Attributions, beliefs about control, and adjustment to breast cancer

Attributions for cancer and beliefs about control over cancer were examined for their association with adjustment to breast cancer. Although 95% of the respondents made attributions for their cancer, no particular attribution (e.g., stress, diet) was associated with better adjustment. Analyses of attributions of responsibility for the cancer to the self, environment, another person, or chance yielded only a negative relation between adjustment and blaming another person. In contrast, both the belief that one could now control one's cancer and the belief that others (e.g. the physician) could now control the cancer were significantly associated with good adjustment. Of the different types of control, cognitive control was most strongly associated with adjustment, behavior control was less strongly associated with adjustment, and information control and retrospective control were unassociated with adjustment. The theoretical and practical implications of these results are discussed.     

Personal control and stress and coping processes: a theoretical analysis

Laboratory and field research indicates that the relationships between personal control and stress, coping, and adaptational outcomes are more complex than was once assumed. Believing that an event is controllable does not always lead to a reduction in stress or to a positive outcome, and believing that an event is uncontrollable does not always lead to an increase in stress or to a negative outcome. These complex relationships involving control are examined in the context of Lazarus's cognitive theory of stress and coping. The first part of the article elaborates this theory and shows how two forms of control, generalized beliefs about control and situational appraisals of control, fit into the overall model. Situational appraisals of control are explored in this section, including the question, Control over what? which must be addressed in order to explain some of the perplexing findings. The second part of the article draws on the theoretical formulation of stress and coping to examine three important issues: (a) how believing one has control in a stressful transaction can heighten threat, (b) the relationship between control and coping, and (c) pathways through which control can affect the adaptational outcomes of stressful encounters.     

Task-related arousal of type A and type B persons: level of challenge and response specificity

To determine whether different levels of challenge had differential effects on the arousal levels of Type A and Type B persons, 30 Type A and 30 Type B male subjects worked on an intelligence test task (digits backwards recall) that was easy, moderately difficult, or extremely difficult. Arousal was measured in terms of systolic blood pressure, diastolic blood pressure, pulse rate, pulse volume, skin resistance, and subjective arousal. Results indicated that while working on the extremely difficult task, the Type A subjects evidenced reliably higher systolic blood pressure than did the Type B subjects (p = 0.1; difference = 7.52 mm of Hg) and that there were not reliable differences between the subjects in systolic blood pressure at other levels of challenge or on other measures of arousal.     

Depressive attributions: selection of different causes or assignment of dimensional meanings?

Attributional models of depression suggest that depression is associated with internal, stable, and global causal explanations of events. However, the models do not specify whether the depressive attributional process involves the selection of certain causes, the assignment of dimensional meanings to those causes, or both. A distinction between these two processes was suggested by the findings that the choice of causes does not reliably indicate the perceived dimensions and that there is poor convergence between existing methods that assess causes and those that assess dimensions. When causes and dimensions were each measured in a manner that avoided confounding by the other, each made a unique contribution to the prediction of depression scores. Cause ratings alone were significantly associated with depression scores, but the optimal prediction of depression included both causes and dimensions. The implications of the distinction between these two processes for experimental manipulations of attributions and for reattribution training programs are discussed.     

One last response to the Rorschach test: a second chance to reveal oneself

This paper explores a technical procedure, that of asking for one more response after the patient has given response(s) to Card X of the Rorschach. This "one last response" in the context of "ending" is discussed. Endings have many meanings but the ending of the Rorschach can be more than just a relief to the weary patient and/or tester who may have been experiencing the disquieting inner workings of the patient's unconscious. The ending of the Rorschach with the additional "one last response" can be the source of valuable clinical questions and inferences applicable to treatment.     

Withholding medical care for religious reasons

Stimulated by publicity over lawsuits involving parents of children who had died from deprivation of medical care, this article is a survey of the beliefs of religious groups that refuse medical care on theological grounds and the legal principles designed to protect children from such abuse. Particular attention is given to whether or not child-neglect laws that carve out exceptions for spiritual healing groups are constitutional under the establishment clause of the First Amendment. Very recent cases, including some still in progress, are used for illustration.     

Understanding and Counseling Narcissistic Clients

This article is intended to provide counselors with an overview of narcissism and its treatment. In the first section, dysfunctional narcissism is described, drawing on the diagnostic indicators presented in the DSM-III and the contemporary object relations theories of Heinz Kohut and Otto Kernberg. The second section focuses on counseling narcissistic clients.     

Assertiveness and cognitive processing in interpersonal situations

This study examined social skills components that precede the delivery of a skilled overt interpersonal response. Using a cognitive-behavioral systems approach to assertiveness, a task analysis of how women receive and process information in interpersonal situations requiring an assertive response to men was performed. Forty women were assigned to high- or low-assertive groups based on their Rathus Assertiveness Schedule scores. In small group sessions, each woman viewed four videotaped problem situations requiring an assertive response to both pleasant and angry males. After viewing each scene, each woman completed three questionnaires: (a) receiving information, (b) processing-generation of alternatives and decision making, and (c) processing-generation of consequences. High- and low-assertive participants were found to differ in their evaluation of consequences, for response options, particularly how a male would likely to behave to them. High-assertive participants were judged to evaluate more correctly than low-assertive participants the likely behavior of males if response options were implemented. All participants generated more complex alternatives and more assertive responses to situations involving an angry male as compared to a pleasant male. No differences were found between groups in their ability to receive information accurately. Correlational results were supportive of a cognitive-behavioral systems approach of assertion, that is, the emission of a skilled response depends on a chain of preceding responses.Thanks are due to Vida Dyson and Lenard Jason for their comments on an early draft of this paper.     

Perceived variability and symbol use: a common language-cognition interface in children and chimpanzees (Pan troglodytes)

Analysis of two chimpanzees' conversations with their teacher during a tool-use training task demonstrated that chimps use lexigrams, a humanly devised visual symbol system, selectively to encode perceived variability; that is, they generally used their symbols to differentiate alternative possibilities or to represent change or novelty in a situation. In contrast, they tended to leave unsaid what was unchanging, repetitive, or the unique possibility in a situation. Perceived variability influenced not only which symbols were selected but also utterance length: A single dimension of variability in a situation leads to single-lexigram utterances; multiple dimensions are associated with multi-lexigram utterances. This pattern of results indicates that the absence of formal grammatical structure in chimp language does not imply that utterances beyond one word in length are either rote strings or imitations. The chimps' tendency to mention the variable while leaving the constant or redundant unsaid is, moreover, strong support for the position that their use of a humanly devised symbol system is more than a series of conditioned responses.