“Yours,Thirsty for Honesty,Ferenczi”: Some Background to Sandor Ferenczi's Pursuit of Mutuality

The American Journal of Psychoanalysis -     

Family Functioning and Mental Illness: A Comparison of Psychiatric and Nonclinical Families

The primary objective of the present investigation was to examine adaptive functioning in the families of patients with a wide range of psychiatric disorders. Seven dimensions of family functioning, as measured by the Family Assessment Device (FAD), were compared across families of patients with a schizophrenia spectrum disorder (n = 61 ), bipolar disorder (n = 60 ), major depression (n = 111 ), anxiety disorder (n = 15 ), eating disorder (n = 26 ), substance abuse disorder (n = 48 ), and adjustment disorder (n = 46 ). Families in each psychiatric group were also compared to a control group of nonclinical families (N = 353 ). Results indicated that regardless of specific diagnosis, having a family member in an acute phase of a psychiatric illness was a risk factor for poor family functioning compared to the functioning of control families. However, with few exceptions, the type of the patient's psychiatric illness did not predict significant differences in family functioning. Thus, having a family member with a psychiatric illness is a general stressor for families, and family interventions should be considered for most patients who require a psychiatric hospitalization for either the onset of, or an acute exacerbation of, any psychiatric disorder.     

The Development of a Clinical Rating Scale the McMaster Model of Family Functioning

This article describes the development and validation of the McMaster Clinical Rating Scale (MCRS). The MCRS is a 7-item scale designed to be completed by a trained rater after completion of an in-depth interview of the family. We present data from four new studies and review previously published articles concerning the reliability, validity, and clinical utility of the MCRS. Adequate interrater reliability and rater stability were obtained. The MCRS was found to correlate significantly with the self-report Family Assessment Device and to discriminate between families in different phases of a depressive disorder.     

A Whiff of Reality: Empirical Evidence Concerning the Effects of Pleasant Fragrances on Work-Related Behavior1

Two studies were conducted to investigate the potential effects on workrelated behavior of one environmental variable: pleasant fragrances. In Study 1, participants performed a word construction task under low or high stress while in the presence or absence of pleasant fragrances. Performance was significantly enhanced by fragrance in both stress conditions. In addition, exposure to pleasant fragrances significantly increased performance on an additional task (decoding written messages) completed by participants following exposure to stress. In Study 2, both exposure to pleasant fragrances and receipt of a small gift increased performance on the same word construction task used in Study 1. In addition, fragrance and a gift increased participants' willingness to engage in both immediate and delayed helping. Together, the results of these studies offer support for the view that pleasant fragrances can influence work-related behavior, and that such effects may be mediated, at least in part, by increments in positive affect.     

Decision-making incapacity among nursing home residents: results from the 1987 NMES survey. National Medical Expenditure Survey

Recent legislative and regulatory developments have focused attention on older adults' capacity for involvement in health care decision-making. The Omnibus Budget Reconciliation Act of 1987 (OBRA 87) focused attention on the rights of nursing home residents to be involved in health care decision-making to the fullest extent possible. This article uses data from the 1987 National Medical Expenditure Survey (NMES) to examine rates of incapacity for health care decision-making among nursing home residents. Elements of the Oklahoma statute were used to operationalize decision-making incapacity: disability or disorder, difficulty in decision-making or communicating decisions, and functional disability. Fifty-three percent of nursing home residents had a combination of either physical or mental impairment and an impairment in either self-care or money management. The discussion focuses on the policy and practice implications of significant rates of incapacity among nursing home residents.     

Worldly and workaday worries: Contemporary concerns of children and young adolescents

Top-of-the-head worries were elicited from young people, grades 4 to 8, both before and after they completed quantitative risk assessments of specific health and environmental problems. Results revealed that many students carry a substantial worry burden that includes not only personal matters such as grades and social relations, but also concerns about death and about global issues such as homelessness and environmental degradation. The gender and grade differences that emerged were consistent with a developmental extension from self to societal perspectives. Differences in worry profiles from before to after the risk assessment interviews revealed some impact of recent exposure, as illustrated by a pre—post increase from 7% to 30% in students spontaneously expressing AIDS-related concerns. Implications of the breadth and severity of young people's concerns are discussed, as are the ambiguities inherent in standard assessment approaches.This research was supported by grants from the National Institute of Child Health and Human Development (HD27035) and the University of California Universitywide AIDS Research Program (R901040). We very much appreciate the cooperation of Sally Snyder and the Irvine Unified School District, Amy Watson and the Corinne A. Seeds University Elementary School, Trina Panaqua and the Bruin Kids of UCLA, and the Fernald Child Study Center. Special thanks are due to the 4th- through 8th-grade student participants. We are also grateful to Ellen Dellis, Virginia Elderkin-Thompson, Judy Hollingshead, Alison Holman, Judy Koch-Jones, and Kim Witte for their help with the interviews and to Tammy Merlo, Shealen Nash, and Beth Twambley for competent coding assistance. Finally, we thank the anonymous editorial reviewers for constructive comments on the nature of fear and worry.     

The perestroika of the family? Gender and occupational differences in family values in modern day Russia

The recent dramatic changes in the political and economic structures of Eastern Europe have focused interest on the position of women in Russia, where a greater openness in discussing inequalities has been accompanied by a more regressive harkening back to traditional gender roles. The study reported in this paper examines gender and occupational differences in general attitude toward the family, disclosure to family members, and child-rearing values. Three hundred sixty-eight students, 179 manual workers, and 160 entrepreneurs completed a structured measure of family orientation and replied to open-ended questions on family taboos and child-rearing practices, while a subsample (N = 475) completed a family disclosure inventory. Multivariate analyses of variance analyses revealed women to be more family oriented than men, while gender and occupation interacted in producing family disclosure rates. HILOGLINEAR analyses found that the topics suitable for family discussion, as well as the child-rearing values promoted by our respondents, were also best predicted by considering the interaction between both gender and occupation. The implications of these findings for the future shape of Russian family relations is discussed.     

Neuropsychological Features of Progressive Supranuclear Palsy

Progressive supranuclear palsy (PSP) is the epitome of a subcortical dementia process. Due to its relative rarity, there is only a small literature on the neuropsychological consequences of PSP. The findings to date demonstrate that PSP patients have dramatically slowed information processing and motor execution, rapid forgetting, problems in orienting attentional resources, and difficulty in planning and shifting conceptual sets. The pattern and severity of these deficits are unique to PSP and suggest that the study of PSP patients can provide a special insight into brain-behavior relations.     

Quantitative measurement of observed workload in the analysis of aircrew performance

A methodology for the quantitative evaluation of observed workload was proposed. The model was designed to provide point estimations of observed workload at any time during the performance of a set of tasks. The model was also designed to provide information about the task-scheduling strategies used to complete a set of tasks. The proposed model was then tested with data from a full mission flight simulation. The model predictions correlated significantly with expert ratings of workload management made during the flight simulation. The model was also able to distinguish between low- and high-performing aircrews when performance was based on the number of errors made during flight simulations.     

Discrimination of Facial Identity and Facial Affect by Temporal and Frontal Lobectomy Patients

The purpose of this study was to determine the extent to which lobectomy affects ability to discriminate facial identity or facial expression. Fifteen right temporal, 15 left temporal, 5 right frontal, and 4 left frontal lobectomy patients, pair-matched for age, sex, and education to normal control subjects, participated in this study. Tasks included a Facial Identity Matching Task and a Facial Affect Matching task. The lobectomized patients as a whole were significantly impaired on both tasks (22% decrement in performance). The patients made twice as many errors resulting from perseveration of response-set of the first condition (identity or emotion matching) into the second condition. The site of lobectomy did not influence general performance on any one task or selective performance on any subset of affective categories. It was concluded that all four brain regions play a significant and equal role in face processing, and that circuits more specifically dedicated to visual face processing, which are responsible for hemispheric dominance affects and affect/identity dissociations, are probably located more posteriorly in the brain. Finally, it was concluded that perseveration of acquired habit may, under specific conditions, characterize temporal lobe dysfunction just as much as frontal lobe dysfunction.