Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.     

A MEDIATIONAL MODEL OF AUTONOMY, SELF-ESTEEM, AND EATING DISORDERED ATTITUDES AND BEHAVIORS

This study expands upon existing literature by examining how the relationship between autonomy deficits and low self-esteem may create a psychological environment conducive to the development of eating disordered behaviors. Findings supported a mediational model to account for eating disordered behaviors in 71 college women. In this model, lack of autonomy was related to decreased global self-esteem, which in turn was associated with bulimia, body dissatisfaction, and drive for thinness. Although only tentative and cross-sectional in nature, this study is of particular importance because it links autonomy and self-esteem in a coherent model predictive of eating disordered behaviors in college women. Developmental aspects of eating disorders and treatment implications are discussed.     

Sexual assault: Myths and stereotypes among Australian adolescents

Myths and stereotypes about sexual assault reflect a society which excuses perpetrators of assault and blames victims for failing to control men's sexuality. Such views are well-established by early adulthood, but there is little research with adolescents. This study surveyed two hundred forty-four 14–16 year old Australian high school students (105 male, 139 female), of Anglo-European descent. Males were significantly more likely to endorse sexual assault myths, to agree that forced sex was acceptable in some situations, and to hold false stereotypes about sexual assault. Males also held more restrictive attitudes toward women's roles and endorsed a greater level of sexism in dating relationships. This suggests that male and female adolescents have differing expectations of dating relationships, which may underlie sexual assault within relationships. Assault-supportive attitudes are apparent at a young age, supporting the need for educational and social interventions targeting young people.     

Corporate consciousness: Defining the paradigm

The concept of corporate consciousness is defined and discussed. In response to Campion and Palmer (1996), it is asserted that corporate consciousness is not a construct related to conscientiousness or moral responsibility, but an entirely new paradigm, related to awareness and information processing; the concept is cognitive, not metaphysical. Corporate consciousness serves as a framework for understanding the current trend within organizations toward greater awareness of societal realities, and of the organization's impact within larger systems. This framework borrows heavily from the cognitive, social, and organizational psychological literature and can be understood from both micro and macro levels of analysis. Also discussed are the issues of why and how to study corporate consciousness, as well as implications for the organizational practitioner.     

The effect of serving as a model of self-control on subsequent resistance to deviation in children

The effect of having a child serve as a rule-following model for other children on the model's own subsequent rule-following was investigated in a resistance to deviation situation. First- and second-grade boys (age range 73 to 94 months) who were told they would serve as self-controlling models for others and who actually served in this capacity touched prohibited toys less than did boys who were not told they would serve as models. Boys told they were to serve as models but who were prevented from performing deviated at a level between the models and boys given no responsibility. Having children serve as rule-following models for others is suggested as an effective, non-punitive technique to increase their self-control.     

A reexamination of sex differences in job preferences

Previous research has found conflicting answers to the question of whether males and females share similar preferences for various job characteristics. It is difficult to determine if the different findings are due to the different populations sampled, the various methodologies employed, or to a real change in the phenomenon itself. This study essentially replicates earlier work by having 130 male and 84 female college students rate the importance of 10 job characteristics for both themselves and members of the opposite sex. Both sexes rated motivators as important, but females also placed importance on the hygienes. Males tended to underestimate the importance of the motivators for females, while females overestimated the importance of hygienes for males. The subject's sex could be predicted by both the importance for self and importance for opposite sex ratings, contrary to the earlier study. The difference in results and interpretation was shown to be due to the type of analyses used. Additionally, it was found that females' job preferences were related to their mothers' educational achievement.     

The EPPI family therapy outcome study

Information was evaluated from 1014 families seen in an eight-year period by therapists connected with the Department of Family Psychiatry at Eastern Pennsylvania Psychiatric Institute in Philadelphia. Statistical analysis revealed several factors that had some predictive value in relation to outcome of therapy; these were race, past psychiatric hospitalization, type of presenting family problem, and number of sessions held. There was a rather good chance of improvement being noted by the therapist if the family stayed in treatment for eight or more sessions. About 90% of the cases were seen for less than 20 interviews. Only about 3% were seen for longer than 35 interviews. The vast majority of EPPI cases were short-term. Black families tended to present different problems from white, and therapy was terminated with blacks sooner than for whites. About 35% of families terminated after one to two interviews, and another 30% after three to seven sessions. Since families tended to benefit most after eight or more sessions, the need for better methods or techniques to engage families is highlighted.The research was supported in part by a Career Development Award from the University of California, San Francisco, to the first author.     

An awareness approach to the covert symptoms of stuttering

Speech-language clinicians working with the confirmed stuttering client are often faced with the clinical management of the covert symptoms of stuttering in addition to the more observable and measurable overt symptoms. The authors report the successful use of awareness techniques to exaggerate the subjective experience of these covert symptoms and encourage the use of these techniques as an adjunct to the counseling and desensitization procedures traditionally employed. A transcribed clinical management session in which several awareness techniques are used to aid the client in an introspective examination of “anticipation of stuttering,” is analyzed in order to reach some specific recommendations for using awareness techniques in the clinical management of the covert symptoms of stuttering.     

Manifestations, acquisition and diagnostic categories of dental fear in a self-referred population

This study aimed to clarify how manifestations and acquisition relate to diagnostic categories of dental fear in a population of self-referred dental fear patients, since diagnostic criteria specifically related to dental fear have not been validated. DSM III-R diagnostic criteria for phobias were used to compare with four existing dental fear diagnostic categories, referred to as the Seattle system. Subjects were 208 persons with dental fear who were telephone interviewed, of whom a subsample of 155 responded to a mailed Dental Anxiety Scale (DAS), State-Trait Anxiety Inventory and a modified FSS-II Geer Fear Scale (GFS). Personal interviews and a Dental Beliefs Scale of perceived trust and social interaction with dentists were also used to evaluate a subsample of 80 patients selected by sex and high dental fear. Results showed that the majority of the 80 patients (66%), suffered from social embarrassment about their dental fear problem and their inability to do something about it. The largest cause of their fear (84%) was reported to be traumatic dental experiences, especially in childhood (70%). A minority of patients (16%) could not isolate traumatic experiences and had a history of general fearfulness or anxiety. Analysis of GFS data for the 155 subjects showed that fear of snakes and injuries were highest among women; heights and injections among men. Fear of blood was rarely reported. Spearman correlations between GFS individual items and DAS scores indicated functional independence between dental fear and common fears such as blood, injections and enclosures in most cases. Only in specific types of dental fear did these results support Rachman and Lopatka's contention that fears are thought to summate.(ABSTRACT TRUNCATED AT 250 WORDS)     

Interpersonal Reactions to Depression and Physical Disablllty In Dyadic Interactions1

Examined the interpersonal responses of persons engaged in dyadic interactions with confederates who enacted either depressed or socially appropriate roles and appeared either with or without a physical disability. Subject negative evaluations of confederates were indirectly obtained from a thought-listing measure. The overt behaviors of subjects were surreptitiously recorded on videotape and measures of verbal and nonverbal behavior were acquired. Subjects spoke less to the depressed targets and had significantly higher rates of negative evaluations of these persons. In addition, subjects gazed less at the depressed confederates. These effects were not moderated by target physical appearance. Findings are discussed as they relate to social models of depression and the stigmatizing effects of disability.