Group processes and process evaluations in a new treatment setting: inpatient group psychotherapy followed by internet-chat aftercare groups

Little is known about processes characterizing therapeutic Internet-chat groups, which offer a novel way of providing group therapy over distances. In this study group processes and group evaluations were examined in a treatment setting where face-to-face inpatient groups are followed by chat aftercare groups. For a sample of 121 patients who participated in both treatment modalities, group processes and group evaluations were modeled using hierarchical linear modeling. The group evaluations followed a consistent upward course from the beginning of therapy until the end of chat aftercare. For the process measures Activity and Emotional Reactivity, the initial scores at the beginning of the chat groups were lower than at the end of the inpatient treatment, but higher than at admission. During chat aftercare, Activity and Emotional Reactivity scores increased less than during the inpatient phase, but on average Activity and Emotional Reactivity were higher during Internet-chat aftercare. The predictive value of the acquaintance of the therapist from inpatient treatment and the course of group evaluations during inpatient treatment on the course of group evaluations during chat aftercare were examined.     

Imitative interaction increases social interest and elicited imitation in non‐verbal children with autism

Recent studies indicate that being intensely imitated for a brief period of time increases social interest among children with autism. The aim of this study was to replicate and extend these findings. Twenty children with an autism spectrum disorder (ASD) were randomly assigned to one of two interaction strategies: imitation (n=10) or contingent (n=10). The children had little or no functional speech, and their developmental age averaged 25 months (mean chronological age =6:5 years). Both conditions were presented with repeated sessions of a modified version of Nadel's ‘still‐face’ paradigm (still‐face/intervention/still‐face/spontaneous play). The analysis revealed a significant increase of both proximal and distal social behaviours (touch and look at person) for the imitation condition, which confirms previous reports. In addition, an increase in elicited imitation, as measured with the PEP‐R developmental assessment procedure, was also observed for children in the imitation condition, but not in the contingent condition. This finding extends earlier reports in that it suggests that the social expectancies unlocked by imitation also spread to tasks outside the experimental setting. Copyright © 2006 John Wiley & Sons, Ltd.     

Two Kinds of Completeness and the Uses (and Abuses) of Exclusion Principles

I argue that the completeness of physics is composed of two distinct claims. The first is the commonly made claim that, roughly, every physical event is completely causally determined by physical events. The second has rarely, if ever, been explicitly stated in the literature and is the claim that microphysics provides a complete inventory of the fundamental categories that constitute both the causal features and intrinsic nature of all the events that causally affect the physical universe. After showing that these claims are distinct, I argue that they can be used to solve a difficulty with existing responses to the exclusion problem—namely, that these existing responses also undermine the powerful causal argument for physicalism. Recognizing that there are two kinds of completeness opens up room for the nonreductive physicalist to solve the exclusion problem while also endorsing a modified, cogent causal argument for a kind of physicalism compatible with her position.     

Video interaction guidance inviting transcendence of postpartum depressed mothers' self‐centered state and holding behavior

By sometimes evoking self‐absorbed and avoidance behaviors in new mothers, postnatal depression affects the quality of mother–infant interaction, which in turn may invoke distress and avoidance in the infant and cause even more lasting impairment in the child's development. Three depressed mothers, A, B, and C, are reported upon after having been offered counseling in accordance with the Marte Meo approach through jointly watching with the therapist video replays of themselves interacting with their newborns. Clinical vignettes are offered which indicate how empathic and positive support of a sensitive therapist can be helpful in inviting the mother's recognition of her importance to her infant and facilitating mutually gratifying interaction between mother and child. Protocol analyses of select sessions of video‐related therapy reveal that two of the mothers sometimes complete the therapist's unfinished statements in an other‐centered manner, thereby transcending their initial self‐centered state. This is most dramatic in the case of Mother A, who starts out in the first session almost incapable of speech, merely nodding or shaking her head. In addition to other indications of improved mother–infant interaction, comparison of pre‐ and postguidance windows regarding the three mothers' holding behaviors reveals a shift from an avoidance or anxious stance to closer and more secure holding.     

Are novice drivers overconfident? A comparison of self-assessed and examiner-assessed driver competences in a Finnish and Swedish sample

Studies of subjective driving skill have usually assessed perceived driving skill in relation to the skills of the average driver. In order to examine whether novice drivers are overconfident with respect to their actual skills, a different method was used in the present study, where specific aspects of perceived driver competence were compared with assessments made by a driver examiner. A Finnish (n = 2847) and a Swedish (n = 805) sample of driving test candidates completed self-assessments and took a practical driving test; the instruments differed between the countries. The results indicated that about 50 percent of the Finnish and between 25 and 35 percent of the Swedish candidates made realistic assessments of their competence in the areas Vehicle manoeuvring, Economical driving and Traffic safety. The proportion of those who overestimated their competence was greater among the Swedish candidates than the Finnish candidates. This might be explained by greater possibilities of practicing self-assessment in the Finnish driver education. Furthermore, the results indicate that males are not overconfident to a greater extent than females. In conclusion, when perceived competence is related to actual competence instead of the skills of the average driver, the majority of drivers are no longer found to overestimate their skills.     

Prenatal testosterone treatment potentiates the aggression‐inhibiting effect of the neurosteroid dehydroepiandrosterone in female mice

The neurosteroid dehydroepiandrosterone (DHEA) is a powerful inhibitor of aggression in murine models when given for 15 days and potentially may be useful in the management of inappropriate human aggression. Although the biosynthesis and metabolism of DHEA have been described, little is known about the potential effect of the steroidal environment during sexual differentiation on the subsequent response to DHEA. Whether prenatal androgen exposure influences the subsequent response to DHEA was assessed by comparing the effect of DHEA (80 μg/d) on aggression in female offspring where dams were treated with 1, 10, or 100 μg of testosterone (T) on days 15 to 18 of gestation (Experiment I) or that developed in different uterine positions (Experiment II). The results showed that DHEA decreased attack behavior in general and that the 100‐μg prenatal T treatments enhanced the antiaggressive effect of this neurosteroid. Neither the lower doses of exogenously administered T nor the uterine position led to an enhanced response to DHEA. In addition, whether DHEA produced changes in social and nonsocial activities was examined. In the 100‐μg T females, DHEA increased the duration of the former and decreased the frequency and duration of the latter, indicating that it was not a general decrement in behavioral expression that mediated the enhanced response to the antiaggressive effect of DHEA. In the second experiment, DHEA treatment led to increased frequencies of social nonaggressive and nonsocial activities. However, the uterine positions × treatment interactions were not significant, demonstrating that contiguity to male fetuses did not differentially affect the response to DHEA. Aggr. Behav. 27:130–138, 2001. © 2001 Wiley‐Liss, Inc.     

Suboptimal exposure to facial expressions when viewing video messages from a small screen: effects on emotion, attention, and memory

The authors examined the effects of suboptimally presented facial expressions on emotional and attentional responses and memory among 39 young adults viewing video (business news) messages from a small screen. Facial electromyography (EMG) and respiratory sinus arrhythmia were used as physiological measures of emotion and attention, respectively. Several congruency priming effects were found. In particular, happy facial primes prompted increased (a) pleasure ratings, (b) orbicularis oculi EMG activity, (c) perceived trustworthiness, and (d) recognition memory for video messages with a positive emotional tone. Emotional and other responses to video messages presented on a small screen can be modified with suboptimal affective primes, but even small differences in the emotional tone of the messages should be allowed for.     

Psychosozialer Versorgungsbedarf bei Arbeitnehmern

Zusammenfassung  Untersuchungen zu Häufigkeit, Verlauf und Ursachen psychischer Erkrankungen bei Arbeitnehmern sind rar. Die Gründe hierfür liegen sowohl auf Seiten der Arbeitsmedizin, die psychosoziale Aspekte wenig berücksichtigt, als auch bei der Psychotherapie, die zu wenig auf die Arbeitssituation eingeht. Die wenigen aussagekräftigen Untersuchungen legen bei Arbeitnehmern eine ähnlich hohe Prävalenz und Behandlungsbedürftigkeit nahe wie in der Allgemeinbevölkerung. Von den Folgen einer störungsinadäquaten Therapie psychischer Erkrankungen sind Arbeitnehmer in besonderem Maße betroffen, da die Erkrankungen nicht nur zu erheblichem persönlichem Leid führen, sondern durch Chronifizierung zu enormen Kosten in der medizinischen Versorgung beitragen. Außerdem sind sie durch krankheitsbedingte Fehlzeiten und (Früh-)Berentungen auch die Ursache weit reichender Produktionsausfälle in der Wirtschaft. Obwohl eine Reihe von Maßnahmen der betrieblichen Gesundheitsförderung zur Besserung der psychischen Befindlichkeit von Arbeitnehmern verfügbar sind, werden sie gegenwärtig noch zu selten eingesetzt und noch weniger evaluiert.

Improving fairness in coverage decisions: performance expectations for quality improvement

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups.