Effects of Social Demand on Reports of Self-Monitored Blood Glucose in Adolescents with Type 1 Diabetes Mellitus

The purpose of this study was to test the hypothesis that social demand could substantially affect reports of self-monitored blood glucose (BG) in adolescents with insulin-dependent diabetes mellitus. Of 34 patients initially enrolled in the study, 10 were excluded because they did not bring any BG records with them to an outpatient clinic appointment. The remaining 24 patients were randomly assigned to either a low or high social demand condition that provided instructions for monitoring of BG for the week following the appointment. The subjects' BG records were quantified to provide frequency of measurement and mean reported BG for the week prior to and after the clinic visit. Five subjects did not return their BG records for the week following the intervention. The analyses were therefore based on the 19 subjects from whom complete records were obtained. The 12 subjects in the low social demand group and 7 subjects in the high social demand group were equivalent with regard to age, duration of diabetes, socioeconomic status, and glycosylated hemoglobin. Frequency of BG measurement was similar in both groups during both weeks. The mean BG value reported in the week prior to intervention was similar for the groups. However, analyses of the post-intervention BGs revealed that subjects in the low-demand group reported significantly higher BGs compared to pre-intervention and to subjects in the high-demand group. These findings suggest that self-monitoring and reporting of BG is a social behavior that is affected by the demand characteristics of the interpersonal patient-health provider relationship. Because optimal treatment planning for individuals with diabetes requires accurate BG records, care must be taken to interpret them in light of the social demand characteristics associated with clinical assessment.     

Attempts to train novices for beer flavor discrimination: a matter of taste

Inexperienced beer-drinkers who could not pass a beer-flavor discrimination test were divided into a taste group, which received additional perceptual experience with beer flavors; a verbal group, which received instruction in beer flavor terminology; a taste/verbal group, which received both additional experience and instruction; and a control group. Before and after training, all subjects participated in a similarity rating task involving beer flavors and flavor-related adjectives. Additional taste experience--but not increased experience with beer-flavor terminology--improved novices' ability to detect identical beer flavors. Results are discussed in terms of the trainability of flavor discrimination and the role of cognitive factors (both flavor-related and flavor-independent) in marketing beverages.     

The effect of mood and pleasant versus unpleasant information feedback on performing a motor skill

The effect of negative, positive, or neutral feedback on a rotary pursuit task as a function of the subject's depressed or elated mood was ascertained. Specifically, the self-schema hypothesis was examined. Ninety female volunteers, ranging in age from 18 to 25 years, participated. They were randomly assigned to one of eight conditions based on depressed or elated mood states, elicited by Velten's (1968) mood induction procedure, and feedback. A control group received no feedback and was not subjected to a mood inducing treatment. Baseline measures and changes in mood were determined by the Multiple Adjective Affective Checklist (MAACL). Bogus feedback was offered after all but one of the trials. The subjects' mood changed significantly during the mood-inducing treatment. For motor performance, partial support was lent to self-schema. Elated and depressed subjects performed best under positive and negative feedback, respectively. The effects, however, were temporary.     

Children's understanding of death according to parents and pediatricians

Thirty pediatricians and 30 parents were interviewed on (a) how and when children develop concepts about death, (b) children's emotional responses to the thought of death, (c) the possibility of dialogue between adults and children about death, and (d) differences in healthy and seriously ill children's conceptualization of death. Pediatricians were no different than parents in their opinions. Moreover, in some cases, less educated parents and older doctors tended to hold opinions that were even farther from reality. Overall, the results suggest that children, healthy or sick, are left alone with the problem of death and are not helped either by their parents or by their doctors.     

A record-keeping format for training systemic therapists

Training in systemic therapy necessitates a structured approach to teaching systemic thinking. The Systemic Therapy Sessions Summary Form, a record-keeping method, is presented as a tool for enhancing training in systemic therapy. The purpose of this form is to provide the structure for the trainee to develop circular hypotheses, to connect reflexively the assessment and intervention components of therapy, and to maintain a sense of the evolving nature of therapy across sessions. A case example illustrates the use of this record-keeping format.     

The Anorectic Process in the Family: A Six-Stage Model as a Guide for Individual Therapy

This article presents a conceptual framework for individual treatment with chronic anorectic patients. In the first part of the article, the six-stage model for the anorectic process developed over the past years by M. Selvini-Palazzoli and her team is briefly explained. After presenting the model, we then discuss some related concepts, namely, "family game," "rule," and "strategy." Finally, the therapeutic technique in individual treatment is discussed. Two basic assumptions underlie this technique: first, the therapeutic relationship is instrumental, its main purpose being to improve the patient's personal relations outside therapy; second, the focus of the treatment is on the strategic incapacity of the patient who is caught up in and unable to cope with the "concealed family game."     

Systemic crisis intervention as a response to adolescent crises: an outcome study

The present study demonstrates the safety and effectiveness of an outpatient program designed to respond to adolescent-precipitated crises by mobilizing and restructuring the family's kinship system. Families of 75 adolescents at risk for hospitalization were followed up to 24 months after treatment with Systemic Crisis Intervention. Measures of offspring and family functioning, suicidal behavior, institutional use, and treatment costs are presented. Results clearly demonstrate the safety, effectiveness, and economic viability of Systemic Crisis Intervention.     

Systemic Optimism — Systemic Pessimism: Two Perspectives on Change

Therapists have a mandate to bring about change, and family therapists appear to have unusual leverage to fullfill such a mandate, that is, to facilitate changes rapidly and effectively. Because and in spite of this mandate, the very notion of change deserves critical reflection. The history of ideas and our clinical experience teach us that changes may be problematic. They may come too fast or too slowly, may endure or fade away, may turn out to be desirable or undesirable, equitable or inequitable, and may, when further consequences and larger systems levels are taken into account, be beneficial or disastrous. This essay examines some of the problematical and contradictory aspects of change and delineates two perspectives on change--systemic optimism and systemic pessimism.