Somatic response to stress, physical symptoms and health service use: The role of current stress

The study examined physical symptoms and health service utilization of subjects high or low on a measure of the tendency to experience stress somatically and high or low on a measure of current stress. High somatic responders reported greater numbers of symptoms than low somatic responders regardless of stress level. However, high somatic responders who were experiencing high levels of current stress reported significantly more symptoms than high somatic responders who were experiencing low levels of stress. These findings indicate that somatic response to stress reflects both a general tendency to focus on physical symptoms, and a specific tendency to focus more on physical symptoms when under stress. Analysis of health service records indicated that high somatic responders had more visits prompted by symptoms than low somatic responders, but did not differ in frequency of health service visits designed to maintain health. The findings further clarify the relationship between somatic response to stress, physical symptoms and health service use.     

On working through: a model from artificial intelligence

Working through is centrally important to clinical psychoanalysis. It is inadequately explained in analytic theory. An artificial intelligence model of the process is proposed. Models of problem solving show that the complexity of necessary computation is an important determinant of how a problem is solved. Not optimal, but only good enough solutions are usually found. The quality of solutions depends on the time and resources available. Generally it is far easier to use existing methods than to develop new approaches. When problems must be solved in an emergency fashion, as in trauma, poor solutions are likely to emerge. In studying the annealing of metals and other complex optimization problems, a process, the Boltzman algorithm, was discovered, which continues the search for better solutions while gradually developing a coherent structure of the overall solution. The algorithm provides a model both for psychoanalytic working through and for the normally ongoing process of psychological development and reworking whose deficiency is characteristic of much psychopathology. Working through in the analytic situation is the reactivation of this normal process, and a good analytic outcome is achieved when the process can continue without the analyst. Properties of the Boltzman algorithm clarify such concepts as "optimal" frustration and anxiety which correspond to working in the area where the stable but not rigid structures emerge in the algorithms operation. These studies are an example of how computer science and artificial intelligence are a potentially rich source for psychoanalytic theory.     

The utility of the Michigan Alcoholism Screening Test in the detection of alcoholics and problem drinkers

This study examined the vulnerability of the Michigan Alcoholism Screening Test (MAST), a widely used, direct alcohol inventory, to positive dissimulation. An earlier study by developers of the MAST suggested that most alcoholics were unable to alter their scores and thereby avoid detection by the instrument. But closer examination indicated that a standard scoring procedure was not employed. This study examined the ability of alcoholics to avoid detection by the MAST when using a standard scoring procedure. As predicted, alcoholics readily manipulated their MAST scores and avoided detection when so motivated. These results are discussed, indications and contraindications for use are included, and recommendations regarding future research are made.     

Drinking practices among black and white alcoholics and alcoholics of different personality types

In order to examine the effects that race and personality type have on self-reported drinking practices, samples of 49 White and 49 Black male alcoholics were matched on age and education, and classified into two personality types according to MMPI scores. The results of multivariate and univariate analyses of variance yielded significant main effects. White alcoholics reported a greater: (a) use of alcohol for symptomatic relief of psychological distress, (b) loss of motor control and tendency to engage in destructive acts, and (c) daily consumption of beverage alcohol than Black alcoholics. Alcoholics with psychiatric-appearing MMPI profiles reported greater: (a) social benefits of alcohol use, (b) alcohol use for symptomatic relief of psychological distress, and (c) perceptual distortions associated with alcohol withdrawal than alcoholics with characterlogical-appearing MMPIs. Results were discussed in terms of need to control confounding effects of biosocial variables in cross-cultural research and implications that these effects may have on the generalizability of alcoholic personality typologies.