Etiology of the Masochistic and Narcissistic Personality

The American Journal of Psychoanalysis -     

Non-heart-beating organ donation: a reply to Campbell and Weber.

In the preceding commentary, Campbell and Weber raise two valid and important issues concerning non-heart-beating organ donation (NHBOD). First, because the procedure links withdrawal of life support and the potential for subsequent organ donation, the desire for organs may create a situation in which care of the dying individual has relatively less importance and the dying may receive suboptimal care. Second, even if concerns about care of the dying were dealt with adequately, there will not be enough non-heart-beating donors to significantly decrease the organ shortage that exists, making the procedure not worth the risk. We agree that attention to the important details of caring for the dying are, and must be, the primary concern of all health care workers caring for those individuals. Ensuring the patients' comfort, dignity, and autonomy, and providing for family and social support are the mainstays of this care. All policies for NHBOD should clearly support and mandate these concepts. Regarding the second concern, we agree that NHBOD is currently rare; however, evidence is increasing that this type of donation has great potential. Continued growth of the practice in this country will depend largely on public acceptance, which we believe will be directly influenced by whether the public perceives that care of the dying is not compromised by this procedure.     

Personal advertisements of male-to-female transsexuals,homosexual men,and heterosexuals

Transsexuals, because of their attempts at gender reversal, offer a unique opportunity to study self-presentation, social roles, and stereotypes. The present study is a content analysis of personal advertisements of male-to-female transsexuals (TM, N =99), homosexual (HoM, N =64) and heterosexual men (HM, N =99), and heterosexual women (HW, N =99). Advertisements were coded for the presence or absence of 11 characteristics either offered or sought, based on the 1984 work of Deaux and Hanna. The content of TM personal advertisements was significantly different from those of HW, HM, or HoM. TM mentioned physical characteristics and sincerity, and requested friendship most often; HoM mentioned sexuality most often; HM offered financial security and status in the form of occupation, and listed marital status most often; and HW offered personality characteristics and attractiveness most often. Several factors may contribute to the pattern of differences observed, including the fact that TM were more likely to be seeking friendship than sexual partners, in contrast to the other three groups.     

Family therapy and soiling

Children and families referrred for soiling problems present special challenges to family therapists. Behaviour modification and the externalizing approach of White and Epston are considered in relation to these challenges. Externalizing may offer advantages over existing approaches and deserves systematic evaluation.     

Counseling and screening for cystic fibrosis in patients with congenital bilateral absence of the vas deferens: Patient perceptions

Congenital bilateral absence of the vas deferens (CBAVD) occurs in approximately 1.3% of infertile males and is thought to be, in most cases, a primarily genital form of cystic fibrosis (CF). Fourteen males with CBAVD considering microsurgical sperm aspiration from the epididymis (MESA) and in vitro fertilization were seen for genetic counseling and screening for CF. To retrospectively evaluate these patients' perceptions of the counseling and screening information, we conducted structured telephone interviews to assess their recall of information about CF and its impact on their health concerns and reproductive plans. We found that, as the health implications of CF are abstract and not as important to patients as the diagnosis of CBAVD itself, patients tend to view their CF status primarily in terms of their reproductive potential. Retrospective analysis afforded us an opportunity to identify the psychosocial issues of most concern to this unique patient population.     

The psychologist's role in assessing and facilitating patients' knowledge of advance directives in medical settings: A preliminary investigation

In a time of budgetary shortfalls in the medical industry, an aging population, and an increased emphasis on health care choices, psychologists are being called upon to administer advance medical directive programs to patients. This study reports preliminary findings from a program to assess and facilitate patients' knowledge of advance directives (ADs) by the Psychology Service at the Ann Arbor VA Medical Center. The participant pool included 243 male veteran patients admitted to medical and surgical wards at the hospital. The intervention included the use of a computer-generated prompt for consultation, which was sent to the psychology staff in response to a patient inquiry regarding ADs. It also involved an increased emphasis on the delivery of written material on ADs by the admissions clerks. The intervention appeared to result in a modest increase in patients' knowledge of advance directives. Suggestions are offered for areas that should be emphasized in future attempts to increase patients' knowledge and utilization of advance directives.     

Nonstranger sexual aggression: A discriminant analysis of the psychological characteristics of undetected offenders

Sex Roles - Rape is an underreported and underconvicted crime. Therefore, many highly sexually aggressive men are missed by research employing judicial identification for sample selection. The...     

Incidental memory for format of presentation of number stimuli: Evidence from monolinguals and bilinguals

Are numerical stimuli represented in an abstract code or is information about surface format preserved in memory? Three experiments bearing on this issue are reported. All used an incidental recall procedure. Two experiments examined memory for numeral versus word format in monolinguals and the third examined memory for words in the first versus second language of Spanish-English bilinguals. Across all studies, memory for format of number presentation was above chance and was as high as 76% under certain conditions. Implications for number representation are discussed.     

Cognitions, affect, and behavior following uncontrollable outcomes: A response to current human helplessness research

A series of articles in the Journal of Personality challenge several central assumptions of the reformulated learned helplessness model: that perceptions of uncontrollability, awareness of noncontingency between responses and outcomes, and attributions made about the outcome are necessary to explain learned helplessness effects. The present article addresses the validity of this challenge through a consideration of the methodology employed in these and other traditional studies of human helplessness conducted in the laboratory. We maintain that although performance deficits can be demonstrated reliably following exposure to uncontrollable outcomes, a number of factors other than expectations of future uncontrollability (i.e., learned helplessness) may be responsible for these effects. In addition, demands of the experimental situation may prevent subjects from admitting their true underlying thoughts and feelings regarding the manipulations employed. Finally, the current use of artificial laboratory paradigms may unnecessarily restrict the study of a complex psychological phenomenon such as learned helplessness. We suggest that future researchers employ paradigms that more closely parallel real world situations to which they hope to generalize, or utilize naturally occurring uncontrollable life events to study the problem. In addition, we argue that future research should broaden its focus beyond attributions to explore other mediators of human helplessness.     

Effects of an observer on eating behavior: the induction of "sensible" eating.

An experiment was conducted to investigate the extent of caloric compensation to differential preloading among normally restrained and unrestrained female subjects. Subjects' eating was either explicitly observed or unobserved by the experimenter. Unrestrained eaters compensated appropriately for the preload, whether or not they were observed. Restrained eaters failed to compensate when unobserved , but compensated strongly when observed. A subsequent unobserved eating task revealed that restrained eaters failed to compensate for prior consumption when the observer was withdrawn. Implications for research and therapy are discussed.