Description of Relational Processes: Recent Changes in DSM‐5 and Proposals for ICD‐11

Epidemiologic, prospective, and retrospective research confirms that family relational variables are significant risk factors for the development of mental and physical health problems in children as well as adults. In addition, relationships also play a moderating role in the maintenance, exacerbation, or amelioration of chronic health problems. Although acknowledgment of the importance of these variables in the pathophysiology of a number of health conditions is reaching more prominence, the integration of assessments of family factors as part of standard health care has made little progress. With the arrival of the Affordable Care Act in the United States, there is a desire for earlier identification of these risk factors, and the ability to implement prevention programs that reduce risk, and enhance protective factors. On a global level, there is increased awareness of the health impact of relational problems, for example, many countries have attempted to implement programs to decrease domestic violence. More reliable and standardized assessments of key relational processes will enhance both of these missions, and allow comparison of a variety of prevention and intervention programs. This article discusses progress over the last decade in constructing more reliable definitions of relationship processes, how these have been integrated into the Diagnostic and Statistical Manual 5th edition (DSM‐5), and progress toward implementation into the World Health Organization's International Classification of Diseases (ICD‐11).     

The concept of risk and responsible conduct of research

Assessment of risk is one of the key issues in the field of responsible conduct of research which covers discourses of research ethics and research integrity. The principle of minimizing risks and balancing of risks and benefits is one of the main requirements of research ethics. In addition, the content of informed consent that is another fundamental principle of research ethics derives from the assessment of risks and benefits related to a particular research project. Risk assessment also plays a crucial role in methodological design of the research project. This is an important point where research ethics and research integrity discourses overlap. Firstly, because the choice of a control group (e.g., placebo control) is a key ethical issue related to the protection of the research subjects' interests. Secondly, because the quality of the research data, that is one of the key elements of research integrity, is closely connected to the choice of research methodology as well. The problem of biased interpretation or manipulation of risk related features of biomedical research should also be taken into account. Despite the importance of the concept of risk to the field of biomedical research, its relevance has not yet attracted a sufficient attention in the responsible conduct of research debate.     

Teaching ethics: More than an honor code

An honor code is certainly a good place to start teaching engineering students about ethics, but teaching students to live honorably requires far more effort than memorizing a code of ethics statement or applying it just to academic performance. In the School of Engineering at Grand Valley State University, we have followed the model provided by the United States Military Academy at West Point. For our students this involves an introduction to the Honor Code as part of a larger Honor Concept at the very beginning of their studies and then making it an integral part of their preparation as engineers. The challenge is significant because the culture at large does not support living with an Honor Concept. This paper will begin with a discussion of the cultural context in which we must teach, because that context has changed significantly in the years since many faculty members were students themselves. The rest of the paper will detail the approach that we have taken to teach ethics as an engineer’s way of life. “The shortest and surest way to live with honor in the world is to be in reality what we would appear to be. All human virtues increase and strengthen themselves by the practice and experience of them.” Plato An earlier version of this paper was presented at the 2005 conference, Ethics and Social Responsibility in Engineering and Technology, Linking Workplace Ethics and Education, co-hosted by Gonzaga University and Loyola Marymount University, Los Angeles, CA, USA, 9–10 June 2005.     

Effects of visual deprivation on space representation: immediate and delayed pointing toward memorised proprioceptive targets

Congenitally blind, late-blind, and blindfolded-sighted participants performed a pointing task at proximal memorised proprioceptive targets. The locations to be memorised were presented on a sagittal plane by passively positioning the left index finger. A 'go' signal for matching the target location with the right index finger was given 0 or 8 s after left-hand demonstration. Absolute distance errors were smaller in the blind groups, with both delays pooled together; signed distance and direction errors were underestimated with the longer delay, and were overestimated by blind groups, whereas the blindfolded-sighted group underestimated them. Elongation of the scatters was stretched but not affected by delay or group. The surface scatter was greater with the longer delay; and orientation of the main axis of the pointing ellipses shows the use of an egocentric frame of reference by the congenitally blind group for both delays, the use of egocentric (0 s) and exocentric (8 s) frame of reference by the blindfolded-sighted group, with the late-blind group using an intermediate frame of reference for both delays. Therefore, early and late visual-deprivation effects are distinguished from transient visual-deprivation effects as long-term deprivation leads to increased capabilities (absolute distance estimations), unaltered organisation (for surface and elongation), and altered organisation (amplitude and direction estimations, orientation of pointing distribution) of the spatial representation with proprioception. Besides providing an extensive exploration of pointing ability and mechanisms in the visually deprived population, the results show that cross-modal plasticity applies not only to neural bases but extends to spatial behaviour.     

Opening What Has Been Closed,Relaxing What Has Been Clenched: Dissociation and Enactment Over Time in Committed Relationships

I use dissociation and the concept of the multiple self to link Mitchell's profound insight with Goldner's critique. In the process, I use the idea of dissociation to think about the nature of different kinds of long-term relationships.     

Play Group Therapy with Psychotic Adolescent Girls

In this paper, by using the perspective of self psychology, we hope to illustrate and explicate (through clinical examples) the positive aspects of the pairing phenomenon in group therapy with the elderly. Traditionally subgrouping or pairing has been viewed as the “Achilles' heel of group therapy,” and usually interpreted as defensive and destructive to group process. In this paper we distinguish between those instances of pairing and subgrouping that are defensive and those that are reparatory of the self system (the latter involving twinship and alter ego selfobject transferences). These reparatory transferences may play a constructive role in establishing group cohesion and allaying primitive somatic anxieties, especially in the elderly patient.     

A Method for the Evaluation of Affective Associations to Figure Drawings

Usual scoring systems for figure drawing techniques are based on structural and content aspects of the drawing, and ignore the affectively toned associations that occur when an observer first sees a drawing. A system for measuring two components of judgment, (a) emission of affective associations (b) evaluation of affective associations, has been developed. This method was applied with some success in studying individuals who had represented in their drawings an image that corresponded to their actual physical appearance. The research so far suggests that the evaluation component of judgment may contribute more to discrimination than the emission component.     

Mental Health and Adverse Childhood Experiences

The theoretical basis of occupational therapy interventions was investigated in two mental health facilities in the Midwestern United States. Using retrospective cohort and grounded theory designs, 121 medical records were reviewed and five occupational therapy practitioners were interviewed. Theoretical reasoning was not explicitly documented, but according to analysis, the behavioral/cognitive-behavioral model, client-centered models, and the model of human occupation were the most frequently used theories to guide interventions. Lack of documentation of theory use has significant implications for the value accorded to occupational therapy skills in health care. A larger study is recommended to increase external generalizability of the findings.