The travails of Martin Orne: On privacy,public disclosure,and confidentiality in psychotherapy

The experiences of one psychotherapist have brought to the fore the entire issue of privacy and confidentiality and the responsibilities of mental health professionals. In a computer driven culture, where data about patients become subject to public scrutiny, how does the mental health professional practice, guided by the concept of confidentiality? Where does confidentiality begin and end? What about the patient's right to self-disclose? What about patient autonomy? In this paper, illustrated by one particular case where the rule of absolute confidentiality, an intrinsic part of the practice of psychotherapy, was questioned, our current confusion comes to the surface. The reader is urged to re-think the concept of confidentiality and patient self-disclosure.     

Prosodic influences on the resolution of temporary ambiguity during on-line sentence processing

We present three experiments designed to investigate the role of prosody during sentence processing. The first investigated the question of whether an utterance's prosodic contour influences its comprehension on-line. We spliced the beginning and end portions of direct object and embedded clause sentences and observed the consequent effects on comprehension using a dual-task procedure to measure processing load. Our second experiment sought to determine-whether the constituent structure of these sentences could be reliably predicted using prosodic information. We found that the duration and F₀ contour associated with the main-clause verb and the following NP reliably distinguished between the direct object and embedded clause constructions. In the final experiment, we manipulated the duration of the main-clause verb and found that subjects used this information to guide their initial parse during on-line sentence comprehension. The need for a model of sentence processing that addresses the use of prosodic information is discussed.The work reported in this paper was supported in part by NTH grant DC00494.     

Culturally Sensitive AIDS Educational Videos for African American Audiences: Effects of Source, Message, Receiver, and Context

The importance of using culturally sensitive educational materials in HIV-related interventions with racial and ethnic minority groups is widely recognized. However, little empirical research has been conducted to assess the relative effectiveness of different techniques for creating culturally sensitive AIDS educational videos. Two field experiments with three samples of African American adults (N = 174, 173, and 143) were conducted to assess how source characteristics (race of communicator), message characteristics (multicultural message vs. culturally specific message), and audience characteristics (racial distrust and AIDS-related distrust) influence proximate (perceptions of the message's credibility and attractiveness) and distal (AIDS-related attitudes, beliefs, and behavioral intentions) output variables for AIDS educational videos. In Study 1, an AIDS video with a culturally specific message was rated as more credible, more attractive, and of higher quality than was a video with a multicultural message. The multicultural message was rated less favorably when delivered by a White announcer than when the announcer was Black. In Study 2, the same pattern was replicated with a second community sample and a campus-based sample. Study 2 also indicated that a multicultural message might be more effective if delivered in a culturally specific context, namely, after audience members watch a culturally specific video. Minimal changes were observed in distal outcome variables. It is argued that influencing proximate output variables is necessary, though not sufficient, for effecting long-term change in AIDS-related attitudes, beliefs, and behaviors.     

The Meaning and Intensity of the Near-Death Experience

This is the second in a three-part study exploring the hypothesis that near-death experiences (NDErs) assign the meaning of the NDE by using causal (effect) and semantic (affect) attributions. To test this hypothesis, 32 spontaneous verbal accounts of NDEs were analyzed. Each statement comprising the account was coded and classified according to the six attributional types in the Norton-Sahlman matrices of attributional classification. On the bases of these findings, we conclude that NDErs abstract the most significant aspects of meaning from their experiences by the use of attributions expressing the purposes of the experience and the intentions of the participants. Second, the meaning and intensity of the experience derives from attributions of both effect (causality) and affective significance: the assignment of subjective meaning to objects and events (affect). Third, the findings demonstrate that there are significant changes in NDErs' overt and affective states, reinforcing our argument that meaning and intensity of the NDE is a function of how the experiencer assigns causation, in addition to the affective significance that the experiencer places on the events constituting the NDE.     

Aggression Observation Scale for Group Psychotherapy

An observational scale to record aggressive behaviors, defenses, and interventions that occur during a psychotherapy group has been developed. Content and process items were included. The content items focus on the spoken material and are on a continuum of increasing group members' awareness of and responsibility for their anger. The process items are directed to underlying psychodynamic issues on a continuum from avoiding anger, to indirect and then expression of anger. Leader interventions (responses) are also included. The development of the scale, the Aggression Observation Scale for Group Psychotherapy (AOSGP), is described including pilot testing and reliability and validity findings.     

Promoting Resilience in At-Risk Children

Intervening effectively with youths at risk from early deprivation, family dysfunction, poverty, abuse, and other factors is a major concern for educational and social service policymakers. Current research suggests that a majority of at-risk youths do not experience drastic outcomes, but many exhibit protective factors that buffer them from negative consequences. Longitudinal studies from Hawaii, the continental United States, and Great Britain have identified several personality, familial, and environmental variables that promote resiliency in youths at risk. This article discusses these variables and provides counselors with an assessment technique and strategies to promote a salutogenesis perspective.     

Measuring intrinsic and extrinsic orientation toward religion: Amendments for its use among religious and non-religious samples

Amendments to the Age-Universal I-E scale, used to measure intrinsic and extrinsic orientations toward religion, are proposed to facilitate the scales' use among both religious and non-religious samples. The original and revised versions of the intrinsic and extrinsic scales were administered to six adult samples from the U.S.A. (N = 156; N = 144), England (N = 135; N = 149) and Norhern Ireland and Republic of Ireland (N = 189; N = 167). Data show in all six samples the percentage of I-E scales completed was greater for the revised version than the original version. In addition, the revised version of the scales demonstrates more satisfactory reliability estimates than the original version. It is suggested that researchers examining intrinsic and extrinsic orientation towards religion may benefit from using the revised version.