Philosophy of science (Wissenschaftstheorie) in Finland

Journal for General Philosophy of Science - A survey of recent work in the philosophy of science in Finland, with a bibliography. The main sources of influence emphasized are Eino Kaila...     

The Therapeutic Alliance in Couple Therapy for Depression: Predicting Therapy Progress and Outcome from Assessments of the Alliance by the Patient, the Spouse, and the Therapists

This study examined Couple Therapy (CT) for depression in a naturalistic setting. It looked at the associations between the therapeutic alliance and subjective distress, and between the alliance and depression outcome. Twenty-nine depressive patients and their spouses were treated via CT. Treatments were adapted in accordance with the patient’s need. The couples assessed the alliance and their subjective distress at every session. In addition, the therapists assessed the alliance at every session. The patient’s depression outcome was assessed at baseline and at 6, 12, 18, and 24 months post-baseline. The Outcome Rating Scale, The Session Rating Scale, and the Beck Depression Inventory were used. At any given session, the patients’ and spouses’ deviations from their average subjective distress ratings predicted their deviations from their average alliance ratings in the same session. At any given session, the patients’ and spouses’ deviations from their average alliance ratings predicted their deviations from their average subjective distress in the next session. The therapy-system alliance was significantly associated with the patients’ depression outcome, explaining 19.4 % of the variance in the patients’ depression change. The results indicate the importance of taking into account the association between the alliance and subjective distress during the treatment, and confirm the usefulness of routine evaluation of the therapeutic process as an indicator of the association between alliance and therapy outcome in everyday CT for depression.     

OPEN DIALOGUE IN PSYCHOSIS II: A COMPARISON OF GOOD AND POOR OUTCOME CASES

As an approach to treatment of psychosis, Open Dialogue aims to begin treatment within 24 hours of first contact between the health system and the patient or family, and in accordance with social constructionist principles, it includes the family and the social network in open discussion of all issues throughout treatment. As one step toward evaluating the impact of this novel model of care, statistical and qualitative analyses of 78 consecutive first-episode psychotic cases was undertaken, discriminating good from poor outcome cases on the basis of functional and symptomatic criteria. Results suggested differences in the diagnosis and duration of prodromal and psychotic symptoms, as well as in treatment processes in the two groups. Avoiding hospitalization and using anxiolytics instead of neuroleptics were associated with a good outcome. Overall, data bearing on the effectiveness of OD were encouraging, as only 22% poor outcome patients emerged. However, if the possibility for starting a dialogical process is minimal, the treatment may lead to poor outcome, even where this is not predicted by premorbid social and psychological factors.     

Sex differences in genetic and environmental effects on aggression

The aim of the present study was to investigate the genetic and environmental factors influencing teacher and parental rated aggression in boys and girls, asking whether the magnitude of these effects is similar across rater and sex. The study is part of an ongoing nationwide twin‐family study of behavioral development and health habits carried out in Finland. The sample consisted of 1651 twin pairs (264 monozygotic male, 300 monozygotic female, 292 dizygotic male, 278 dizygotic female, and 517 dizygotic opposite‐sex twin pairs), representing subsets of five 11‐ to 12‐year‐old twin cohorts (b. 1983–1987). The data were collected using the teacher and parental rating forms of the Multidimensional Peer Nomination Inventory. Structural equation models of sex‐limitation assessed sex differences in genetic and environmental influences on aggression. The results suggested significant genetic, common environmental, and specific environmental effects on aggression in both boys and girls, but the best fitting model differed depending on the informant. For both ratings, boys showed lower levels of heritability and higher levels of common environment than girls. In addition, the teacher rating data also suggested the presence of either sex‐specific common environmental effects or sex‐specific genetic effects. Support is provided also for sibling contrast effects, either at the behavioral level or as a rater bias. Aggr. Behav. 29:55–68, 2003. © 2003 Wiley‐Liss, Inc.     

Postmodern society and social networks: open and anticipation dialogues in network meetings

Network therapy flourished in the U.S. during the 1970s, but has since dwindled there and begun to find new applications in Europe, especially in the Nordic countries. State social and healthcare systems, in developing deep vertical expertise, seems to build up a need for complementary horizontal expertise. The latest theories of sociology are used to analyze the need for networking, with the focus on language and dialogue as specific form. Two approaches developed in crisis service for psychotic patients (Open Dialogue) and in consultation for stuck cases in social care (Anticipation Dialogues), are dealt with. What becomes essential seems no longer to be the therapeutic method itself but the ability to see the polyphonic nature of clients' reality. In this respect, language--and dialogue as a specific form of being in language--as the focus of treatment, makes the practical forms of different approaches secondary.