Diagnostic issues in posttraumatic stress disorder: considerations for the DSM-IV

Four issues of key interest with regard to posttraumatic stress disorder in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are discussed. These include: (a) how to define the stressor criterion, especially, whether or not the victim's response ought to be included and whether low-magnitude traumas qualify etiologically; (b) the cohesiveness of the syndrome and the validity of items across stressor groups; (c) the position of posttraumatic stress disorder within DSM-IV; and (d) comorbidity with other illnesses.     

Antidepressants in group psychotherapy

This article alerts us to consider depression as a relatively frequent cause of impasse in the course of group psychotherapy. The authors recommend the combined use of antidepressant medication along with group psychotherapy when such depression is confirmed independently outside the group. Common obstacles and pitfalls preventing successful combined treatment are reviewed; the depressive logjam is differentiated from common resistance; and profiles of responders versus nonresponders are described. A rationale of the combined treatment, its results, and implications for group therapists are all delineated.     

Emergent themes and roles in short-term loss groups

Clinical observations regarding themes and roles that are characteristic of short-term, psychoanalytically oriented therapy groups for loss patients are presented. They reflect aspects of both the therapy and the patients. Themes refer to the content of a recurrent conflict in the group. They include trust, survivor guilt, mortality, and termination. Roles refer to a set of patient behaviors that represent a shared conflict. They include the apparition, monk, professor, professional nurturer, emotional conductor, and cruise director. Challenges that the themes and roles present to the therapist and clinical guidelines for addressing them are offered. Awareness of characteristic themes and roles and possible therapist responses are regarded as important parts of the preparation and training of therapists who plan to conduct short-term loss groups.     

Assertiveness, social support, and psychological adjustment following spinal cord injury.

Tested predictions that assertiveness and social support would be significantly predictive of psychological adjustment. Furthermore, it was anticipated that assertiveness and certain types of social relationships would differentially interact to predict adjustment, since positive and negative effects of both variables have been noted in prior research. Trained raters interviewed 156 persons receiving either in-patient or out-patient care for cord injuries and administered measures of assertiveness, social support, depression and psychosocial impairment. Persons who reported a keen sense of responsibility for the welfare of another reported more depression and impairment. Persons reporting higher levels of support facilitating social integration and reassuring personal worth were less depressed. Several significant interactions between assertiveness and different social support relationships revealed beneficial and deleterious effects on depressive behavior and impairment secondary to the disability. Results are discussed as they advance theoretical understanding of the effects of assertiveness and social support. Implications for discriminate cue learning in assertion training for persons with physical disability are proposed.     

Cognitive therapy. A 30-year retrospective

Several lines of investigation have evolved from the initial cognitive model of depression and other disorders. A large number of studies have tested the cognitive model using both clinical and laboratory-based strategies. In general, studies that most closely approximate the clinical conditions from which the theory was derived are supportive of the cognitive model of depression. Studies of anxiety and panic, although fewer, generally support the cognitive model of anxiety and panic. The application to the treatment of clinical problems has been promising and supports the concept of cognitive specificity. The cognitive therapy of depression has led to the utilization of specific cognitive strategies based on the specific conceptualizations of a given disorder to a wide variety of disorders. Study of abnormal reactions has also provided clues to the cognitive structure of normal reactions.     

Recognition and Ratings of Television Music Videos: Age, Gender, and Sociocultural Effects

High school, younger college, and older college subjects rated explicit, neutral, or Christian television music videos according to theme clarity/recognition and whether the respective videos were liked/disliked. Subjects of each age group were able to recognize the themes of each music-video category with a high degree of accuracy. Younger subjects and males were found to rate the music videos, especially those selected for explicitness, more favorably than older or female subjects. Sociocultural background factors were also found to be related to recognition and ratings of the television music videos. In particular, working class background subjects. subjects who watched music videos regularly, and those that seldom or never attended church rated the music videos, especially the explicit ones, more favorably than subjects from a college town background, subjects who seldom or never watched music videos, and subjects who regularly attended church. These findings were interpreted in terms of media-based social influence processes and reciprocal determinism.     

Self-Efficacy,Perceptions of Success,and Intrinsic Motivation for Exercise1

A number of investigators have attempted to identify the determinants of continued participation in exercise regimens. Within a social cognitive framework, the present study examined the relationships among self-efficacy cognitions, perceptions of success, and multidimensional intrinsic motivation in the exercise domain. Multivariate analyses of variance indicated that highly efficacious individuals were more intrinsically motivated toward aerobic dance than were their less efficacious counterparts. However, multiple regression analyses revealed both perceptions of success and self-efficacy to account for significant variance in intrinsic motivation at both the composite and dimensional levels. Moreover, perceptions of success were considerably stronger predictors than were efficacy cognitions. The results are discussed in terms of the need for multiple measures of perceived success, the employment of longitudinal designs to determine the direction of causality among these variables, and possible implications for adherence issues.     

Fathers' involvement in their children's healthcare.

Fathers' involvement in the routine healthcare of young children was investigated, and fathers' relative participation in two tasks, staying home with a sick child and taking the child to the doctor or dentist, was assessed. The relationships between fathers' involvement in healthcare and several other measures, including mothers' employment status, fathers' attitudes toward women's rights and roles, the amount of time fathers spent at work, and fathers' involvement in housework, were also examined. The subjects were 50 fathers of young children in intact, White, middle-class families. Both staying home with a sick child and taking a child to the doctor or dentist were usually performed by mothers, but when mothers were employed, fathers were significantly more involved, regardless of the child's sex. Staying home with a sick child and taking a child to the doctor or dentist were positively related to fathers' involvement in housework. Fathers' staying home with a sick child was significantly correlated with fewer hours at work and liberal attitudes toward women's rights and roles; these variables were not related to taking a child to the doctor or dentist. Positive correlations between fathers' involvement in housework and staying home with a sick child and taking a child to the doctor or dentist suggests that fathers' involvement in childcare is viewed as an aspect of family work.