Daily stress and anxiety and their relation to daily fluctuations of symptoms in asthma and chronic obstructive pulmonary disease (COPD) patients

Although stress and anxiety have long been assumed to play an exacerbatory role in asthma, no study has systematically documented that daily exacerbations of asthma symptoms are related to stress and/or anxiety. In this study, 24 airways obstruction patients (12 asthmatics and 12 chronic obstructive pulmonary disease patients) were instructed to monitor the severity of daily respiratory symptoms. In addition, subjects recorded their daily anxiety level and the number and perceived impact of daily stressors. The results showed that although there were differences between high- and low-stress days for both groups, there were no differences between groups on symptom severity or between high- and low-anxiety days, as measured by the State-Trait Anxiety Inventory (STAI). Thus, although the number and impact of daily stressors were found to be directly associated with the severity of asthma symptoms, anxiety does not appear to have a direct role in the exacerbation of asthma. The findings failed to support the anxiety theory of asthma but provided an explanation for the poor results obtained in previous treatment studies which employed anxiety management with asthmatics.     

The Multilevel Conception of Intentionality: Implications for counselor training

Counseling training programs have failed to differentiate between and among behavioral, cognitive, and unconsciousness dimesnsions. This omission has resulted in confusion and competition in many counseling curricula in that valuable programs are competing for space rather than being integrated systematically. This article proposes a multilevel model of intentionality which integrates the several aspects of the counselor-client relationship. In turn, this integration of behavioral, cognitive, and unconscious dimensions will have important applications in counselor daily practice.     

Recurring thoughts on unconscious ego resistances.

Analysis of the unconscious ego resistances is one of those clinical concepts more honored in the breach than in the observance. This same point has been made periodically over the past fifty years. It has not been sufficiently realized that a true psychoanalytic understanding of resistance analysis could only begin with Freud's second theory of anxiety. Freud himself never fully embraced this theory, and clinical contributions since then have varied in their ability to use the techniques inherent in the second theory of anxiety. Recent contributions to the literature have not eliminated the espousal of theories of resistance based on earlier views of anxiety. Reasons cited for this include: the ambiguities in Freud's writing, the direction of the early ego theorists, and proclivities toward deeper interpretations.     

Selecting a best multiattribute alternative with partial information about attribute weights

Use of approximate weights would greatly simplify decision analysis under certainty since detailed weight elicitation could be avoided. This paper examines the degree to which rank order information about weights can be used to identify a best alternative, or falling uniqueness prescribes an easily implemented rule for selecting a ‘best’ alternative. The prescribed rule uses as weights the centroid of the feasible region defined by the rank order information. In conjunction with the rule, the value of the rank order information can be determined using an ‘expected gain from weight precision’ (EGWP) measure, analogous to ‘expected value of perfect information’ in decision analysis under uncertainty.     

When depression breeds contempt: reassurance seeking, self-esteem, and rejection of depressed college students by their roommates.

To test Coyne's (1976b) theory of depression, students' levels of depressive symptoms, reassurance seeking, and self-esteem were assessed at Time 1, and their same-gender roommates' appraisals of them were assessed 5 weeks later. Mildly depressed students engaged in the type of reassurance seeking described by Coyne. Among men, but not women, mildly depressed students were rejected if they strongly sought reassurance and had low self-esteem but not if they did not seek reassurance or had high self-esteem. Although induction of depressed symptoms in roommates did occur, this contagion effect did not account for the depression-rejection relationship. The prediction that unsupportive, intolerant, or unempathic others would be particularly likely to respond with rejection to reassurance-seeking depressed students with low self-esteem received partial support. Implications for future work on the interpersonal aspects of depression are discussed.     

Confirming the latent structure and base rate of schizotypy: a taxometric analysis.

Meehl's (1962, 1990) model of schizotypy and the development of schizophrenia implies that the structure of liability for schizophrenia is dichotomous and that a "schizogene" determines membership in a latent class, or taxon (Meehl & Golden, 1982). The authors sought to determine the latent structure and base rate of schizotypy. They applied Meehl's (1973; Meehl & Golden, 1982) MAXCOV-HITMAX taxometric analytic procedures to a subset of items from the Perceptual Aberration Scale (PAS; Chapman, Chapman, & Raulin, 1978), a prominent psychometric index of schizotypy, derived from a randomly ascertained nonclinical university sample (N = 1,093). The results, in accordance with Meehl's conjectures, strongly suggest that schizotypy, as assessed by the PAS, is taxonic at the latent level with a general population taxon base rate of approximately .10.     

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.