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.     

A neural-network model enabling sensorimotor learning: Application to the control of arm movements and some implications for speech-motor control and stuttering

Summary Low-level motor control is defined as adapting an organism to the unique physical properties of its own limbs. The two-jointed arm serves to exemplify that effective low-level motor control demands a neurally mediated inversion of the dynamics, as well as of the kinematics, of a limb system. Reflex-like processing — that is, feedforword of either actual or predicted proprioceptive signals —is thereby assumed to be the principle of the dynamics control. As regards speech-motor control, the overall tool transformation is assumed to transform the force pattern of the articulatory muscles into speech sounds. Like the arm model, the vocal-tract transformation thus defined is also divided into two parts, namely the transformation relating the muscle forces to the mechanospatial states of the vocal tract (which is analogous to the forward dynamics including natural interarticulatory couplings), and the transformation relating the mechanospatial states to the speech sounds. Low-level speech-motor control, then, needs to invert both transformations, each of which can be learned by means of the self-imitation algorithm. Erroneous learning can fail to decouple interarticulatory coupling and therefore lead to abnormal feedback loops through the reflex-like operating neural network, which in turn can cause stuttering if audiophonatoric coupling is involved in learning.     

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.     

(My) spirituality in medical education

During these times of the situated, contingent text, it is not unusual for an author to disclose her biases and other sources of potential partiality as a researcher or theorist. That is, an author often discloses her race, class origins, or sexual orientation at the onset, announcing particularities that enable readers to adjust their reading to the subjectivities inherent to knowledge production. One glaring omission to these announcements, especially in medicine, has to do with the spiritual domain. This essay, written as a personal narrative, provides one example of how one's spirituality is connected to what and how one chooses to teach, even in the medical academy. Acknowledging those beliefs and considering how our spirituality (along with our other subjectivities that are known to us) may influence our work is an important process in developing a more reflective practice.     

The importance of stories in the act of caring

This article focuses on the essential role and function of story in the care of young children with emotional and behavioral disorders in an institutional setting. Highlighted in this article is the importance of story in the therapeutic relationship, its educational implications, and in theological reflection. A narrative approach of care becomes a way of healing both heart and mind, and is ultimately an act of love.     

Training Soviet immigrant therapists in the field of group psychotherapy

Between 1970 and 1990 about one-half million Jews immigrated to Israel, most of them from the former Soviet Union, including many mental health therapists who had trained and worked in the Soviet Union. This article addresses the special characteristics of this population, in general, and of the mental health therapists, in particular. It relates these characteristics to training for group psychotherapy. Key issues include their unique experience of the inner world as a source of danger, the specific defensive modes connected with this experience, their perception of authority as an agent of ideology, and their representation of the group as a persecutory entity and as a vehicle of indoctrination.     

Stories for therapy: The right story to the right person at the right time

In the postmodern information era with its increasing complexity and demands on my time, I find storytelling increasingly attractive. The right story told to the right person(s) at the right time in the right way can powerfully define and shape both individuals and the systems into which they organize themselves. As interventions go, I find stories to be relatively high impact, low-risk, parsimonious, and user-friendly. This paper contains some of my favorite teaching stories and describes why and how I use them as both a family therapist and teacher of family therapy.