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.     

The relationship between STD locus of control and STD acquisition among adolescent girls

This longitudinal study examined adolescent girls' perception of control over sexually transmitted disease (STD) acquisition. Participants were asked questions regarding their perception of their STD locus of control (internal control; control by parents, partners, peers, and health care providers; and chance) at two waves of data collection. Of the 116 participants (mean age = 17 years), 82% were African-American and 18% were Caucasian. Responses to the measure of locus of control were significantly correlated across a 6-month interval. The responses regarding internal control, control by partner, and chance were not related to the acquisition of an STD in the next 6 months. Further, they were not influenced by an STD in the preceding 6 months. These results indicate that responses to a locus of control measure were stable over a 6-month period, and internal, partner, and chance locus of control perceptions seem to be neither determined by STD experience nor directly related to future STD acquisition. However, understanding an individual's locus of control may be helpful in providing appropriate counseling. Future research could examine how adolescent girls form their perceptions of control over STD acquisition.     

Between Wonder and Doubt: Psychoanalysis in the Goal-Free Zone

This paper examines the experiential dimensions of wonder and doubt as one way to articulate the creative and growth-promoting tensions between the medical/scientific model and the spiritual/mystical model. Both forms of experience, it is argued, function as necessary elements in a psychotherapy that integrates psychoanalysis and spiritual praxes. Fundamental differences between the medical/scientific model and the spiritual/mystical models are examined. The notion of the gap serves to illustrate these diametrically opposed, albeit compatible and necessary, points of view. The multifaceted layers of movement between Buddhism and psychoanalysis typify interacting dynamics between the two disciplines and provide a focal point for discussion. The paper then explores parallels between the Zen Buddhist notion of Satori as explicated in the writings of D. T. Suzuki and Wilfred Bion's notion of O. Theoretical aspects of the discussion provide a backdrop for exploring clinical experience regarding the relationship between acceptance and change, the clinical relevance of the Buddhist notions of gaining idea and basic goodness. The author also explores relationships between presence as actuality and ideal; knowing and not knowing; wonder and doubt. Clinical material supports the theoretical aspects of the discussion.     

Dual-task attention deficits in dysphoric mood

The attentional functioning of nondysphoric, mildly dysphoric, and moderately to severely dysphoric college students was tested using the attentional blink (AB) paradigm. These groups performed equally well at reporting a single target appearing in a rapidly presented stream of stimuli. All groups showed an AB, with report sensitivity for a 2nd target being reduced when the 2 targets were presented less than 0.5 s apart. Nondysphoric and mildly dysphoric participants showed the same size ABs, but the ABs for moderately to severely dysphoric participants were larger and longer. As predicted, the results showed that moderately to severely dysphoric individuals have attentional impairments. These impairments, however, were evident only in the more demanding dual-task condition.     

Waxing and waning in concert: dynamic comorbidity of conduct disorder with other disruptive and emotional problems over 7 years among clinic-referred boys

Six waves of structured diagnostic assessments were conducted of 168 clinic-referred 7- to 12-year-olds, over 7 years. Wave-to-wave changes in the number of conduct disorder (CD) behaviors were paralleled by correlated changes in the numbers of symptoms of oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), depression, and anxiety. In addition, CD in Wave 1 predicted levels of ODD, ADHD, depression, and anxiety in later waves when initial levels of those symptoms were controlled, but only ODD in Wave 1 predicted CD in later waves when initial CD levels were controlled. These findings indicate a striking degree of dynamic comorbidity between CD and other types of psychopathology and provide an initial empirical framework for needed developmental models of comorbidity.     

Context and the interpretation of likelihood information: the role of intergroup comparisons on perceived vulnerability

Four experiments investigated how people's perceptions about a group's (e.g., women's) vulnerability to a disease are influenced by information about the prevalence of the disease in a comparable group (e.g., men). Participants read symptom and prevalence infomation about fictitious diseases before answering questions regarding target group vulnerability. Participants used the prevalence rate for a nontarget group as an immediate comparison standard for intuitively interpreting the degree of vulnerability of a target group, resulting in robust contrast effects. Experiments 3 and 4 illustrated that these contrast effects can cause a person's intuitive perceptions about a group's vulnerability to selected diseases to conflict with his or her knowledge of the prevalence rates for the diseases. The results support a distinction between 2 components of psychological uncertainty-beliefs in objective probability and more intuitive perceptions of certainty.     

Reviews: Books, Art

POLITICS ON THE COUCH: CITIZENSHIP AND THE INTERNAL LIFE. By Andrew Samuels, 235 pp. New York: Karnac (Other Press). $16.00. MARTHA, MARTHA: HOW CHRISTIANS WORRY. By Elaine Leong Eng, M.D. Binghamton, NY: Haworth Press, Inc., 2000. $14.95. SPILT MILK: PERINATAL LOSS AND BREAKDOWN. Edited by Joan Raphael-Leff. 100 pp. London: Institute of Psychoanalysis, 2000. MOTHERHOOD AND SEXUALITY. By Marie Langer, 305 pp. New York: Other Press, 2000. $30.00. BRANCHING STREAMS FLOW IN THE DARKNESS: ZEN TALKS ON THE SANDOKAI. By S. Suzuki. Eds: M. Weitsman and M. Wegner. 193 pp. Berkeley, CA: University of California Press. $22.50. RESTORED HARMONY: AN EVIDENCE BASED APPROACH FOR INTEGRATING TRADITIONAL CHINESE MEDICINE INTO COMPLEMENTARY CANCER CARE. By Stephen Sagar, MD. xviii + 134 pp. Hamilton, Ontario, Canada: Dreaming Dragonfly Communications, 2001. $19.95 (US); $29.95 (Can.), paperback. (ISBN: 0-9689488-0-4). CHIYO-NI, WOMAN HAIKU MASTER. By Patricia Donegan and Yoshie Ishibashi, 184 pp. Boston: Charles E. Tuttle Co., 1998. $16.95. THE METAPHYSICAL CLUB: A STORY OF IDEAS IN AMERICA. By Louis Menand, 442 pp. New York: Farrrar, Straus, and Giroux, 2001. $27.00. BUDDHISM WITHOUT BELIEFS: A CONTEMPORARY GUIDE TO AWAKENING. By Stephen Bachelor, 127 pp. Riverhead Books, 1997. $21.95. Video Art is Dead, Long Live Video Art