Family work for schizophrenia: some issues for Chinese immigrant families

This paper discusses some specific issues relevant to immigrant Chinese families in the context of family work for schizophrenia. The issues include shame and guilt, isolation and mistrust of officials, the importance of negotiation before details of problem-solving are worked out, high academic ambitions for children, and apparent ‘overprotectiveness’ in the Chinese culture. It is argued that cognitive-behavioural, goal-orientated family work could be adapted well for immigrant Chinese families with a member suffering from schizophrenia. A case study is presented to illustrate how such a family was helped.     

Perelman, ad Hominem Argument, and Rhetorical Ethos

Perelman’s view of the role of persons in argument is one of the most distinctive features of his break with Cartesian assumptions about reasoning. Whereas the rationalist paradigm sought to minimize or eliminate personal considerations by dismissing them as distracting and irrelevant, Perelman insists that argumentation inevitably does and ought to place stress on the specific persons engaged in an argument and that the relationship between speaker and what is spoken is always relevant and important. In taking this position, Perelman implicitly revives the classical conception of proof by character (ethos or “ethotic” argument), but despite an extended discussion of act and person in argument, The New Rhetoric does not give much consideration to the classical concept and confuses differing approaches to it within the tradition. The result is that Perelman treats the role of the speaker in argument only by reference to abstract techniques and does not recognize the importance of examining particular cases in order to thicken understanding of how ethotic argument works in the complex, situated context of its actual use. Consequently, Perelman’s account of the role of persons in argument should be supplement by reference to case studies, and to that end, I consider ethotic argument in W.E.B. Du Bois’ famous essay “Of Mr. Booker T. Washington and Others”.

Rhetoric and Dialectic in the Twenty-First Century

The paper presents a historical overview of some characteristic differences between rhetoric and dialectic in the pre-modern tradition. In the light of this historical analysis, some current approaches to dialectic are characterized, with special attention to Ralph Johnson's concept of dialectical tier.     

Role of female behavior in controlling population growth in mice

Sex ratio does not appear to be a factor in generating the characteristic population growth curve. Freely growing populations of house mice, consisting of all females and one male, stopped their growth at approximately the same densities as normal sexratio populations used as references. The mechanism(s) of female control of population dynamics may be related to female aggressive behavior. As the all-female/one-male populations approached their maximum size, the females began to show wounding patterns and social hierarchies in much the same manner as males in populations with normal sex ratios. The male in each of the populations was severely wounded in the posterior region, and each lost its tail as a result of injuries which could have been inflicted only by the females. The female social hierarchy can be seen only when there has been reproduction and population growth. Assembled populations of all females rarely exhibit aggressive behavior. Female aggression becomes apparent only when the population approaches its maximum size and thereafter. These data are consistent with the hypothesis that males are competitive among themselves for territory and social rank, and ultimately to mate with the females. Other investigators have indicated that females respond to population size, which may reflect increased competition between the females with the establishment of territories. Thus female agression may control population growth, a role previously ascribed to male aggression.     

A meta-analytic approach to growth curve analysis

A meta-analytic approach to growth curve analysis is described and illustrated by applying it to the evaluation of the Arizona Pilot Project, an experimental project for financing the treatment of the severely mentally ill. In this approach to longitudinal data analysis, each individual subject for which repeated measures are obtained is initially treated as a separate case study for analysis. This approach has at least two distinct advantages. First, it does not assume a balanced design (equal numbers of repeated observations) across all subjects; to accommodate a variable number of observations for each subject, individual growth curve parameters are differentially weighted by the number of repeated measures on which they are based. Second, it does not assume homogeneity of treatment effects (equal slopes) across all subjects. Individual differences in growth curve parameters representing potentially unequal developmental rates through time are explicitly modeled. A meta-analytic approach to growth curve analysis may be the optimal analytical strategy for longitudinal studies where either (1) a balanced design is not feasible or (2) an assumption of homogeneity of treatment effects across all individuals is theoretically indefensible. In our evaluation of the Arizona Pilot Project, individual growth curve parameters were obtained for each of the 13 rationally derived subscales of the New York Functional Assessment Survey, over time, by linear regression analysis. The slopes, intercepts, and residuals obtained for each individual were then subjected to meta-analytic causal modeling. Using factor analytic models and then general linear models for the latent constructs, the growth curve parameters of all individuals were systematically related to each other via common factors and predicted based on hypothesized exogenous causal factors. The same two highly correlated common factors were found for all three growth curve parameters analyzed, a general psychological factor and a general functional factor. The factor patterns were found to be nearly identical across the separate analyses of individual intercepts, slopes, and residuals. Direct effects on the unique factors of each subscale of the New York Functional Assessment Survey were tested for each growth curve parameter by including the common factors as hierarchically prior predictors in the structural model for each of the indicator variables, thus statistically controlling for any indirect effect produced on the indicator through the common factors. The exogenous predictors modeled were theoretically specified orthogonal contrasts for Method of Payment (comparing Arizona Pilot Project treatment or "capitation" to traditional or "fee-for-service" care as a control), Treatment Administration Site (comparing various locations within treatment or control groups), Pretreatment Assessment (comparing general functional level at intake as assigned by an Outside Assessment Team), and various interactions among these main effects. The intercepts, representing the initial status of individual subjects on both the two common factors and the 13 unique factors of the subscales of the New York Functional Assessment Survey, were found to vary significantly across many of the various different treatment conditions, treatment administration sites, and pretreatment functional levels. This indicated a severe threat to the validity of the originally intended design of the Arizona Pilot Project as a randomized experiment. When the systematic variations were statistically controlled by including intercepts as hierarchically prior predictors in the structural models for slopes, recasting the experiment as a nonequivalent groups design, the effects of the intercepts on the slopes were found to be both statistically significant and substantial in magnitude. (ABSTRACT TRUNCATED)     

Assessing ADHD across settings: contributions of behavioral assessment to categorical decision making

Adapted methods of behavioral assessment to assess home and school functioning in a way that maps directly to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., [DSM-IV]; American Psychiatric Association, 1994). The study was conducted in a school-based sample with 5- to 12-year-old children referred to a school intervention team. A multigate set of procedures was used to assign children to one of 3 groups: attention deficit hyperactivity disorder (ADHD), inattentive group; ADHD, combined group; and a non-ADHD control group. The ADHD Rating Scale-IV was used to assess parent and teacher ratings of ADHD symptoms as delineated in DSM-IV. The findings suggest that the use of a fixed cutoff point (i.e., 6 or more symptoms), which is employed in the DSM-IV, is often not the best strategy for making diagnostic decisions. The optimal approach depends on whether diagnostic information is being provided by the parent or teacher and whether the purpose of assessment is to conduct a screening or a diagnostic evaluation. Also, the results indicate that a strategy that aggregates symptoms in the order in which they are accurate in predicting a diagnosis of ADHD is a more effective strategy than the approach used in DSM-IV, which aggregates any combination of a specific number of items. Implications for using methods of behavioral assessment to make diagnostic decisions using DSM-IV criteria are discussed.     

Modes of action of family interventions in depression and schizophrenia: the same or different?

The role of relatives' expressed emotion (EE) in mediating the efficacy of family interventions has been studied in randomized controlled trials (RCTs) involving people with schizophrenia and depression. Reanalysis of two RCTs (n=48) by Leff (1989) indicated that lowering relatives' EE and/or reducing social contact between the patient and family members accounted for the efficacy of the intervention for schizophrenia. However, this relationship has not been investigated previously with regard to depression, and this paper presents the results of a recent RCT which included measurement of EE and other possible mediating variables. In this study, amelioration of the critical attitude of the partner did not account for the superiority of couples therapy over antidepressant medication, since the same change occurred in the drug group. However, reducing the patient's exposure to the partner's hostility partially explained the efficacy of couples therapy. Further research on the process of change in families undergoing therapy is indicated to identify the variables that account for the efficacy of therapy.