Cognitive-behavior therapy and physical disability

This article attempts to assist the cognitive understanding of children and adults with significant physical disability. A discrimination is offered between disability and handicap. Common cognitive schemes and irrational beliefs of people with physical disabilities are explored. The development of belief systems from a social learning perspective and several cognitive assumptions of parents and families of children who have physical disabilities are presented. Finally, certain self evaluative beliefs specifically related to physical disability are examined in terms of how they relate to self image and, concomitantly, behavior. The article offers information arrived upon from the author's clinical practice as well as the author's personal experience as a person with a physical disability.Dr. John D. Sweetland, received his Ph.D. in Clinical and School Psychology from Hofstra University in 1979. His doctoral dissertation involved the application of a Rational Emotive Education program specifically for severely physically disabled children. He is a licensed psychologist in New York State, a school psychologist with the Port Washington Public Schools and in private practice with offices in Merrick and Massapequa, Long Island. Dr. Sweetland had polio and is semiambulatory. He was also a gymnast and a nationally ranked competitive acrobat.     

Distinguishing deviant and non-deviant nurses using the personnel reaction blank

Personnel Reaction Blank (PRB) scores and biographical data were obtained from two groups of registered nurses; a deviant group, represented by those who had official actions taken against their nursing license by the Minnesota Board of Nursing (n=53) and a non-deviant group of nurses (n=79) randomly selected from a broader population. The hypothesis that the deviant group of nurses would exhibit lower PRB scores, on average, compared to the non-deviant group was confirmed. The mean PRB scores for the deviant nurses (m=32.43) were significantly lower (p.01) than for the randomly selected non-deviant nurses (m=35.06). A multiple regression logit analysis showed that in addition to PRB scores, college degree, sex, and household income variables were also significantly related (p.001) to deviant and non-deviant group assignment; nonetheless, PRB significantly differentiated these groups after holding these variables constant.This study is based on the Masters thesis research of the first author. We acknowledge the help of the study subjects who contributed their time and effort.     

Safety locus of control and employees' accidents

This study further established the criterion-related validity of the Safety Locus of Control Scale. The safety scale was designed to predict employment applicants' propensity for on-the-job accidents. In this study, 283 hospital employees with moreexternal safety locus of control orientations reported significantly more occupational accidents, as well as more severe and costly injuries, than workers with moreinternal safety attitudes (p<.05 in all cases). Implications of these results are discussed.Research study presented at the 1988 Annual Conference of the Association of Human Resources Management and Organizational Behavior, Long Beach, California, October 26–29.     

Near-death experiences in India: They have tunnels too

An advertisement in an Indian newspaper solicited accounts from people who had come close to death. Of 19 received, 7 reported no experiences, 4 reported dreamlike experiences, and 8 reported near-death experiences (NDEs). These DNEs were comparable to those reported by Ray-mond Moody, and included tunnels, dark spaces, and bright lights, contrary to previous reports of Indian cases. Many respondents reported positive life changes regardless of whether or not they had an NDE.     

Group analytic therapy with schizophrenic outpatients

This paper describes a model for group analytic psychotherapy with patients who have been psychotic, namely, schizophrenics and manic depressives. The groups are run on the group centered principles of S. H. Foulkes. They are continuous, slow-open groups, in line with these patients' needs for long-term therapy. A theory is proposed which justifies treating these patients in group-centered groups despite their great dependency needs. The paper also describes the task of the therapist in building and running such a group.Acknowledgments to Geoffrey Elkan, Marcia Levene, Noa Rotem, Aya Levi-Posnanski, Yossi Ezrati, S. Littman, Tamar Sternberg, E. Danilowitz, and C. Kauffman.     

Menarche: A crossroads that previews developmental change

In recent years the developmental implications of menarche have garnered particular attention. Investigators have determined that this developmental event tends to affect three significant domains of the adolescent girl's function: psychological status, relationships with peers, and role in the family. This paper explores these issues and introduces a new technique, referred to as previewing, that may help the teenage girl acclimate to the status of sexual maturity. Derived from the early life interactions of caregiver and infant, previewing promotes representational skills and enhances self-esteem as the adolescent confronts developmental challenges.     

Affective interactions of depressed and nondepressed mothers and their children

The expressed affect of clinically depressed and nondepressed mothers as measured by the Schedule for Affective Disorders and Schizophrenia: Lifetime Version (SADSL) and their children (1 1/2 to 3 1/2 years) was observed in seminatural situations. The objectives were to investigate how maternal depression enters into affective interactions between mother and child and how the affect patterns of mother and child are related. Fortynine unipolar and 24 bipolar depressed mothers and 45 nondepressed mothers were observed on 2 days, 2 weeks apart, for a total of 5 h. Each minute was coded for the predominant affect of mother and child. Affects relevant to depression (anxioussad, irritableangry, downcast, pleasant, tenderaffectionate) were coded. Depressed mothers expressed significantly more negative affect than did control mothers. Mothers' expressed affect and their selfreports of affect on days of observation were unrelated. Mother's and child's affects, measured on different days, were significantly correlated. Unipolar mothers and mothers severely depressed spent significantly more time in prolonged bouts of negative affect. There was significant synchrony between their bouts and the negative bouts of their daughters. Gender of child was related to mother's and child's affect, and to relations between mother's and child's affect.     

Three forms of stress in Cambodian adolescent refugees

Sixty-nine Cambodian adolescents and young adults were interviewed to determine their experience as children surviving the Pol Pot regime (1975–1979);their first-year experience of resettlement in this country; and their experience of stressful events during the past year. Current DSM-III-R diagnostic status was also determined. A strong relationship between earlier war trauma, resettlement strain, and symptoms of posttraumatic stress disorder (PTSD) was found. In contrast, the strongest relationship with depressive symptoms was found for recent stressful events. These results are discussed in light of current findings from stress and PTSD research.Dr. Clarke is Assistant Professor of Psychiatry in the Division of Child Psychiatry, Oregon Health Sciences University, Portland, Oregon. Dr. Sack is Director of the Division of Child Psychiatry and Principal Investigator of the Khmer Adolescent Project. Brian Goff is a Research Assistant.This project was supported by the National Institutes of Mental Health [NIMH] grant #5-RO1-MH42927-02, Dr. William H. Sack, M.D., Principal Investigator.     

Conversational time patterns and mutual influence in parent-child interactions: A time series approach

Mutual influencing processes are assumed to be the basic building blocks in establishing parentchild bonding and in influencing cognitive and language behavior. A study by Jasnow and Feldstein (1986) revealed that, within the temporal domain of speech, preverbal (9-month-old) infants and their mothers exhibit a pattern of mutual influence (attunement) in their average durations of switching pauses. The general purpose of this research was to extend those findings to children with higher verbal functioning. In addition, parent and child genders, nature of the interaction, and specific aspects of parents' personalities, expressiveness, and instrumentality were considered. Each parent interacted with their 4-or 5-year-old son or daughter in each of two conversations—unstructured (social conversation) and structured (task activity). Conversations were processed by an automated computer system yielding objective measure of turns, vocalizations, pauses, and switching-pause durations. To examine interspeaker influence or attunement of temporal speech patterns, influence coefficients were computer for each speaker on a turn-by-turn basis using time series regression. Analysis of these coefficients revealed that: (1) Mutual influence is most evident with switching-pause duration. (2) Structure in the conversation (as defined by the task or parental instrumentality) seems to facilitate attunement for vocalization and switching pause duration. (3) Attunement with girls seems to occur equally well with both parents, while boys exhibit a style of temporal patterning influence which suggests greater identification with the father. (4) Expressiveness seems to facilitate attunement to the child's switching-pause duration.     

The termination phase of combined therapy

Three different kinds of termination are described and discussed. In combined therapy the group can help to resolve and clarify the meanings of moves to terminate therapy. The role of the therapist's countertransferences in this stage of the work is important to consider, and here, too, the group is an important part of the work. The author sees termination as an important part of the treatment process. In combined therapy it may be more complex but it also allows for a fuller exploration of the relevant issues.