One-session treatment for specific phobias

A rapid and effective treatment for specific phobias, in which the treatment is done in one single session, is described in detail. The treatment method consists of a combination of exposure in vivo and modeling. The short- and long-term outcome for a consecutive series of 20 patients are reported. Mean treatment time was 2.1 h and at follow-up after an average of 4 yr 90% were much improved or completely recovered.     

A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia

A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.     

Negativism and countertransference

The purpose of this work is to explore the phenomenon of negativism and the analyst's response to it during the course of analytic work with a patient in whom negativism is a central behavioral pattern. Melville's short story, "Bartleby the Scrivener," describing in telling detail the response of a sympathetic lawyer to profound and pervasive negativism in his legal scribe, is discussed as a literary analogy to the analyst-analysand dyad. Aspects of the concept of negativism within psychoanalysis are discussed. The potential usefulness of understanding certain unexpected countertransference responses to pervasive negativism is explored, as this is a relatively neglected area of psychoanalytic technique. A case is presented describing the analysis of a patient whose character, like Bartleby's, is a mixture of profound negativism along with schizoid, obsessional, and masochistic elements.     

Developmental psychopathology. Current research, issues, and directions

Developmental psychopathology refers to the study of clinical dysfunction in the context of maturational and developmental processes. Although the field encompasses the entire life span, the present focus is on childhood. Special characteristics make the study of childhood dysfunction somewhat unique, including the emergence, evolution, and attenuation of seemingly problematic behaviors over the course of development; the manner in which children are referred for clinical evaluation; and complexities in identifying the appropriate foci for clinical intervention. Notwithstanding these obstacles, recent work has advanced considerably in diagnosis, assessment, and treatment of childhood disorders. The present article highlights recent advances in these areas and promising extensions in current research. Many advances have relied heavily on the extension of paradigms developed in research with adults. Additional research is needed that draws on and integrates conceptual and empirical work from developmental psychology.     

Emotional disturbance and the development of self-consciousness in adolescence

The development of self-consciousness and its relationship to emotional disturbance was examined in early and late adolescence. The Imaginary Audience Scale was administered to emotionally disturbed and nondisturbed adolescents. As predicted, results indicated that self-consciousness decreased with age in nondisturbed adolescents. For the emotionally disturbed adolescents, the development of self-consciousness in temporary situations did not follow consistent patterns, as indicated by interaction effects. A significant negative relationship was found between intelligence test scores and self-consciousness in the disturbed group. The findings support the premise that social-cognitive shifts found in early to late adolescence are disrupted in disturbed populations. The mediating role of social experience as a factor in cognitive and emotional development is discussed.     

School administrators, parents, and sex education: a resolvable paradox?

The emergence of AIDS as an untreatable, lethal disease, responding to educational prevention strategies in high-risk populations, has brought the issues of sex education in the public schools to the forefront. However, administrators, teachers, and parents perceive different barriers to sex education implementation. This study, undertaken in a northeastern, multigenerational, ethnic city, characterized by adolescent pregnancy rates a third higher than the state overall, polled 42 junior and senior high school administrators regarding educational priorities, perceived barriers to expansion of sex education, and preferred methods of introducing sex education. Administrators perceive parents as a major barrier to the introduction of more formalized sex education in their schools. Paradoxically, these same administrators felt that parents were generally uncomfortable in talking to their children about human sexuality. Recommendations are offered from existing models of health education for resolution of administrators' conflicting views on parental roles.     

Adolescent school performance following parental divorce: are there family factors that can enhance success?

Most research on the effects of divorce on children has focused on delineation of specific areas of child maladjustment. A more optimistic approach seeks to identify variables that may mediate negative effects of a stressor, such as parental divorce. The goal of this study was to examine the relationship between one area of child adjustment, school achievement, and family factors which may mediate the negative influence of divorce. The subjects were 71 early adolescents and their recently divorced mothers. The adolescents were divided into low, medium, and high grade achievement groups. Analyses of variance and subsequent Newman-Keuls tests revealed that adolescents with high grade point averages had mothers with a lower level of depression, a higher educational level, less conflict with their ex-spouse, and less intense levels of conflict between mother and adolescent than those in the low grade point average group. A discriminant analysis resulted in a two-variable equation which accounted for 33% of the variance between low and high grade achievers. The two variables were mother's report of conflict between her and her ex-spouse in front of the adolescent and the adolescent's report of the intensity of arguments between him/herself and mother. These results indicated that school performance following divorce is not uniform for all adolescents and that family factors may mediate scholastic achievement problems.     

Age-appropriate behaviors: a comparison of three generations of females

The purpose of this study was to examine differences in older adolescent and adult females' perceptions of age-appropriate behavior in adults. Subjects were three generations of maternally related females (95 older adolescents, 78 mothers, 83 grandmothers) who were administered a questionnaire designed to assess age-appropriate behaviors in three broad categories: recreation, occupation/career, and family. Major findings were that older adolescents were most tolerant of behaviors performed by individuals at varying ages while older women most closely ascribed to age constraints, and that the greatest agreement on appropriateness of age constraints concerned family relationships while least agreement concerned recreational activities. Results support the view that adolescents' values on family issues are consistent with those of their parents, and suggest that adherence to age norms increases throughout the life span or are the result of generational differences in socialization.     

The impact of anxiety on visual attention to central and peripheral events

Recent reports in the literature suggest that anxious individuals show an attentional bias to mood-congruent information. Various investigators have hypothesized that such anxiety-based coding biases contribute to the maintenance of mood disorders. The present study sought to determine if attentional biases in anxious subjects extends to the perception of neutral, as opposed to affect-laden, stimuli. A procedure used to determine the locus of attention to foveal and peripheral visual events was used in combination with two inter-stimulus intervals, fixed and variable, to examine anxious and non-anxious subjects' attentional biases. Mood states were established by a well-validated musical induction procedure. The results revealed an attentional bias to foveal visual events in non-anxious subjects and an attenuated or reversed (peripheral) bias in anxious subjects. The clinical implications of these findings are discussed.