A Comparison of Two Multidimensional Health Locus of Control Instruments

This study examined the factor structure, internal consistency reliability and construct validity of the multidimensional health locus of control (MHLC) instruments developed by K. A. Wallston, B. S. Wallston, and DeVellis (1978) and Lau (Lau, 1982; Lau & Ware, 1981), Both measures were administered to a sample of Veterans Administration (VA) medical outpatients (N = 181). Only minimal evidence of convergence was found between corresponding scales of the two MHLC instruments. Low convergent validity appears attributable to the poor internal consistency reliability of the Lau-Ware subscales. Moreover, results of factor analysis largely supported the a priori factor structure of the K. A. Wallston et at. (1978) MHLC instrument but failed to support the factor structure of the Lau-Ware instrument, Health locus of control (HLC) dimensions that emerged from simultaneous factor analysis of both instruments were most consistent with a three-dimensional typology (i.e., Personal Control, Professional Control and Chance) rather than the four-dimensional typology proposed by Lau (Lau, 1982; Lau & Ware, 1981). Implications for HLC conceptualization and measurement are discussed.     

Popular Versus Skinnerian Views on the Relation Between Human Freedom and Dignity

This study evaluated Skinner's (1971) contention that the function relating the degree to which a person's behavior is ascribed to voluntary choice and the level of dignity ascribed to that person originates at zero dignity for zero choice. In Study 1, 91 American college students answered questions about themselves, their beliefs about voluntary versus environmental control of behavior, and their bases for judging dignity. Then they attempted to describe their views of the functional relationship between perceived human dignity and perceived voluntary control of both prosocial and antisocial behaviors. Most indicated belief in voluntary choice, and some in intrinsic (unearned) dignity, but few could relate them quantitatively. A second study used 27 students in an advanced class, for whom the theoretical implications of various functional relationships were discussed before the functions were drawn. Both studies refuted Skinner's pragmatic argument against the concepts of freedom and intrinsic dignity.     

Surviving as a personality disorder service

Personality disorder services working along psychotherapeutic lines gained appeal with Health Care Commissioners following the publication of the National Institute for Health and Clinical Excellence (NICE) guidelines for Borderline & Antisocial Personality Disorders and the emerging successful application of psychoanalytically derived approaches. In parallel to this creative development, the economic downturn has faced the National Health Service (NHS) with considerable challenges in its ongoing survival. The potential for creative pursuit often then sits in competition, juxtaposed with the need to survive. We examine the impact of this dynamic upon the therapeutic efforts of a newly established personality disorder service. We suggest that both conscious and unconscious aspects stirred up within such encounters are demanding of the need for development of a capacity within each to bear contact with unfamiliar experiences. Through attention to that development, both patient and clinician may further enliven and enrich individual and collective identities, such that the potential to survive creatively is actualized.     

Transference Focused Psychotherapy for Patients with Comorbid Narcissistic and Borderline Personality Disorder

Clinical experience involving the treatment of patients with comorbid borderline and narcissistic personality disorders suggests that this patient population is among the more difficult to treat within the personality disorder spectrum. In this article, we present refinements of Transference Focused Psychotherapy (TFP) based on our clinical experience with and research data on patients with comorbid narcissistic personality disorder/borderline personality disorder (NPD/BPD). We briefly review object relations formulations of severe narcissistic pathology, as well as recent research in attachment and the allied concept of mentalization, which have provided a new lens through which to view narcissistic disorders. The research findings from two randomized clinical trials demonstrating the efficacy and effectiveness of TFP are presented. The data from the two Randomized Clinical Trials (RCT) allowed for the study of the characteristics of the subgroup of borderline personality disorder patients who have comorbid NPD/BPD. Findings on comorbidity, attachment status, capacity for mentalization, and level of personality organization of borderline patients with comorbid NPD/BPD, compared with borderline patients without comorbid narcissistic pathology (BPD), are presented. Clinical implications of the observed group differences are discussed, with a focus on refinements in the technique of TFP. Clinical case material is presented to illustrate the specific challenges posed by narcissistic patients to carrying out TFP in each phase of treatment.     

CACREP Accreditation: A Solution to License Portability and Counselor Identity Problems

A confluence of forces addressing counselor identity occurred with the 20/20: A Vision for the Future of Counseling initiative, the 2009 Standards of the Council for Accreditation of Counseling and Related Education Programs (CACREP), and the quest by the American Association of State Counseling Boards to establish license portability. This article provides a historical context for the profession's struggles with these issues, 1 state's experience, TRICARE's impact, and the role CACREP standards can play in their resolution.     

Calibrated probabilities and the epistemology of disagreement

This paper assesses the comparative reliability of two belief-revision rules relevant to the epistemology of disagreement, the Equal Weight and Stay the Course rules. I use two measures of reliability for probabilistic belief-revision rules, calibration and Brier Scoring, to give a precise account of epistemic peerhood and epistemic reliability. On the calibration measure of reliability, epistemic peerhood is easy to come by, and employing the Equal Weight rule generally renders you less reliable than Staying the Course. On the Brier-Score measure of reliability, epistemic peerhood is much more difficult to come by, but employing the Equal Weight rule always renders you more reliable than Staying the Course. I conclude with some normative lessons we can draw from these formal results.     

Methylphenidate improves some but not all measures of ATTENTION,as measured by the TEA-Ch in medication-naïve children with ADHD

The Test of Everyday Attention for Children (TEA-Ch) is a reliable neuropsychological assessment of attention control in children. Methylphenidate (MPH) is an effective treatment to improve attentional difficulties in children with attention deficit/hyperactivity disorder (ADHD). Previous studies investigating the effects of MPH on attention performance of children with ADHD have produced mixed results and prior MPH usage may have confounded these results. No previous study has tested the effects of MPH on the entire TEA-Ch battery. This study investigated the effects of MPH on attention performance using the entire TEA-Ch in 51 medication-naïve children with ADHD compared with 35 nonmedicated typically developing children. All children were tested at baseline and after 6 weeks: The children with ADHD were medication-naïve at baseline, received MPH for 6 weeks and were tested whilst on medication at the second testing session. A beneficial effect of MPH administration was found on at least one subtest of each of the three forms of attention (selective, sustained, and attentional control) assessed by the TEA-Ch, independent of practice effects. MPH aided performance on the TEA-Ch tasks that were inherently nonarousing and that might require top-down control of attention. It is recommended that the TEA-Ch measures—Sky Search Count (selective attention),Score! (sustained attention), Creature Counting Time Taken for older children (attentional control), and Same Worlds (attentional control) be prioritized for use in future pharmacological studies using MPH.     

Stove on inductive scepticism

Book Information Warranted Christian Belief. By Alvin Plantinga. Oxford University Press. New York. 2000. Pp. xx + 508.