Therapist empathy,homework compliance,and outcome in cognitive behavioral therapy for generalized anxiety disorder: partitioning within- and between-therapist effects

Although client-perceived therapist empathy relates to positive therapy outcomes, including in cognitive behavioral therapy (CBT), little is known about how empathy exerts its ameliorative effect. One possible way is by promoting clients’ subsequent homework compliance, a variable that also predicts positive outcomes in CBT. The present study sought to investigate simultaneously, in the context of 43 therapist–client dyads receiving 15 sessions of CBT for generalized anxiety disorder, (1) the association of early client-perceived therapist empathy (averaged over sessions 1, 3, 5) with mid-treatment client homework compliance (averaged over sessions 6, 8, 10); (2) the association of mid-treatment homework compliance on client posttreatment worry severity; and (3) the indirect effect of early perceived therapist empathy on posttreatment worry through mid-treatment homework compliance. Given that clients were nested within therapists, we examined both within- and between-therapist differences in clients’ ratings of therapist empathy and homework compliance, and tested both of these indices as predictors of the relevant dependent variables in a multilevel model. At the within-therapist level (i.e., differences between clients within a given therapist’s caseload), greater early empathy was associated with greater mid-treatment homework compliance. At the between-therapist level (i.e., differences between therapists across all of their cases), greater between-therapist homework compliance was related to lower posttreatment worry. Finally, homework compliance was not found to mediate the relationship between empathy and posttreatment outcome. The results underscore the importance of parsing client and therapist effects, and are discussed with regard to their training and research implications.     

Computerized procedure for analyzing hand kinematics with a peg-moving task (Sarah-Pegworks)

This article describes Sarah-Pegworks, a computerized procedure for analyzing hand kinematics based on the peg-moving task. The procedure, developed in Visual Basic 6 programming language, includes (1) processing raw data from an infrared motion-tracking system, (2) identifying movement components, and (3) analyzing and presenting hand kinematic information in numerical and graphic outputs. Fifty-five normal adults set the parameters relative to filtering and movement identification. A case was presented to illustrate the clinical value of this procedure.     

某院3年医院感染患者细菌分离及耐药性分析

应用WHONET5．3软件对2005年1月至2007年12月检出的1749株病原菌种类、分布及其耐药性进行统计分析。结果发现院内感染病原菌以条件致病菌为主,革兰阴性菌检出率61．8％,革兰阳性菌的检出率33％,真菌检出率为5．2％。大肠埃希菌及肺炎克雷伯菌属的ESBLs阳性率分别为34．4％和48．9％,MRSA和MRCNS的检出率分别为40．8％和36．4％。大多数病原菌对抗生素产生多重耐药性。由此可见,由于临床抗生素的广泛使用,病原菌不断变迁且其耐药性逐渐上升,应加强耐药性监测及合理使用抗生素,以有效控制细菌感染和耐药性播散。     

Stress factors,social support,and violence in Israeli society: A quantitative analysis

In the present study violence in Israel for a period of 32 years (1950-1981) was analyzed, within a stress model according to which the probability of violence and agression as a reaction to stress will increase when social support systems fail or malfunction. Following this model, three types of variables were identified: 1. Measures of stress and social change: to the regular social stressors (i.e., inflation and unemployment), we added two measures of affluence (income per capita and rates of cars) as well as population density. 2. Measures of social support: rates of birth to unmarried mothers and marriage and divorce rates served as measures of the strength of the family. Another measure in this category was rates of psychiatric hospitalization. 3. Measures of violence: in addition to rates of homicide, robbery, and all offenses, inward directed aggression (suicide) was included in this category. At the first stage of the data analysis, Guttman's Smallest Space Analysis (SSA-1) was applied, providing a two-dimensional space diagram of the correlations between the variables. At the second stage, a multiple regression analysis was introduced. The findings indicate that the theoretical model received substantial support mainly from four stress measures (inflation, income per capita, cars, and population density) and one measure of social support (divorce). Unemployment contributed significantly (in the expected direction) only to homicide. Some theoretical implications of the findings, as well as their relevance to some developments in Israeli society are discussed, and suggestions are made for future research.     

预测加工：走出两代认知科学的历史僵局

表征-计算观与具身行动观对认知的本质几乎做了截然相反的强调。近年来,预测加工理论的发展为统一两代认知科学提供了契机。预测加工是层级预测加工与主动预测加工这两大理论部件的合称,前一部件主要继承了第一代认知科学中的层级计算加工进路,后一部件则发扬了第二代认知科学中与行动有关的理论,这两大理论部件被视为同一个统一整合理论的两个不同方面。在当代,预测加工被认为有望成为未来认知科学的新范式。     

A counselling service as a growth centre

The Associates programme at the University of East Anglia is designed as an opportunity for self-development and as a testing ground for those who want to explore their own helping abilities. The structure and content of the programme are described; some examples are provided of the range of follow-up activities which have arisen from it; and attention is given to the potential of the programme as a contribution to the development of the institution as a community.     

COCAINE ADDICTS AND THEIR FAMILIES: AN EMPIRICAL STUDY OF THE PROCESSES OF IDENTIFICATION

The processes of identification between adolescent cocaine addicts and their parents were studied in 402 subjects, in total 134 familial triads (father"mother"son), subdivided into two groups of 67 triads, one of these groups having as the child an adolescent of masculine sex dependent on cocaine and the other, equal in number, being a control group, duly matched for age and socio-economic status. The instrument employed was the Rorschach test (1922), limited to the application of the Lerner Defense Scale (LDS; Lerner & Lerner, 1980). The findings in the affected triads showed up as consistent statistically for the presence of intense processes of pathological identification, especially between father and son, a sign of the importance of the presence of disturbances of paternal function in the development of this addiction. The utilisation of very regressive defence mechanisms, above all of projective identification, was the predominant mode of procedure in triads with a dependent child. In comparisons between the fathers the odds ratio (OR) for projective identification was 8.66 to 1, which points to the association between cocaine addiction and the primitive mental functioning of the fathers. With empirical methodology these findings serve to corroborate the psychoanalytical conclusions based on studies of single case studies, testifying that the dysfunctions of identificatory phenomena in familial functioning are predominant in the mental organisation of cocaine addicts.     

Why Ockham’s Razor should be preferred to the Laser

Philosophical Studies - Ockham’s Razor advises us to not multiply entities (or kinds of entities) without necessity. Recently, Jonathan Schaffer and Karen Bennett have argued that we ought to...