Diaphragmatic spasm: A neglected cause of dyspnoea and chest pain

The study included 17 patients, 12 women and 5 men, with a recurrent symptom complex involving chest pain and dyspnoea characterized by inability to get a full breath. Some attacks had subsided spontaneously. Others had lasted hours or days. When examined by fluoroscopy during an attack, each subject was found to have a nearly maximally contracted (flat) diaphragm. In some of them the attack was promptly interrupted by a small intravenous injection of sodium amytal. In others it could be aborted by a conscious effort at full expiration. The syndrome associated with diaphragmatic spasm is discussed in comparison with other noncardiac sources of chest pain and dyspnoea.     

Sentence Context and Word Recognition in Children with Average Reading Ability and with a Specific Reading Disability

The inhibitory and facilitatory effects of context on word recognition were investigated in 24 8-to 10-year-old children with a specific reading disability in comparison with a group of 24 children matched for reading ability and a group of 24 children matched for chronological age. To avoid confounding the effects of reading level with those of word difficulty, target words of equivalent relative familiarity for each participant were presented in congruous, neutral, and incongruous sentence contexts. In agreement with previous studies, there was clear evidence of both general inhibitory and facilitatory effects. In contrast to previous findings, however, reading level did not have a major impact on the inhibition of word recognition in incongruous contexts compared with neutral contexts, although it may have led to greater facilitation in congruous contexts compared with neutral contexts. Although further research is required, these results suggest that if reading-age appropriate materials are selected, less skilled readers and those with a reading disability may not be as influenced by context as has been claimed previously.     

Beliefs about stories: Parents' and therapists' explanations of childhood difficulties

Therapists and parents were given vignettes describing the behavioural and emotional difficulties of two nine-year-old children and were asked to rate the importance of a number of possible explanations for such difficulties. Broad agreement was found between parents and therapists, but also there were a number of significant differences. Parents endorsed more child centered explanations and put greater emphasis on physical and developmental factors, while therapists endorsed relationships factors and saw the beliefs of other family members as important. Therapists who were parents showed a pattern of responses that lay between those of parents and non-parent therapists.     

MFT trainee adjustment to program lifestyle stress: The TAPS scale

The 30-item Trainee Adjustment to Program Stress (TAPS) scale was developed to measure lifestyle stress of family therapy trainees. Initially, 70 items were generated from propositional statements based on four constructs. Following pilot testing, 329 out of 900 (37%) student members of the American Association for Mariage and Family Therapy (AAMFT) returned TAPS questionnaires. Internal consistency reliability analyses and principal components and factor analyses produced a final 30 item TAPS scale appropriate for use in family therapy training programs. Reliability and validity measures are reported.     

Boundary regulation in family and personal systems: Perceptions of late adolescents

Examination of boundary regulation can provide family therapists with a framework to describe both the functioning of family systems and personal systems (i.e., the intrapsychic functioning of individual family members). In the present study, late adolescents' perceptions of boundary regulation within their family systems (i.e., ratings of family health, communication, leadership, expressiveness, cohesion, and family conflict) were related to regulation of their personal boundaries (i.e., self-reported personal competence, distress, and patterns of defense mechanism use). In addition, personal system variables reliably discriminated between adolescents who described their families as psychologically healthy versus psychologically unhealthy.     

Joining with all members of a family system: The rhetoric of antilogic in family therapy dialogue

Family therapists face a significant rhetorical challenge in working with families that disagree about the problematic life-situation which brought them to therapy. Therapists must find a way to join with disagreeing family members and then find a way to engage in a therapeutically useful conversation with them. Thus, they must deal resourcefully with contradictions. This article explores the ways that the Sophistic rhetorical concept of antilogic may be employed in helping therapists join and then engage in a therapeutically useful conversation with families who hold contradictory views concerning the problem that brought them to therapy.The author wishes to thank Ronald Chenail, PhD, Douglas Flemons, PhD, and Shelly Green, PhD, for their assistance in the development of this project.     

A plea for more intervision

The author presents an argument for tolerance, mutual understanding and reconciliation in psychotherapy, instead of a continued emphasis of schools. Psychotherapists' work with clients is proposed as a likely area for mutual understanding, rather than continued emphasis on their particular theories and academic matters. Psychotherapeutic intervision groups in which a small number of therapists voluntarily discuss their cases with peers from various backgrounds have become increasingly common again in recent years.Slightly revised version of a presentation made at the Georgetown Family Center Symposium in November 1995.