Reassurance in Analytic Therapy

The American Journal of Psychoanalysis -     

DIRECT AND COLLATERAL EFFECTS OF RESTRAINTS AND RESTRAINT FADING

Mechanical restraints are commonly used to reduce the risks associated with severe self-injurious behavior (SIB), but may result in movement restriction and adverse side effects (e.g., bone demineralization). Restraint fading may provide a method for decreasing SIB while increasing movement and reducing these side effects. In the current investigation, rigid arm sleeves and restraint fading (gradually reducing the rigidity of the sleeves) were used with 3 clients who engaged in hand-to-head SIB. Restraints and fading reduced the hand-to-head SIB of all clients. However, for 1 client, the addition of a water mist procedure further reduced SIB to near-zero levels. For a 2nd client, another form of SIB developed that was not prevented by the rigid sleeves. For a 3rd client, a topography of SIB that was not physically prevented by the rigid sleeves was also reduced when restraints and fading were introduced.     

A course in hypnosis for chaplains

Understanding the mental processes involved in suffering has always been the best basis for communication between patients and caretakers. In this paper we are concerned first with acknowledgment of the existence, generally unknown, and the effects, generally unrecognized, of the hypnotic processes that occur in many forms of suffering, and second with developing our thesis that the understanding and use of hypnotic principles can greatly enrich the chaplain's capacity to alleviate suffering. In this brief presentation we will confine our discussion to the teaching of hypnosis as a virtual necessity in modern clinical training for chaplains. Comments and considerations will precede and follow an outline of the course presently offered at Lenox Hill Hospital [but we cannot here attempt to discuss or explain the fundamentals of hypnotic process or any other aspects of the course content itself]. A basic bibliography is appended for those who wish to know more about hypnosis itself.     

A DEVELOPMENTAL DEFICIT IN LOCALIZING OBJECTS FROM VISION

Abstract— We describe a college student, A. H., with a developmental deficit in determining the location of objects from vision. The deficit is selective in that (a) localization from auditory or tactile information is intact, (b) A H reports the identity of mislocalized objects accurately, (c) visual localization errors preserve certain parameters of the target location, and (d) visual localization is severely impaired under certain stimulus conditions, but nearly intact under other conditions. These results bear on the representation and processing of location information in the visual system, and also have implications for understanding developmental dyslexia.     

Measures of feeling-of-knowing accuracy: A new look at an old problem

Two ordinal measures of feeling-of-knowing performance appropriate for n × n data arrays are reviewed. Goodman and Kruskal's gamma provides a measure of association between recognition performance and feeling-of-knowing judgements. The Hamann coefficient provides a measure of agreement accuracy. The relative strengths and weaknesses of each measure are compared at length. A proof is provided, which reveals a lack of one-to-one relation between the two and suggests that they may be independent under most circumstances. It is concluded that both measures should be reported together as complementary indices as each captures a different facet of feeling-of-knowing performance. Alternative measures for gamma and the Hamann coefficient are considered and a number of recommendations are made for future research.     

Use of a computer-controlled firearms training simulator in perception response time experiments

This paper describes the use of a custom-configured computer-controlled firearms training simulator to measure perception response (reaction) time (RT) to a stimulus in which the degree of threat presented is a manipulable variable across trials. The computer records the number of frames of videotape traversed between the point of presentation of the threat in the video stimulus and the point at which the subject responds by drawing the firearm. For the purposes of data analysis, these frame-count measures are converted to RT measurements. Example data are presented that capture perception RT at both thedraw-stimulus and thefire-stimulus points in situations for which either only one threat or more than one threat exists. Other elements, such as degree of threat and accuracy of response, provide additional data.     

The mediating role of anxiety in self-reported somatic complaints of depressed adolescents

This study examined the mediating role of anxiety in the self-reports of somatic complaints in 96 depressed adolescent inpatients. Sixty-four subjects with major depressive episodes and comorbid anxiety disorders (MDE-A) determined from the Diagnostic Interview for Children and Adolescents-Revised (DICA-R) reported significantly more somatic complaints than 32 adolescents having major depressive episodes without comorbid anxiety (MDE). An analysis of covariance demonstrated that, with anxiety symptoms controlled, MDE and MDE-A groups did not differ significantly in somatic complaints. A hierarchical multiple-regression analysis revealed that, with demographic and anxiety symptoms controlled, depressive symptoms did not contribute to the explanation or prediction of somatic complaints. The results suggest that anxious, but not depressive symptoms, are independently associated with somatic complaints. The results are discussed in light of new affective models of psychopathology.     

Indirect modes of aggression among women of Buenos Aires,Argentina

This study utilizes the construct indirect aggression to investigate aggressive behavior among middle class Argentine women and men by administering an attitude and self-report survey to 95 inhabitants of Buenos Aires and by analyzing ethnographic interviews and observations conducted over a nine month period in 1992. An examination of sex roles in Argentina, including machismo and marianismo, provide a cultural context for interpreting aggression. Factor analyses revealed the presence of indirect aggression (e.g., social manipulation, gossip, exclusion) in addition to verbal and physical aggression. Survey and ethnographic findings converge in suggesting that women employ more indirect aggression than men, while men utilize more physical aggression. While competition and aggression are salient elements of social life for both sexes, women and men tend to favor different approaches. The findings are compared with the literature on female aggression from other cultural settings. We conclude that cultural and evolutionary perspectives elucidate aspects of female aggression.We would like to thank the Ford Foundation for providing the financial support to make this research possible. We would also like to thank Patricia de Gyldenfeldt and Debbie Bandura for their endless contributions with translations, ideas, and help in general. Finally, we would like to thank Eckerd College, la Universidad del Salvador, and Michael Hobson for their base of support, all those in Argentina, especially Agueda, Andrea, Carmen, Cecilia, Claudio, Daniela, Heidi, Ingrid, Javier, Julio, María, Mariela, Roberto, and Victor, who offered their enthusiastic assistance and ideas, and Victoria Burbank, Ayala Gabriel, and the anonymous reviewer for their helpful suggestions.