The effect of punishment and reinforcement procedures on a stutterer's factor II avoidance response

The purpose of this clinical experiment was to investigate the manipulability of a Factor II avoidance response (arm movement). The substantive hypothesis under test was that its suppression would be enhanced by repeated punishment sessions. During the first of nine therapy sessions response-contingent negative stimulation was not delivered. In the next five, after a base-rate period, “wrong” was made consequent upon the target response. In each of these sessions the suppression of arm movement was apparent. However, the magnitude of the suppression decreased from session to session. Evidently, the continued use of punishment did not enhance suppression. Because of this finding procedural changes were introduced in the next three therapy sessions. Verbal praise was added as a consequence of increasingly stringent omission criteria and three consecutive units of praise led to time-out from the reportedly fatiguing task of continuous speech. A marked reduction and then complete extinction resulted. Moreover, learning was evidenced since the frequency of arm movement lessened in the base-rate period of each session.     

Art therapy in transcultural family therapy

The increased existence of foreign culture patterns in the child population calls for transcultural comprehension in child psychiatry. This case report describes transcultural aspects in the therapy of an 11 year-old Moslem girl admitted to a child psychiatric department. Her symptoms were abdominal pain, headache, anxiety, and pretended fever. A family therapeutic approach was used together with elements of art therapy and individual therapy in a successful treatment. The family therapeutic approach was based on art therapy as a part of the communication where cultural symbols were an important part. An interpreter was not used. The cultural context where it is acceptable to overstep the borderline between reality and fantasy is seen as an important healing capacity.I would like to acknowledge my debt and my appreciation to Ebba Ernst, psychologist of the department and supervisor in the therapy of the S. family. I would also like to thank professor Kai Tolstrup and child psychiatrist Torben Marner for stimulating support in the process of writing the article. A grant from Enkefrue Hermansens Mindelegat made the participation in the Krakow Congress possible.     

Dissociative Experiences and Trauma Exposure Among Newly Arrived and Settled Young War Refugees

War-traumatized refugee adolescents are a vulnerable and understudied group. This study of two different groups of war-traumatized youth (N = 77) resettled in Sweden (newly arrived refugee adolescents, n = 42, 13–19 years, and settled students with childhood war experiences, n = 35, 11–18 years) evaluated their war experiences, refugee journey, general trauma exposure, posttraumatic stress symptoms, and dissociative experiences. Both groups had experienced many traumas and a substantial proportion reported levels consistent with posttraumatic stress (71% in the newly arrived group and 34% among the settled students) and dissociation (36% and 23%, respectively). The study also provides information about the type of adverse events experienced by war-refugee adolescents, including their own subjective appraisals of the worst events. The results show that the extent of trauma exposure and posttraumatic and dissociative symptomatology among refugee adolescents are considerable even after a period of resettlement, a finding that has educational, clinical, and social implications.