An investigation of the effects of comorbid Axis II pathology on outcome of inpatient treatment for unipolar depression

DSM-based research on comorbidity has suggested thatdepression andpersonality disorder frequently occur together and that the combination of syndromes is associated with a poor response to treatment for depression. The present study was designed to explore the effect of comorbid Axis II pathology for a sample of 45 inpatients who received treatment for major depression. Both categorical and dimensional ratings of personality disorder were used in the statistical analysis. Positive categorical diagnosis of Cluster C (anxious-avoidant) disorder, as well as higher dimensional rating of Cluster A (odd-eccentric) pathology, was predictive of a poor response to treatment (p<.05), as measured by change in pre-post clinical ratings on the Montgomery-Asberg Depression Rating Scale. These results were construed as indicative of a significant Axis II comorbidity effect in the context of an inpatient, multimodal treatment setting for depression. The results also spotlight the influence of techniques of measurement in determining the outcome of statistical analysis.     

Critical incidents for refugee counsellors: An investigation of indigenous human resources

The mental health of refugees is increasingly being recognized as an important dimension of refugee welfare. In 1992 the Finnish Refugee Council established one of the first aid programmes to provide a therapeutic intervention to traumatized refugees. In an attempt to establish the necessary therapeutic ski& to work with this client group, we investigated the experiences of 15 refugee counsellors, using the technique of Critical Incidents Analysis. All of these counsellors were themselves refugees. Key features of their work are identified and the pros and cons of employing refugees as counsellors are discussed.     

Self-concept of African-American male youth: Self-esteem and ethnic identity

The role of perceived efficacy, parent support, and community involvement in the self-esteem and ethnic identity of 68 African-American male youth were investigated in this research. The results provided support for the distinctiveness of ethnic identity and self-esteem. A sense of mastery was positively associated with both self-esteem and ethnic identity. Parent support was associated with self-esteem, while community involvement and an appreciation of African-American heritage were positively related to ethnic identity. Implications for future research and the evaluation of prevention and support programs for youth are discussed.     

Depression and unemployment: Panel findings from the Epidemiologic Catchment Area study

Studies that have found an association between unemployment and psychological depression often fail to establish the direction of causal influence. Analyses of Epidemiologic Catchment Area panel data revealed that of employed respondents not diagnosed with major depression at first interview, those who became unemployed had over twice the risk of increased depressive symptoms and of becoming clinically depressed as those who continued employed. Although the increase in symptoms was statistically significant, the effect on clinical depression was not, possibly because of the low power of the test. The reverse causal path from clinical depression at Time 1 to becoming unemployed by Time 2 was not supported. The unemployment rate in the respondent's community at time of interview was not related directly to psychological depression but appeared associated indirectly with depression via its impact on the risk of becoming unemployed. Implications for policy and further research were discussed. The research described in this paper was supported by Grant #5 RO1 AA08379-02 from the National Institute of Alcohol Abuse and Alcoholism. The authors appreciate the suggestions provided by members of the Consortium for Research Involving Stress Processes sponsored by the W. T. Grant Foundation and by two anonymous journal reviewers.     

Examining the relationships between the socially desirable and undesirable aspects of agency and communion

Sex Roles - Two theories addressing the relationship between the socially desirable and undesirable elements of agency and communion have been proposed. In their 1979 study, Spence, Helmreich, and...     

Acceptance and commitment therapy: Altering the verbal support for experiential avoidance

Acceptance and Commitment Therapy (ACT) is a behavior-analytically-based psychotherapy approach that attempts to undermine emotional avoidance and increase the capacity for behavior change. An overview of this approach is given, followed by several specific examples of the techniques used within ACT. In each instance the behavioral rationale of these techniques is described. A contemporary view of verbal relations provides the basis for new approaches to adult outpatient psychotherapy.     

The Relationship Between Racism and Racial Identity Among White Americans: A Replication and Extension

The purpose of this investigation was to assess the influence of White racial identity attitudes on racism. A total of 234 White undergraduate students participated in this investigation. The students completed the White Racial Identity Attitude Scale (Helms & Carter, 1990) and the New Racism Scale (Jacobson, 1985). Consistent with findings in previous research, White racial identity attitudes were predictive of racism. We also found gender and age differences in White racial identity attitudes. Implications of these findings are discussed in terms of the role of counselors in addressing racial awareness on college campuses.     

Examining the Association Between Self-Reported Multicultural Counseling Competencies and Demographic Variables Among Counselors

The authors examined the association between demographic variables and self-reported multicultural counseling competencies among counselors. A national sample of 220 counselors affiliated with university counseling centers participated in this investigation. Counselors responded to 40 Likert-type statements about multicultural awareness, knowledge, skills, and relationships. Results from a series of multivariate and univariate analyses indicated that Asian American and Hispanic counselors reported more multicultural knowledge than did White counselors, and African American, Asian American, and Hispanic counselors reported more competence in multicultural awareness and relationships than did White counselors. No effects were found for other demographic variables. Implications of these findings are discussed.     

Accreditation Standards for University and College Counseling Centers

The accreditation standards outlined in the article are used by the International Association of Counseling Services, Inc., as the basis for the formal accreditation of college and university counseling programs throughout the United States and Canada. They reflect the program elements and practice standards that are deemed essential in a counseling center that provides high-quality services to students.     

Facilitator influence in facilitated communication

The use of facilitated communication with individuals with autism has generated considerable controversy over the past several years. Only recently has research begun appearing which examines the procedure using reasonable scientific controls to establish the validity of this form of communication. The present study assessed the validity of facilitated communication and evaluated the effects of facilitator influence with seven individuals with autism and mental retardation. Three individuals showed clear evidence of facilitator influence, another three showed no such influence, and one subject performed at chance levels. A follow-up session with the three subjects who showed no facilitator influence demonstrated that they also showed no unexpected language competence compared to their measured IQ and to assessment under standard conditions. Results are discussed in terms of significance for facilitated communication in general and in terms of the utility of the methodology as a means of demonstrating language competence or facilitator influence.