Symptom substitution: A rational-emotive perspective

Theorists who endorse the concept of symptom substitution reject treatments of psychopathology that do not address the underlying causes of symptoms. They hypothesize that such treatments lead to worsening or relapsing of original symptoms, or the substitution of new for old symptoms. In contrast to behavioristic approaches that dispute this hypothesis, Ellis accepts the concept of symptom substitution. Unlike the psychodynamic positions which are credited with the concept, however, rational-emotive therapy (RET) focuses on changing underlying irrational philosophies and beliefs. Symptom substitution is believed to be prevented in RET by teaching clients to dispute irrational thinking in an ongoing way.The author gratefully acknowledges Leonard G. Rorer for his assistance in the preparation of this article.     

Questioning nuclear waste substitution: a case study

This article looks at the ethical quandaries, and their social and political context, which emerge as a result of international nuclear waste substitution. In particular it addresses the dilemmas inherent within the proposed return of nuclear waste owned by Japanese nuclear companies and currently stored in the United Kingdom. The UK company responsible for this waste, British Nuclear Fuels Limited (BNFL), wish to substitute this high volume intermediate-level Japanese-owned radioactive waste for a much lower volume of much more highly radioactive waste. Special focus is given to ethical problems that they, and the UK government, have not wished to address as they move forward with waste substitution. The conclusion is that waste substitution can only be considered an ethical practice if a set of moderating conditions are observed by all parties. These conditions are listed and, as of yet, they are not being observed.     

Symptom substitution in a male hysteric

The American Journal of Psychoanalysis -     

Sadistic fantasies modified by aversive conditioning and substitution: a case study

A case study involving unpleasant electric shocks as the consequence of sadistic fantasies seems to have successfully helped to suppress or extinguish them while incompatible “normal” sex fantasies were strengthened. The results are seen as analogous to other studies using extinction with aversive stimuli.     

Visual imagery: A case study

This paper describes the performance of a subject who, when presented with a word or a sentence, is abnormally proficient at spelling this material in reverse order. She reports that she does this by visualizing this material and reading off from this visual image. Her tachistoscopic performance is also abnormally good. It is suggested that her superiority in these two tasks is achieved principally because her internal visual representations are extremely resistant to disruption by other mental activities.     

Formal paraphasias: A single case study

A case study is reported of an aphasic patient, RB, who showed frequent form-related whole-word substitutions in oral naming, writing to dictation, and reading aloud. In both written language tasks, the abstractness of the targets influenced the number of formal errors. In oral naming, a high proportion of formal paraphasias was related to the intended words in both form and meaning. A comparison between targets and formal paraphasias indicated a high agreement both in word class, number of syllables, stress pattern, and in basic (stressed) vowels. The agreement in consonants (including word-initial consonants), however, was low. It is argued that RB's formal substitutions are not caused solely by errors of lexical selection but that semantic, lexical, and segmental factors contribute to the error outcome.     

Forgiveness and responsibility: A case study

Pastoral Psychology -     

Symptom structure in obsessive-compulsive disorder: a confirmatory factor-analytic study

Although obsessive-compulsive disorder (OCD) has long been a unitary diagnosis, there is much recent interest in its potential heterogeneity, as manifested by symptom subgroups. This study evaluated existing models of symptom structure in a sample of 203 individuals with OCD. Using confirmatory factor analysis, we examined the ability of each model to account for two levels of data: a priori symptom groupings (second-order) and individual symptoms, identified by the Yale-Brown Obsessive Compulsive Scale symptom checklist. Four models were examined: a single-factor, a two-factor (i.e., obsessions and compulsions), and two multidimensional models, comprising three and four factors. Adequate fit was found solely for the four-factor model--specifying obsessions/checking, symmetry/ordering, contamination/cleaning, and hoarding--but only at the second-order level; it did not account for relationships among discrete symptoms. Parameter estimates showed within-factor heterogeneity, as well as overlap between factors, most notably the two representing checking and contamination-related symptoms. The implications of these findings are discussed. Results provide evidence for the multidimensionality of OCD symptoms, but suggest that a comprehensive model has yet to be identified. They also point to the inadequacy of groupings based solely upon overt behavioural similarities (e.g., 'checking'). Recommendations are made for future research.     

A journey in pastoral care: A case study

What is pastoral care? Many health professionals are not clear about the role of the chaplain on the health care team. This article addresses the question by using an actual case study to demonstrate how the chaplain interacts with the patient and the value of this interaction to the well-being of the patient. It attempts to define, by example, pastoral care.     

The nontraditional female athlete: A case study

Abstract

Current research presents traditional female college student-athletes as unmarried and childless individuals between 18 and 24 years of age. However, many colleges/universities are experiencing increases in the number of nontraditional students returning to higher education following leave from academic involvement. Possibly, this has implications for an increase in nontraditional student athletes. This case study examined a Caucasian female (age 36), Division II state ranked distance runner at an historically Black college. Compared to female athletes discussed in the literature, this nontraditional athlete was similar in motivation, locus of control, self-esteem, and attentional focus. She was different in role conflict, social support, use of imagery, and anxiety experiences. Nontraditional athletes may have different support systems and vary in participation motivations from the traditional athletes in the literature. Practitioners need to understand nontraditional athletes and the influence of lifestyle differences in relation to training and performance. Practitioners working with nontraditional athletes should focus on the impact of lifestyle and role differences on psychological variables related to participation and performance.     

Convergent methodologies in cyber-psychology: A case study

“On-line communities” (and especially MUDs—“multiuser domains”) are a popular, growing Internet phenomenon. This paper provides an overview of a project designed to provide a careful characterization of what “life” is like in LambdaMOO—a classic social MUD—for most, or at least many, members. A “convergent-methodologies” approach embracing qualitative and quantitative, subjective and objective methods was used to generate a large and rich database on this on-line community in terms of four general categories: (1) users and use, (2) sociality, (3) identity, and (4) spatiality. The evidence thus far appears to debunk some of the more provocative claims of widespread MUD addiction and rampant identity fragmentation on line. While supporting the primary importance of sociality in the MUD, the results also demonstrate the strong prevalence of personal, one-on-one social interactions over larger social gatherings. Finally, some close correspondences between patterns of spatial behavior and spatial cognition “in real life” and in LambdaMOO were found.     

Pupil perceptions of counselling: A case study

Using a case-study school with a highly-developed counselling service employing three trained school counsellors, pupil perceptions of counsellors are examined in terms of their duties within the school and their potential helpfulness. Despite the fact that many of the features of the school were ideally adapted to the effective development of counselling, the counsellors were broadly perceived as senior teachers with a great deal of administrative responsibility. Few of the pupils indicated a willingness to approach any of the counsellors voluntarily with a personal problem.