An evaluation of the Garren-Edwards diet and behavior modification program

This study evaluated the efficacy of the Garren-Edwards Behavior Modification Program, which uses the Garren-Edwards Gastric Bubble as an adjunct to treatment. Group therapy sessions were conducted with 23 morbidly obese subjects for 6 months on a biweekly basis. Each therapy session used a five-stage problem-solving sequence designed to facilitate adaptive behavioral alternatives. In evaluating weight change, a multivariate analysis of variance was conducted along with two preplanned orthogonal comparisons. Patients lost significant amounts of weight between initial to 3-month (p<.0001) and 3- to 6-month intervals (p<0001). A similar treatment effect was noted in an additional sample of 24 morbidly obese subjects following 3 months of treatment (p<0005). The findings support the value of longer goal-oriented programs in promoting continued weight loss. Implications for treatment process and therapist interventions prompted by this new format are discussed.     

Fixing forensic patients: Psychiatric recommendations for treatment in pretrial settings

This article is concerned with psychiatric recommendations for treatment at the Metropolitan Toronto Forensic Service (METFORS), a clinical assessment agency providing both 1-day and 30-day evaluations of criminal defendants in Toronto, Canada. Analysis of both psychiatric reports and quantitative research instruments demonstrated the saliency of treatment as a central forensic issue at METFORS. Among a sample of 592 defendants, 134 were considered in need of outpatient care. Persons recommended for hospitalization were most likely to exhibit histories of mental health rather than criminal justice contacts; to be arrested for nonviolent offenses; to manifest psychotic behavior while at METFORS; to be found unfit for bail, incompetent to stand trial, in need of further assessment and dangerous to self; and to experience higher rates of hospitalization, but lower levels of criminalization during the two years following their initial forensic assessment. Psychiatric reports at METFORS tended to merge recommendations for treatment and assessment; to suggest prison or probation as means for securing clinical treatment; and to provide little written support for judgments about the need for intervention. Along with competency and dangerousness, treatment is a key issue in forensic practice, and warrants further attention in the psycholegal literature.     

Treatment recommendations for mentally disordered offenders: More than roulette?

Clinical judgments on the treatability and prognosis of mentally disordered offeenders (MDO) may strongly influence legal dispositions and the availability of treatment resources. This study examined 1,238 discharge summaries for MDOs referred for court assessments. Psychiatrists evidenced marked variability in how often they recommended treatment and how frequently they judged patients to have a poor prognosis. Two logit analyses suggested that diagnosis and consultation by other clinicians were associated with (a) treatment recommendations (i.e., Axis I diagnosis and social work consultations) and (b) prognosis (i.e., Axis II diagnosis and psychology consultations).     

Effects of male social status on reproductive success and on behavior in mice (Mus musculus)

Differences in reproduction as well as in behavior in the presence of females were evaluated according to dominant and subordinate male rank in albino mice, in the temporary absence of each male's antagonist. Dominant males reproduced more successfully than subordinate males. Subordinate males were generally inactive, except for displacement activities, during the first 15 min they were exposed to female partners. These findings suggest that mechanisms other than male-male interference or mating order may be operating or influencing behavior and reproductive results.     

Daily stress and anxiety and their relation to daily fluctuations of symptoms in asthma and chronic obstructive pulmonary disease (COPD) patients

Although stress and anxiety have long been assumed to play an exacerbatory role in asthma, no study has systematically documented that daily exacerbations of asthma symptoms are related to stress and/or anxiety. In this study, 24 airways obstruction patients (12 asthmatics and 12 chronic obstructive pulmonary disease patients) were instructed to monitor the severity of daily respiratory symptoms. In addition, subjects recorded their daily anxiety level and the number and perceived impact of daily stressors. The results showed that although there were differences between high- and low-stress days for both groups, there were no differences between groups on symptom severity or between high- and low-anxiety days, as measured by the State-Trait Anxiety Inventory (STAI). Thus, although the number and impact of daily stressors were found to be directly associated with the severity of asthma symptoms, anxiety does not appear to have a direct role in the exacerbation of asthma. The findings failed to support the anxiety theory of asthma but provided an explanation for the poor results obtained in previous treatment studies which employed anxiety management with asthmatics.     

The Multilevel Conception of Intentionality: Implications for counselor training

Counseling training programs have failed to differentiate between and among behavioral, cognitive, and unconsciousness dimesnsions. This omission has resulted in confusion and competition in many counseling curricula in that valuable programs are competing for space rather than being integrated systematically. This article proposes a multilevel model of intentionality which integrates the several aspects of the counselor-client relationship. In turn, this integration of behavioral, cognitive, and unconscious dimensions will have important applications in counselor daily practice.     

Recurring thoughts on unconscious ego resistances.

Analysis of the unconscious ego resistances is one of those clinical concepts more honored in the breach than in the observance. This same point has been made periodically over the past fifty years. It has not been sufficiently realized that a true psychoanalytic understanding of resistance analysis could only begin with Freud's second theory of anxiety. Freud himself never fully embraced this theory, and clinical contributions since then have varied in their ability to use the techniques inherent in the second theory of anxiety. Recent contributions to the literature have not eliminated the espousal of theories of resistance based on earlier views of anxiety. Reasons cited for this include: the ambiguities in Freud's writing, the direction of the early ego theorists, and proclivities toward deeper interpretations.