Taking an individualized approach to the assessment of self-efficacy and the prediction of alcoholic relapse

The present study reports on a clinical instrument designed for assessing self-efficacy in alcoholics. In contrast to studies that construct general measures, it was proposed that taking an individualized approach to assessment might offer an effective methodology. Thirty-four alcoholics in an outpatient, behaviorally oriented treatment program participated as subjects. During therapy, an Individualized Self-Efficacy Survey (ISS) was developed for each subject. The ISS was developed by (a) administering the Drinking Patterns Questionnaire (DPQ) to identify important problem areas (e.g., work, children, marital) and specific drinking antecedents and (b) constructing a 15-item scale using each drinker's most important cues. The utility of having clients choose their own items was supported by finding a significant relationship between problem areas identified as important on the DPQ and the areas reported as surrounding relapse. ISS ratings were reflective of efficacy changes during treatment, while posttreatment ISS scores were predictive of subsequent relapse. Situation-specific prediction of relapse was not found. The advantages of this methodology for clinical use are discussed, while general directions for future research are suggested.     

IMPLICIT MEMORY IN AMNESIC PATIENTS:

Abstract— Previous observations of spared priming in amnesic patients have been based almost entirely on data from visual implicit memory tests Our research examined perceptual priming.in amnesic patients and control subjects on an auditory identification task in which previously spoken words and new words were presented in white noise We manipulated type of encoding task (semantic vs nonsemantic) and speaker's voice at study and test (same vs different) Priming was little affected.by either manipulation, and amnesic patients exhibited normal priming in all experimental conditions On an explicit test of recognition memory, by contrast, amnesic patients exhibited.severely impaired performance following the semantic study task, all subjects showed poor explicit memory following the nonsemantic study task Results are consistent with the idea that auditory priming depends largely on a presemantic auditory perceptual representation system     

The role of theory in treating adolescent substance abuse

The adolescent substance abuser, like adult addicts, is most commonly considered from the perspective of the disease model. The usefulness of the disease model in conceptualizing adolescent substance abuse is questioned, and an alternative view of the topic is set forth. Substance abuse, is regarded as an adaptive aspect of the ongoing interactive processes within the family. The developmental process of the adolescent substance abuser is seen as a functional dynamic in the family's preservation. Three characteristic elements of parental interaction common to the development of adolescent substance abuse are highlighted.An earlier version of this paper was presented at the Texas Association for Marriage and Family Therapy annual conference on January 28, 1993 in Houston Texas.a research associate and director of the Don D. Jackson Archive at the Mental Research Institute, Palo Alto, CA. Authors are listed alphabetically.     

Marcel's “availability” in existential psychotherapy with couples and families

Gabriel Marcel was a French, Catholic, existential philosopher who first presented the concept of human availability as a central way of strengthening the self and facilitating the experience of human freedom. In this article Marcel's ideas about availability are described, reviewed, and examined for their implications for the practice of existential psychotherapy with couples and families.     

Long term marriages in Sweden: And some comparisons with similar couples in the United States

This international, five-country long term marriages study of couples who have been married, or unmarried and cohabiting, for 20 years or longer is designed to study, among other things, marital satisfaction. This first report of the Swedish part of the study reports on a Swedish version of the self-rating Dyadic Adjustment Scale (DAS) used to investigate self-rated marital satisfaction. The couples describe high marital satisfaction and a high sense of coherence (SOC) compared to other groups. Contrary to other studies, no differences were found between men and women regarding SOC. The differences between them, that describe high relative to low marital satisfaction, pertain to matters of recreation, sex, life philosophy, time spent together, and frequency of quarrels. The men reported greater marital satisfaction than the women.     

Reliability of self-reported service use: Test-retest consistency of children's responses to the Child and Adolescent Services Assessment (CASA)

This paper reports on the reliability of children's responses on the Child and Adolescent Services Assessment (CASA) — a self-report instrument for use with 8– to 18-year-olds that gathers information about services used to address mental health problems. Findings were based on interviews completed by 77 children at a one week test-retest interval. Results showed that reports of lifetime service use were as reliable as were reports of service use in the preceding three months. Children reported restrictive and intrusive services more reliably than services that were provided in their natural environment. Reliability appeared to be associated more strongly with characteristics of the type of service than with characteristics of the child. Children also could report reliably on some details about their encounters with service providers (e.g., length of stay, number of visits, and onset of service use).     

Optimism and coping as determinants of psychosocial adjustment to rheumatoid arthritis

Psychosocial adjustment in 66 patients with chronic rheumatoid arthritis, with a mean duration of 12 years with the disease, were evaluated in a prospective design, with 62% of the sample followed up 16 months later. It was predicted that dispositional optimism would predict adjustment over time and that perceived support and perceived control would be related to psychosocial adjustment at the time of concurrent measurement. At Time 1, psychosocial adjustment was associated with greater optimism and perceived support and less disability. Optimism at Time 1 was the only significant predictor of changes in adjustment at Time 2 controlling for Time 1 adjustment and Time 2 disability. It was found that optimism temporally precedes increases in psychosocial adjustment. In terms of coping strategies, wishful thinking was related to poorer social adjustment, whereas problem-focused coping was marginally related to positive adjustment. Neither coping strategy predicted adjustment across time. Optimism at Time 1 did predict problem-focused coping at Time 2. Perceived social support regarding a specific circumstance at a given point in time enables one to persist in solving a task. Interventions to enhance the quality of life of individuals coping with progressive deteriorative disease must look at the influence of their behavior and attitude on those who provide care for them.     

Effects of anxiety sensitivity on emotional response to a stress task

The purpose of this investigation was to further define the role of anxiety sensitivity, in relation to physiological arousal and the cognitive perception of anxiousness, as a determinant of anxiety. One hundred and thirty-two undergraduates at an urban university served as subjects. Two physiological measures of arousal and two cognitive measures of anxiety were used following an anxiety inducing task (mental arithmetic). The general expectation, which was supported, was that individual differences in anxiety sensitivity levels are more closely related to subjects' reported anxiousness in stressful conditions than are the actual physiological changes. Additionally, anxiety sensitivity was related to poststress levels of anxiety whereas trait anxiety was only related to pre- and postrelaxation levels of anxiety. Implications of the findings are addressed.     

Dual diagnosis: Clinical issues in the treatment of substance abuse,and affective,personality, and psychotic disorders

Co-morbidity of alcohol and substance with the spectrum of other psychiatric diagnoses is examined with specific emphasis on diagnostic indicators for anxiety and mood disorders. Diagnostic issues for the chemically dependent person are examined with the context of borderline personality disorder, schizophrenia and other psychiatric disorders. Clinical research related to the dually-diagnosed patient is explored