Introduction to the special section on health and cognitive function.

Numerous factors related to health and diseases have been studied in relation to cognitive function. It has been shown that across the life span, systemic medical diseases can negatively impact cognitive function. Factors that influence the development of medical diseases, such as poor health habits, biological risk factors, hormones, genetic factors, exposure to environmental toxins, and certain treatments for disease, can also have an adverse effect on cognitive function. Conversely, factors such as high levels of education, good health habits, and some treatments for disease can be protective. Included in this special section are 6 empirical articles that examine the relation of health or disease to cognitive function.     

A longitudinal study of the performance of hypertensive and normotensive subjects on the Wechsler Adult Intelligence Scale

Performance on the Wechsler Adult Intelligence Scale was followed over two 5- to 6-year intervals for essential hypertensive Ss (EH; n = 22) free from medical complications and for normotensive Ss (N; n = 20). EH were treated with adrenergic beta-blocking drugs, diuretics, or both. Mean age was 46 years (SD = 12.6 years), initially (Time 1). Results were unaltered by adjustment for initial age. N improved modestly on the Verbal scale, from Time 1 to Time 2 only. EH neither improved nor declined on the Verbal scale. Scores remained unchanged for both EH and N Ss for the Performance scale. Overall, and at Times 2 and 3, Verbal scores were lower for the EH group. It was concluded that neither decline nor improvement in cognitive function over time are necessary outcomes of modest, carefully treated, uncomplicated hypertension in the middle years.     

Family therapy and outcome: Relationships between therapist and family styles

This study examined therapeutic outcome for a group of 175 clinic families divided into levels of family competence and style, and, later, into seven clinical groupings. The division into these groups was based on the level of rated Competence and Style determined by using the Beavers Systems Model. Therapists also rated their level of Openness/Sharing Strategy, Power Differential, and Partnership with the family at the third session. Results indicate that more competent families who fared well in therapy had therapists who formed a partnership, disclosed strategy, and employed a minimal power differential with the family. The most disturbed families, and those with a Centrifugal style, did better with therapists employing a high power differential and lower levels of openness and partnership. The study also presented the distribution of individual diagnoses by family groups. Implications for family therapists, including the value of family assessment, are provided.     

The role of blood pressure, cortisol, and prolactine among soldiers injured in the 1991–1993 war in Croatia

Ninety soldiers with at least three months of combat exposure—60 injured soldiers (30 with permanent disabling and 30 with nondisabling injuries), 30 noninjured soldiers and 30 healthy controls—were interviewed and investigated with physiological (Prolactine, Cortisol, BP, Hb) and psychological tests (MMPI), IES-15 (Impact of Event Scale), PTSS (Post-Traumatic Symptom Scale). Their was related injuries had a different effect on the physiological stress response of the soldiers as reflected in the levels of prolactine, cortisol, hemoglobin and blood pressure. In a report of personality characteristics of the same soldiers, we demonstrated that the experience of posttraumatic stress was not dependent upon physical injury, but rather on the psychological appraisal of the situation. The results of the present article confirm earlier findings that the relationship between physiological and psychological consequences of trauma are complex, and that the perception of an event and the social context within which the traumatized soldier exists is as important as the event itself. The physiological response to the trauma varied greatly among the soldiers regarding the psychosocial impact of the consequence of the injury. So the anticipation of future possible trauma among less severely wounded soldiers (expected to go back to war) was followed by pathological stress responses. Trauma seems to operate somewhat independently from the overt conscious appraisal of the situation and relationship between psychological, psychosocial, and physiological aspects are interrelated in a multifactorial way. An integrative approach is therefore of great importance in assessment as well as in treatment of Posttraumatic Stress Disorder (PTSD). Editorial Note This historical article is being published for the first time. It is based on the Ph.D. thesis of Dr. Harry A. Teitelbaum for which he was awarded a doctorate by the University of Maryland in College Park in 1936. The dissertation was stored prior to publication and was not rediscovered until 1997. Teitelbaum’s work was performed during the early days of the development of knowledge regarding the mechanisms that regulate endocrine function. The understanding of the broad capability of interactions among endocrine glands was evolving. It was a field that Teitelbaum contributed to for several years, many of which were spent in collaboration with Horsley Gantt in his laboratory at Johns Hopkins. Although some of the experimental strategies and some of the wording of the report seem quaint today, the contribution of Teitelbaum’s research was solid and highly relevant to questions being asked at the time.     

The interaction between cohesive systems and dispersive systems: Creating the trigenerational therapeutic context

The author presents a model for research investigation and clinical use that deals with the interaction between cohesive and dispersive family of origin systems as reflected in marital and family interaction in nuclear families.From a paper presented at the tenth annual meeting of the American Family Therapy Association, June, 1988, Montreal, PQ, Canada.     

Establishing enduring prevention programs: Advancing the legacy of Swampscott

The recent anniversary of the 1965 Swampscott Conference provided an opportunity to reconsider the implications of that meeting for prevention research. An unfulfilled aspect of the Swampscott legacy is the relative paucity of demonstration programs that become enduring parts of their host settings. A macrolevel, systems-oriented reformulation of Albee's (1982) prevention formula is presented to help conceptualize the linkage of prevention programs to their host settings. Finally, structural considerations necessary for weaving efforts at prevention and health promotion into adaptive, enduring organizational niches are reviewed.     

Intuition in family therapy: A short manual on post-modern witchcraft

Intuition is an important part of a mature clinician's work. Yet, it is a component of clinical work which is looked upon with suspicion, due in part to the Middle-Age's association between intuition and the work of witches. This paper describes a tenuous link between intuition, witches, and Carl Whitaker. Patterns for including intuition in family therapy are discussed.     

An Evaluation of a School-Based Suicide Awareness Intervention

This study employed a self-report questionnaire in a Solomon four-groups design to assess the efficacy of suicide intervention classes in achieving their instructional objectives. Because adolescents are often the first to know of a peer's suicidal thoughts or plans, the goal of the classes was to increase the likelihood that students who come into contact with potentially suicidal peers can more readily identify them and will be consistently inclined to take responsible action on their behalf. Students who participated in the classes as compared to controls showed significant gains in relevant knowledge about suicidal peers and significantly more positive attitudes toward help seeking and intervening with troubled peers. Results of this study will be used to strengthen components of the lessons aimed at enhancing the likelihood of performance of responsible interventions