Cultural Dysthymia: An Unrecognized Disorder Among African Americans?

Many African Americans experience low‐grade depression, referred to as dysthymia in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). After more than 250 years of enslavement, prejudice, and discrimination, dysthymia is reflected in chronic low‐grade sadness, anger, hostility, aggression, self‐hatred, hopelessness, and self‐destructive behaviors. To avoid misdiagnosis, counselors need to understand how cultural factors can elicit a collective psychological condition in an oppressed group. Muchos Afroamericanos experimentan depresión leve, llamada distimia en el Diagnostic and Statistical Manual of Mental Disorders (4a ed., texto rev.; American Psychiatric Association, 2000). Después de más de 250 años de esclavitud, prejuicio y discriminación, la distimia se refleja como tristeza crónica leve, ira, hostilidad, agresividad, odio a uno mismo, desesperanza y comportamientos autodestructivos. Para evitar un diagnóstico erróneo, los consejeros deben comprender cómo los factores culturales pueden acarrear una condición psicológica colectiva en un grupo oprimido.     

The support appraisal for work stressors inventory: Construction and initial validation

In order to better understand the role of perceived available support in buffering the negative effects of workplace stressors, a new multidimensional measure of perceived available support, the SAWS, was developed. Initial item development and content validation were conducted, followed by scale evaluation and validation. Two samples of 190 and 170 nursing staff supported the hypothesized structure of the scale, and provided evidence for discriminant validity amongst the sub-constructs of source of support (e.g., support from supervisor) and supportive function (e.g., emotional support). Criterion-related validity of the SAWS constructs were supported by measures of network orientation and relationship closeness. Evidence for predictive validity was provided by examining the moderating effects of the SAWS constructs on the relationship between work-family conflict and adjustment outcomes. The final SAWS inventory assesses three sources of support, and within each source, assesses four distinct supportive functions.     

To coerce and be coerced

Coercion is a way of forcibly influencing others. While one's core conflicts may contribute to an experience of being coerced in any interaction, specific situations or circumstances commonly encountered in clinical practice set the stage for analyst or patient to feel forced or manipulated. The interaction that develops in these instances is conceptualized as a coercive enactment. Conditions that increase the susceptibility to coercing and being coerced may develop at any stage in the psychoanalytic process. Supervision and conversion from psychotherapy to psychoanalysis are examined as situations that predispose to coercion. Silences and other difficulties in maintaining the analytic frame, as well as crises in the life of the analyst, may also lead to coercive enactments. Pertinent literature is reviewed and illustrative clinical cases are presented.     

Systems-Centered Therapy: A Protocol for Treating Generalized Anxiety Disorder

The systems-centered short-term therapy protocol was adapted and applied in three single case studies with generalized anxiety disorder (GAD) patients in a ten-session individual treatment over a two week period. All three subjects showed substantial improvement and no longer met diagnostic criteria post-treatment. Changes were maintained at follow up both six months and one year later. These results are promising and suggest the importance of further research on SCT as a viable, alternative treatment for generalized anxiety disorder.     

A normative zone of RPE ratings for use during graded exercise testing

The purposes of this investigation were to identify a zone of normality for ratings of perceived exertion (RPE) and to compare the RPE responses in patients with coronary artery disease to this zone. The zone was generated from RPE estimated during the last minute of each stage of a Bruce treadmill test in 44 normal adult men. RPE were regressed against the corresponding MET level for each exercise stage. The zone was established as the 95% confidence interval (CI) spanning the average RPE vs MET regression line. RPE estimated during the last 1.0 min. of a Bruce or Modified Balke treadmill test administered to adult men (n=37) with coronary artery disease were compared to the 95% CI zone. A total of 19 (51%) of the coronary artery disease patients estimated RPE during a progressively incremented treadmill test that were above the zone, indicating a comparatively greater than normal perception of strain for a given metabolic stress. The presently generated zone provides a practical use of RPE in the interpretation of clinical exercise tests.     

On dreaming one's patient: reflections on an aspect of countertransference dreams

This paper explores the phenomenon of the countertransference dream. Until very recently, such dreams have tended to be seen as reflecting either unanalyzed difficulties in the analyst or unexamined conflicts in the analytic relationship. While the analyst's dream of his/her patient may represent such problems, the author argues that such dreams may also indicate the ways in which the analyst comes to know the patient on a deep, unconscious level by processing the patient's communicative projective identifications. Two extended clinical examples of the author's countertransference dreams are offered. The author also discusses the use of countertransference dreams in psychoanalytic supervision.     

Recommendations from Multi-disciplinary Focus Groups on Cascade Testing and Genetic Counseling for Fragile X-associated Disorders

The purpose of this paper is to report the outcome of a collaborative project between the Fragile X Research and Treatment Center at the Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute at the University of California at Davis, the National Fragile X Foundation (NFXF), and the Centers for Disease Control and Prevention (CDC). The objective of this collaboration was to develop and disseminate protocols for genetic counseling and cascade testing for the multiple disorders associated with the fragile X mental retardation 1 (FMR1) mutation. Over the last several years, there has been increasing insight into the phenotypic range associated with both the premutation and the full mutation of the FMR1 gene. To help develop recommendations related to screening for fragile X-associated disorders, four, two day advisory focus group meetings were conducted, each with a different theme. The four themes were: (1) fragile X-associated tremor/ataxia syndrome (FXTAS); (2) premature ovarian failure (POF) and reproductive endocrinology; (3) psychiatric, behavioral and psychological issues; and (4) population screening and related ethical issues.     

Directed forgetting in the list method affects recognition memory for source

The effects of list-method directed forgetting on recognition memory were explored. In Experiment 1 (N = 40), observers were instructed to remember words and their type-cases; in Experiment 2 (N = 80), the instruction was to remember words and their colours. Two lists of 10 words were presented; after the first list, half of the observers (forget) were instructed to forget that list, and the other half (remember) were not given the forget instruction. Recognition of items (words) as well as source (encoding list + case/colour) was measured for forget and remember observers. The forget instruction affected case/colour memory more consistently than item and list memory; a multinomial analysis indicated that source information was affected by the forget instructions. The results indicated that recognition of source information may be a more sensitive indicator of forgetting than recognition of items.