Observed behaviors during clinical interviews predict improvement in depression

A considerable percentage of depressed patients do not respond to antidepressive treatment. Early indicators of prognosis are needed. The aims of this study are to examine (a) whether the interpersonal behavior of patients and psychiatrist, as assessed by means of direct observation of behavior during a baseline clinical interview, might have predictive value with respect to therapeutic outcome and (b) which predictive potency measures of psychomotor activation, as assessed by less refined methods, such as global clinical judgment, might have. In the analysis used, speech-pause behavior was taken as the basic structure of the interaction. The relations of other behaviors such as looking and hand and head movement with this structure were determined. Evidence is presented that in a group of 31 depressives, improvement after a period of 10 weeks was related to observed behaviors during a baseline interview. The behaviors of the patients are interpreted as relational or nonrelational. The relational behaviors (i.e., looking yesnodding, gesturing) occur less in patients who will improve, whereas the nonrelational behaviors (i.e., intensive body touching, head movements) occur more in these patients. The nonrelational behaviors are presumed to be indicative of the state of arousal. The predictive potency of these variables could not be explained by their relationship with the baseline severity of depression, which in itself also predicted improvement. Moreover, global clinical assessment of psychomotor activation (i.e., retardation and agitation) could not be related to outcome.     

Albert Ellis' personal responses to the Survey of Rational-Emotive Therapists

This article presents Albert Ellis' personal responses to the Survey of Rational-Emotive Therapists and his answers to a number of questions that the first and second authors asked Ellis regarding some of his responses. Ellis also commented on how adequately he thought the results of the survey appeared to represent the current philosophies and practices of RET.     

Fallacies in pragma-dialectical perspective

In the pragma-dialectical approach, fallacies are considered incorrect moves in a discussion for which the goal is successful resolution of a dispute. Ten rules are given for effective conduct at the various stages of such a critical discussion (confrontation, opening, argumentation, concluding). Fallacies are discussed as violations of these rules, taking into account all speech acts which are traditionally recognized as fallacies. Special attention is paid to the role played by implicitness in fallacies in everyday language use. It is stressed that identifying and acknowledging fallacies in ordinary discussions always has a conditional character. Differences between the pragma-dialectical perspective, the Standard Treatment, and the formal logic approach to fallacy analysis are discussed.     

Conflict of interest between therapist-patient confidentiality and the duty to report sexual abuse of children

All 51 jurisdictions in the United States require physicians to report suspected child abuse. In most jurisdictions, reporting requirements override both confidentiality and privilege associated with the physician-patient relationship. The authors review the literature relevant to the conflict between privacy and reporting abuse and report the results of a national survey of therapists at sex offender treatment units. They discuss ethical problems experienced under these statutes by therapists who attempt to provide treatment for sex offenders, and by therapists who are required to report past instances of child abuse even when there is no evidence of ongoing abuse.     

Intimate homicide: An analysis of violent social relationships

Homicide which occurs in intimate social relationships was studied using data from three Western Canadian cities. Variables which may be related to the relationship and homicide are also examined. Unstable relationships are clearly differentiated from other relationships and are more likely to result in homicide. Implications for future research are discussed.     

Reasons for employee sabotage in the workplace

Unionized workers at a factory were asked to rate a variety of reasons which would justify the use of sabotage in an organization, as well as the justifiability of four general methods of sabotage (slowdowns, destructiveness, dishonesty, and causing chaos). Results showed that as compared to those who didn't accept a wide variety of reasons for sabotage, those who accepted a variety of reasons would more readily justify all forms of sabotage except dishonesty. The data is discussed in terms of the reasons for the lack of justification that dishonesty receives, as well as future directions for the study of sabotage.     

Adjustment to hemodialysis treatment through behavioral controls

The present study was conducted to examine the hypothesis that compliant chronically ill patients, typically described as adjusted, reinforce more positive social environments using behavioral controls than noncompliant patients, typically described as maladjusted. Specifically, it is hypothesized that diet-compliant chronic hemodialysis patients emit significnatly more active involvement-in-treatment behaviors and more social behaviors than diet-noncompliant chronic hemodialysis patients. Subjects, who ranged in age from 30 to 77 years, were outpatients at a kidney center. Behavioral observations were conducted to assess the occurrence or frequency of (1) four involvement-in-treatment behaviors that are routinely taught to all patients and (2) two social behaviors, which were patient verbalizations and smiles. The results showed that compliant patients emitted significantly more involvement-in-treatment behaviors and smiles than noncompliant patients. Results support the proposed control framework that compliant, in contrast to non-compliant, chronically ill patients have recourse through positive behavioral controls when adjusting to the stresses of illness. It was proposed that through these controls, compliant patients reinforce positive environments rather than simply respond to life circumstances as given.     

Sex-related differences and visual-spatial mental imagery as factors affecting symbolic motor skill acquisition

The ability of males and females to use visual-spatial imagery as a facilitator of symbolic motor skill acquisition was investigated. Subjects, ordered by gender into control and mental imagery groups, performed 15 trials on a mirrored drawing task. The results indicated that, although both male and female mental imagery groups performed the task more skillfully than the control groups, the male mental imagery group scores over the early stages of performance were better as compared to the female mental imagery group scores. This difference was eradicated during the latter stages of performance. The findings, in addition to supporting the positive effects of mental imagery, lend support to the hypothesis that sex-related differences in selected visual-spatial tasks may be amendable through training followed by practice.