Treatment indication in psychotherapy: Some methodological aspects

In this paper it is argued that the general problem of indication, increasingly discussed in the field of psychotherapy in recent years, actually is a pseudoproblem with no solution to be expected. In its objectives and premises it is trongly suggestive of conceptions and ideas of early logical empiricism, to be considered as out-of-date today. The concept of indication is identified as ambiguous, and preliminary remarks aiming at an explication of the concept are made. Finally, the consequences of our arguments for the immediate problem of integration of the different therapeutic approaches are pointed out.     

BEHAVIOR THERAPY AND THE CONDITIONING MODEL OF NEUROSIS

The methods of applied science are usually based on the findings of pure science, and the discovery of successful methods of therapy for the neuroses is dependent on the formulation of appropriate theories for these disorders. It is argued that the only viable theory about neurosis at the moment is an adaptation of the Watsonian conditioning model, suitably altered to fit in with more recent discoveries in the fields of the formation and extinction of conditioned responses. Such a model has important relevance to behaviour therapy and the various methods for treating neuroses falling under that heading, and indeed for an explanation of the apparent effectiveness of psychotherapy, psychoanalysis, and whatever events mediate spontaneous remission.     

Accents in equitone sequences

Equitone sequences are defined as sequences of tones that are identical in all respects: frequency, spectral composition, intensity, and duration. The only parameter varied in these sequences is the time-interval between tones. In such sequences, clear accents are perceived. This paper describes accent perception in equitone sequences containing two alternating intervals; such sequences are perceived as consisting of repeating groups of two tones. An accent is heard on the first tone of a group if the difference between the intervals is about 5% to 10%. If the difference is made bigger, the accent is heard on the last tone of the group; this latter accent is considerably stronger than the accent previously heard on the first tone. In a number of experiments, the conditions under which the two types of accents occur were investigated. From these experiments, it was tentatively concluded that the accent on the last tone is heard because that tone, since it is followed by a longer interval, can be processed more completely. This “intervalproduced” accent indeed occurs only if the between-group interval is considerably longer than the within-group interval and if the latter does not exceed a duration of about 250 msec. The effect is slightly dependent on tone duration. The interval-produced accent can be balanced if the nonaccented tone is increased by about 4 dB in intensity. This shows that the effect is quite robust. The specific type of accentuation reported here might explain some rhythmical phenomena, examples of which are given.     

The influence of verbal specifications on ratings of relative properties of pictures

Summary Sixty subjects were shown pictures each containing two objects (A and B). The objects were unobtrusive with respect to relative properties such as long — short, big — small, etc. The pictures were preceded by sentences referring either to objects A and B or only to object A. Object A was dimensionally specified: The same object was called, e.g., long for one and short for a different subject. Ratings during a later test (without presentation of the pictures) revealed that not only were objects A remembered according to the verbal specification provided during the presentation but ratings of objects B also changed in line with the specification of A. This was true even when object B had not been mentioned verbally during the presentation. In this way, verbal specifications had an effect beyond the referential bond. It is concluded that models based on the assumption that the semantic interpretation of an event depends on the application of syntactic rules — rules indicating, e.g., to which object an adjective refers — lack an important clue.     

Validity and quantification in intuitionism

We distinguish three different readings of the intuitionistic notions of validity, soundness, and completeness with respect to the quantification occurring in the notion of validity, and we establish certain relations between the different readings. For each of the meta-logical notions considered we suggest that the most natural reading (which is not the same for all cases) is precisely the one which is required by the recent intuitionistic completeness theorems for IPC.This paper was partly written while the first author, H. C. M. de Swart, was a Visiting Fellow at Princeton University for the academic year 1976–1977. This opportunity was given to him by the Niels Stensen Stichting in Amsterdam, the department of philosophy of the Catholic University in Nijmegen and by Princeton University. He is happy to express his appreciation for that opportunity.     

A characterization of stochastic independence by association,with an application to random utility theory

A characterization of stochastic independence in terms of association of random variables is given. The result is applied to yield a simple proof of the Sattath-Tversky inequality without continuity assumptions.     

Lesions of the basal ganglia, thalamus, and deep white matter: Differential effects on language functions

Forty-five patients with unilateral demarcated vascular lesions in the basal ganglia, the thalamus and the deep white matter were investigated with an "aphasia battery." Patients with basal ganglia lesions performed worse than both other groups in tests of articulation, syntax, and lexical functions. The deficit of patients with basal ganglia lesions on all expressive language modalities was lateralized to the left hemisphere. Patients with left thalamic lesions showed impairments of speech fluency and in the Token Test. Patients with white matter lesions alone showed no effect of laterality in tests of language functions. The results are discussed on the basis of a recent theory of the participation of the deep nuclei in language processing.     

Freud,Piaget and Macmurray: A theory of knowledge from the standpoint of personal relations

The following comparisons between Freud's and Piaget's concepts are proposed: eros drive = constructive assimilation = direction toward the object in the sense of love for newness and otherness; death drive = constrictive assimilation = direction away from or destruction of the object out of fear for self to preserve the system. Eros and assimilation drive combine in the developing object and symbol formation to transform personal relations and knowledge. These psychological theories are further confirmed by evolutionary considerations about human social relations and by Macmurray's philosophy of personal relations as the primary function of reason.     

Assertive training for agoraphobics

Twenty-one unassertive agoraphobic patients were assigned to one of three treatments: (1) prolonged exposure in vivo, (2) assertive training and (3) a combination of assertive training and prolonged exposure in vivo. Each treatment was conducted in groups which were led by two therapists. Assessments involved both phobic targets and assertiveness, and were made before and after treatment, and at 1-month follow-up. Exposure in vivo was found to be superior to assertive training on phobic targets. Assertive training produced greater gains in assertiveness than exposure in vivo. The combination of treatments produced results comparable to exposure in viro. Results indicated that the type of change produced by the treatments is a rather specific one and is related to the specific target of treatment.     

Group psychotherapy in chronic psychiatric outpatients: a Toronto model.

Seventy to 80 chronic psychiatric patients are treated in an aftercare clinic with a goal of tertiary preventive care. The major component of the treatment approach is reality-oriented group psychotherapy with an emphasis on interpersonal relationships. Attention to three factors in group psychotherapy with this population of patients has facilitated our work and outcome. These are the concept of the core group, diagnostic heterogeneity, and staff structure.