable statements. A significant effect was found for self-ideal discrepancy and for the interaction between self-ideal discrepancy and content favorability. In contrast to moderate and low discrepancy subjects, high discrepancy subjects accepted more of the interpretations, accepted more unfavorable, and rejected more favorable interpretations. High discrepancy subjects also accepted more neutral interpretations than did low discrepancy subjects. High discrepancy subjects expected to receive more negative feedback than low discrepancy subjects, and also interpreted this feedback more negatively than did low discrepancy subjects, while scores for the moderate discrepancy subjects were consistently between these two groups.     

The susceptibility of the Rorschach to malingering: a critical review

Empirical studies of malingering on the Rorschach are reviewed. Results from these studies are to this point inconsistent and inconclusive. Although several indices are related to malingering in individual studies, no specific malingering pattern has been found that replicates across studies. A methodological problem specific to this literature is discussed and future research designs are recommended.     

The Open Door: A Structural Approach to a Family With an Anorectic Child

This commentary on a videotape of an initial interview with a family of an anorectic girl demonstrates a set of therapeutic techniques based on a structural view of family organization and dysfunction. In the commentary, the interventions of the therapists are analyzed move by move throughout the session. The goal of the therapists is to assist the family to reorganize itself so that its dysfunctional structure will not support the symptom in the child. During the interview, they probe the characteristic interaction patterns of the family and engage with the family subsystems, making changes in the husband-wife relationship, the parent-child relationships, and the sibling relationships. The connection between the anorectic symptom and the structural organization of the family becomes clearer as the interview unfolds, with the result that the child's eating at the end seems incidental compared to the many changes in family relationships that precede it.     

The Rational-Reality Based Approach to Treating the Criminal Child Abuser

The Rational-Reality based approach to treating child abusers incorporates the philosophies of Rational Behavior Training and Reality Therapy into a therapeutic strategy that helps clients to learn skills in making rational decisions that can aid them in living harmoniously within the family structure. Those persons involved with the practical implementation of theoretical constructs while working in counseling sessions with persons who are child abusers may find that an eclectic approach such as this one is beneficial in teaching people how to increase their skill in reasoning. It seems that this approach to counseling the parental child abuser is a strategy that allows the parent figure to understand and perceive positively the personal benefits that accrue from not abusing the child.     

Toward a Process Analysis of Emotions: The Case of Surprise

Based on an earlier model of the processes elicited by surprising events, the present studies provide evidence for one of these processes, the evaluation of the surprising event's relevance for ongoing activities (action-relevance check). The central prediction tested was that, if unexpected events elicit among other processes an action-relevance check, then response delay on a concurrent task will be more pronounced in a condition where this process is more elaborate and hence takes more time. In accord with this prediction, Experiment 1 found that an unexpected appearance change of the imperative stimulus in a choice reaction time (RT) task caused greater response delay than an equivalent appearance change of a distractor stimulus. Experiment 2 replicated this finding and tested several additional predictions that concerned the effects on response delay of a second appearance change of either the imperative or the distractor stimuli. These predictions, which were also mostly confirmed, were derived by combining the logic underlying the first study with the assumption that once made, appraisals of unexpected events are stored as part of the situational schema and are reused when the same or similar events reoccur leading to an abbreviation of appraisal processes. Experiment 3 once more replicated the basic finding of the previous studies and ruled out a possible alternative explanation. It is suggested that the proposed RT method of process verification may be of broader interest as a tool to study appraisal processes in emotion.