Change after long-term psychoanalytic psychotherapy

Psychoanalytic psychotherapy in clinical practice is traditionally a long-term treatment conducted by well-trained psychotherapists. However, very few studies have been published that evaluate the effects of such treatment. To redress this lack of studies, 55 individuals selected for long-term psychoanalytic psychotherapy (average, 3 years) were invited to participate in a naturalistic study. The psychotherapists had a mean of 15 years of professional experience. The 36 patients who completed psychotherapy manifested a substantial reduction in symptomatic suffering and decreased levels of character pathology, as measured by the Karolinska Psychodynamic Profile (KAPP) and the Karolinska Scales of Personality. Generally, such changes were not found in the individuals who did not engage in treatment. In the therapy group, improvements were found on eight KAPP subscales defining different aspects of character: Intimacy and Reciprocity, Frustration Tolerance, Regression in the Service of the Ego, Coping with Aggressive Affects, Conceptions of Bodily Appearance and their Significance for Self-esteem, Sexual Function, Sexual Satisfaction, and Personality Organization. The results indicate that individuals who engaged in psychotherapy improved their capacity to handle crucial aspects of life and reduced their symptomatic suffering.     

Psychological research online: report of Board of Scientific Affairs' Advisory Group on the Conduct of Research on the Internet

As the Internet has changed communication, commerce, and the distribution of information, so too it is changing psychological research. Psychologists can observe new or rare phenomena online and can do research on traditional psychological topics more efficiently, enabling them to expand the scale and scope of their research. Yet these opportunities entail risk both to research quality and to human subjects. Internet research is inherently no more risky than traditional observational, survey, or experimental methods. Yet the risks and safeguards against them will differ from those characterizing traditional research and will themselves change over time. This article describes some benefits and challenges of conducting psychological research via the Internet and offers recommendations to both researchers and institutional review boards for dealing with them. ((c) 2004 APA, all rights reserved)     

Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes

This study extends the data on the efficacy of cognitive interventions for patients with chronic medical problems and describes the case of a 37-year-old woman with an anxiety disorder related to diabetes. The effects on panic frequency, use of safety behaviour and related beliefs were investigated after the introduction of two main cognitive-behavioral interventions. The results are consistent with predictions from the cognitive model of panic. This case demonstrates the usefulness of directly challenging the 'meaning' of the feared situation in order to produce clinically significant improvements in the management of physical disease.     

The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors

This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.     

Feedback specificity, exploration, and learning

Greater feedback specificity is generally considered to be beneficial for performance and learning, but the evidence for this generalization is limited. The authors argue that increasing the specificity of feedback is beneficial for initial performance but discourages exploration and undermines the learning needed for later, more independent performance. The results of their transfer experiment demonstrate that increasing the specificity of feedback positively affected practice performance, but its benefits did not endure over time or modification of the task. In addition, feedback specificity negatively affected levels of exploration during practice and interacted with exploration strategies to affect learning. The results suggest that those who received feedback of varying specificity may have learned through different but equally beneficial mechanisms.     

The positive and negative effects of anger on dispute resolution: evidence from electronically mediated disputes

Scholars have argued that anger expressed by participants in mediation is counterproductive; yet, there is also reason to believe that expressions of anger can be productive. The authors tested these competing theories of emotion by using data from online mediation. Results show that expression of anger lowers the resolution rate in mediation and that this effect occurs in part because expressing anger generates an angry response by the other party. However, when respondents are especially vulnerable, expressions of anger by the filer do not hinder settlement. The authors also examined precursors to anger, such as value of dispute and reputation, and the degree to which a focus on dispute resolution is reciprocated.