The 20 questions task with families of schizophrenics: divergent findings

The study attempted to replicate and extend the results of an earlier study by Wild and Shapiro (16), establishing the utility of Mosher and Hornsby's (8) 20 Questions Task as a means of differentiating families with schizophrenic patients from those of psychiatrically hospitalized but nonschizophrenic individuals. In the current study, Wild and Shapiro's original design was expanded and revised by (a) diagnosing patients using Research Diagnostic Criteria rather than hospital diagnoses and (b) including families with schizophrenic daughters and/or one-parent families, in addition to intact families with schizophrenic sons. Families were comparable on age, intelligence, and socioeconomic variables. The results failed to replicate those reported by Wild and Shapiro, and indicated that the 20 Questions Task was sensitive to differences in family constellation and offspring gender as well as offspring diagnosis. The findings suggest that forms of familial communication deviance detected with the 20 Questions Task may not be unique to families of schizophrenics, thus highlighting the need to expand research on family communication deviance in families with schizophrenic offspring to families with varied family constellations and characteristics.     

The role of the leader in managing the preoedipal patient in the group setting

Preoedipal patients present a special problem in group treatment. This is because their difficulties arose largely before they learned to use words. Such patients are prone to act rather than talk. They do not respond well to interpretation. They must be approached and influenced through feelings. We can utilize the group to provide them with maturational experiences, helping them reach a more adult level of mental functioning so that our usual technical interventions can be brought into play. The paper discusses methods for enhancing this process, including reflection, emotional communication, using reconstruction to close developmental gaps, and immunization.     

Group psychotherapy with preadolescent sexual abuse victims: literature review and description of an inner-city group

The demand for therapy groups for child sexual assault victims has risen as detection of abuse has increased, but little has been published about conducting and evaluating such groups. The authors present a comprehensive review of the literature and describe their sixteen-week therapy group with seven eleven- and twelve-year-old girls. Treatment themes, activities, group process issues, and psychometric findings on the Piers-Harris Children's Self Concept Scale and the Child Behavior Checklist are discussed. Suggestions for future groups and research are offered.     

Cerebral laterality and depression: differences in perceptual asymmetry among diagnostic subtypes

Examined the influence of diagnostic subtype of depression on perceptual asymmetry for dichotic listening and visual tachistoscopic tasks. A total of 65 unmedicated patients with major depressive disorders and 30 normal controls were tested on a verbal and nonverbal task in each modality. Patients diagnosed according to the DSM-III with melancholia had abnormal perceptual asymmetry for dichotic nonsense syllable and complex tone tasks. In contrast, patients having a nonmelancholic "atypical depression" (reactivity of mood with preserved pleasure capacity and associated features) did not differ from normal controls on these tasks, but had an increased incidence of left handedness. Bipolar depression (history of hypomania) differed from unipolar depression in showing abnormal perceptual asymmetry for a tachistoscopic dot enumeration task. Alterations of perceptual asymmetry in melancholia and bipolar depression were consistent with hypothesized right hemisphere dysfunction.     

ACQUISITION,GENERALIZATION, AND MAINTENANCE OF QUESTION-ANSWERING SKILLS IN AUTISTIC CHILDREN

We conducted an investigation to evaluate the effects of a training strategy for teaching autistic students generalized responses to three forms of wh— questions (what, how, and why). Students were taught, using modeling and reinforcement procedures, to answer questions with magazine pictures as the referents. Each question form was divided into two or more subcomponents reflective of common social usage and was taught within the context of a modified multiple probe design across subcomponents. Following acquisition of each subcomponent, generalization to natural context and storybook questions was assessed; additional probes were conducted to assess responding over time and whether acquisition of responses to questions promoted question-asking skills. Results showed that the picture training procedure was effective in teaching a generalized response to questions for which the relevant cue was visible, whereas specific generalization programming was required for situations in which the relevant cue was not visible. All acquired responses were durable over time.     

Nonclinical panic in college students: an investigation of prevalence and symptomatology

This article presents data on the prevalence and symptomatology of panic attacks and panic disorder (PD) in a large nonclinical sample (n = 2,375) of college students. Results showed that approximately 12% of the sample had experienced at least one unexpected panic attack and that 2.36% met DSM-III-R criteria for panic disorder. Although there were no sex differences in overall panic attack prevalence, men reported significantly more panic-related worry than women, and women reported a higher panic frequency than men. Compared to subjects who met DSM-III-R criteria for PD, infrequent panickers presented with fewer panic symptoms, fewer panic episodes, less panic-related worry, lower anxiety sensitivity, and less panic-related avoidance. Moreover, compared with PD subjects, the infrequent panickers were much less likely to report fears of dying, going insane, and derealization during a panic attack. The findings provide preliminary support for the role of anxious apprehension as a psychological vulnerability factor in the pathogenesis of panic disorder.     

Family Functioning of Male Alcoholics and Their Female Partners during Periods of Drinking and Abstinence

Family functioning of 20 alcoholic male veterans and their female partners was assessed in relation to drinking (wet) and abstinent (dry) intervals. Repeated measures analyses performed on the McMaster Family Assessment Device (FAD) indicated that on all 7 scales of the FAD, alcoholics and their mates perceived family functioning to be better during dry than wet periods. In contrast to their alcoholic mates, female partners gave healthier ratings to all FAD scales except Roles in the dry condition and Affective Involvement in the wet condition. According to published cutoff scores for healthy and unhealthy family functioning, alcoholics as a group viewed their wet and dry family functioning as unhealthy, although the female group regarded the family's dry Problem Solving and Behavioral Control as healthy. These findings suggest that the family functioning of alcohol-involved couples is biphasic, oscillating between drinking and abstinent periods.     

A paradigm for construction of family therapy tasks

Typically, family therapy task interventions involve direct assignment of specific behaviors, which may or may not encourage client compliance. To enhance the clinician's probability of bringing about progress in treatment, this article broadens the parameters of task intervention to include (a) Direct versus Indirect, (b) Behavioral versus Nonbehavioral, and (c) Paradoxical versus Nonparadoxical dimension alternatives. The resulting 2 x 2 x 2 model, the Family Therapy Task Construction Paradigm, yields eight possible choices for end-of-the-session punctuation. Each option is linked to corresponding treatment contexts and illustrated with examples from productive case vignettes.     

The "psychosomatic family" model: an empirical and theoretical analysis

Evolution of the Family Systems Paradigm has been constrained by the dichotomy between theory building and empirical research. This article integrates these two domains by presenting a theoretical analysis of the "psychosomatic family" model as it informs and is informed by an empirical research project. Forty families of children with Crohn's disease (CD), ulcerative colitis (UC), and functional recurrent abdominal pain syndrome (RAP) were rated during standard, videotaped family interaction tasks, lunch, and interview. Laboratory scores of disease activity were associated with triangulation, marital dysfunction, and total "psychosomatic family" scores. Disease activity was not significantly correlated with enmeshment, overprotection, rigidity, conflict avoidance, or poor conflict resolution. Thus, the marital/triangulation and enmeshment/overprotection/conflict clusters may be subcomplexes of the "psychosomatic family" complex. CD, UC, and RAP groups differed in the relations among particular family patterns and disease activity. A heuristic family-psycho-somatic model is presented to facilitate future research.