Psychoanalytic patients in the U.S., CANADA,and Australia: I. DSM-III-R disorders,indications, previous treatment,medications, and length of treatment

To determine the demographics, DSM-III-R disorders diagnosed, indications used in recommending psychoanalysis, previous treatment histories, use of medication, and length of treatment in patients in psychoanalysis in the U.S., Canada, and Australia, a mail survey of practice was sent to every other active member of the American Psychoanalytic Association and every member of the Australian Psychoanalytical Society. This supplemented an earlier survey sent to all Ontario psychoanalysts. The response rates were 40.1 % (n = 342) for the U.S., 67.2% (n = 117) for Canada, and 73.9% (n = 51) for Australia. Respondents supplied data on 1,718 patients. The employment rate for patients increases as analysis progresses (p < .0001). The mean number of concurrent categories of disorders (Axis I, Axis II, and Disorders First Evident in Childhood) per patient at the start of treatment is 5.01 (SD = 3.66; median = 4; mode = 3). There are no statistically significant differences across countries. Mood, anxiety, sexual dysfunction, and personality disorders are most common. American Psychiatric Association / American Psychoanalytic Association peer review criteria for indicating psychoanalysis are followed for 86.5% of patients. Over 80% of patients in all three countries had undergone previous treatments prior to analysis. In the U.S., 18.2% of analysands are on concurrent psychoactive medication; in Australia, 9.6%. The mean length of analyses conducted in the U.S. is 5.7 years, in Australia 6.6, and in Canada 4.8. Psychoanalytic patients in all three countries have similar rates of DSM-III-R psychopathology, and many indications of chronicity.     

Multiple cues for quantification in infancy: is number one of them?

A review and synthesis of the literature on quantification in infancy and early childhood is provided. In most current conceptualizations, early quantification is assumed to be number based. However, the extant literature provides no clear-cut evidence that infants use number to perform quantitative tasks. Instead, new research suggests that quantification is initially based on nonnumerical cues, such as area and contour length, whether or not a task involves discrete items. The authors discuss the implications of these findings with respect to early quantification and its relation to later numerical development.     

A basis for bias in geographical judgments

To determine why North Americans tend to locate European cities south of North American cities at similar latitudes (Tversky, 1981), we had observers provide bearing estimates between cities in the U.S. and Europe. Earlier research using latitude estimates of these cities has indicated that each continent has several subjective regions (Friedman & Brown, 2000a). Participants judged cities from two subjectively northern regions (Milwaukee-Munich), two subjectively southern regions (Memphis-Lisbon), and the two "crossed" regions (Albuquerque-Geneva; Minneapolis-Rome). Estimates were biased only when cities from the subjectively northern regions of North America were paired with cities from the subjectively southern region of Europe. In contrast to the view that biases are derived from distorted or aligned map-like representations, the data provide evidence that the subjective representation of global geography is principally categorical. Biases in numerical location estimates of individual cities and in bearing estimates between city pairs are derived from plausible reasoning processes operating on the same categorical representations.     

Diagnosing agoraphobia in the context of panic disorder: examining the effect of DSM-IV criteria on diagnostic decision-making

A diagnostic and statistical manual (DSM)-IV diagnosis of agoraphobia in the context of panic disorder (PD) is based on three nosologically sufficient criteria: (1) avoidance, (2) use of companions, and (3) endurance of situations despite distress. Therefore, an agoraphobia diagnosis can be made across an extremely broad range of cases including when there are no avoidance behaviors (e.g., the patient endures the situation). It was hypothesized that clinicians do not weight these criteria equally and that the DSMs individual, sufficient criteria lead to poor inter-rater reliability. Clinicians (N=48) rated hypothetical patients with symptom profiles emphasizing each of these three criteria. Consistent with expectation, clinicians differentially weighted these criteria. Avoidance was relatively more apt to produce a diagnosis when only one criterion was emphasized in clinical vignettes. Inter-rater reliability was poor in instances when only one sufficient criterion was highlighted. Knowledge concerning DSM criteria resulted in a greater rate of agoraphobia endorsement, but knowledge did not account for the overall pattern of findings.     

IQ decline following early unilateral brain injury: a longitudinal study

We examine whether children with early unilateral brain injury show an IQ decline over the course of development. Fifteen brain injured children were administered an IQ test once before age 7 and again several years later. Post-7 IQ scores were significantly lower than pre-7 IQ scores. In addition, pre-7 IQ scores were lower for children with larger lesions, but children with smaller lesions and higher pre-7 IQ scores showed a greater IQ decline over time. These findings suggest that the cognitive outcomes of children with early lesions, particularly those with relatively small lesions, change over the course of development.     

Evaluating the efficiency and community safety goals of the Broward County Mental Health Court

Mental health courts have developed as one response to persons with mental illness who are involved with the criminal justice system. This study investigated the efficiency and safety goals of one such court in Broward County, FL. Mental health court (MHC) clients spent significantly fewer days in jail for the index arrest associated with study enrollment than a comparison group. MHC clients had similar survival time to re-arrest up to one year after study enrollment. MHC clients did not significantly differ from the comparison group in self-reported aggressive acts over an 8 month follow-up period, while they did self-report significantly fewer acts of violence than the comparison group at the 8 month follow-up. These findings suggest that some of the benefits associated with the MHC reported in prior studies were not achieved at the expense of efficiency and safety.