Entrevista con J. D. Frank

RESUMEN

Jerome Frank, posiblemente el autor más provocativo en la línea de considerar que las psicoterapias pueden ser placebos o que éstos deben considerarse como auténticas terapias, responde en la entrevista a algunas de las cuestiones que su reconocimiento de los factores comunes a todas las terapias han planteado a otros profesionales. Comienza explicando que desde la publicación de Persuasion and Healing se han acumulado más datos a favor de su hipótesis de la desmoralización, e introduce algunas clarificaciones terminológicas en relación con el “efecto placebo”. Seguidamente aborda, entre otras, cuestiones tales como las características que se deben considerar al diseñar un grupo control placebo, cómo deben emplearse éstos en el campo de la psicología clínica o su defensa del terapeuta ecléctico, finalizando con algunos comentarios acerca de la eficacia de varias formas de psicoterapia.     

How Should We Assess the Fit of Rasch-Type Models? Approximating the Power of Goodness-of-Fit Statistics in Categorical Data Analysis

We investigate the performance of three statistics, R ₁, R ₂ (Glas in Psychometrika 53:525–546, 1988), and M ₂ (Maydeu-Olivares & Joe in J. Am. Stat. Assoc. 100:1009–1020, 2005, Psychometrika 71:713–732, 2006) to assess the overall fit of a one-parameter logistic model (1PL) estimated by (marginal) maximum likelihood (ML). R ₁ and R ₂ were specifically designed to target specific assumptions of Rasch models, whereas M ₂ is a general purpose test statistic. We report asymptotic power rates under some interesting violations of model assumptions (different item discrimination, presence of guessing, and multidimensionality) as well as empirical rejection rates for correctly specified models and some misspecified models. All three statistics were found to be more powerful than Pearson’s X ² against two- and three-parameter logistic alternatives (2PL and 3PL), and against multidimensional 1PL models. The results suggest that there is no clear advantage in using goodness-of-fit statistics specifically designed for Rasch-type models to test these models when marginal ML estimation is used.     

I feel so sorry! Tapping the joint influence of empathy and personal distress on helping behavior

Observing a person in need usually provokes a compound and dynamic emotional experience made up of empathy and personal distress which, in turn, may influence helping behavior. As the exclusive use of rating scales to measure these two emotions does not permit the analysis of their concurrent evolution, we added the analogical emotional scale (AES) in order to measure how these two emotions evolve throughout the emotional experience, from its onset to its conclusion. Therefore, in two studies, the concurrence of empathy and personal distress was induced, both rating scales and AES were used, and participants were given an unexpected opportunity to help. Two effects were found. First, the helping behavior was lower when personal distress prevailed over empathy at the end of the experience (Studies 1 and 2). Second, this “end” effect was coherent with the nature of the different motives evoked by personal distress and empathy—directed to increasing either one’s own welfare (egoistic) or the victim’s welfare (altruism) (Study 2). These results support the usefulness of combining the rating scales and the AES for gaining a better understanding of the nature and behavioral consequences of complex, compound and dynamic emotional experiences.     

Hermanas de Corazón y Alma

Friendship is a relationship that can traverse generations or be located within a specific era of a person's life. In this article, the author examines the role that her childhood friendship played in shaping her understanding of gender, ethnicity, poverty, immigration, spirituality and family processes. This friendship was during emerging adolescence and helped the author navigate and develop mestiza consciousness. These lessons were reinforced during her graduate training and have influenced her identity as a Chicana feminist therapist and the manner in which she connects with clients in psychotherapy. After presenting the story of her friendship, the author incorporates the theoretical perspectives of Chicana Feminism and Spirita to demonstrate how this friendship has influenced her clinical work with women. Specific themes discussed are language, invisibility, and cultural formulations of gender and spirituality.     

Quality adjusted survival analysis: A neglected application of the quality of well-being scale

Abstract

Background In survival analysis, those who are alive are statistically coded as 1.0 while those who are dead are coded as 0.0. Since everyone who remains alive is given the same score, a person confined to bed with an irreversible coma is alive and is counted the same as someone who is active and asymtomatic. The Quality of Well-being (QWB) scale defines levels of wellness on the continuum between death and optimum function and integrates morbidity and mortality into the same number. This paper demonstrates the effect of including mortality in QWB estimates for male adults with HIV infection.

Method This study involves follow-up of a cohort of 386 male adults participating in the San Diego HIV Neurobehavioral Research Center (HNRC). Patients were evaluated using the QWB at enrollment and at six month intervals. All patients were classified into three stages of HIV disease according to the Center for Disease Control (CDC) classification: CDC IV (symptomatic HIV disease), CDC II or III (asymptomatic infection) and uninfected male controls.

Results QWB scores were calculated with and without mortality included for men in each CDC class who completed a one year (N = 148) or two year follow-up (N = 60). At each evaluation, there were significant differences among CDC classes and inclusion of deaths increased the variance accounted for by CDC class at each evaluation.

Conclusions HIV infection has significant impacts upon both morbidity and mortality. Survival analysis captures only the mortality dimension, while quality adjusted survival analysis using the QWB includes both dimensions. We propose quality adjusted survival analysis as a more sensitive method for assessing outcome in HIV disease and other health conditions.     

Attentional deficits in fibromyalgia and its relationships with pain,emotional distress and sleep dysfunction complaints

Cognitive complaints are common among subjects with fibromyalgia (FM). Yet, few studies have been able to document these deficits with cognitive tasks. A main limitation of existing studies is that attention has been broadly defined and the tasks used to measure attention are not designed to cover all the main components of the attentional system. Research on attention has identified three primary functions of attention, known as alerting, orienting and executive functioning. This study used the attentional network test-interactions task to explore whether and which of the three attentional networks are altered in FM. Results showed that FM patients have impaired executive control (greater interference), reduced vigilance (slower overall reaction time) and greater alertness (higher reduction in errors after a warning cue). Vigilance and alertness showed several relations with depression, anxiety and sleep quality. Sleep dysfunction was a significant predictor for alertness, whereas there were no significant predictors for vigilance. These findings highlight that the treatment of sleep difficulties in FM patients may help with some of their cognitive complaints.     

Job Conditions,Coping and Wellness/Health Outcomes in Spanish Secondary School Teachers

This cross-sectional study is part of EUROTEACH; a project aimed at examining the possible relationships between job conditions and wellness/ health outcomes in teachers from 11 European countries. The Spanish sample consists of 198 (53% female) teachers working in mixed public secondary schools in Alicante. The Job Demand-Control-Social Support (JDCS) model (Johnson and Hall, <citeref rid="bib18">1988</citeref>; Karasek and Theorell, <citeref rid="bib22">1990</citeref>) provides the theoretical framework for the study and specific instruments measuring additional job conditions and coping are applied to investigate these variables in the teaching profession. Moreover, the relationships between the variables are studied to clarify their possible interaction. Results confirm the expected relationship between job conditions and wellness/health effects, and also show the presence of an interaction between coping and the variables in the JDCS model. The need to perform further research on the role of coping, as well as considering other individual variables that might influence teacher occupational stress, is pointed out.     

How Many is Enough? Determining Optimal Sample Sizes for Normative Studies in Pediatric Neuropsychology

The purpose of this investigation was to determine how confidence intervals (CIs) for pediatric neuropsychological norms vary as a function of sample size, and to determine optimal sample sizes for normative studies. First, the authors calculated 95% CIs for a set of published pediatric norms for four commonly used neuropsychological instruments. Second, 95% CIs were calculated for varying sample size (from n?=?5 to n?=?500). Results suggest that some pediatric norms have unacceptably wide CIs, and normative studies ought optimally to use 50 to 75 participants per cell. Smaller sample sizes may lead to overpathologizing results, while the cost of obtaining larger samples may not be justifiable.     

The Catholic Church,moral doctrine,and HIV prevention in Recife,Brazil: Negotiating the contradictions between religious belief and the realities of everyday life

Religious beliefs have had a key role in shaping local responses to HIV and AIDS. As the world's largest Catholic country, Brazil is no exception. Yet little research has been conducted to document how religious doctrine is enacted in practice among its lay leaders and followers. In this article, we present ethnographic research from Recife, Brazil, conducted to understand the way in which religious doctrines are interpreted at a local level. Contextualised within the sociology of contemporary Brazilian Catholicism, we draw on interviews with clergy members, lay leaders, and parishioners to discuss how the Catholic Church's vision of sexuality translates into everyday lives of its followers. We explore the disjuncture between the Catholic ideals of fidelity and delaying sex until marriage with the everyday reality of the Church's followers, highlighting the role that gender plays in defining sexual roles and expectations. We conclude by posing questions for future research and HIV prevention strategies considering the formal institutional response of the Brazilian Catholic Church to AIDS on the one hand, and the social and cultural contexts in which Catholics live their daily lives on the other.