Audit in psychoanalytic psychotherapy with children and adolescents

The importance of multidisciplinary audit in child and adolescent psychiatry, including the work of child psychotherapists, is discussed. Research is highlighted which shows that certain groups of children in particular benefit from psychoanalytic psychotherapy. The problems related to auditing psychoanalytic psychotherapy are discussed, and a possible method of audit based on peer review of notes, which takes into account both inner and outer change, is presented.

A patient is discussed whose notes have been audited using the audit form. It is suggested that this form of audit has good educational potential as well as ensuring a high standard of patient care.     

Relations Between Parenting Behavior and SES in a Clinical Sample: Validity of SES Measures

Two common methods of measuring socioeconomic status (SES) were examined in relation to observed parenting behaviors in a clinical sample of 89 mothers of 3- to 6-year-olds referred for treatment of oppositional defiant disorder. Families were 74% Caucasian, 9% African American, 5% Hispanic, 1% Asian, and 11% Biracial. Most children were male (75%). Parenting behaviors were measured with the Dyadic Parent–Child Interaction Coding System (DPICS) categories of prosocial talk and negative talk. Analyses were conducted with SES measured in two ways: (a) the Hollingshead Four-Factor Index of Social Status (HI) was correlated with parenting behaviors; and (b) family income, parent education (5 categories), and parent occupation (5 categories) were used to predict parent behavior. SES was significantly positively related to maternal prosocial talk. When SES was operationalized as income, occupation, and education, the model predicted three times more variance in maternal prosocial talk than the HI alone. SES was not related to maternal negative talk by either measure of SES.     

Prologue: Introduction and Overview to Special Volume

Abstract

The editors provide an overview of the obstacles that prevent us from ending child abuse in the United States and briefly summarize the various articles in this volume that address these obstacles from multiple points of view.     

The role of perceived negativity in the moderation of African Americans' implicit and explicit racial attitudes

The present paper examines the relationship between Blacks' implicit and explicit racial attitudes and the extent to which perceived negativity from out-groups moderates the two attitudes. Results from two studies provide converging evidence that perceived negativity is related to both implicit and explicit attitudes, but in opposite directions. While perceived negativity showed a significant positive correlation with in-group bias on explicit measures, it was negatively correlated with in-group bias on implicit measures, such that Blacks who believed that Whites generally dislike Blacks showed significantly lower levels of implicit in-group bias compared with African Americans who believe that Whites positively regard Blacks. African Americans' level of exposure to out-groups was also negatively related to implicit in-group bias, but this relationship was mediated by perceived negativity.     

Two sets of twins with selective mutism: neuropsychological findings.

Neuropsychological data are reviewed from two sets of dizygotic twins presenting with selective mutism characterized by situation specific anxiety, extreme passive behavior, lack of responsivity, lack of peer interaction, and a chronic course of selective mutism. Both sets of twins had a history of prematurity and delayed speech development. One set of twins presented with normal intelligence and normal receptive language skills but with expressive language and oral motor sequencing difficulties. The second set of twins presented with Verbal IQ deficits and significant receptive and expressive language deficits. A summary of current conceptualizations regarding etiology and treatment of selective mutism is provided.     

Do conflict management styles affect group decision making? Evidence from a longitudinal field study

This study examined the relationship between group conflict management styles and effectiveness of group decision making in 11 ongoing, naturally occurring workgroups from 2 large U.S. organizations. The major postulate of the study was that groups develop norms regarding how they will manage conflicts that carry over to affect other activities, such as decision making, even when these activities do not involve open conflict. To determine the impact of conflict management style on decision effectiveness, a longitudinal design was used that identified conflict management styles in the initial portion of each team's series of meetings and then analyzed a group decision taken in a meeting near the end of that series. Group conflict management styles were determined using observational methods, and decision effectiveness was measured using multiple indices that tapped member, facilitator, and external observer viewpoints. Task complexity also was considered as a possible moderating variable. The findings suggest that groups that developed integrative conflict management styles made more effective decisions than groups that utilized confrontation and avoidance styles. Groups that never developed a stable style were also less effective than groups with integrative styles.     

Posttraumatic Stress Disorder Symptom Clusters and Acquired Capability for Suicide: A Reexamination Using DSM-5 Criteria

This study used the interpersonal–psychological theory of suicide to explore the relationships among DSM-5 posttraumatic stress disorder (PTSD) symptom clusters derived from the six-factor anhedonia model and facets of acquired capability for suicide (ACS). In a sample of 373 trauma-exposed undergraduates, most PTSD symptom clusters were negatively associated with facets of ACS in bivariate correlations, but the anhedonia cluster was positively associated with ACS in regression models. Structure coefficients and commonality analysis indicated that anhedonia served as a suppressor variable for the other symptom clusters. Our findings further elucidate the complex relationship between specific PTSD symptom clusters and ACS.     

Effect of dopamine on diuresis and its role in forming a renal CR

Four female mongrel dogs were used. Three had both ureters transplanted to the surface of the abdomen and one had a unilateral nephrectomy on the left and the right ureter transplanted to the abdomen. In dogs with externalized ureters our results with dopamine show changes in cardiac rate and renal secretion. The method used was 1) injection of dopamine, 2) measurement of subsequent changes in renal secretions (unconditional reflex), 3) and heart rate (HR). After 40 daily injections im of 2.5 mg/kg in normal saline the possible production of a diuretic CR was tested by injecting normal saline im and a tone was used as a signal. The control for normal saline showed no change in HR nor any of the constituents measured. The dopamine injection resulted in an increase of epinephrine in the urine of 300–600 per cent for 45 minutes; of norepinephrine of 200–500 per cent for 45 minutes; of an increase of 50 per cent in urine volume for 45 or more minutes; of absolute Na secretion of 49 per cent, of K, 20 per cent; of creatinine, 39 per cent (average in 3 dogs for 45 minutes diuresis). When the conditional stimulus (normal saline and tone) was given after several months training with the conditional signal and the injection of dopamine, there was no significant CR change to the HR nor any of the above components of urine. The conclusion is that in spite of the great increase of urine volume and composition of above substances there was no significant increase to the signals for the im injection of dopamine,i.e., no conditioning to dopamine.