Quality of object relations as a moderator of the relationship between pattern of alliance and outcome in short-term individual psychotherapy

In this study, we investigated the personality variable quality of object relations (QOR) as a moderator of the relationship between the pattern of the therapeutic alliance and treatment outcome in two forms (interpretive, supportive) of short-term individual psychotherapy. In a sample of 72 psychiatric outpatients who completed interpretive therapy, QOR emerged as a moderator for the outcome factor general symptomatology and dysfunction. For high-QOR patients, an increasing level of alliance was directly related to benefit, whereas for low-QOR patients, a decreasing level of alliance was directly related to benefit. An explanation for these findings emphasized the importance of patients repeating their typical pattern of maladaptive interpersonal behavior in the therapy sessions in the context of the therapist working with the transference. In a sample of 72 psychiatric outpatients who completed supportive therapy, QOR did not emerge as a moderator. These findings in combination with evidence from previous studies suggest that QOR should be investigated as a moderator variable in future studies of short-term psychotherapy.     

Alignment during feeding and swallowing: does it matter? A review

This article provides a critical assessment of evidence for the claim of experienced clinicians that proper body alignment will ameliorate the feeding problems of patients with cerebral palsy and related neuromotor disorders and reduce the risk of aspiration. While there is evidence that alignment reduces extensor tone and improves feeding, further research is needed to determine whether this population's high risk for aspiration can be reduced by alignment.     

Odors and the perception of hygiene

Although certain odors, such as lemon, are commonly associated with cleanliness and positive hygiene, empirical assessment of such associations for other odors and attributes is generally lacking. Moreover, differences between men and women in such associations have not been established. In this study of lemon, onion, pine, and smoke odors, ratings were obtained from 142 men and 336 women (M age= 30.1 yr., SD = 12.3) for odor intensity, gender association (masculine/feminine), and the success, sociability, intelligence, cleanliness, and attractiveness of a hypothetical person whose clothes smell like the odor in question. Ratings of the pleasantness or unpleasantness one would attribute to each odor in various rooms of the home were obtained, as well as a specification of whether such ratings are influenced by laundry habits, e.g., whether laundry is smelled before or after washing. Numerous associations were found. For example, a hypothetical person whose clothes smell of pine was rated as relatively more successful, intelligent, sociable, sanitary, and attractive than one whose clothes smelled of lemon, onion, or smoke. Sex differences, as well as differences between people who reported smelling their own laundry, were also found.     

Peering into the bias blind spot: people's assessments of bias in themselves and others

People tend to believe that their own judgments are less prone to bias than those of others, in part because they tend to rely on introspection for evidence of bias in themselves but on their lay theories in assessing bias in others. Two empirical consequences of this asymmetry are explored. Studies 1 and 2 document that people are more inclined to think they are guilty of bias in the abstract than in any specific instance. Studies 3 and 4 demonstrate that people tend to believe that their own personal connection to a given issue is a source of accuracy and enlightenment but that such personal connections in the case of others who hold different views are a source of bias. The implications of this asymmetry in assessing objectivity and bias in the self versus others are discussed.     

Psychophysiological mediators of caregiver stress and differential cognitive decline

The authors examined relationships between chronic stress and cognitive decline and whether such relationships were mediated by psychophysiological factors. Ninety-six caregivers of spouses with Alzheimer's disease (AD) were compared with 95 similar noncaregiver spouses. All were free of diabetes. Although the groups started similarly, over 2 years caregivers declined by a small but significant amount (1 raw score point and 4 percentile points, each p<.05) on Shipley Vocabulary. In contrast, noncaregivers did not change. Higher hostile attribution (beta=-.09; p<.05) and metabolic risk (beta=-.10; p<.05) in caregivers mediated the cognitive decline. This is the first study of cognitive decline and mediators in caregivers. This work has implications for caregiver and care-recipient health and for research on cognition, psychophysiology, diabetes, and AD.     

The usefulness of coroners' data on suicides for providing information relevant to prevention

Coroners' records are an accessible source of information on suicides. To assess their usefulness in relation to the investigation of specific methods of suicide, we examined coroners' records for 492 suicides across 24 jurisdictions in England. Generally data on demographic variables were well recorded. Information on contact with general practitioner and psychiatric services was less commonly available. Where those who had self-poisoned died in hospital, information on treatment and blood levels of drugs taken were not routinely available. For suicides by hanging, information on the source of ligature was frequently missing. Where firearms were used, information about licensing and storage were not routinely recorded. Generally there was wide variation across coroners in information relevant to specific methods. The use of standardized forms by coroners would assist studies of factors associated with suicide and potentially provide a representative source of information relevant to suicide prevention.     

Assessing implicit motives in U.S. college students: effects of picture type and position, gender and ethnicity, and cross-cultural comparisons

We assessed implicit needs for power, achievement, and affiliation in 323 U.S. college students using a Picture Story Exercise (PSE; McClelland, Koestner, & Weinberger, 1989) consisting of 6 picture cues and Winter's (1994) content coding system. Picture cues differed markedly in the amount of motive imagery they elicited and picture motive profiles closely resembled those reported by Schultheiss and Brunstein (2001) for a German student sample. Picture position influenced the expression of power and affiliation motivation, with affiliation motivation being most strongly expressed at the beginning and power motivation being most strongly expressed in the middle of the PSE. Women had higher affiliation motive scores than men. Asian Americans had higher affiliation motive scores than Whites, and African Americans had higher levels of achievement motivation than Asian Americans or Whites. PSE motive measures showed little or no overlap with questionnaire measures of impulsivity and anxiety (Behavioral Inhibition System-Behavioral Activation System scales; Carver & White, 1994) or specific motivational orientations (Personality Research Form; Jackson, 1984). Comparisons with Schultheiss and Brunstein's (2001) German sample indicate that U.S. students have higher achievement motivation and lower power motivation and activity inhibition scores than German students.     

Level of alliance, pattern of alliance, and outcome in short-term group therapy

This study investigated the relationships between initial level of alliance, pattern of alliance over sessions, and outcome in a sample of 107 patients who completed short-term group therapy for complicated grief. Both patient-rated alliance and therapist-rated alliance were studied. For patient-rated alliance, both the initial level of alliance and the linear pattern of alliance were directly and significantly related to favorable outcome. For therapist-rated alliance, no significant direct relationships with outcome were found. Instead, significant interaction effects were found. For patients with relatively high initial alliance, the greater the increase in alliance over sessions, the better the outcome. For patients with relatively low initial alliance, the greater the decrease in alliance over sessions, the better the outcome. Explanations for the findings are considered as well as possible clinical implications.     

The cognitive-behavioural treatment of low self-esteem in psychotic patients: a pilot study

Low self esteem in individuals with a psychotic disorder is common and may be related to poorer clinical outcomes. However, there has been little research on devising treatment methods to improve self-esteem either generally or in psychotic patients in particular. The aims of this study were to evaluate the efficacy of a simple cognitive behavioural intervention to improve self esteem in psychotic patients who scored poorly on a self-esteem measure. This pilot study was a randomised control trial with a convenience sample of chronic psychotic inpatients. The cognitive behavioural self-esteem intervention, as an adjunct to treatment as usual (TAU), was compared to TAU alone in patients with psychosis. The individual self-esteem intervention as described by Tarrier (The use of coping strategies and self-regulation in the treatment of psychosis. (2001)) consisted of working with participants to elicit positive self-attributes and then identify specific behavioural examples to provide evidence of this attribute. Emphasis was given to any consequential change in the patient's belief that they had the attribute. The results indicated that this cognitive behavioural treatment for self-esteem used as an adjunct treatment in psychosis, resulted in clinical benefits in terms of increased self-esteem, decreased psychotic symptomatology and improved social functioning. These benefits were largely maintained at 3-month follow-up.     

Challenges in studying the effects of scientific societies on research integrity

Beyond impressionistic observations, little is known about the role and influence of scientific societies on research conduct. Acknowledging that the influence of scientific societies is not easily disentangled from other factors that shape norms and practices, this article addresses how best to study the promotion of research integrity generally as well as the role and impact of scientific societies as part of that process. In setting forth the parameters of a research agenda, the article addresses four issues: (1) how to conceptualize research on scientific societies and research integrity; (2) challenges and complexities in undertaking basic research; (3) strategies for undertaking basic research that is attentive to individual, situational, organizational, and environmental levels of analysis; and (4) the need for evaluation research as integral to programmatic change and to assessment of the impact of activities by scientific societies. This topic was initially discussed at the AAAS-Office of Research Integrity (ORI) meeting in Washington DC on the theme: “The Role and Activities of Scientific Societies in Promoting Research Integrity” held on April 10–11, 2000. Joyce Miller Iutcovich, PhD, is President of the Keystone University Research Corporation.