A Participant-Observer's Perspective on Psychotherapy Integration

Jacobson has raised a number of issues about the usefulness of psychotherapy integration. Some of his concerns stem from his doubt that people are capable of change, and some that appear to be the result of a misinterpretation of what constitutes psychotherapy integration. This article attempts to clarify some of these misunderstandings, which seem to be the result of equating psychotherapy integration with the integration of theories. Comments are also made about the research underpinings related to work in this area.     

Subjective and Objective Risks of Carrying a BRCA1/2 Mutation in Individuals of Ashkenazi Jewish Descent

This repeated measures study examines (1) the change in subjective risk of mutations pre- to postcounseling, (2) the accuracy of BRCAPRO estimates of mutations, and (3) the discrepancy between subjective risk and BRCAPRO estimates of mutations before and after genetic counseling. Ninety-nine Ashkenazi Jewish individuals pursued testing for BRCA1/2 mutations. Most had a personal cancer history (N = 51; family only: N = 48); and received uninformative negative results (N = 66; positives: N = 23; informative negative: N = 10). The coping strategy of defensive pessimism predicts that individuals will believe the worst case scenario to better cope with a potential negative outcome. Consistent with this, most felt they would have a mutation, if not mutations in both genes. The BRCAPRO model appeared to overestimate risk of having a mutation in this sample (p < .001). BRCAPRO overestimates notwithstanding, genetic counseling increased accuracy of subjective risk (p < .01). Individuals with a family-only cancer history had the least accurate estimates of risk (p < .05) and may need further intervention to either manage anxiety or improve knowledge.     

Working-Through Collective Wounds: Trauma,Denial, Recognition in the Brazilian Uprising by Raluca Soreanu,Palgrave MacMillan,London, 2018, 247pp.

The American Journal of Psychoanalysis -     

On the role of theoretical inquiry in psychology: A double-edged sword

Wachtel's article is as relevant today as it was over a quarter century ago, especially as public support for higher education has declined, and increased pressure to obtain external research funding is needed in order to support universities. Although Wachtel's observation that research and grant funding are more likely to be reinforced then theoretical inquiry, there is a serious question regarding whether theory can be effective in advancing the field of psychology and psychotherapy. Some of problems that typically have been associated with theory in our field are discussed, and the argument is made that theoretical inquiry be directed to the formulation of less abstract and more focal principles of human behavior and the therapy change process.     

Spatial constraints on learning in visual search: modeling contextual cuing

Predictive visual context facilitates visual search, a benefit termed contextual cuing (M. M. Chun & Y. Jiang, 1998). In the original task, search arrays were repeated across blocks such that the spatial configuration (context) of all of the distractors in a display predicted an embedded target location. The authors modeled existing results using a connectionist architecture and then designed new behavioral experiments to test the model's assumptions. The modeling and behavioral results indicate that learning may be restricted to the local context even when the entire configuration is predictive of target location. Local learning constrains how much guidance is produced by contextual cuing. The modeling and new data also demonstrate that local learning requires that the local context maintain its location in the overall global context.     

The shaping of personality: genes, environments, and chance encounters

I started my career as a clinical psychologist with an interest in personality assessment. But a loss of faith in psychoanalytic theory, projective tests, and clinical case studies in general led to a shift in my interests to personality research. Subsequent jobs at research institutes and universities allowed me to indulge in science. I developed the trait-state concept and its application in tests for affect measurement. For 10 years I did experimental research in the field of sensory deprivation. The sensation seeking idea and tests evolved from this work but soon expanded to many other areas. Research in the biological basis of sensation seeking started with genetic and psychophysiological research, but research conducted in other laboratories also pointed to a psychopharmacological basis for the trait. Over the last several decades, I have formulated a psychobiological model for personality. I have used factor analysis and the biosocial model to develop an "alternative-five" factorial trait structure for personality.     

Family secrecy: a comparative study of juvenile sex offenders and youth with conduct disorders

The reported research was designed to compare adjudicated male juvenile sexual offenders and youth with conduct disorders on five aspects of family secrecy and deception. Twenty-nine male juvenile sex offenders and 32 comparison youth from three child welfare agencies in New York State participated in the study. Research assistants, blind to the hypotheses of the study and status of the youth, coded agency records for five variables identified a priori as a basis of comparison. Analyses revealed that the two groups were different on three of the five and on the total number of items scored. Families of juvenile sex offenders told more lies, had more family myths, and were more likely to be involved in taboo behavior. Logistic regression revealed that this factor of family deception significantly increased the odds of sexual offending over and above other measures of family pathology. These data support the hypotheses of the study and have implications for both clinical practice and future research in this area.     

Effects of involuntary outpatient commitment on subjective quality of life in persons with severe mental illness

Recent evidence suggests that involuntary outpatient commitment (OPC), when appropriately applied, can improve adherence with psychiatric treatment, decrease hospital recidivism and arrests, and lower the risk of violent behavior in persons with severe mental illness. Presumably these are benefits that improve quality of life (QOL); however, insofar as OPC involves legal coercion, the undesirable aspects of OPC could also exert a negative effect on quality of life, thus offsetting clinical benefits. Involuntarily hospitalized subjects, awaiting discharge under outpatient commitment, were randomly assigned to be released or continue under outpatient commitment in the community after hospital discharge, and were followed for one year. Quality of life was measured at baseline and 12 months follow-up. Treatment characteristics and clinical outcomes were also measured.Subjects who underwent longer periods of outpatient commitment had significantly greater quality of life as measured at the end of the 1 year study. Multivariable analysis showed that the effect of OPC on QOL was mediated by greater treatment adherence and lower symptom scores. However, perceived coercion moderated the effect of OPC on QOL. Involuntary outpatient commitment, when sustained over time, indirectly exerts a positive effect on subjective quality of life for persons with SMI, at least in part by improving treatment adherence and lowering symptomatology.     

The sociology of adolescent drug and drinking behavior: A review of the state of the field: Part II

This is Part II of our general assessment of the state of sociological research on adolescent substance use. In Part I, presented in the previous issue of this journal, we analyzed the methodological issues in the field and summarized findings on extent and trends of use. Here, we summarize structural, interactional, and attitudinal correlates of teenage drinking and drug behavior. We characterize the field as being theoretically underdeveloped and argue that the place to look for theory to organize empirical generalizations and derive testable hypotheses is among the existing sociological theories of deviance, which have been given scant attention in the adolescent drug and drinking literature. The field of study is in need of primary data collected to test hypotheses from a single general theory that is capable of integrating structural, interactional, and attitudinal variables.