Feedback in Couple and Family Therapy: A Randomized Clinical Trial

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC (“treatment as usual” or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed.     

The Autonomy of the Health Professional: An Introduction

Theoretical Medicine and Bioethics -     

Does perceived exertion depend on glycemic index of foods ingested throughout three hours before a one-hour high-intensity exercise?

The purpose of this study was to assess the relationships between perceived exertion (RPE) and plasma glucose concentrations or hunger feelings during a 1-hr. bicycle submaximal exercise after ingestion of pre-exercise test foods with a different glycemic index. Each of endurance-trained male triathletes ingested three different glycemic index (GI) foods (HighGI: glucose, LowGI: whole-wheat biscuit or water) throughout the 3 hr. before exercise at 80% maximal oxygen uptake (VO2 max). RPE values increased as a logarithmic function of time. This result is opposite to results obtained with longer exercise bouts up to 3 hr. duration. RPE and hunger ratings were not significantly different for the three test foods whatever the time. Moreover, RPE did not correlate with plasma glucose concentrations during exercise. Consequently, RPE did not depend on the GI of the pre-exercise test foods during a 1-hr. exercise at 80% VO2 max. Physiological and psychological factors other than glycemic index may have mediated the perceptual responses during a 1-hr. high-intensity exercise. It is possible that during endurance exercise of longer duration, the level of blood glucose mediates the intensity of peripheral exertional perceptions arising from active skeletal muscle during prolonged exercise.     

Illusory recouplings of onsets and terminations of glide tone components

We present a new auditory illusion, the gap transfer illusion, supported by phenomenological and psychophysical data. In a typical situation, an ascending frequency glide of 2,500 msec with a temporal gap of 100 msec in the middle and a continuously descending frequency glide of 500 msec cross each other at their central positions. These glides move at the same constant speed in logarithmic frequency in opposite directions. The temporal gap in the long glide is perceived as if it were in the short glide. The same kind of subjective transfer of a temporal gap can take place also when the stimulus pattern is reversed in time. This phenomenon suggests that onsets and terminations of glide components behave as if they were independent perceptual elements. We also find that when two long frequency glides are presented successively with a short temporal overlap, a long glide tone covering the whole duration of the pattern and a short tone around the temporal middle can be perceived. To account for these results, we propose an event construction model, in which perceptual onsets and terminations are coupled to construct auditory events and the proximity principle connects these elements.     

Matrix correlation

A correlational measure for ann byp matrixX and ann byq matrixY assesses their relation without specifying either as a fixed target. This paper discusses a number of useful measures of correlation, with emphasis on measures which are invariant with respect to rotations or changes in singular values of either matrix. The maximization of matrix correlation with respect to transformationsXL andYM is discussed where one or both transformations are constrained to be orthogonal. Special attention is focussed on transformations which causeXL andYM to ben bys, wheres may be any number between 1 and min (p, q). An efficient algorithm is described for maximizing the correlation betweenXL andYM where analytic solutions do not exist. A factor analytic example is presented illustrating the advantages of various coefficients and of varying the number of columns of the transformed matrices.This research was supported by grant APA 0320 from the Natural Sciences and Engineering Research Council of Canada. The authors wish to acknowledge valuable discussion of this problem with Jan de Leeuw, University of Leiden.     

A joint treatment of varimax rotation and the problem of diagonalizing symmetric matrices simultaneously in the least-squares sense

The present paper contains a lemma which implies that varimax rotation can be interpreted as a special case of diagonalizing symmetric matrices as discussed in multidimensional scaling. It is shown that the solution by De Leeuw and Pruzansky is essentially equivalent to the solution by Kaiser. Necessary and sufficient conditions for maxima and minima are derived from first and second order partial derivatives. A counter-example by Gebhardt is reformulated and examined in terms of these conditions. It is concluded that Kaiser's method or, equivalently, the method by De Leeuw and Pruzansky is the most attractive method currently available for the problem at hand.The author is obliged to Dirk Knol for computational assistance and to Dirk Knol, Klaas Nevels and Frits Zegers for critically reviewing an earlier draft of this paper.     

Occupational therapy in neurology--results of 7 years' experience

Indications, mode of referral, therapeutic methods, and documentation of the functional occupational therapy practised in the field of neurology are presented and experiences hitherto existing discussed. For many of neurological diseases, the occupational therapy may be regarded as an equivalent method to the medication and to the physiotherapeutic treatment. When carrying-out as group therapy, it is an economical way of treatment, and most of the patients take this kind of therapy in a positive manner. In addition to this, the occupational therapy renders possible that the state of the rehabilitation can be sized up.     

Uniqueness of three-mode factor models with sparse cores: The 3 × 3 × 3 case

Three-Mode Factor Analysis (3MFA) and PARAFAC are methods to describe three-way data. Both methods employ models with components for the three modes of a three-way array; the 3MFA model also uses a three-way core array for linking all components to each other. The use of the core array makes the 3MFA model more general than the PARAFAC model (thus allowing a better fit), but also more complicated. Moreover, in the 3MFA model the components are not uniquely determined, and it seems hard to choose among all possible solutions. A particularly interesting feature of the PARAFAC model is that it does give unique components. The present paper introduces a class of 3MFA models in between 3MFA and PARAFAC that share the good properties of the 3MFA model and the PARAFAC model: They fit (almost) as well as the 3MFA model, they are relatively simple and they have the same uniqueness properties as the PARAFAC model.This research has been made possible by a fellowship from the Royal Netherlands Academy of Arts and Sciences to the first author. Part of this research has been presented at the first conference on ThRee-way methods In Chemistry (TRIC), a meeting of Psychometrics and Chemometrics, Epe, The Netherlands, August 1993. The authors are obliged to Age Smilde for stimulating this research, and two anonymous reviewers for many helpful suggestions.     

Improved bounds for optimal intervals in weakly constrained regression problems

The solution of weakly constrained regression problems typically requires the iterative search, in a given interval, of a point where a certain function has a zero derivative. This note deals with improved bounds for the interval to be searched.     

A general solution to Mosier's oblique procrustes problem

Browne provided a method for finding a solution to the normal equations derived by Mosier for rotating a factor matrix to a best least squares fit with a specified structure. Cramer showed that Browne's solution is not always valid, and proposed a modified algorithm. Both Browne and Cramer assumed the factor matrix to be of full rank. In this paper a general solution is derived, which takes care of rank deficient factor matrices as well. A new algorithm is offered.