Psychiatry Residents' Attitudes on Ethics and Professionalism: Multisite Survey Results

Recent studies show that psychiatry residents express a relatively greater need for ethics curricula than their colleagues in other specialties. Such studies have been limited in their generalizability because they were conducted at one site. This study of 151 psychiatry residents at seven U.S. psychiatry programs aims to address that limitation. Residents were surveyed on issues pertaining to ethics and professionalism education. Participants were found to support such curricula during training and to value its relevance to the practice of psychiatry. Gender differences and the influence of the “hidden curriculum” on such results merit further study.     

Felt obligation and the family life cycle: A study on intergenerational relationships

Since the 1990s researchers have considered as the dominant view on family obligation a set of responsibilities, duties, and obligation of care and assistance, that adult children should assume when parents are old or infirm. This concept is limited, because it assumes that family obligation is salient only in one period of life: when parents reach old age and are infirm. In contrast, a relational approach to family obligation considers family relationships as central to understanding children's duties and responsibilities. Following Stein, family obligation can be defined as felt obligation: expectations for appropriate and negotiated behaviour, perceived within the context of specific personal relationships with kin across life course. Felt obligation is conceptualized in five dimensions: a duty to maintain contact, assistance, avoidance of conflict, personal sharing, and self‐sufficiency. The purpose of the present study was to analyze perceptions of felt obligation in intergenerational relationships (parent–child and family of origin) in different phases of the family life cycle in a specific cultural context (Italy). The sample was composed of 92 parents with children of different ages (infants, school‐aged children, and young adults). The measure addressed the five dimensions of felt obligation, all assessed in various phases of family life. Results indicated differences in dimensions of felt obligation between intergenerational relationships (both parent–child and with family of origin). Some of these differences, such as self‐sufficiency and personal sharing, assumed more importance and salience in some periods of the life cycle than in others.     

Mass psychology of the led and the leaders

Abstract

Some salient features of a Sullivanian perspective are given as a background for a discussion of the case of Anna. Lived experience is mentioned as of equal importance as fantasy. Technically, analytic inquiry in the form of questions is stressed. In his review of the case presentation, the author observes that too much emphasis is given to content, compared to form. He notes that the therapist does not report key transference and non-transference interactions with the patient and further suggests that the patient still has significant narcissistic problems. He suggests that it is time to confront the patient with her characterological ways of relating to the analyst.     

Addendum to: Heterogeneity Coefficients for Mahalanobis' D as a Multivariate Effect Size

In a previous paper (Del Giudice, 2017 [Heterogeneity coefficients for Mahalanobis' D as a multivariate effect size. Multivariate Behavioral Research, 52, 216–221]), I proposed two heterogeneity coefficients for Mahalanobis' D based on the Gini coefficient, labeled H and EPV. In this addendum I discuss the limitations of the original approach and note that the proposed indices may overestimate heterogeneity under certain conditions. I then describe two revised indices H₂ and EPV₂, and illustrate the difference between the original and revised indices with some real-world data sets.     

Brief treatment with alprazolam and behavioral guidance in panic disorder

Abstract

Thirty-two patients with panic disorder, with or without agoraphobic limitations, were treated with alprazolam (mean dose 3.5 mg/d) plus brief behavioral guidance in an open study during eight weeks. The sample had a notorious severity in the frequency of panics and phobic avoidance but was only mildly depressed. Before starting treatment the presence of demoralized mood and extensive avoidance were significant indicators of clinical severity, whereas the presence of dizziness as a relevant somatic complaint was not related to higher severity. After eight weeks of treatment a clinical improvement equal to or exceeding 80% of change was obtained in all cases (29) who completed treatment. Ninety-two percent of the patients were panic free at the end of treatment. There were significant reductions in all the scales with comparable declines in the subgroups formed according to the presence or absence of agoraphobic avoidance and demoralization. The data suggested that moderate doses of alprazolam could be a quick and effective treatment for panic-agoraphobic patients in the short term. The behavioral guidance probably helped in reducing agoraphobic avoidance and in obtaining global good effectiveness although this awaits controlled tests. Finally, the similarity in the response to treatment regardless of the presence of extensive avoidance or demoralized mood argues in favor of not considering the different variants of panic-agoraphobic syndrome differently, at least in samples with similar severity to the present one.     

John Wesley's Doctrine of Grace in Light of the Christian Tradition

This ecumenically minded article explores Wesley's understanding of grace both in its relation to experience – inward religion – and in relation to his doctrines of justification and sanctification. Wesley's treatments of justification and sanctification are compared to those of Luther, Calvin and Trent. His unique and ecumenical blending of traditions allowed Wesley to develop a doctrine of grace which offers significant resources to contemporary understandings of Christian life and practice.