Three forms of stress in Cambodian adolescent refugees

Sixty-nine Cambodian adolescents and young adults were interviewed to determine their experience as children surviving the Pol Pot regime (1975–1979);their first-year experience of resettlement in this country; and their experience of stressful events during the past year. Current DSM-III-R diagnostic status was also determined. A strong relationship between earlier war trauma, resettlement strain, and symptoms of posttraumatic stress disorder (PTSD) was found. In contrast, the strongest relationship with depressive symptoms was found for recent stressful events. These results are discussed in light of current findings from stress and PTSD research.Dr. Clarke is Assistant Professor of Psychiatry in the Division of Child Psychiatry, Oregon Health Sciences University, Portland, Oregon. Dr. Sack is Director of the Division of Child Psychiatry and Principal Investigator of the Khmer Adolescent Project. Brian Goff is a Research Assistant.This project was supported by the National Institutes of Mental Health [NIMH] grant #5-RO1-MH42927-02, Dr. William H. Sack, M.D., Principal Investigator.     

Conversational time patterns and mutual influence in parent-child interactions: A time series approach

Mutual influencing processes are assumed to be the basic building blocks in establishing parentchild bonding and in influencing cognitive and language behavior. A study by Jasnow and Feldstein (1986) revealed that, within the temporal domain of speech, preverbal (9-month-old) infants and their mothers exhibit a pattern of mutual influence (attunement) in their average durations of switching pauses. The general purpose of this research was to extend those findings to children with higher verbal functioning. In addition, parent and child genders, nature of the interaction, and specific aspects of parents' personalities, expressiveness, and instrumentality were considered. Each parent interacted with their 4-or 5-year-old son or daughter in each of two conversations—unstructured (social conversation) and structured (task activity). Conversations were processed by an automated computer system yielding objective measure of turns, vocalizations, pauses, and switching-pause durations. To examine interspeaker influence or attunement of temporal speech patterns, influence coefficients were computer for each speaker on a turn-by-turn basis using time series regression. Analysis of these coefficients revealed that: (1) Mutual influence is most evident with switching-pause duration. (2) Structure in the conversation (as defined by the task or parental instrumentality) seems to facilitate attunement for vocalization and switching pause duration. (3) Attunement with girls seems to occur equally well with both parents, while boys exhibit a style of temporal patterning influence which suggests greater identification with the father. (4) Expressiveness seems to facilitate attunement to the child's switching-pause duration.     

The termination phase of combined therapy

Three different kinds of termination are described and discussed. In combined therapy the group can help to resolve and clarify the meanings of moves to terminate therapy. The role of the therapist's countertransferences in this stage of the work is important to consider, and here, too, the group is an important part of the work. The author sees termination as an important part of the treatment process. In combined therapy it may be more complex but it also allows for a fuller exploration of the relevant issues.     

Toward a Process Analysis of Emotions: The Case of Surprise

Based on an earlier model of the processes elicited by surprising events, the present studies provide evidence for one of these processes, the evaluation of the surprising event's relevance for ongoing activities (action-relevance check). The central prediction tested was that, if unexpected events elicit among other processes an action-relevance check, then response delay on a concurrent task will be more pronounced in a condition where this process is more elaborate and hence takes more time. In accord with this prediction, Experiment 1 found that an unexpected appearance change of the imperative stimulus in a choice reaction time (RT) task caused greater response delay than an equivalent appearance change of a distractor stimulus. Experiment 2 replicated this finding and tested several additional predictions that concerned the effects on response delay of a second appearance change of either the imperative or the distractor stimuli. These predictions, which were also mostly confirmed, were derived by combining the logic underlying the first study with the assumption that once made, appraisals of unexpected events are stored as part of the situational schema and are reused when the same or similar events reoccur leading to an abbreviation of appraisal processes. Experiment 3 once more replicated the basic finding of the previous studies and ruled out a possible alternative explanation. It is suggested that the proposed RT method of process verification may be of broader interest as a tool to study appraisal processes in emotion.     

(My) spirituality in medical education

During these times of the situated, contingent text, it is not unusual for an author to disclose her biases and other sources of potential partiality as a researcher or theorist. That is, an author often discloses her race, class origins, or sexual orientation at the onset, announcing particularities that enable readers to adjust their reading to the subjectivities inherent to knowledge production. One glaring omission to these announcements, especially in medicine, has to do with the spiritual domain. This essay, written as a personal narrative, provides one example of how one's spirituality is connected to what and how one chooses to teach, even in the medical academy. Acknowledging those beliefs and considering how our spirituality (along with our other subjectivities that are known to us) may influence our work is an important process in developing a more reflective practice.     

The importance of stories in the act of caring

This article focuses on the essential role and function of story in the care of young children with emotional and behavioral disorders in an institutional setting. Highlighted in this article is the importance of story in the therapeutic relationship, its educational implications, and in theological reflection. A narrative approach of care becomes a way of healing both heart and mind, and is ultimately an act of love.     

Training Soviet immigrant therapists in the field of group psychotherapy

Between 1970 and 1990 about one-half million Jews immigrated to Israel, most of them from the former Soviet Union, including many mental health therapists who had trained and worked in the Soviet Union. This article addresses the special characteristics of this population, in general, and of the mental health therapists, in particular. It relates these characteristics to training for group psychotherapy. Key issues include their unique experience of the inner world as a source of danger, the specific defensive modes connected with this experience, their perception of authority as an agent of ideology, and their representation of the group as a persecutory entity and as a vehicle of indoctrination.