Some brief considerations on the relationship between theory and practice

The present crisis in models of training and in psychoanalytical education in general can be linked to the gulf that has come to be created between analytical theory and clinical practice. The paper(1) examines the historical facts that have led to this split and suggests the need to return to the models of Freud and Jung. Both these fathers of depth psychology stressed the dangers inherent in the dogmatic use of theory and both insisted that theory must always spring from and be able to account for clinical practice rather than vice versa, as is so often the case today. The paper also looks at how theory should be taught in our analytical institutes in order to ensure that what we transmit to our candidates is not knowledge in the form of dogma but rather a way of proceeding that will enable them to think creatively about their clinical practice and thus produce new knowledge, essential if depth psychology is to remain relevant to our post-modern culture.     

Partner effects of Mexican cultural values: the couple and parenting relationships

In this investigation, the authors explored the impact of individuals' cultural values on their partners' relationship adjustment and perceptions of their parenting relationship. The authors examined Mexican cultural values of simpatía (i.e., harmonious interpersonal relationships) and respeto (i.e., respect for authority figures) using a sample of 50 Mexican-origin couples in southern Arizona. Congruent with their hypotheses, results supported the proposition that fathers' simpatía is positively associated with both relationship adjustment and the parenting relationship as reported by mothers, whereas fathers' respeto is negatively associated with both relationship adjustment and the parenting relationship as reported by mothers. However, the authors found little evidence of a contribution of mothers' cultural values to fathers' perceptions of either relationship adjustment or the parenting relationship. They interpret these findings to suggest that mothers' relationship adjustment and parenting relationship are more sensitive to and dependent on fathers' degree of traditional cultural values among Mexican-origin families.     

Control,responsibility, and moral assessment

Recently, a number of philosophers have begun to question the commonly held view that choice or voluntary control is a precondition of moral responsibility. According to these philosophers, what really matters in determining a person’s responsibility for some thing is whether that thing can be seen as indicative or expressive of her judgments, values, or normative commitments. Such accounts might therefore be understood as updated versions of what Susan Wolf has called “real self views,” insofar as they attempt to ground an agent’s responsibility for her actions and attitudes in the fact (when it is a fact) that they express who she is as a moral agent. As such, they seem to be open to some of the same objections Wolf originally raised to such accounts, and in particular to the objection that they cannot license the sorts of robust moral assessments involved in our current practices of moral responsibility. My aim in this paper is to try to respond to this challenge, by clarifying the kind of robust moral assessments I take to be licensed by (at least some) non-volitional accounts of responsibility and by explaining why these assessments do not in general require the agent to have voluntary control over everything for which she is held responsible. I also argue that the limited applicability of the distinction between “bad agents” and “blameworthy agents” on these accounts is in fact a mark in their favor.

Quality of Life in Pediatric Cancer Patients: The Relationships Among Parents’ Characteristics,Children’s Characteristics,and Informant Concordance

As advancements in the treatment of childhood cancer have resulted in increasing survival rates, the psychosocial functioning of child patients has become an increasingly important issue. In this pilot study, we investigate the relationships among parents’ characteristics, children’s characteristics, and the quality of life experienced by children who are diagnosed with cancer. Forty-seven mothers, sixteen fathers, and nineteen children completed measures about their own psychological functioning as well as measures about the children’s quality of life. Mothers’ ratings of their children’s quality of life were correlated positively with the ratings provided by both fathers and the children themselves. In addition, significant relationships were found between mothers’ depression and parenting stress and children’s quality of life as well as between mothers’ and fathers’ anxiety and children’s quality of life. Finally, using regression analyses, mothers’, fathers’, and children’s ratings of their own characteristics predicted significantly their ratings of the children’s quality of life. The importance of examining the psychological characteristics of family members when assessing the quality of life of children who are diagnosed with cancer is discussed.     

Perceptual organization based on illusory regions in infancy

Prior research indicates that, like adults, infants use enclosed regions to group elements. It is not clear whether infants or adults can use regions that have to be inferred from illusory contours to group elements. We examined whether 3- to 4-month-olds use illusory regions to group elements and generalize this organization to novel regions. Infants habituated to pairs of shapes in illusory vertical or horizontal regions subsequently discriminated, in novel regions, pairs of elements that had previously shared a region from pairs of elements that had been in different regions. A control group of infants, who had experienced the same stimuli except for the presence of illusory regions, failed to discriminate between within-region and between-region pairs of stimuli. These results reveal that (1) illusory regions can be used to group elements, (2) perceptual organization is sufficiently developed early in life for 3- to 4-month-olds to group on the basis of ecologically relevant illusory contours, and (3) such grouping in infancy generalizes to novel regions.     

A Pilot Study of a Functional Contextual Treatment for Bulimia Nervosa

This paper describes the initial development of a treatment for bulimia nervosa using a functional contextual treatment approach. Seven women (6 with a diagnosis of bulimia nervosa and 1 with a diagnosis of eating disorder not otherwise specified) completed 12 sessions of functional contextual treatment. Participants were assessed with the Eating Disorders Examination at baseline and following treatment. The intervention produced significant reductions in binge eating, purgative behavior, dietary restraint, and eating concerns. A functional contextual treatment holds promise for the treatment of bulimia nervosa. However, the treatment needs to be refined further and will need to be tested in controlled clinical trials with long-term follow-up.     

External support for collaborative problem solving in a simulated provider/patient medication scheduling task

Taking medication requires developing plans to accomplish the activity. This planning challenges older adults because of age-related cognitive limits and inadequate collaboration with health providers. The authors investigated whether an external aid (medtable) supports collaborative planning in the context of a simulated patient/provider task in which pairs of older adults worked together to create medication schedules. Experiment 1 compared pairs who used the medtable, blank paper (unstructured aid), or no aid to create schedules varying in complexity of medication constraints (number of medications and medication co-occurrence restrictions) and patient constraints (available times during the day to take medication). Both aids increased problem-solving accuracy and efficiency (time per unit accuracy) compared to the no-aid condition, primarily for more complex schedules. However, benefits were similar for the two aids. In Experiment 2, a redesigned medtable increased problem-solving accuracy and efficiency compared to blank paper. Both aids presumably supported problem solving by providing a jointly visible workspace for developing schedules. The medtable may be more effective because it externalizes constraints (relationships between medication and patient information), so that participants can more easily organize information. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

Serotoninergic regulation of emotional and behavioural control processes

5-Hydroxytryptamine (5-HT, serotonin) has long been implicated in a wide variety of emotional, cognitive and behavioural control processes. However, its precise contribution is still not well understood. Depletion of 5-HT enhances behavioural and brain responsiveness to punishment or other aversive signals, while disinhibiting previously rewarded but now punished behaviours. Findings suggest that 5-HT modulates the impact of punishment-related signals on learning and emotion (aversion), but also promotes response inhibition. Exaggerated aversive processing and deficient response inhibition could underlie distinct symptoms of a range of affective disorders, namely stress- or threat-vulnerability and compulsive behaviour, respectively. We review evidence from studies with human volunteers and experimental animals that begins to elucidate the neurobiological systems underlying these different effects.     

The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: a meta-analytic review

The present study meta-analytically reviewed the efficacy of cognitive-behavioral therapy (CBT) vs. control conditions in the reduction of anxiety sensitivity. A computerized search was conducted to indentify CBT outcome studies that included the Anxiety Sensitivity Index as a dependent variable. Of the 989 studies that were identified, 24 randomized-controlled trials with a total of 1851 participants met inclusion criteria and were included in the analysis. Data were extracted separately for treatment-seeking (16 studies) and at-risk (eight studies) samples. Results indicated large effect sizes for treatment-seeking samples, Hedges' g=1.40, SE=0.21, 95% CI: 1.00-1.81, p<0.001, and moderate to large effect sizes for at risk samples Hedges' g=0.74, SE=0.18, 95% CI: 0.39-1.08, p<0.001. Additionally, both the amount of therapist contact and control modality (waitlist vs. psychological control) moderated the effect sizes for treatment-seeking samples. Our review indicates that CBT is efficacious in reducing anxiety sensitivity. However, more research is needed to determine the mechanisms by which CBT exert its effects on anxiety sensitivity.