The analyst's style and its impact on the analytic process: overcoming a patient-analyst stalemate.

Analysts have characteristic styles in working with their patients. At times of crisis or stalemate, an alteration in style may facilitate the progress of the treatment. To illustrate the impeding effects of an analytic style at a particular phase of analysis, I describe a stalemate in the analysis of a severely self-critical patient. Recognition of the limiting effects of style on the treatment became apparent in a countertransference enactment, influenced by the patient-analyst match. Self-analysis and alteration in the characteristic style of the analyst resolved the stalemate and enabled the analytic work to progress.     

Selecting a best multiattribute alternative with partial information about attribute weights

Use of approximate weights would greatly simplify decision analysis under certainty since detailed weight elicitation could be avoided. This paper examines the degree to which rank order information about weights can be used to identify a best alternative, or falling uniqueness prescribes an easily implemented rule for selecting a ‘best’ alternative. The prescribed rule uses as weights the centroid of the feasible region defined by the rank order information. In conjunction with the rule, the value of the rank order information can be determined using an ‘expected gain from weight precision’ (EGWP) measure, analogous to ‘expected value of perfect information’ in decision analysis under uncertainty.     

Risk and behavior: The mediating role of risk appraisal

The main issue of this paper concerns the mediating role of risk appraisal in the relation between past and future behavior. We expected previous risky behavior to heighten risk appraisal, which, in turn, should stimulate preventive behavior. Results ofthree tests of this mediation hypothesis showed that past behavior was strongly related to future behavior; people who behaved hazardously in the past indicated that they tend to do so in the future. Generally, the expected relation between past behavior and risk appraisal was supported. More risky behavior in the past was associated with a heightened risk appraisal. Results also indicate a relation between risk appraisal and future behavior, but in the opposite direction as predicted. Heightened risk appraisal was related to increased levels of risk in future behavior. When predicting future behavior by both risk appraisal and past behavior the effect of risk appraisal on future behavior disappeared, while past behavior remained a strong predictor of future behavior. In a few cases risk appraisal still predicted future behavior when past behavior was controlled for. Unfortunately, these cases showed the opposite relation; i.e., heightened risk appraisal was related to more risky future behavior. Implications of these findings for research on the role of risk appraisal will be discussed.     

Psychopathology in incarcerated juvenile delinquents: does it extend beyond externalizing problems?

The present study attempted to delineate factors that are associated with and may contribute to juvenile delinquency. Delinquents were compared to a matched control group of nonoffenders on a measure of mental health problems. Twenty-four male and female incarcerated juvenile offenders and 24 nonoffending adolescents were evaluated on the Revised Behavior Problem Checklist (RBPC). As expected, the offenders scored higher (an indication of more psychopathology) on the subscales of the RBPC which represent externalizing types of problems. The offenders also scored significantly higher on the subscales reflecting internalizing problems and psychotic behavior. The results of this study point to the importance of assessing and treating offenders, especially those who are incarcerated, for difficulties other than externalizing problems.     

Malevolent object representations in borderline personality disorder and major depression.

To study malevolent representations, earliest memories were reliably coded on scales of affect tone. Ss were diagnosed with borderline personality disorder: 31 without and 30 with concurrent major depression. Nonborderline comparison subjects had either major depressive disorder (n = 26) or no psychiatric diagnosis (n = 30). Borderline subjects were discriminated from comparison subjects by their more malevolent representations; they more frequently produced memories involving deliberate injury; and they portrayed potential helpers as less helpful. Results suggest the diagnostic significance of malevolent representations, which need to be explained by any theory of borderline personality disorder.     

Perceptual asymmetry in psychosis-prone college students: evidence for left-hemisphere overactivation.

The hypothesis that psychosis-prone students demonstrate a pattern of exaggerated perceptual asymmetry across both left- and right-hemisphere dichotic-listening tasks (consonant-vowel [CV] and tonal contour discrimination) was investigated. Subjects who scored high on the Perceptual Aberration or Magical Ideation scale or both (n = 20) demonstrated a significantly exaggerated right-ear advantage on a CV task in relation to normal control subjects (n = 27) but showed a reduced left-ear advantage on a tone task. The hypothesis of exaggerated functional lateralization across hemispheres in the psychosis-prone subjects was not supported, but the results are consistent with a hypothesis of left hemisphere overactivation in this sample.     

Comparison of bulimics, obese binge eaters, social phobics, and individuals with panic disorder on comorbidity across DSM-III-R anxiety disorders.

Eighty-two women, presenting as normal-weight bulimics, obese binge eaters, social phobics, and individuals with panic disorder, were compared on anxiety, depression, and substance abuse. All were administered the Anxiety Disorder Interview Schedule-Revised and completed the Michigan Alcohol Screening Test, Drug Abuse Screening Test, and Self-Consciousness Scale. A striking proportion of eating disorder subjects were comorbid for one or more anxiety disorders, the most frequent diagnoses being generalized anxiety disorder and social phobia. The results suggest that the place of anxiety in bulimia nervosa goes beyond that discussed within the context of the anxiety reduction model. Conflicting comorbidity findings among this and prior investigations are noted, however, and discussed in terms of the issue of differential diagnosis between eating and anxiety disorders.     

Confirming the latent structure and base rate of schizotypy: a taxometric analysis.

Meehl's (1962, 1990) model of schizotypy and the development of schizophrenia implies that the structure of liability for schizophrenia is dichotomous and that a "schizogene" determines membership in a latent class, or taxon (Meehl & Golden, 1982). The authors sought to determine the latent structure and base rate of schizotypy. They applied Meehl's (1973; Meehl & Golden, 1982) MAXCOV-HITMAX taxometric analytic procedures to a subset of items from the Perceptual Aberration Scale (PAS; Chapman, Chapman, & Raulin, 1978), a prominent psychometric index of schizotypy, derived from a randomly ascertained nonclinical university sample (N = 1,093). The results, in accordance with Meehl's conjectures, strongly suggest that schizotypy, as assessed by the PAS, is taxonic at the latent level with a general population taxon base rate of approximately .10.     

Illness, Family Theory, and Family Therapy: I.Conceptual Issues

This article examines and clarifies controversies about the concept of illness in the field of family therapy. We contend that illness, as traditionally understood in all cultures, is a relational, transactional concept that is highly congruent with core principles of present-day family theories. Family therapists need not buy into a biotechnical, reductionistic reframing of illness as disease. Rather, it is more appropriate to conceptualize and work with illness as a narrative placed in a biopsychosocial context. Such a narrative includes how shared responsibility for coping and for finding solutions can take place, without becoming involved in disputes about causal models.