Reducing sexual transmission of HIV for injecting drug users: The challenge for counselling

Harm minimization approaches have been recommended to reduce the risks of transmission of HIV for injecting drug users by the elimination of sharing injecting equipment. The risks associated with the sexual behaviours of these individuals have been given less emphasis, and where considered have been in terms of the threat to non-drug partners and potential penetration of HIV infection into the general population. Data are presented from four survey studies conducted between 1985 and 1990 focusing on both drug-taking behaviours and sexual activities. These provide evidence for larger shifts, over this period, in injecting practices than in sexual behaviours. The risks associated with sexual activities for injecting drug users and their sexual partners are considered. It is concluded that counsellors have an important role to play in introducing a second phase of harm minimization that involves interventions to modify sexual behaviours and offers integrated services for injecting drug users and their families.     

Personality, social support, and psychological distress in later life

A conceptual model was developed to address 2 issues that have received relatively little attention in the social support literature. First, an attempt was made to assess the interrelationships among 3 types or dimensions of supportive social relations. In addition, the impact of selected psychological and social factors on social support use was examined. Findings from a nationwide survey of older adults in the United Kingdom suggest that social contact tends to increase the amount of received support, and received support in turn tends to bolster perceptions of support availability in the future (i.e., anticipated support). With regard to the second issue, social roles (especially marital status) and social extraversion emerged as potentially important correlates of social support use in later life.     

Family therapy and a “good” society: Fit or misfit?

Contextual therapy is compared with a good society based on socialist principles of equality, planning and sociality. The two models are analyzed across dimensions of justice, connectedness, change, and basic human resource for similarities and differences.     

Sleep apnea syndrome: Symptomatology,associated features,and neurocognitive correlates

This article reviews the essential features, types, prevalence, pathophysiology, and neuropsychological correlates associated with the sleep apnea syndrome. Persons who experience the intermittent hypoxia and fragmented sleep characteristic of the sleep apnea syndrome tend to exhibit moderate symptoms of diffuse cognitive dysfunction as well as multiple emotional and psychosocial sequela. It is concluded that more research is required in order to elucidate the relationship between the hypoxic parameters and neurocognitive deficits seen in the sleep apnea syndrome, and that neuropsychological assessment might represent a means whereby the effectiveness of various treatments for sleep apnea may be evaluated.     

Comparisons of female and male early adolescent sex role attitude and behavior development

This study contrasted female and male early adolescent sex role attitude and behavior development in an ecological context as defined by Bronfenbrenner. Data were the results of a state-wide survey of early adolescents and their parents. Hierarchical multiple regression was used to test both sex role attitude development and behavior development models. Only the models for attitude development were significant. The level of traditionalism of female sex role attitude development was significantly influenced by maternal employment, the level of traditionalism of the father's sex role attitudes in interaction with the amount of time he spent with his daughter, and chronological age. In contrast, the level of traditionalism of male sex role attitude development was significantly influenced by the level of traditionalism of the mother's sex role attitudes in interaction with the level of closeness to the mother that was reported by the son, and both mother's and father's perception of pubertal age. The implications of the findings for human development theory, early adolescence as a stage of development, and sex role theory and research are discussed.     

The processing of homophonic homographs during reading: Evidence from eye movement studies

Research on the processing of homophonic homographs during reading is reviewed. The primary dependent variable considered was fixation time on target homographs. Both the characteristics of the homograph (whether there are two equally likely meanings or one dominant meaning) and the characteristics of the preceding context (whether it is neutral or contains disambiguating information) were varied. When the preceding context was neutral, readers fixated longer on balanced homographs (homographs having two equally likely meanings) than on control words matched on frequency and length, but didn't look any longer at biased homographs (homographs having a highly dominant meaning) than matched control words. However, when the preceding context disambiguated toward the subordinate meaning, readers fixated longer on a biased homograph than a matched control word (the subordinate bias effect). Attempts to eliminate the subordinate bias effect are described and the implications of our research for models of lexical ambiguity resolution are discussed.Preparation of this paper was supported by grant DBS-9121375 from the National Science Foundation. We wish to thank our colleagues Sara Sereno and Chuck Clifton for their helpful comments on earlier drafts of this paper.     

The impact of connectives on the memory for expository texts

Three experiments investigated the influence of connectives on memory for expository text. Subjects in Experiments 1 and 2 read and later recalled passages with either no connectives, temporal connectives (before/ and then), causal connectives (which caused/which enabled), or intentional connectives (in order that/so that). There was connective interference rather than connective facilitation in the studies reported here: the recall for passages without connectives was higher than the recall for passages with connectives. The results partially supported a semantic complexity hypothesis, which predicted that recall should increase with the semantic complexity of the connective (i.e. temporal < causal < intentional). In a third experiment, the semantic appropriateness of the connective was manipulated. Recall for passages without connectives was better than recall for passages with either appropriate or inappropriate connectives. In a fourth experiment, the subjects filled in missing connectives in natural expository texts. Subjects were able to select the connective category which was originally used by the author. The influence of connectives on text was discussed from the perspective of resource limitations, elaborations, and the semantic compatibility of the connectives to the text.     

Reassessing Predictors of Therapist Competence

Clinicians frequently cite theoretical orientation and training as the central aspects of therapist competence: however, research has indicated that neither is predictive of therapy outcome. Instead, nonspecific factors such as therapist personal characteristics may be the primary determinants of successful outcome. A redefinition of therapist competence is necessary to complement the continued search for significant predictors of therapy outcome.     

The reach of systems theory: A clinician's retrospective, 1984–1993

One of the early family therapists provides a review and analysis of his work in the recent decade (1984–1993), providing also a structure and perspective that connects it with his earliest work in the early 1960s. His work describing the blaming process as a common source of pathogenic relating resulted in a key article in 1984, from which two streams of work and one tributary emerged. A 1984–1989 stream defined a conflict cycle by which therapists might sort out the countless conflicts heard in family interviews, thus aiding diagnosis and treatment. A 1989–1992 stream defined another form of pathogenic relating, learning to be possessed, a learned means of skillfully avoiding blame for wrongdoing which is roughly but usefully defined as The Devil made me do it. The writer concluded that if one became very good at it, learning to be possessed was excellent training for the development of delusional thinking in adolescence and afterwards. Piaget's work suggested that a case could be made for a good match between adult delusional and the problem-solving difficulties of six-to-eight year-old children. During 1992–1993, the author returned to a topic he believes he was the first to introduce and seriously address in family therapy: The problem of defining phases of family therapy (which he wrote about in the early 1970s). Rejecting the traditional beginning-middle-ending model in psychotherapy, he substituted a series of four-interview units, beginning with the engagement series and ending with termination. The early work concentrated on engagement, the recent on termination.Three decades ago family therapy hardly existed, but today it is firmly established among the major psychotherapies. There are tens of thousands of mental health workers familiar with the basic concepts and techniques of the field; and of these, there are several thousand highly skilled practitioners. The field has been both blessed and cursed by the absence of a single father. The blessing has been a rich diversity of viewpoints powerfully enunciated by quite gifted individuals and their disciples. The curse has been factionalism that at times has reached an unusual level of personal vindictiveness, and has encouraged ideologues intent on subordinating the originality and creativeness of the field.Exponents of major viewpoints in the field have, it seems to me, an obligation to continue to enunciate them clearly, to add depth and breadth to those viewpoints whenever possible. As one of the early family therapists, I believe I have such an obligation. In this article I propose to summarize, review, and analyze my work of the past decade, 1984–1993; to add a perspective whenever that may be possible; to relate the work of the recent decade to the work of past decades, whenever possible; to propose a structure for the work of the past decade, and whenever possible to relate that structure to those of previous decades. I am not a writer of books in the ordinary sense, but a writer of articles enunciating particular ideas; and often it has taken several articles to enunciate an idea to my satisfaction. In this article I will attempt to enunciate two streams which flowed from a common source, and also a tributary. It incorporates seven previously published articles.During the preparation of this article I learned of the death in October 1992 of Ernest A. Haggard, who was my chief mentor while I was a graduate student many decades ago at the University of Chicago. Thoughts about Ernie do not seem to leave me. I would like to dedicate this article to his memory.     

Husbands and wives

Woody Allen's film,Husbands and Wives, examines the relationships of two married New York couples over a period of just over a year-and-a-half. Through a variety of means, it explores the undifferentiated nature of its principle figures and what might be called the intersystemic issues between the two dyads. It also offers strong, though undeveloped, indications of previous sexual abuse in several of its female characters.My thanks to M. K. Johnson, PhD, for her thoughtful reading and suggestions.