Analysis of play

Abstract

Play has long been considered a useful therapeutic tool when working with children. Even though play is used extensively by psychotherapists of various theoretical persuasions, relatively little is written concerning the nature and therapeutic value of play. In addition, the therapeutic significance of play in psychotherapy with adults is an area that has been neglected and under‐utilized. This paper will address the nature of play and what it is that makes play therapeutic within a conceptual framework derived from psychoanalytic theory, existentialism and phenomenology. In particular, the nature of play and its therapeutic value will be analyzed through three constitutive elements: the paradoxical nature of play, the role of the imagination and the symbolic, and the playful therapist.     

Treating PTSD in active duty service members using cognitive processing therapy or prolonged exposure therapy: Examining everyday practice at a military outpatient clinic

The Institute of Medicine has stressed the need for evaluations of evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) among active duty service members (AD) using a variety of evaluation approaches (Institute of Medicine, 2012). The current study examined the clinical files of 134 service members who completed treatment for PTSD using either prolonged exposure (PE) or cognitive processing therapy at an outpatient clinic. At the completion of each session, therapists made a clinical rating as to whether or not the session was protocol adherent. The total number of treatment sessions and the proportion of sessions rated as being protocol adherent were calculated. Multi-level models estimated the change in patient PTSD and other psychological symptoms over time as a function of clinician-rated protocol adherence and total number of sessions. Approximately 65% of clinic encounters were rated by therapists as being protocol adherent. Significant reductions in PTSD and psychological symptoms were associated with protocol adherence, and this was particularly true for patients who began treatment above clinical thresholds for both PTSD and other psychological symptoms. However, as the number of sessions increased, the impact of protocol adherence was attenuated. Patient characteristics, including gender, ethnicity, and co-morbidity for other psychiatric disorders were not related to symptom change trajectories over time. These findings suggest that protocol adherence and efficiency in delivery of EBTs for the treatment of PTSD with AD is critical.     

Standard Errors of Multivariate Range-Corrected Validities

The multivariate rather than the univariate range correction is used for estimating unrestricted applicant population validities in many military test validity studies but not uniformly. A Monte Carlo approach compared the standard errors of range-corrected validities under various experimental conditions adhering to the assumptions underlying correction accuracy. The multivariate corrected validities had smaller standard errors than both the univariate-corrected validities and the unrestricted validities. We conclude that using the univariate correction could fail to reveal the most valid selection instrument and that the multivariate correction should be used when scores for relevant predictors are available for the unrestricted population.     

Natural Course and Treatment of Neuropsychological Deficits in a Child with Early-treated Galactosemia

Galactosemia is an autosomal recessive disorder that results from a breakdown in the metabolism of galactose, which can be found in milk and milk products. Acute medical complications are controlled by early diagnosis through newborn screening and strict adherence to a galactose-free diet, but there remain physical and neurobehavioral sequelae from treated galactosemia. We present a case study of a 7-year-old boy with treated galactosemia. This study describes his history and course over a 41-month period from age 6 to 10 years old using repeated neuropsychological assessments. This child exhibited a decline in intellectual functioning, weaknesses in visual-spatial processing, fine motor skills, handwriting, math, language, and reading, and a deficit in executive functioning. He also met criteria for Attention Deficit Hyperactivity Disorder, Inattentive Type. Following treatment with stimulant medication, the child reportedly had decreased problems with sustained attention and increased consistency of responding and motor planning. Recommendations are made for repeated neuropsychological assessments to chart the course of children with treated galactosemia and to identify potential areas for remediation (e.g., attention).     

Executive functions and social skills in survivors of pediatric brain tumor

Medical advances have resulted in increased survival rates for children with brain tumors. Consequently, issues related to survivorship have become more critical. The use of multimodal treatment, in particular cranial radiation therapy, has been associated with subsequent cognitive decline. Specifically, deficits in executive functions have been reported in survivors of various types of pediatric brain tumor. Survivors are left with difficulties, particularly in self-monitoring, initiation, inhibition, and planning, to name a few. Another domain in which survivors of pediatric brain tumor have been reported to show difficulty is that of social skills. Parents, teachers, and survivors themselves have reported decreased social functioning following treatment. Deficits in executive functions and social skills are likely interrelated in this population, as executive skills are needed to navigate various aspects of social interaction; however, this has yet to be studied empirically. Twenty-four survivors of pediatric brain tumor were assessed using a computerized task of executive functions, as well as paper-and-pencil measures of social skills and real-world executive skills. Social functioning was related to a specific aspect of executive functions, that is, the survivors' variability in response time, such that inconsistent responding was associated with better parent-reported and survivor-reported social skills, independent of intellectual abilities. Additionally, parent-reported real-world global executive abilities predicted parent-reported social skills. The implications of these findings for social skills interventions and future research are discussed.     

Violence as Worship: Religious Wars in the Age of Globalization,by Hans G. Kippenberg,trans. Brian McNeil,Stanford University Press: Stanford,CA, 2011, viii + 286 pp. ISBN 978 0 8047 68726, US$70 (cloth); ISBN 978 0 8047 6873 3, US$21.95 (paperback)

The author argues in this paper that the ‘state effects’ generated by religious movements – even those operating at the margins of societies – require us to consider anew the impact of religious movements on state formation. In Sri Lanka, for instance, evangelicals are a minority. Yet their practice of proselytizing to new audiences was considered ‘unethical,’ generating opposition that was directed not only at them, but also at ruling elites for failing to stem what was seen as an intrusion of incompatible ‘Western’ ideals. Instead of considering how such Christian movements seek to ‘take over’ the functions of the ‘state’ as has been the experience in the United States and parts of Latin America, the author illustrates in this article why it makes more theoretical sense to ask how their activities impinge upon the conceptual frameworks through which the ‘state’ is imagined.     

The mythic significance of risk-taking,dangerous behaviour

Clinical research using grounded theory methodology was undertaken to discover the origin, structure and meaning of risk-taking, dangerous behaviour in childhood. Three different situations were identified in which risk-taking, dangerous behaviour occurred. These were named illusory-haven, no-haven and perilous-haven: 'haven' describing different object relationships which occurred both inter-psychically and intra-psychically, each of which was dangerous for the child. These configurations of relationships were found to be meaningfully linked to different situations in the Oedipal drama. The 'havens' were also found to be important in linking patterns of family relationships to gang formation. By using the havens in this broader context the insights gained from the Oedipus Complex are seen to be more widely applicable. Es wurde klinische Forschung , die sich auf theoretische Methodik beruft, benutzt, um den Ursprung, die Struktur und die Bedeutung von risikohaftem, gefährlichem Verhalten in der Kindheit zu entdecken. Es wurden drei verschiedene Situationen identifiziert, in denen risikohaftes, gefährliches Verhalten auftrat. Diese wurden illusorische Oase, keine Oase und gefähliche Oase genannt: 'Oase' beschreibt verschiedene Objektbeziehungen, die sowohl interpsychisch als auch intrapsychisch auftreten und jeweils gefährlich für das Kind sind. Diese Beziehungskonfigurationen konnten bedeutungsvoll mit verschiedenen Situationen des ödipalen Dramas verbunden werden. Die 'Oasen ' wurden auch als bedeutend dafür gesehen, Muster von Familienbeziehungen mit Gangformationen in Verbindung zu setzen. Indem man die Oasen in diesem weiteren Zusammenhang benutzt, werden die Einsichten, die aus dem ödipuskomplex gewonnen werden, als weitreichender anwendbar gesehen. Des recherches cliniques utilisant la méthodologie dite de la théorisation ancrée (analyse qualitative et catégorielle) ont été entreprises afin de déceler, chez l'enfant, l'origine, la structure et la signification de la prise de risques et du comportement dangereux. Trois situations différentes, dans lesquelles ce type de comportement se produit, ont été identifiées. Elles sont appelées «havre illusoire», «absence de havre» et «havre périlleux»; le mot «havre» est ici employé pour désigner les différentes relations objectales, inter-psychiques comme intra-psychiques, qui s'avèrent dangereuses pour l'enfant concerné. Ces configurations relationnelles sont liées de façon significative à certains avatars du drame ?dipien. L'idée du «havre» est une représentation qui permet de relier certaines configurations relationnelles familiales à la formation de «gangs» ou de bandes. La notion de «havre» utilisée dans ce contexte élargi permet de conclure que les insights acquis grâce au complexe d'?dipe sont d'application plus générale. Sono state fatte delle ricerche cliniche utilizzando una metodologia teorica fondata per scoprire l'origine, la struttura e il significato del comportamento di correre rischi e di quello pericoloso nell'infanzia. Si identificarono tre diverse situazioni in cui si presentava tale comportamento. Queste furono denominate rifugio-illusorio, non rifugio e rifugio pericoloso: 'il rifugio' descrive diverse relazioni d'oggetto sia a livello inter-psichico che intra-psichico, ciascuna delle quali e' stata pericolosa per il bambino. Risulto' che queste configurazioni di relazioni erano significativamente correlate a diverse situazioni nel dramma edipico. I 'rifugi' erano anche importanti nel correlare modelli di relazioni familiari alla formazione della gang. Usando i rifugi in questo contesto piu' ampio le insights ricavate dal complesso edipico possono essere piu' largamente applicabili.     

Race,sex, and juvenile inmate roles

Mate selection researchers have long assumed that surveyed listings of ''ideal traits'' indicate strong preferences by women for virtuous males. This assumption is contradicted, however, by increasing evidence of sexual abuse in dating relationships and suggests the possibility that the hero-centric Western culture of romance greatly complicates the mating process. A review of literary heroism revealed extraordinary individualism. Notably, George Gordon Byron's protagonists ('Byronic Heroes') are men of stupendous assertiveness and uncertain morality; derivatives abound in contemporary American popular culture. A comparison was made of three typologies; the third, domestic batterers being ''stand-ins'' for abusive dates. Byronic traits were found to much more closely resemble those of batterers than of hypothetical ideal mates. Thus, the development of intense admiration of fictional Byronic Heroes during socialization could lead to an admiration of same traits in encountered males with or even tragic results.     

Early Menarche: Confluence of Biological and Contextual Factors

An important factor in a girl’s feelings about menstruation as well as psychological outcomes is the timing of menarche. Reaching menarche early compared to one’s peers has been implicated as a risk factor for multiple negative outcomes including depression, delinquency, body dissatisfaction, and substance abuse. Early menarche also involves a convergence of biological and contextual factors that interact to influence psychological outcomes. In this paper we first review the biology of menarche. Drawing from studies conducted in the U.S. as well as European nations and New Zealand, we synthesize the research on environmental factors that contribute to early menarche, as well as evidence that early menarche changes a girl’s social environment. Then we review the hormonal influence hypothesis, the maturation disparity hypothesis, the contextual amplification hypothesis, and the accentuation hypothesis as models that may explain the mechanisms by which early menarche contributes to negative psychological outcomes. Finally, we describe how both mediation and moderation models can be used to understand the processes that link early menarche to adverse outcomes.     

Identity,coping style,and health behaviour among first generation Irish immigrants in England

Abstract

Berry's (1997) framework for acculturation research was used to explore the relationship between identity and health among Irish immigrants in England. One hundred and twelve first generation Irish immigrants completed questionnaire measures of ethnic identity, opportunities for identity expression, generalised coping style, and health behaviour. Significant, though small, positive correlations were observed between identity and health behaviour as predicted. Regression analyses and path analysis were used to present a model of the link between variables. Of particular note were the contrasting ways in which the two dimensions of identity were associated with health behaviour. Participants who positively evaluated their ethnic origins reported engaging in healthier behaviour and adopting more beneficial coping strategies when faced with day-to-day stresses and problems. Participants who reported their ethnic origin as more central to their overall identity were also more likely to adopt beneficial coping strategies. Concomitantly, however, they had fewer than desired opportunities for expressing their ethnic identity which was, in turn, associated with less beneficial coping and health behaviour. In looking for ways to tackle the well-documented health problems of both first and second generation Irish in England, the results suggest that encouragement to feel more positive about their ethnic identity might result in greater usage of behavioural approach coping and, relatedly, to improved health behaviour.