Brief Strategic Family Therapy: Twenty-Five Years of Interplay Among Theory, Research and Practice in Adolescent Behavior Problems and Drug Abuse

This article describes a systematic program of research that focuses on Brief Strategic Family Therapy (BSFT) and the adaptations that were developed based on BSFT principles. The culture-specific origins of BSFT are reviewed, as well as its broader applications to the field of family therapy. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Programmatic work is described that challenges basic principles of family therapy by expanding BSFT to a One Person modality and a strategic engagement procedure. Both of these novel approaches are intended to add tools to therapists' repertoire in working with difficult-to-engage families. A preview discussion of results is presented from a randomized clinical trial that is an application of an ecosystemic prevention version of BSFT. The implications of the work of the Center for Family Studies are discussed in the context of the broader service system. Ultimately, this article articulates a way of thinking about adolescent problem behavior, its social interactional determinants, and a range of theoretically consistent family-centered strategies that attempt to change social ecological processes that impact adolescent developmental trajectories.     

Mean response times, variability, and skew in the responding of ADHD children: a response time distributional approach

Response time (RT) distributions from three fixed foreperiod conditions (2, 4, and 8 s) in a warned four-choice RT task were obtained for a group of boys with attention-deficit/hyperactivity disorder, combined type (ADHD; n = 17) and for two groups of normal control boys (age-matched, n = 18, and younger-aged, n = 10). Quantitative measures of distributional shape were derived by fitting the ex-Gaussian distributional model to the individual RT data. Statistical results indicate that the ADHD distributions differ from the age-matched control distributions with respect to the size of the tail (larger for the ADHD boys), but differ from the younger control distributions with respect to the location of the leading edge (slower for the younger control boys). Receiver operating characteristic (ROC) results reveal that the ex-Gaussian exponential component is highly diagnostic of the ADHD boys.     

Cognitive neuroscience of episodic memory encoding

This paper presents a cognitive neuroscientific perspective on how human episodic memories are formed. Convergent evidence from multiple brain imaging studies using positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) suggests a role for frontal cortex in episodic memory encoding. Activity levels within frontal cortex can predict episodic memory encoding across a wide range of behavioral manipulations known to influence memory performance, such as those present during levels of processing and divided attention manipulations. Activity levels within specific frontal and medial temporal regions can even predict, on an item by item basis, whether an episodic memory is likely to form. Furthermore, separate frontal regions appear to participate in supplying code-specific information, including distinct regions which process semantic attributes of verbal information as well as right-lateralized regions which process nonverbal information. We hypothesize that activity within these multiple frontal regions provides a functional influence (input) to medical temporal regions that bind the information together into a lasting episodic memory trace.     

Repeat pregnancy among urban adolescents: sociodemographic, family, and health factors

First-time adolescent mothers are at high risk for a repeat pregnancy. The present investigation, part of an ongoing longitudinal study, examined sociodemographic, family, and health factors associated with repeat Pregnancy in a clinic sample of urban, first-time adolescent mothers (ages 13 to 17 years). They were predominantly African-American and from low-income households. Repeat pregnancy within one year and between one and two years postpartum was determined from medical records. Summary statistics, point biserial correlations, and chi-square statistics were used to analyze the data. Results indicated that postpartum contraceptive method was associated with repeat pregnancy at Year 1; contraceptive use, maternal age, history of miscarriages, and postpartum contraceptive method were associated with repeat pregnancy at Year 2. It was concluded that efforts to prevent repeat pregnancies among first-time adolescent mothers should include the continuous monitoring of contraceptive use, as well as the promotion of long-acting contraceptives (e.g., medroxyprogesterone or progesterone implants). Further, counseling should be offered to adolescent mothers with a history offered miscarriages.     

Paranoid-Schizoid Anxiety,Triangulation, and Oedipal Trauma

The interaction of strong aggressive and libidinal drives, various primitive intrapsychic fantasies linking somatic sensations, body parts, ego, object, and the effects of early environmental stress and trauma all produce a potential crisis in the paranoid-schizoid period of development. Certain innate methods of understanding somatic experiences as well as the interaction between internal and external reality lead to an unconscious triangulation of part objects. A frustrating, stimulating, or punitive "third" that blocks, nullifies, or overgratifies certain wishes then emerges as a pivotal object in the internal landscape. During the paranoid-schizoid, triadic process, there is a fluctuation between separation/individuation and de-differentiation/fusion. If the early triangulation process has been either exceedingly frustrating or overly stimulating in regards to "reaching the third" or "warding off the third," the infantile ego is fixed by aggressive and libidinal forces to de-differentiation experiences rather than to more separate and individuated ways of relating. Therefore, the later oedipal stage will be colored by excessive oral and anal conflicts and will be weighted on the side of primitive maneuvering based on splitting, projection, and introjection. When the child (and later the adult) becomes involved in oedipal situations marked by stimulation or frustration of triadic drives, there can be a regression to the earlier paranoid-schizoid triadic period. A case study was presented in which a patient struggled with a partial working through of these conditions in dreams and in the transference. This pulled her more in the direction of a differentiated Oedipal conflict and whole object functioning.     

Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder

The cognitive-behavioural theory of Obsessive Compulsive Disorder (OCD) proposes that a key factor influencing obsessional behaviour is the way in which the intrusive cognitions are interpreted. The present paper reports an investigation of links between clinical symptoms (of anxiety, depression and obsessionality) and responsibility beliefs. These beliefs include not only measures of general responsibility attitudes (assumptions) but also more specific responsibility appraisals consequent on intrusive cognitions. The characteristics of two new questionnaires specifically designed to measure these beliefs were assessed in patients suffering from Obsessive Compulsive Disorder, in patients suffering from other anxiety disorders and in non-clinical controls. The scales measuring negative beliefs about responsibility were found to have good reliability and internal consistency. Comparisons between criterion groups indicate considerable specificity for both assumptions and appraisals with respect to OCD. There was also good evidence of specificity in the association between responsibility cognitions and obsessional symptoms across groups, and that this association was not a consequence of links with anxiety or depressive symptoms. Although the two measures were correlated, they each made unique contributions to the prediction of obsessional symptoms. Overall, the results are consistent with the hypothesis that responsibility beliefs are important in the experience of obsessional problems.     

Counterconditioning in the treatment of spider phobia: effects on disgust, fear and valence

From the perspective that disgust is a core feature of spider phobia, we investigated whether the treatment efficacy could be improved by adding a counterconditioning procedure. Women with a clinically diagnosed spider phobia (N = 34) were randomly assigned to the regular one-session exposure condition (EXP) or to the exposure with counterconditioning condition (CC). In the CC-condition tasty food-items were used during the regular exposure exercises and the participants' favourite music was played. Both treatment conditions appeared very effective in reducing avoidance behaviour and self-reported fear of spiders, strongly attenuated the disgusting properties of spiders and altered the affective evaluations in a positive direction. CC was not more effective in altering the affective valence of spiders than EXP and was not superior with respect to the long term treatment efficacy at 1 year follow up. Apparently, regular exposure treatment is already quite effective in altering the affective-evaluative component of spider phobia and it remains to be seen whether it is possible to further improve treatment outcome by means of procedures which are specifically designed to reduce the spiders' negative affective valence.     

"Factor analyses of the family assessment device," by Ridenour, Daley, & Reich

Ridenour, Daley, and Reich conducted a series of factor analyses using the correlational matrix of the subscale scores of the Family Assessment Device (FAD), published in Family Process, December, 1999. They conclude that "the FAD subscales be reorganized from their current seven-subscale format" (p. 507). We propose that this suggestion for reorganization is premature and based on the inappropriate application of an "internal consistency" model of scale construction to the FAD. We further suggest that the most important criteria regarding an assessment instrument are those of reliability, validity, and clinical utility. In the absence of this kind of data regarding alternative organizations of the FAD, we believe that the original subscales remain the best choice.     

Temporal context and conditioned reinforcement value

The effectiveness of a stimulus as a conditioned reinforcer depends on the temporal context of reinforcement, that is, the overall rate of reinforcement in the situation. The dominant view has been that context determines the learned value of a stimulus directly, according to delay-reduction theory. By contrast, the contextual choice model (CCM) maintains that value is independent of context and incorporates the effects of context on choice in the framework of the matching law. The authors report 2 experiments with pigeons as subjects that use transfer tests to assess the value of stimuli in the concurrent-chains procedure. Results strongly support the assumption of CCM that pigeons learn the temporal relations between events independently of context but that context modulates the expression of that learning as choice.     

The role of stimulus-based and response-based spatial information in sequence learning

In 4 experiments, relational structures were independently varied in stimulus and response sequences in a serial reaction time task. Moreover, the use of spatial and symbolic stimuli and responses was varied between experiments. In Experiment 1, spatial stimuli (asterisk locations) triggered spatial responses (keystrokes); in Experiment 2, spatial stimuli triggered symbolic responses (verbal digit naming); in Experiment 3, symbolic stimuli (digits) triggered keystrokes; and in Experiment 4, digits triggered verbal responses. The results showed that there is a remarkably stronger effect of relational structures in spatial sequences than in symbolic sequences, irrespective of whether stimulus or response sequences are concerned. This suggests that learning is particularly effective for sequences of spatial locations. It is argued that spatial learning is a critical determinant for the debate on perceptual and motor learning.