Book Reviews

F ordham , M ichael . The Making of an Analyst: A Memoir
R edfearn , J oseph . The Exploding Self: The Creative and Destructive Nuckus of the Personality
G ordon , R osemary . Bridges: Metaphor for Psychic Processes
J ackson , M urray and W illiams , P aul . Unimaginable Storms: A Search for Meaning in Psychosis
S tevens , anthony . Jung
W eissman , J udith . Of Two Minds: Poets Who Hear Voices     

Life after Trauma: Personality and Daily Life Experiences of Traumatized People

In this study, we explored differences in personality and daily life experiences of traumatized (n= 26) versus nontraumatized (n= 30) college students. Study participants completed a variety of personality measures as well as a 28–day experience sampling study assessing daily activities, emotions, and physical health. Although not differing on general demographics, traumatized individuals reported more trait anxiety and lower self–esteem than nontraumatized individuals. They scored higher on Neuroticism, were more introverted, and were less emotionally stable than nontraumatized participants. Traumatized individuals also reported more cognitive disturbances, emotional blunting, and interpersonal withdrawal. They did not report being more depressed, but did endorse cognitive styles associated with heightened risk for depression. Earlier age of trauma was associated with more pathological outcomes: lower self–esteem and psychological well–being, more anxiety, more pessimism, and emotional constriction of positive mood. We compare this symptom profile to that of posttraumatic stress disorder.     

The listening heart and the chi square: clinical and empirical perceptions in the family therapy of anorexia nervosa

Clinical and empirical methods are commonly considered to be complementary activities. However, many people in the fields of mental health and social welfare espouse a strong adherence to experimental, scientific methods for the evolution of theory and practice and consider only that which has been experimentally tested as‘really true”. Others would propose the clinical method as the main source of useful knowledge and are suspicious of enumeration and quantification as sources of useful information. Formal, empirical methodology is well and extensively described whilst there is less systematic exposition of the clinical method. Family therapy evolved in a context in which activity was visible and the emerging discipline was propelled by a theoretical framework with strongly scientific origins that was critical of the exclusive clinical method of pre-existing psychotherapies. This paper describes some of the clinically based contributions to the family therapy of anorexia nervosa and compares this information with that which comes out of the Maudsley trials of psychotherapies in anorexia nervosa.     

Aesthetic preference and DSM-IIIR personality disorders

This report tested whether those individuals with a cluster B DSM-IIIR personality disorder (narcissistic, borderline, antisocial or histrionic) had higher scores for aesthetic preference for visually complex drawings using the Barron-Welch Art Scale. In a sample of 141 patients and controls, the 56 subjects who met the criteria for one of the cluster B personality disorder diagnoses displayed higher Barron-Welch Art Scale Scores. A multiple regression analysis showed that narcissistic and borderline personality disorder contributed positively, while dependent personality disorder, negatively to preference for complexity. The findings support the notion that aesthetic choices and values reflected through the dimension of openness to experience may contribute to the behavioral manifestations of the personality disorders.     

Procuring organs from a non-heart-beating cadaver: commentary on a case report

Procurement of organs from non-heart-beating cadaver donors raises concerns. Standards for optimal patient care during withdrawal of life-sustaining therapy are evolving and continue to be debated and studied. Consensus on specific procedures and methods has not been attained, however, and protocols for the procurement of organs from patients following the withdrawal of life-sustaining therapies may compromise the evolving standards and harm the patient and the attendant family. In addition, there is little evidence to suggest that such protocols will significantly increase the number of organs procured. "Non-heart-beating cadaver" protocols that do not give comprehensive attention to optimal patient/family care at the time of withdrawal of life-sustaining therapy ought not to be endorsed.     

Aggressivity,inattention, hyperactivity,and impulsivity in boys at high and low risk for substance abuse

Aggressivity, inattention, hyperactivity, and impulsivity are cardinal dimensions of externalizing behavior problems of childhood. They are diagnostic and clinical features of childhood disorders, and are thought to be linked to the subsequent development of adult disorders such as substance abuse (SA). Little is known, however, about the convergent and discriminant validity of these four constructs. We used multiple measures to develop indices of aggressivity, inattention, hyperactivity, and impulsivity in a sample of 10- to 12-year-old boys (N=183) with and without a family history of SA. Data were taken from mother reports, child reports, teacher reports, and laboratory tasks. The study aims were (1) to test the convergent and discriminant validity of aggressivity, inattention, hyperactivity, and impulsivity; (2) to examine whether the data were consistent with a model specifying the four constructs as indicators of one superordinate factor; and (3) to differentiate boys with and without a family history of SA in construct scores. The results supported the convergent and discriminant validity of the four constructs. Although discriminable, the constructs covaried strongly and were consistent with a model specifying them as indicators of a single superordinate factor. Boys with a family history of substance abuse scored higher than control boys on aggressivity, inattention, and impulsivity scores, but the groups did not differ on hyperactivity scores. The results are discussed in terms of the role of childhood behavior problems in vulnerability to SA.This work was supported by the National Institute on Drug Abuse grant No. DA 05605.     

An advocacy intervention program for women with abusive partners: Six-month follow-up

Presented the 6-month follow-up findings of an experimental intervention designed to provide postshelter advocacy services to women with abusive partners. The intervention involved randomly assigning half the research participants to receive the free services of an advocate, 4 to 6 hours per week, for the first 10 weeks postshelter. One hundred forty-one battered women were interviewed about their experiences immediately upon their exit from a domestic violence shelter: 95% of the sample were interviewed 10 weeks thereafter (postintervention), and 93% were successfully tracked and interviewed 6 months later. At the 6-month follow-up, participants in both groups reported increased social support, increased quality of life, less depression, less emotional attachment to their assailants, and an increased sense of personal power. Although women in both groups reported some decrease in physical abuse over time, there were no statistically significant differences between those with and those without advocates, and abuse continued to be a problem for many women. Those who were still involved with their assailants continued to experience higher levels of abuse and had been more economically dependent upon the men prior to entering the shelter. Women who had worked with advocates continued to report being more satisfied with their overall quality of life than did the women in the control group. The authors thank the Editor and anonymous reviewers for their helpful comments. Thanks also to all present and past staff of the Community Advocacy Project, who helped in data collection and analyses. This work was supported by National Institute of Mental Health Grant 1R01 MH 44849.     

Working with older adults and their families – a review

This paper discusses family work with older adults by exploring some of the related literature published since Herr and Weakland's work in 1979, and compares psychoeducational and systems-based approaches to work with later life families. Issues of bias and omissions in the existing literature, and the definition of family therapy with this client group are raised. Areas for future research are indicated.