Patients’ Perceptions of Risky Developments During Psychotherapy

Research on risks and unwanted effects is largely missing in psychotherapy. Using exploratory factor analysis six dimensions of personal therapy situation were identified in a preliminary study, three of them were associated with risky developments during the psychotherapeutic process: (1) (poor) quality of therapeutic relationship, (2) burden caused by psychotherapy, and (3) dependency/isolation. Based on the finding of this study an online survey was performed to examine these three dimensions. Aside from these three factors another variable was associated with risky therapy developments: the online questionnaire also asked for premature terminations of psychotherapy as a consequence of risky conditions for the therapeutic development. Risky conditions were found to be associated with the following variables: (1) the combination of female patient–male therapist, (2) the therapeutic orientation (particularly with the psychodynamic approaches) and (3) the duration of therapy. Fewer humanistic and systemic psychotherapies were found among the high risk-prone group of patients who were at risk in at least three of the four variables which were associated with risky developments. Differences in the findings of the study regarding the four therapeutic orientations stress the importance of an extensive differential indication and a cooperative partnership between patient and therapist, in order to facilitate a positive patient participation towards the choice of therapy method and subsequent successful participation throughout the course of treatment. Further studies should also focus on female patient and male therapist psychotherapies.     

Development and Construct Validation of the Individuation Test for Emerging Adults (ITEA)

This article presents the construction, exploratory dimensionality analysis (Study 1), and validation (Study 2) of the self-report and 36-item Individuation Test for Emerging Adults (ITEA). It is the first instrument to measure different aspects of individuation (in relation to mother and father) specifically in emerging adulthood. The construct validity of the final 5-factor structure (Support Seeking, Connectedness, Intrusiveness, Self-Reliance, and Fear of Disappointing the Parent) was satisfactory. The results of multigroup analyses demonstrated that the factor structure is stable across male and female emerging adults for ITEA assessments in relation to both mother and father. The ITEA scales also show good internal consistency and concurrent validity against Emotional, Conflictual, and Functional Dependence scales of the Psychological Separation Inventory.     

Conceptual clarity in international collaborations: A point of departure for policy-relevant research on discrimination

A workshop was conducted as part of the International Metropolis Conference held in Vienna, Austria in September 2003. The Metropolis Project is meant to facilitate research in the area of migration that can optimally inform policy. In this context, a workshop was conducted with the objective of discussing how policy-relevant research on discrimination could be conducted internationally. Four broad areas were addressed: ‘key stakeholder’ involvement, obtaining ethical and other forms of approval, international, national and local funding opportunities, and qualitative and quantitative methodology and questionnaire development. Viewpoints represented included those of non-governmental organizations, researchers, health professionals, and policy-makers/implementers. Countries represented in the discussions included Australia, Austria, Canada, Germany, Norway, Sweden, the United Kingdom, and the United States. Key conceptual differences included how best to define discrimination, societal acknowledgement of discrimination, the meaning of ‘race’, ‘racism’, ‘national’, and ‘migrant’, and perceptions of national identity.     

Benchmarking Treatment Effectiveness of Community‐Delivered Trauma‐Focused Cognitive Behavioral Therapy

It is critical for urban youth with post‐traumatic stress disorder (PTSD) living in poverty to have access to evidence‐based interventions for their traumatic stress. However, there is limited research on the effectiveness of these interventions when provided in urban, community settings. The objectives of the current study are to (a) evaluate the effectiveness of trauma‐focused cognitive behavioral therapy delivered from 2013 to 2016 in 15 behavioral health agencies on youth (N = 114) PTSD as well as  general mental health symptoms and  functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. Effectiveness data are from the Philadelphia County Community Behavioral Health System, a system that has invested significantly in the training and ongoing support of clinicians providing high‐quality trauma services to youth since 2012. From baseline to last assessment, youth PTSD symptom severity (d = 0.34), PTSD functional impairment (d = 0.38), and overall mental health problem severity (d = 0.29) improved. The effect sizes of  improvements were smaller than effect sizes observed in efficacy and effectiveness studies. This study is the first benchmarking study of TF‐CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF‐CBT to urban community settings that serve youth in poverty.     

Family factors associated with attention deficit hyperactivity disorder and emotional disorders in children

Few well-controlled studies have identified psychosocial profiles of families of boys with ADHD and boys with emotional disorders compared with normal controls. However, the clinical and theoretical literature pinpoints four domains in which distinctive profiles would be expected to occur. In this study, twenty-two mothers and thirteen fathers of twenty-two boys with ADHD; twenty mothers and fifteen fathers of twenty boys with a mood or anxiety disorder; and twenty-six mothers and sixteen fathers of twenty-seven normal controls were compared on: (1) stress, support and quality of life; (2) current family functioning; (3) parenting style and satisfaction in the family of origin and current family; and (4) current and past parental functioning. The two clinical groups showed higher levels of stress and lower levels of both social support and quality of life than did normal controls. Both clinical groups showed deficits in current family functioning, but contrary to expectations the ADHD and emotional disorder group did not show distinctly different profiles. Parents of ADHD children reported higher levels of authoritarian parenting styles, and parents from both clinical groups reported less parenting satisfaction than did normal controls in both their current families and their families of origin. Parents of children with ADHD and emotional disorders reported greater parenting satisfaction in their families of origin than in their current families. This discrepancy was greatest for parents of ADHD children. Parents of children with ADHD and emotional disorders reported greater psychological health problems and more childhood ADHD symptomatology than did normal controls. Parents of children with ADHD and emotional disorders have significant psychosocial difficulties in family and personal functioning. Family intervention is highly appropriate for families with children who are referred for help with both types of difficulties.     

The integration of object levels and their content: a theory of global/local processing and related hemispheric differences

This article presents and tests the authors' integration hypothesis of global/local processing, which proposes that at early stages of processing, the identities of global and local units of a hierarchical stimulus are represented separately from information about their respective levels and that, therefore, identity and level information have to be integrated at later stages. It further states that the cerebral hemispheres differ in their capacities for these binding processes. Three experiments are reported in which the integration hypothesis was tested. Participants had to identify a letter at a prespecified level with the viewing duration restricted by a mask. False reporting of the letter at the nontarget level was predicted to occur more often when the integration of identity and level could fail. This was the case. Moreover, visual-field effects occurred, as expected. Finally, a multinomial model was constructed and fitted to the data.     

The influence of adaptation and stochastic fluctuations on spontaneous perceptual changes for bistable stimuli

Spontaneous perceptual change was studied by measuring the probabilities of the first two spontaneous pattern switches as a function of time following the onset of a bistable apparent quartet for which either horizontal or vertical motion is perceived. Contrary to the classical satiation hypothesis (Köhler & Wallach, 1944),differential time-dependent adaptation of the perceived compared with the unperceived motion directions was not necessary to account for the first spontaneous switch. In addition, adaptation of the perceived motion accompanied by recovery from adaptation of the unperceived motion was not necessary to account for the increased probability of the second spontaneous switch. It was concluded that regardless of possible adaptation effects, stochastic fluctuations are necessary for the actual reversal of activation levels that produces the spontaneous switch. When the difference in detector activation is reduced by differential adaptation of competing motion detectors (or by the occurrence of a prior spontaneous pattern change), smaller stochastic fluctuations are sufficient to reverse the relative activation of competing detectors. Thus, adaptation can increase the probability of spontaneous switches without directly causing them.     

Binocular single vision achieved by fusion and suppression

The occurrences of fusion and suppression were determined from stereograms which produced two retinal images located at equal distances but in opposite directions from the fovea. Subjects reported whether the dichoptic stimulus appeared single or not, and if single whether it appeared in the center of the visual field. The report of centrality is predicted by the fusion theory of single vision and that of noncentrality by the suppression theory. Experiment 1, with eight subjects, showed that for small disparities perceived singleness was the percept predicted by the fusion theory; for larger disparities, the percepts could sometimes be predicted by the fusion theory and other times by the suppression theory. Experiment 2, with 16 subjects, showed that with larger stimuli the percept predicted by the fusion theory is more likely to occur. Experiment 3, with four subjects, showed that the centrality was reported when the stimuli were presented for 100 msec. This result provided support for our interpretation that the centrality reports in Experiments 1 and 2 were not due to fixation error and suppression.     

Evidence for generalized motor programs using gait pattern analysis

Human intra limb gait kinematics were analyzed via statistical and structural pattern recognition methods to determine the role of relative timing of limb segments within and between modes of gait. Five experienced runners were filmed while walking (3-6 km/hour) and running (8-12 km/hour) on a motor driven treadmill. Kinematic data consisted of relative timing of the four phases of the Philippson step cycle and intersegmental limb trajectories, determined from angle-angle diagrams. Despite marked decreases in absolute time durations within gaits remained constant over the speeds which were studied. Although a 2-fold increase in locomotor speed occurred in walking and a 1.5-fold speed increase occurred within running, the percentage of time spent in each of the Philippson phases was not significantly changed. However, significant differences in the time percentages and sequences of the step cycle phases were found between walking and running. Correlations between limb segment trajectories occurring in the different gaits showed strong coherence for overall step cycle patterns, but within step cycle phases and across speeds, selective phases displayed little correspondence.