Family Therapy in Trouble: Psychoeducation as Solution and as Problem

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho-therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.     

Frontal amnesia and the dysexecutive syndrome

This study analyzes the memory deficits shown by an amnesic patient with bilateral frontal damage and a dysexecutive syndrome. He resembles a classic amnesic patient in showing grossly impaired episodic memory for both verbal and nonverbal material, together with normal digit span, and on occasion normal recency in free recall. He differs from the classic amnesic pattern however in showing an impairment in both the speed and accuracy of performance on tests of semantic memory, and in clear evidence for impaired performance on some though not all procedural learning tasks. Finally, his autobiographical memory was poor and subject to substantial confabulation. It is suggested that the pattern of deficits is consistent with a combination of a classic amnesic syndrome with the additional problems associated with the frontal dysexecutive syndrome, rather than exhibiting a qualitatively different form of amnesia.     

The perception of an optical flow projected on the ground surface

In most experiments in which the importance of visual control on postural stability is studied, optical stimuli attached to vertical surfaces are used. Analyses of long-term standing readjustments generally involve back-and-forth movements of a visual scene or its projection on vertical circular screens. In a natural environment, however, visual information is largely available from the ground. The aim of the experiment reported was to assess the effect of a flow pattern simulating an open outdoor setting on motion perception and postural control. Subjects were presented with an optical texture projected onto the ground. Periods of motionless texture alternated with equivalent durations of unidirectional flows. The change of position of the subject's centre of gravity over time was recorded on a force platform. Results show that the direction of body sway corresponded with that of texture motion. Important aftereffects, as shown in linear vection experiments, were also observed. However, the latency of postural responses was much shorter than with prolonged unidirectional flows produced in other locations of the visual environment. The hypothesis of an ecological specificity of the flows perceived on the ground during terrestrial displacements is discussed.     

Effects of concreteness and semantic relatedness on composite imagery ratings and cued recall

Day and Bellezza (1983) rejected a dual coding imagery explanation for the superior recall of concrete words because unrelated concrete pairs were rated lower in composite imagery but were still remembered better than related abstract pairs. We show that dual coding theory explains their results and our new findings using the same paradigm. In Experiment 1, 120 subjects rated imagery or relatedness for 108 pairs that varied in concreteness, pair relatedness, and associative strength. Incidental cued recall followed. Relatedness and strength affected imagery ratings, as did concreteness, and very low relatedness partly accounted for the low composite imagery ratings for unrelated concrete pairs. Concreteness and relatedness also affected recall, and suporior recall for unrelated concrete pairs occurred consistently under imagery but not under relatedness instructions. In Experiment 2, 40 subjects rated imagery value and recalled 24 pairs. Subsequent questioning indicated that composite images were retrieved better given stimuli from unrelated concrete than from related abstract pairs. These findings and Day and Bellezza’s original results are explained in terms of (1) imaginal and verbal associative processes, which jointly influence composite imagery ratings and recall, and (2) the critical role of stimulus concreteness during image retrieval and recall (i.e., the conceptual peg hypothesis).     

Short-term memory for Chinese characters and radicals

Short-term memory for Chinese radicals and characters, varying in orthographic complexity, frequency, and—for radicals—intercharacter frequency (the number of compound characters that contain the radical), was studied using an immediate free-recall task. When radicals or characters are relatively frequent, so that their pronunciations are well known by literate Chinese, they seem to be maintained in verbal form in short-term memory. For these stimuli, intercharacter frequency and complexity have relatively small influences on memory span. Stimuli low in frequency, with pronunciations that are not apt to be known, seem to be maintained in visual form in short-term memory. Memory span is much smaller for these stimuli and is influenced by both intercharacter frequency and complexity. Furthermore, short-term memory for relatively high-frequency characters is interfered with more by a verbal than by a visual intervening task, whereas the opposite is true for low-frequency characters.     

Frontal cortex grafts have opposite effects at different postoperative recovery times

We studied the effect of different postoperative times on the behavioral recovery following brain implants. Adult male rats received cortical tissue grafts 2 weeks after aspiration of the medial frontal cortex. Either 2 (Immediate Group) or 28 (Delay Group) days after grafting, the performance of these rats on a behavioral battery, comprising the Morris water maze task, forepaw use, and grooming, was compared to that of rats with similar lesions and postoperative recovery times but no grafts. Rats tested immediately after receiving implants performed better on the spatial navigation task than rats with similar lesions but no grafts. This improvement, however, was less than that shown by rats with lesions but no grafts permitted to recover for 28 days before testing. In contrast, in the Delay Group, rats with grafts were more greatly impaired than were their operated controls. Neither lesions nor grafts affected grooming although the Immediate Group with grafts were significantly more impaired in using their forepaws during feeding than were any of the other groups. These results lead us to conclude that differing postoperative recovery times and task requirements may account for some of the inconsistent results of the influence of brain grafts on behavioral recovery reported in the literature. We also conclude that cortical tissue implants can have two effects with different time courses and opposite net behavioral effects.