Illness, Family Theory, and Family Therapy: I.Conceptual Issues

This article examines and clarifies controversies about the concept of illness in the field of family therapy. We contend that illness, as traditionally understood in all cultures, is a relational, transactional concept that is highly congruent with core principles of present-day family theories. Family therapists need not buy into a biotechnical, reductionistic reframing of illness as disease. Rather, it is more appropriate to conceptualize and work with illness as a narrative placed in a biopsychosocial context. Such a narrative includes how shared responsibility for coping and for finding solutions can take place, without becoming involved in disputes about causal models.     

The MOS Short-Form General Health Survey: single item vs multiple measures of health-related quality of life: some nuances.

Researchers concluded that Item 2 of the Short-form General Health Survey of the Medical Outcomes Study can be used as a single-item measure of health-related quality of life. This conclusion is tested again on a random sample of elderly people in the Netherlands. Although it can be concluded that the psychometric properties of the short form are satisfactory, the use of the single item as a measure of health-related quality of life is discussed.     

Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease.

Although visuoconstructive impairment has been reported in both Alzheimer's (DAT) and Huntington's (HD) disease, there is little knowledge concerning how this cognitive deficit differs quantitatively and qualitatively in these two progressive dementias. To address this issue, the present study compared performances on the Clock Drawing Test (CDT: command and copy) of 25 DAT patients, 25 equally demented HD patients, and 25 elderly normal controls (NC). In the command condition, both patients groups were significantly impaired compared to the NC group. Although there was no significant difference between DAT and HD patients' total quantitative scores, a qualitative error analysis revealed a number of dissociations between the two patient groups. Graphic difficulties, very common in HD patients, were virtually absent in DAT patients; in contrast, conceptual errors were almost exclusively seen in DAT patients and were related to the severity of their dementia. Perseveration and "stimulus-bound" responses were also more frequent in DAT patients, and both groups made visuospatial errors. In the copy condition, the DAT, but not the HD, patients evidenced a marked improvement in performance. These results indicate that while both DAT and HD patients have significant visuoconstructive difficulties even in the early stages of their disorders, the specific cognitive processes underlying their quantitative impairments are quite different. It is possible that the DAT patients' conceptual errors are yet another indicator of the deterioration of their semantic knowledge.     

Dominance,sex, and leader emergence

A 3×2×2 incomplete factorial design was employed to test the effects of sex, dominance, and their interaction on leader emergence. The factors included dominance distribution (high/high, high/low, middle/middle), sex (male-female), and dyad composition (mixed sex-same sex). The subjects were all Caucasians and were pretested on the California Psychological Inventory Dominance Scale. The data revealed that dominance was a predictor of leader emergence in same-sex conditions where high-dominant individuals assumed the role of leader in much greater proportions than their low-dominant partners. In mixed-sex dyads, sex appeared to be a more potent predictor with males becoming leaders at levels greater than would be suspected given dominance levels.     

Spatial cognition and neighborhood use: the relationship in older adults.

Measures of spatial cognition, neighborhood knowledge, and neighborhood use from the research described by Walsh, Krauss, and Regnier (1981) were examined to determine if laboratory tests of spatial cognition were significant predictors of older adults' use of their neighborhoods. The overall results show that laboratory-based measures of spatial cognition and subjects' knowledge of their neighborhoods are both significant predictors of their use of neighborhood goods and services. The ability to learn and remember the location and orientation of objects, when contextual cues were not provided at test, was more predictive of the participants' neighborhood use than either the participants' number of years in the neighborhood or their mobility. Spatial memory as measured by the Educational Testing Service Building Memory task predicted neighborhood knowledge, which was predictive of neighborhood use.     

Age-related differences in three tests of visual imagery.

Adult age differences were explored on 3 short tests of the ability to generate and manipulate mental images. Age-related decrements were found in all 3 tests and were especially marked on the Clock Test. The tests are all reliable, as shown by test-retest reliability coefficients. Correlations also revealed that the Brooks Letter Test and the East-West Test appear to tap one common underlying ability, whereas the Clock Test measured a somewhat different ability. The East-West and Clock tests, in particular, may provide rapid and easily administered assessments of age-related changes in aspects of mental imagery.     

Crime and the elderly: a review of British and American research

Research into the victims of crime is of fairly recent origin and has been centred in America. However, a review of research into the experience of the elderly as the victims of crime, and their anxiety about crime, reveals a paradox. Numerous studies show that while the elderly are less likely to be the victims of crime than are the other age groups, they are among those who exhibit most anxiety over crime. The research is discussed in the context of theories of why the elderly appear as a low-risk group and in terms of an attempt to explain the paradox.     

Three intensive community-based programs for children and youth with serious emotional disturbance and their families

Systems of care for children with serious emotional disturbance and their families have generally lacked intensive community-based programs. We describe three types of newly established community-based programs in New York State and present a general evaluation plan for determining which programs work for various children and their families. The three community-based programs are Intensive Case Management, Family-Based Treatment, and Family-Centered Intensive Case Management. Process and outcome evaluations are being conducted for each of these programs. These evaluations make use of common intake and termination instruments, based on a minimum data set, standardized assessment instruments, and a common logic model, thus facilitating the comparison of findings across evaluations.     

Motor-motor adaptation: preliminary findings

This study investigated the relationship between speech perception and speech production. An experimental technique called motor-motor adaptation was devised. Subjects produced a speech token repeatedly (20 to 40 repetitions), then produced a second token one time. These tokens all contained stop consonants and were subsequently analyzed for voice onset time. The results paralleled previous findings using the experimental procedure, perceptuomotor adaptation. The present study supports the notion of a perception-production link.