Autism: from research to practice

Autism is the most commonly studied of a spectrum of developmental disorders that are believed to be neurobiologically based but which, at this point, for lack of good biomarkers, are defined purely by behavior. In the last 20 years, the definition of autism has shifted in emphasis from extreme aloofness and positive signs of abnormality in repetitive and sensorimotor behaviors to a greater awareness of the importance of more subtle reciprocal social communication deficits as core features. Standard diagnostic instruments were developed for research purposes to acquire information both through caregiver interviews and direct clinical observation. Use of these instruments in clinical practice resulted in major improvements, which in turn affected research results. These results yielded further improvements that led to changes in clinical practice over time. The synergism between research and clinical practice in the understanding of autism is discussed.     

Distinctions Between Hostile and Nonhostile Forms of Perceived Criticism From Others

Criticism and hostility from others are related to fluctuations in symptom severity across many disorders, including depression and anxiety. Objective coding systems typically allow for distinctions between criticism and hostility, but the primary self-report measure of perceptions of criticism (the Perceived Criticism Measure) contains no such distinction. This report presents results from two samples regarding the assessment of specific perceptions of hostile and nonhostile criticism. In addition to these specific perceptions, we assessed relationship satisfaction, perceptions of overall criticism, and symptoms of depression and anxiety. Perceptions of hostile criticism were similar to ratings of overall criticism, as indicated by a positive correlation between these two and similar correlations with related variables. In contrast, perceptions of nonhostile criticism demonstrated more complex patterns of associations, showing a positive correlation with relationship satisfaction, a negative correlation with perceptions of hostile criticism, and a positive association with general perceptions of criticism only in the context of low depressive symptoms (as depressive symptoms increased, this association became significantly weaker). These results suggest that respondents do distinguish between perceptions of hostile and nonhostile criticism, and these perceptions are not simply different points on the same continuum. Moreover, they suggest that individuals with higher levels of depression may be less likely to incorporate nonhostile criticism into their overall perceptions of criticism from others.     

Relationship between a history of consistent maternal employment and depression in young adults

Research on the correlates of maternal employment has yielded inconsistent results. In this study, 79 male and 120 female undergraduates with mothers who had been employed from the students' infancy through their adolescence scored higher on the Beck Depression Inventory-II than those whose mothers had not been employed. This relationship between children's depressive symptoms and mothers' employment history was not evident among young adults whose mothers' employment was perceived to be financially unnecessary.     

Begin with a Text: Teaching the Poetics of Medicine

This paper suggests that the purpose of humanities teaching within medical education should be primarily to teach and promote the informed, attentive, critical, and precise reading of the multiple texts that constitute medicine as a discursive field—in short, a poetics of medicine. This claim is illustrated by reconsidering Margaret Edson’s play Wit, not as it is often used in medical education, as a cautionary tale about unprofessional behavior or as a way to inculcate “humanistic skills,” but as an analysis of the relationships between texts and feelings—or cognition and emotion, or science and art. This reading is illustrated by comparing the poetics of Wit with those of two other texts representing ovarian cancer: a scientific paper in Oncology and a clinical case conference in JAMA.     

Community-Based Participatory Research for Improved Mental Health

Community-based participatory research (CBPR) focuses on specific community needs, and produces results that directly address those needs. Although conducting ethical CBPR is critical to its success, few academic programs include this training in their curricula. This article describes the development and evaluation of an online training course designed to increase the use of CBPR in mental health disciplines. Developed using a participatory approach involving a community of experts, this course challenges traditional research by introducing a collaborative process meant to encourage increased participation by special populations and narrow the parity gap in effective mental health treatment and services delivery.     

The Group Psychotherapy Literature: 1976

This paper reviews and critiques the literature on countertransference (CT) in group psychotherapy. The literature review is organized within a framework that calls attention to the origins, triggers, manifestations, and effects of CT in groups, as well as CT management factors. An overriding critique is that the present literature lacks a research foundation of any kind. An argument is made for beginning research in this domain, and guidelines for doing so are presented.     

Play Group Therapy with Psychotic Adolescent Girls

In this paper, by using the perspective of self psychology, we hope to illustrate and explicate (through clinical examples) the positive aspects of the pairing phenomenon in group therapy with the elderly. Traditionally subgrouping or pairing has been viewed as the “Achilles' heel of group therapy,” and usually interpreted as defensive and destructive to group process. In this paper we distinguish between those instances of pairing and subgrouping that are defensive and those that are reparatory of the self system (the latter involving twinship and alter ego selfobject transferences). These reparatory transferences may play a constructive role in establishing group cohesion and allaying primitive somatic anxieties, especially in the elderly patient.     

State-Dependent Memory Effects Using Caffeine and Placebo Do Not Extend to Metamemory

The authors examined the impact of caffeine on human memory and predictions of memory (i.e., metamemory). On Day 1, 83 college students drank a sweetened beverage containing either caffeine (4 mg/kg body weight) or a placebo before they studied 40 pairs of words. While the participants studied, they predicted their future memory performance for each word pair. On Day 2, the participants again received caffeine or a placebo before the memory test. The participants who drank the same beverage on both days (either caffeine or a placebo) recalled more word pairs than did those who drank different beverages (caffeine on 1 day and a placebo on the other day). In contrast, memory predictions were more accurate when the beverages did not match on both days. These data provide evidence for state-dependent memory when caffeine is used, but not for state-dependent metamemory. People's memory and their predictions of memory can be influenced in different ways if they drink caffeine before they study or take a test.