Assessment of therapists' and patients' personality: relationship to therapeutic technique and outcome in brief dynamic psychotherapy

My first focus of this study was to explore therapists' personal characteristics as predictors of the proportion of interpretation in brief dynamic psychotherapy (N=39; maximum 40 sessions). In this study, I used data from the Norwegian Multicenter Study on Process and Outcome of Psychotherapy (1995). The main finding was that therapists who had experienced good parental care gave less interpretation (28% variance was accounted for). Therapists who had more negative introjects used a higher proportion of interpretation (16% variance was accounted for). Patients' pretreatment characteristics were not predictive of therapists' use of interpretation. The second focus was to investigate the impact of therapists' personality and the proportion of interpretation on the development of patients' maladaptive defensive functioning over the course of therapy. Better parental care and less negative introjects in therapists were associated with a positive influence and accounted for 5% variance in the reduction of patients' maladaptive defense.     

Interpersonal problems and outcome in outpatient psychotherapy: findings from a long-term longitudinal study in Germany

We used a comprehensive longitudinal data set from Germany to examine trajectories of symptom distress depending on interpersonal problems at study intake measured via the Inventory of Interpersonal Problems-64 (IIP-64; Horowitz, Strau, & Kordy, 1994). Participants (N=622) underwent mid- or long-term outpatient psychotherapy (either psychodynamically oriented psychotherapy, cognitive behavioral therapy, or analytic psychotherapy). Data comprises up to 5 assessments during a 2-year period and was analyzed via hierarchical linear modeling. In the analytic psychotherapy subgroup, initial symptom level was higher in submissive patients. Initial interpersonal problems were not predictive of the rate of symptom change during therapy. Only in psychodynamic treatments, low affiliation positively affected treatment outcome. Interpersonal problems at intake were not related to the number of utilized sessions and utilization rate across treatment subgroups. We discuss the findings and outline future research topics.     

Functional analysis and treatment of verbal perseverations displayed by an adult with autism

The function of perseverative speech for an adult man who had been diagnosed with autism and mental retardation was examined. Results showed that verbal perseverations were maintained by social attention. An intervention consisting of differential reinforcement of appropriate verbal responses and extinction of perseverative verbal responding was effective in decreasing verbal perseverations.     

A modest proposal: (re)defining unconscious fantasy

The author argues that unconscious fantasy, properly defined, necessarily represents the three-dimensional intersection of wishful thinking (fantasy), veridical perception of the environment (reality), and the naive cognition of childhood. It is proposed that, although attachment theory developed out of the intent to capture the unalloyed reality of dyadic experience, that experience is inextricably entangled with the other two components, wishes and naive cognition, and furthermore, that the behavior of children in the attachment paradigm can only be accounted for by positing the existence of underlying unconscious fantasies. In making these arguments, the author also addresses the development of unconscious fantasies and their relationship to compromise formations and trauma.     

Evidence-based treatment of stuttering: V. The art of clinical practice and the future of clinical research

This epilogue summarizes and expands on some of the many points raised in Parts I through IV, emphasizing that evidence-based practice is not in conflict with the "art" of clinical practice but may actually be synonymous. An evidence-based practice framework is also used to suggest some future directions for clinical research in stuttering. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1) describe the similarities between evidence-based practice and the art of clinical practice, (2) explain how evidence-based practice provides a structure for future stuttering research, and (3) evaluate the importance of an evidence-based approach to stuttering treatment.     

Modulation of tremor amplitude during deep brain stimulation at different frequencies

Rest tremor was quantified in the index finger tip of 16 patients with Parkinson's disease (PD) receiving deep brain stimulation (DBS) of the ventro-intermediate nucleus (Vim) of the thalamus, the subthalamic nucleus (STN), or the internal part of the globus pallidus (GPi) while being off L-dopa for 12h. Clinically, without DBS, tremor amplitude varied from absent to high. Tremor was recorded continuously for about 5 min under three conditions of DBS repeated twice, namely, effective frequency (E), ineffective frequency (I), and no DBS (O). No changes in tremor were observed across conditions in subjects with little or no tremor. However, in subjects with moderate to large amplitude tremor, DBS decreased tremor amplitude to near normal values within a few seconds. Generally, transitions were progressive and occurred with a varying time delay. Occasionally, tremor escaped from control regardless of the stimulation condition considered. In some cases tremor amplitude in one condition appeared to depend on the preceding condition. Finally, the results were reproducible on two consecutive days. We conclude that tremor control with DBS follows specific dynamical rules, which must be compatible with the hypotheses proposed regarding the underlying mechanisms of DBS.     

When parallel processing in visual word recognition is not enough: new evidence from naming

Low-frequency irregular words are named more slowly and are more error prone than low-frequency regular words (the regularity effect). Rastle and Coltheart (1999) reported that this irregularity cost is modulated by the serial position of the irregular grapheme-phoneme correspondence, such that words with early irregularities exhibit a larger cost than words with late ones. They argued that these data implicate rule-based serial processing, and they also reported a successful simulation with a model that has a rule-based serial component—the DRC model of reading aloud (Coltheart, Rastle, Perry, Langdon, & Ziegler, 2001). However, Zorzi (2000) also simulated these data with a model that operates solely in parallel. Furthermore, Kwantes and Mewhort (1999) simulated these data with a serial processing model that has no rules for converting orthography to phonology. The human data reported by Rastle and Coltheart therefore neither require a serial processing account, nor successfully discriminate among a number of computational models of reading aloud. New data are presented wherein an interaction between the effects of regularity and serial position of irregularity is again reported for human readers. The DRC model simulated this interaction; no other implemented computational model does so. The present results are thus consistent with rule-based serial processing in reading aloud.     

New mothers and their babies: attachment in the face of maternal life-threatening illness

Life-threatening illness in the mothers of babies or young children is rare. Its impact is discussed in this paper, which focuses on attachment theory as a foundation for work in this area. A single case study is used to illustrate the potential conflicts and dilemmas for professionals caring for babies and their families in this situation.     

Studying Sexual Harassment in the Laboratory: Are Egalitarian Women at Higher Risk?

A laboratory experiment is reported in whichmale participants in Northern Italy (N = 120 universitystudents) were given the opportunity to sendpornographic material to a female interaction partner(“computer harassmentparadigm”). The allegedgender-role orientation of the female (traditional vs.egalitarian) and the construal of the interaction aseither intergroup or interpersonal were variedsystematically. Results show that participants molest femaleinteraction partners more when they express egalitarianrather than traditional gender-role attitudes; this isparticularly true for males with a high propensity to harass (high scores on likelihood of sexualharassment scale, Pryor, 1987), with sexist attitudes,with a strong identification as “males,” andfor low self-monitors. Also, males with a highpropensity to harass were more likely to harass theirinteraction partner when they perceived the situation asa male-female inter-group setting (rather than asinterpersonal). Results are interpreted as supporting a social identity account ofmisogyny.