The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.     

Integrating sport psychology and sports medicine in research: The dilemmas

Abstract

The recent acceleration of interest in conducting sport psychology research within sports medicine settings has prompted an introspection on the stringency of sport injury-focused research protocols and methodology. Much of the literature relating to the psychology of sport injury is anecdotal, comprised of conjecture, or is an extrapolation from allied psychological study. In addition, retrospective studies, involving the recall of an unpleasant event (i.e., sport injury) proliferate the literature. Quality research that integrates sport psychology and sports medicine presents a unique challenge because of the multifactorial nature of sport injury and the necessity for sound interpretation of research outcomes relative to the nature of psychology. sport, and injury. Confounding and complicating aspects of this integrated research include definition of injury variables, timing of data collection. evaluation of pain. and the physiological sequelae of injury. Research and methodological issues relating to sport psychology and sport injury are discussed.     

The Effects of Spatial Frequency and Temporal Waveform on Three Measures of Temporal Processing

The effects of spatial frequency and temporal transition of sine-wave grating onset and offset were assessed using measures of reaction time, visual persistence, and temporal order judgments. The stimuli were lateralized fields, separated by 1° of visual angle. Slow temporal transition resulted in significantly poorer performance than did abrupt onset and offset, but spatial frequency had a minimal effect. Thus, the latency, temporal resolution, and temporal ordering of events are mediated by a mechanism that is sensitive to abrupt temporal transients. The stimulus conditions employed did not result in a shift in the point of subjective simultaneity.     

Infant-led innovations in a mother-baby therapy group

A mother-baby therapy group for mothers and infants in their first year who are experiencing difficulties is described. In a literature review no comparable group where the infants are seen as members in their own right has been found. Themes in the mothers' material are outlined, followed by the infants' evolving interactive and internal processes. Some therapeutic factors, in particular interactions between the infants and interventions on the part of the therapists, are then illustrated with clinical material. Some infant-led innovations are described, such as the way the infants' activity is used as a basis for making ‘group as a whole’ interpretations, and in particular how the therapists' actions towards the infants have come to be viewed as a non-verbal form of interpretation. The role of attuned play in direct work with infants is discussed further.     

A Direct Method of Assessing Underlying Cognitive Risk for Adolescent Depression

An enduring tendency towards negative thinking is thought to increase vulnerability for future depression. However, it has not been possible to assess this tendency in non-depressed mood states. We examined if response latency to endorse dysfunctional attitudes is associated with depressive outcomes in a longitudinal study. A sample of young people at familial risk of depression (N?=?252, aged 10–19, 56.3 % female) completed a computer-administered dysfunctional attitude scale. The main outcome measure was the difference in reaction time to agree versus disagree with dysfunctional attitudes. Cross-sectional differences between current and previous depression and no psychiatric disorder groups as well as longitudinal associations with depressive symptoms were examined. Young people with current and previous depression were quicker to agree with dysfunctional attitudes than those without disorder. In young people free from depressive disorder, faster agreements with dysfunctional attitudes were specifically associated with increased depressive symptoms over time. Self-reported dysfunctional attitudes did not differentiate the formerly depressed and no disorder groups and showed a longitudinal association with depressive symptoms for older adolescents only. Reaction time to endorse dysfunctional attitudes may indicate changes in affective processing that represent an early risk for future depression that is not indexed by self-report measures of negative thought.     

Recognition of tactile relief by children and adults

This study was designed to compare tactile sensitivity of children and adults on printed target stimuli covering a wide range of elevations and requiring different resolutions. A recognition-relief task using 9 digits at 6 levels of elevation from a surface (0.5, 0.4, 0.3, 0.2, 0.1, and 0.05 mm) was presented to 24 young adults and 24 children. As predicted, relief elevations as low as 0.05 mm were recognized above chance. As predicted, children performed significantly more poorly than the adults on recognition at all elevations, although the difference increased as elevation increased. Adults performed significantly better than children on high-resolution digit 8, but there was no reliable age difference on low-resolution digit 1. Recognition difference between the high- and low-resolution digits decreased nonlinearly as elevation increased, irrespective of age. Overall, the findings support previous research indicating greater tactile sensitivity in adults than in children, but the superiority was moderated by the elevation and resolution requirements of the stimuli.     

Frustration and Discomfort Intolerance: Introduction to the Special Issue

This article aims to provide an overview of the Rational Emotive Behavior Therapy (REBT) concept of frustration intolerance. Therapeutic issues regarding these beliefs are discussed, including engagement, the use of disputation, and behavioral techniques.