Group analytic therapy with schizophrenic outpatients

This paper describes a model for group analytic psychotherapy with patients who have been psychotic, namely, schizophrenics and manic depressives. The groups are run on the group centered principles of S. H. Foulkes. They are continuous, slow-open groups, in line with these patients' needs for long-term therapy. A theory is proposed which justifies treating these patients in group-centered groups despite their great dependency needs. The paper also describes the task of the therapist in building and running such a group.Acknowledgments to Geoffrey Elkan, Marcia Levene, Noa Rotem, Aya Levi-Posnanski, Yossi Ezrati, S. Littman, Tamar Sternberg, E. Danilowitz, and C. Kauffman.     

Order effects in belief updating with consistent and inconsistent evidence

The current study tests for the presence of differential order effects in evaluation tasks with consistent and inconsistent evidence as predicted by the Hogarth and Einhorn (1992) belief-adjustment model. The results, based on both between-subjects and within-subjects experiments, demonstrate that there were significant recency effects with inconsistent evidence as predicted, larger recency effects when the inconsistent evidence was farther apart in subjective value as predicted, and significant recency effects even when subjects were given training designed to both help them understand the task as completely as possible and to be better able to assess the pieces of evidence. By including a within-subjects design, we were able to demonstrate that the difference in subjective value between two pieces of evidence is the primary factor influencing the magnitude of the recency effect, regardless of whether the evidence is consistent or inconsistent. This latter finding is unique and contrary to previous research and theory.     

An evaluation of the reliability of probability judgments across response modes and over time

Despite the importance of probability assessment methods in behavioral decision theory and decision analysis, little attention has been directed at evaluating their reliability and validity. In fact, no comprehensive study of reliability has been undertaken. Since reliability is a necessary condition for validity, this oversight is significant. The present study was motivated by that oversight. We investigated the reliability of probability measures derived from three response modes: numerical probabilities, pie diagrams, and odds. Unlike previous studies, the experiment was designed to distinguish systematic deviations in probability judgments, such as those due to experience or practice, from random deviations. It was found that subjects assessed probabilities reliably for all three assessment methods regardless of the reliability measures employed. However, a small but statistically significant decrease over time in the magnitudes of assessed probabilities was observed. This effect was linked to a decrease in subjects overconfidence during the course of the experiment.     

A comparison of Guided Imaginal Coping and imaginal exposure in the treatment of panic disorder

The present study evaluated the efficacy of a new intervention, Guided Imaginal Coping (GIC), compared to imaginal exposure (IEX), and a waiting-list control (WLC) condition among 24 clinic outpatients meeting DSM-III-R criteria for panic disorder (PD) or PD with agoraphobia. GIC was the more consistently effective intervention, with individuals demonstrating significant improvement in frequency and severity of panic attacks (Pas) as well as significant reductions in physiological and subjective arousal to provocative imagery. Individuals in the IEX intervention demonstrated less consistent improvement on the dependent measures, while individuals in the WLC condition essentially remained unchanged. Both GIC and IEX were effective according to a composite measure of clinically significant improvement. However, only GIC was superior to the WLC condition when clinical improvement was defined as zero PAs at follow-up. These findings, while preliminary, suggest that GIC can be added to the armamentarium of effective approaches to treating PD.     

The Continuum of Consciousness

Research in a wide variety of domains provides converging evidence for the psychological unconscious—percepts, memories, and other mental contents that influence experience, thought, and action outside of phenomenal awareness. Studies of preconscious processing indicate that two continua underlie conscious experience—one having to do with the quality of the stimulus event or its mental representation, and the other having to do with the cognitive resources brought to hear on the processing of that representation. However, evidence of subconscious processing violates these conclusions and suggests that something more is involved—perhaps a link between mental representations of events and of the self as the agent or experiencer of them.     

Double agency and the ethics of rationing health care: a response to Marcia Angell

The arguments against doctors as "double agents" that are presented by Marcia Angell in the preceding article do not defeat the core justification for rationing some relatively high-expense, low-benefit care, and they do not enable us to conclude that clinicians should be barred from any active, substantive role in decisions to limit that care. They do, however, reveal several important conditions that need to govern cost-conscious medial practice in order to preserve an ethic of fidelity to patients: insurers' profits and providers' incomes must be fair, providers must inform patients of any economic reasons that lead to the foregoing of care, and "direct incentive" arrangements must not be used to contain costs.     

Using self-evaluation to improve difficult-to-read handwriting of secondary students

We used delayed multiple-baseline and multiple-probe techniques to assess the effects of self-evaluation training on the legibility of cursive handwriting. Five secondary special education students with difficult-to-read handwriting served as participants. All participants improved the legibility of their handwriting during self-evaluation training. A systematic withdrawal of the training package demonstrated maintenance of treatment effects. For the most part, the students' handwriting remained at least 90% legible to judges following the systematic withdrawal of the self-evaluation training.     

Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.