The assessment of adolescents: preconceptions and realizations

The paper explores, in detail, the process of a single assessment as it unfolds session by session. It draws attention to the inevitability of the clinician's harbouring preconceptions of all kinds - especially when working with adolescents. It focuses on the difficulty of withstanding those preconceptions and allowing the patient's true anxieties, conscious and unconscious, to emerge. The process is a complex one requiring close attention to transference and countertransference manifestations, to the central significance of observation, to Bion's notion of the opacity of memory and desire. The case, that of a hypochondriacal 17-year-old young woman, highlights some main concerns and defences of the age group, for example, somatization, separation, fears of madness, issues of identity and, most fundamental of all, sexuality.     

Integration,unintegration, disintegration: an introduction

This introduction to the two papers that follow by Anne Alvarez and Edna O'Shaughnessy is a revised version of the introduction to the ACP Study Day in February 2005 on ‘Integration, Unintegration, Disintegration’, at which Alvarez and O'Shaughnessy had presented and which the author had chaired. The background to the debate is given in terms of how the ACP Study Day itself came about, and the central theme is highlighted in terms of the question of whether unintegration is conceived of as a normal stage of development or only a temporary state of mind in response to catastrophic anxieties. Brief clinical material from a case supervised by the author is discussed in order to elaborate this central question.     

Screening for Behavioral Disorders With the Dyadic Parent-Child Interaction Coding System: Sensitivity,Specificity, and Core Discriminative Components

We assessed the ability of the Dyadic Parent-Child Coding System to discriminate between Norwegian children with Oppositional Defiant Disorder and/or Conduct Disorder (n = 36) and community controls with no diagnosis (n = 122). All children were diagnosed by the Preschool Age Psychiatric Assessment. Results showed that a composite score of three negative parent codes—Negative Talk, Indirect Commands with No Opportunity for Compliance, and Direct Command with Compliance—as well as one child code, Command, evidenced excellent screening efficiency. Results are discussed in light of possible cultural differences in parent-child interaction and revisions of the coding system.     

Stepwise Latent Class Models for Explaining Group-Level Outcomes Using Discrete Individual-Level Predictors

Explaining group-level outcomes from individual-level predictors requires aggregating the individual-level scores to the group level and correcting the group-level estimates for measurement errors in the aggregated scores. However, for discrete variables it is not clear how to perform the aggregation and correction. It is shown how stepwise latent class analysis can be used to do this. First, a latent class model is estimated in which the scores on a discrete individual-level predictor are used to construct group-level latent classes. Second, this latent class model is used to aggregate the individual-level predictor by assigning the groups to the latent classes. Third, a group-level analysis is performed in which the aggregated measures are related to the remaining group-level variables while correcting for the measurement error in the class assignments. This stepwise approach is introduced in a multilevel mediation model with a single individual-level mediator, and compared to existing methods in a simulation study. We also show how a mediation model with multiple group-level latent variables can be used with multiple individual-level mediators and this model is applied to explain team productivity (group level) as a function of job control (individual level), job satisfaction (individual level), and enriched job design (group level).     

A longitudinal analysis of the course of depressive symptomatology in geriatric patients with cancer of the breast, colon, lung, or prostate.

This study mapped the trajectory of depression and its components (depressive mood, somatic expression of depression, and lack of positive affect) for 1 year after an initial cancer diagnosis, revealing the complex nature of the psychological response to the cancer experience. The analysis was based on 4 waves of panel data from 860 older patients with incident breast, colon, lung, or prostate cancer. Predictors of depressive symptoms included cancer site; stage; comorbidities; sociodemographic characteristics; and indicators of physical functioning, symptom severity, and treatment. Patients' overall depressive symptoms declined, especially depressive mood and somatic indicators. By contrast, the sense of well-being did not recover; in fact, it would have deteriorated without improvements in physical functioning and physical symptoms. The present findings show the importance of psychological assessments and symptom management during cancer treatment.     

An empirical investigation of the factor structure of the AUDIT

This study investigated the Alcohol Use Disorders Identification Test's (AUDIT) factor structure and psychometric properties. The factor structure was derived from a sample of 7,035 men and women primary care patients. A principal components analysis identified 2 factors in the AUDIT data and was supported in a confirmatory factor analysis (CFA). The 2 factors were Dependence/Consequences and Alcohol Consumption. The CFA also provided support for a 3-factor model whose factors (Alcohol Consumption, Alcohol Dependence, and Related Consequences) matched those proposed by the AUDIT's developers. Psychometric indexes were determined by use of the baseline and 12-month follow-up data of 301 men and women who entered a clinical trial. The results showed that the 2 factors had good reliability. Validity tests supported the interpretation of what the 2 factors measure, its implications for relationships to other variables, and the comparability of the 2- and 3-factor models.     

Broverman's methodology reversed: assessing university students' perceptions of the gender-role characteristics of counselors

This study examined university students' perceptions of which gender-role characteristics described helpful counselors for 137 nonmajors from an introduction to counseling class. Using a modification of the Broverman, et al. method (1970) and a modified version of their Stereotype Questionnaire, participants were randomly assigned to one of three conditions. Participants indicated the characteristics of a helpful counselor, a helpful female counselor, or a helpful male counselor using 20 bipolar items of gender-role characteristics. t tests were applied to whether agreement of the pole considered most frequently was greater than chance (50%). Analysis indicated agreement on characteristics were most helpful in a counselor, and the direction of this agreement did not differ across the three conditions or as a function of participants' sex. Agreement was high for the individual gender-role characteristic items across conditions as two of 20 items showed significant differences. There was significantly more agreement that male counselors should not have their feelings easily hurt than female counselors and significantly less agreement that male counselors should be able to express tender feelings easily relative to a counselor of unspecified sex.