Systems-Centered Therapy: A Protocol for Treating Generalized Anxiety Disorder

The systems-centered short-term therapy protocol was adapted and applied in three single case studies with generalized anxiety disorder (GAD) patients in a ten-session individual treatment over a two week period. All three subjects showed substantial improvement and no longer met diagnostic criteria post-treatment. Changes were maintained at follow up both six months and one year later. These results are promising and suggest the importance of further research on SCT as a viable, alternative treatment for generalized anxiety disorder.     

A normative zone of RPE ratings for use during graded exercise testing

The purposes of this investigation were to identify a zone of normality for ratings of perceived exertion (RPE) and to compare the RPE responses in patients with coronary artery disease to this zone. The zone was generated from RPE estimated during the last minute of each stage of a Bruce treadmill test in 44 normal adult men. RPE were regressed against the corresponding MET level for each exercise stage. The zone was established as the 95% confidence interval (CI) spanning the average RPE vs MET regression line. RPE estimated during the last 1.0 min. of a Bruce or Modified Balke treadmill test administered to adult men (n=37) with coronary artery disease were compared to the 95% CI zone. A total of 19 (51%) of the coronary artery disease patients estimated RPE during a progressively incremented treadmill test that were above the zone, indicating a comparatively greater than normal perception of strain for a given metabolic stress. The presently generated zone provides a practical use of RPE in the interpretation of clinical exercise tests.     

On dreaming one's patient: reflections on an aspect of countertransference dreams

This paper explores the phenomenon of the countertransference dream. Until very recently, such dreams have tended to be seen as reflecting either unanalyzed difficulties in the analyst or unexamined conflicts in the analytic relationship. While the analyst's dream of his/her patient may represent such problems, the author argues that such dreams may also indicate the ways in which the analyst comes to know the patient on a deep, unconscious level by processing the patient's communicative projective identifications. Two extended clinical examples of the author's countertransference dreams are offered. The author also discusses the use of countertransference dreams in psychoanalytic supervision.     

Recommendations from Multi-disciplinary Focus Groups on Cascade Testing and Genetic Counseling for Fragile X-associated Disorders

The purpose of this paper is to report the outcome of a collaborative project between the Fragile X Research and Treatment Center at the Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute at the University of California at Davis, the National Fragile X Foundation (NFXF), and the Centers for Disease Control and Prevention (CDC). The objective of this collaboration was to develop and disseminate protocols for genetic counseling and cascade testing for the multiple disorders associated with the fragile X mental retardation 1 (FMR1) mutation. Over the last several years, there has been increasing insight into the phenotypic range associated with both the premutation and the full mutation of the FMR1 gene. To help develop recommendations related to screening for fragile X-associated disorders, four, two day advisory focus group meetings were conducted, each with a different theme. The four themes were: (1) fragile X-associated tremor/ataxia syndrome (FXTAS); (2) premature ovarian failure (POF) and reproductive endocrinology; (3) psychiatric, behavioral and psychological issues; and (4) population screening and related ethical issues.     

Heterophenomenology: Heavy-handed sleight-of-hand

We argue that heterophenomenology both over- and under-populates the intentional realm. For example, when one is involved in coping, one’s mind does not contain beliefs. Since the heterophenomenologist interprets all intentional commitment as belief, he necessarily overgenerates the belief contents of the mind. Since beliefs cannot capture the normative aspect of coping and perceiving, any method, such as heterophenomenology, that allows for only beliefs is guaranteed not only to overgenerate beliefs but also to undergenerate other kinds of intentional phenomena.     

Directed forgetting in the list method affects recognition memory for source

The effects of list-method directed forgetting on recognition memory were explored. In Experiment 1 (N = 40), observers were instructed to remember words and their type-cases; in Experiment 2 (N = 80), the instruction was to remember words and their colours. Two lists of 10 words were presented; after the first list, half of the observers (forget) were instructed to forget that list, and the other half (remember) were not given the forget instruction. Recognition of items (words) as well as source (encoding list + case/colour) was measured for forget and remember observers. The forget instruction affected case/colour memory more consistently than item and list memory; a multinomial analysis indicated that source information was affected by the forget instructions. The results indicated that recognition of source information may be a more sensitive indicator of forgetting than recognition of items.     

“You are our only hope”: Trading metaphorical “magic bullets” for stem cell “superheroes”

In the wake of two recent developments in stem cell research, it is a fitting time to reassess the claim that stem cells will radically transform the concept and function of medicine. The first is the U.S. Food and Drug Administration’s decision in January 2009 to approve Geron Corporation’s Phase I clinical trial using human embryonic stem cells for patients with spinal cord injuries. The second is the National Institutes of Health’s decision to permit federal funding of research using donated IVF human embryos in their July 2009 Guidelines on Human Stem Cell Research. We are now poised to see whether stem cell research can deliver on what it promises. However, what exactly does it promise and how? Moreover, who is doing the promising? Turning to the use of metaphor can help us to answer these questions and enable us to develop a better appreciation of the unique features of promised stem cell therapies. Indeed, metaphors have exerted profound influence in medicine, and it is fitting that we seek new metaphors for new therapies where appropriate. In this case, other metaphors such as magic bullets or the Holy Grail cannot capture what is unique about stem cells. Accordingly, I propose a new metaphor: the stem cell superhero. Stem cell superheroes are characterized by the following traits: they are seemingly capable of fighting the evil of virtually all disease (unlike “magic bullets”) and they seem to be our only hope of doing so, although to summon them we must make difficult moral choices. In the course of assessing the merits of three recent yet covert references to the superhero metaphor, I conclude that this powerful new paradigm employs a problematic logic (i.e., we cannot know that something is “our only hope”), but that the aspiration as such is a good one.     

Lightweight relevance filtering for machine-generated resolution problems

Irrelevant clauses in resolution problems increase the search space, making proofs hard to find in a reasonable amount of processor time. Simple relevance filtering methods, based on counting symbols in clauses, improve the success rate for a variety of automatic theorem provers and with various initial settings. We have designed these techniques as part of a project to link automatic theorem provers to the interactive theorem prover Isabelle. We have tested them for problems involving thousands of clauses, which yield poor results without filtering. Our methods should be applicable to other tasks where the resolution problems are produced mechanically and where completeness is less important than achieving a high success rate with limited processor time.