Motivational enhancement treatment in outpatient addiction centers: A multisite randomized trial

Background/Objectives: Motivational Enhancement Treatment in Spanish (METS) is a brief intervention aimed at resolving patient ambivalence towards behavior change that has demonstrated efficacy in substance use disorder treatment to reduce use and increase treatment engagement in different populations. In order to have evidence for its implementation in Mexico, a multi-site, randomized, two-arm, controlled clinical trial was conducted at three outpatient addiction treatment centers in the country to compare the effect of METS with Counseling as Usual (CAU). Method: One hundred and twenty patients were randomized to receive three sessions of METS (n = 54) or CAU (n = 66) during the first four weeks of treatment and were assessed during the following 12 weeks. Primary outcome measures were self-reported days of substance use and of treatment services utilization, which were tested using Generalized Estimating Equations. Results: Results associated both conditions with significant changes in substance use over, whereas there were no differences between conditions in substance use or in service utilization. Conclusions: Findings do not support the hypothesis that METS is more effective than CAU, but suggest that brief interventions at treatment initiation may improve patient outcomes.     

Employee adaptive performance and job satisfaction during organizational crisis: the role of self-leadership

This study tests the hypothesis that self-leadership is positively related with employee adaptive performance and job satisfaction in rapid change and unpredictable work environments. This assumption was tested through a quasi-experimental study regarding the implementation of a self-leadership training programme in the Private Banking department of an international bank. Change in private bankers’ self-leadership, adaptive performance and job satisfaction was measured three times, over a period of 8 months. During the fourth month of the training programme implementation, the bank underwent an unexpected bailout. Fifty-two private bankers were randomly assigned to an experimental group (n = 28) and to a control group (n = 24). The results showed an increase in self-leadership, adaptive performance and job satisfaction for the experimental group, while job satisfaction decreased for participants in the control group. Our findings suggest that change in the level of self-leadership is positively related with change in the level of adaptive performance and job satisfaction over time. This study presents new evidence that individual adaptive performance and job satisfaction can be enhanced through self-leadership training. Self-leadership training can be used as a valuable tool to help organizations improve employees’ adaptive performance and job satisfaction, especially during organizational crisis.     

THE NEED FOR TRUE CONTROVERSIES IN PSYCHOANALYSIS: THE DEBATES ON MELANIE KLEIN AND JACQUES LACAN IN THE RÍO DE LA PLATA

Controversies are part of the process of scientific knowing. In psychoanalysis, the diversity of theoretical, technical and epistemological positions makes the debate particularly necessary and by the same token difficult. In this paper, the author examines the function of controversies and the obstacles to their development, taking as examples the debates held in the Rao de la Plata (Buenos Aires and Montevideo) during the nineteen seventies, when the dominant Kleinian ideas came into contact with Lacanian thought. The author examines different examples of argumentative discourses, using concepts taken from the theory of argumentation. The major difficulties encountered did not hinge on characteristics pertaining to psychoanalytic theories (i.e. the lack of commensurability between them), but on the defensive strategies aimed at keeping each theory's premises safe from the opposing party's arguments. A true debate implies the construction of a shared argumentative field that makes it possible to lay out the different positions and see some interaction between them and is guided by the search for the best argument. When this occurs, controversies promote the discipline's development, even when they fail to reach any consensus.     

Judgment of line orientation depends on gender, education, and type of error

Visuospatial tasks are particularly proficient at eliciting gender differences during neuropsychological performance. Here we tested the hypothesis that gender and education are related to different types of visuospatial errors on a task of line orientation that allowed the independent scoring of correct responses ("hits", or H) and one type of incorrect responses ("commission errors", or CE). We studied 343 volunteers of roughly comparable ages and with different levels of education. Education and gender were significantly associated with H scores, which were higher in men and in the groups with higher education. In contrast, the differences between men and women on CE depended on education. We concluded that (I) the ability to find the correct responses differs from the ability to avoid the wrong responses amidst an array of possible alternatives, and that (II) education interacts with gender to promote a stable performance on CE earlier in men than in women.     

Maternal perceptions of their infants' daycare

Results are presented from an extensive questionnaire administered to the mothers and caregivers of 40 infants who were in full-time daycare. Four general areas were explored: mother and daycare, mother-child relationship, mother and her work, and mother and family. Although most mothers described the decision to place their child in daycare as a difficult one, most did not feel that daycare had had a negative effective upon their infants. Mothers and caregivers both reported relatively few linkages between the daycare and home environments, with mother-caregiver contact quite limited in duration and content. Further, discrepancies between mother and caregiver perceptions suggested a possible need by mothers to see their infants' experience in more favorable terms. For example, caregivers described infants as being more distressed when first entering daycare than did mothers.     

Transfer of conditioned inhibition across different aversive reinforcers in the rat

Three experiments using a conditioned suppression procedure in rats assessed transfer of conditioned inhibition across different aversive reinforcers. Experiment 1, using shock and car horn blast as reinforcers, showed that a noise negatively correlated with 0.7-mA shock between sessions attenuated suppression of lever pressing elicited by the signals for 0.7-mA shock and 110-db horn blast. Similarly, when the noise signaled the omission of horn blast, it attenuated suppression elicited by the signals for horn blast and shock. Experiment 2, using the same procedure, replicated transfer of conditioned inhibition from shock to horn found in Experiment 1, and indicated that such effects should be attributed to associative factors. Experiment 3, using the conditioned inhibition paradigm and different chambers during training and testing, replicated transfer from horn to shock and indicated that transfer cannot be attributed to multiple-background-reinforcer associations established during inhibitory training. The results of these experiments have implications for theories of conditioned inhibition.     

Prevention of depression with primary care patients: A randomized controlled trial

The prevention of major depression is an important research goal which deserves increased attention. Depressive symptoms and disorders are particularly common in primary care patients and have a negative impact on functioning and well-being comparable with other major chronic medical conditions. The San Francisco Depression Prevention Research project conducted a randomized, controlled, prevention trial to demonstrate the feasibility of implementing such research in a public sector setting serving low-income, predominantly minority individuals: 150 primary care patients free from depression or other major mental disorders were randomized to an experimental cognitive-behavioral intervention or to a control condition. The experimental intervention group reported a significantly greater reduction in depressive levels. Decline in depressive levels was significantly mediated by decline in the frequency of negative conditions. Group differences in the number of new episodes (incidence) of major depression did not reach significance during the 1-year trial. We conclude that depression prevention trials in public sector primary care settings are feasbile, and that depressive symptoms can be reduced even in low-income, minority populations. To conduct randomized prevention trials that can test effects on incidence with sufficient statistical power, subgroups at greater imminent risk have to be identified.