Fiduciary Duty and Boundaries: Acting in the Client's Best Interest

The task of defining boundaries and boundary violations in the therapeutic relationship is examined from several perspectives. This paper reviews the ethical rules of the major mental health associations and the American Medical Association to determine the professions' ethical positions with regard to boundary maintenance and boundary violations. It also analyzes judicially sanctioned causes of action for recovery by clients for damages suffered as a result of boundary violations. The authors examine the ways in which fiduciary theory is used in the formulation of the ethical rules and to support the imposition of civil liability for boundary violations. The authors conclude that fiduciary theory provides a useful paradigm for setting and evaluating boundaries that acknowledge and address the fiduciary nature of the therapist–client relationship. The authors point out that measuring boundary violations with the yardstick of fiduciary duty serves the interests of both the client and the therapist. © 1997 John Wiley & Sons, Ltd.     

Images of the self and self-esteem: do positive self-images improve self-esteem in social anxiety?

Negative self-images play an important role in maintaining social anxiety disorder. We propose that these images represent the working self in a Self-Memory System that regulates retrieval of self-relevant information in particular situations. Self-esteem, one aspect of the working self, comprises explicit (conscious) and implicit (automatic) components. Implicit self-esteem reflects an automatic evaluative bias towards the self that is normally positive, but is reduced in socially anxious individuals. Forty-four high and 44 low socially anxious participants generated either a positive or a negative self-image and then completed measures of implicit and explicit self-esteem. Participants who held a negative self-image in mind reported lower implicit and explicit positive self-esteem, and higher explicit negative self-esteem than participants holding a positive image in mind, irrespective of social anxiety group. We then tested whether positive self-images protected high and low socially anxious individuals equally well against the threat to explicit self-esteem posed by social exclusion in a virtual ball toss game (Cyberball). We failed to find a predicted interaction between social anxiety and image condition. Instead, all participants holding positive self-images reported higher levels of explicit self-esteem after Cyberball than those holding negative self-images. Deliberate retrieval of positive self-images appears to facilitate access to a healthy positive implicit bias, as well as improving explicit self-esteem, whereas deliberate retrieval of negative self-images does the opposite. This is consistent with the idea that negative self-images may have a causal, as well as a maintaining, role in social anxiety disorder.     

A Meta‐analytic and Conceptual Update on the Associations Between Procrastination and Multidimensional Perfectionism

The equivocal and debated findings from a 2007 meta‐analysis, which viewed perfectionism as a unidimensional construct, suggested that perfectionism was unrelated to procrastination. The present meta‐analysis aimed to provide a conceptual update and reanalysis of the procrastination–perfectionism association guided by both a multidimensional view of perfectionism and self‐regulation theory. The random‐effects meta‐analyses revealed a small to medium positive average effect size (r  = .23; k  = 43, N  = 10 000; 95% confidence interval (95% CI) [0.19, 0.27]) for trait procrastination and perfectionistic concerns and a small to medium negative average effect size (r  = ?.22; k  = 38, N  = 9544; 95% CI [?0.26, ?0.18]) for procrastination and perfectionistic strivings. The average correlations remained significant after statistically accounting for the joint variance between the two perfectionism dimensions via semi‐partial correlations. For perfectionistic concerns, but not perfectionistic strivings, the effects depended on the perfectionism measure used. All effects did not vary by the trait procrastination measure used or the respondent's sex. Our findings confirm that from a multidimensional perspective, trait procrastination is both positively and negatively associated with higher‐order perfectionism dimensions and further highlights the value of a self‐regulation perspective for understanding the cognitive, affective and behavioural dynamics that characterise these traits. Copyright © 2017 European Association of Personality Psychology     

Narcissism,Mania and Analysts' Envy

Character traits like narcissism, mania and grandiosity are routinely discussed in the psychoanalytic literature as aspects of psychopathology only. However, many individuals who have both achieved and contributed to society in the most profound ways often have such characteristics. Psychoanalysts, sometimes envious of patients who possess considerable wealth and/or power, may be inclined to overly pathologize such qualities, denying their own desires for the perks of power and material success. Mad Men is discussed largely in this context.     

A preliminary study of perfectionism and loneliness as predictors of depressive and anxious symptoms in Latinas: a top-down test of a model

In the present study, we used a top-down approach to examine perfectionism and loneliness as additive sociocognitive predictors of depressive and anxious symptoms in a sample of 121 Latina college students. Consistent with expectations, we found perfectionism and loneliness to be associated with both depressive and anxious symptoms. In addition, results of conducting hierarchical regression analyses indicated that certain dimensions of perfectionism, especially doubts about actions, accounted for significant variance in both depressive and anxious symptoms. Moreover, the inclusion of loneliness as a predictor was found to predict additional unique variance in both depressive and anxious symptoms beyond what was accounted for by perfectionism. Implications of the present findings for future research on negative affective conditions in Latinas are discussed.     

“Ghosts in the Nursery:” Infant sleep and sleep‐related cognitions of parents raised under communal sleeping arrangements

In an experiment of nature, a normal cohort of parents who were raised under communal sleeping arrangements (CSA) in Israeli kibbutzim are raising their infants at home under home‐based family sleeping arrangements. The present study focused on exploring the links between the early sleep experiences of CSA parents and their present sleep‐related beliefs and behaviors. In particular, the study assessed whether the cognitions of CSA parents regarding infant sleep differ from cognitions of parents who were raised under home‐based family sleeping arrangements. Furthermore, parental soothing methods and infant sleep patterns were compared. One hundred forty‐one families participated in this study. The children's ages ranged between 4.5 to 30 months. Parental cognitions were evaluated by two questionnaires. Infant sleep was assessed by a questionnaire and by daily parental reports. As expected, CSA parents were more likely than were control parents to: (a) interpret infant night wakings as a sign of distress and (b) actively soothe their infants at bedtime, co‐sleep with them, and report more night wakings of their infants. These findings support the hypothesis that early childhood sleep‐related experiences of parents (“Ghosts in the Nursery”) influence their parental sleep‐related cognitions that in turn affect infant sleep patterns.