Reflections on the process of psychotherapeutic change as applied to medical situations

This article takes the basic ideas on the process of changing implicit knowledge put forward in this special issue, and extends them beyond psychotherapy to include other therapeutic relationships that occur in medicine. One vignette, from an encounter between a medical student and a dying patient, illustrates how a “moment of meeting” changes the student as well as the patient. The second shows how therapeutic interventions for new mothers with their newborn infants involve “moments of meeting” that alter the mother's implicit knowledge of her baby and of herself as a mother. © 1998 Michigan Association for Infant Mental Health     

Reply to Bermudez and Bonjour

Helen Beebee has recently argued that David Lewis’s account of compatibilism, so-called local miracle compatibilism (LMC), allows for the possibility that agents in deterministic worlds have the ability to break or cause the breaking of a law of nature. Because Lewis’s LMC allows for this consequence, Beebee claims that LMC is untenable and subsequently that Lewis’s criticism of van Inwagen’s Consequence Argument for incompatibilism is substantially weakened. I review Beebee’s argument against Lewis’s thesis and argue that Beebee has not refuted LMC and concomitantly has not demonstrated that Lewis’s criticism of the Consequence Argument fails.     

Accounting for sequential trial effects in the flanker task: Conflict adaptation or associative priming?

The conflict-control loop theory proposes that the detection of conflict in information processing triggers an increase in cognitive control, resulting in improved performance on the subsequent trial. This theory seems consistent with the robust finding that conflict susceptibility is reduced following correct trials associated with high conflict: the conflict adaptation effect. However, despite providing favorable conditions for eliciting and detecting conflict-triggered performance adjustments, none of the five experiments reported here provide unequivocal evidence of such adjustments. Instead, the results corroborate and extend earlier findings by demonstrating that the conflict adaptation effect, at least in the flanker task, is only present for a specific subset of trial sequences that is characterized by a response repetition. This pattern of results provides strong evidence that the conflict adaptation effect reflects associative stimulus-response priming instead of conflict-driven adaptations in cognitive control.     

Well-being and Need for Support of Adolescents with a Chronically Ill Family Member

This study investigates whether there are differences in the well-being, need for help and use of support services between adolescents with and without a chronically ill or disabled family member. It also examines the role played by the type of illness, the relationship to the family member and the nature and intensity of the help provided by the adolescent. A Dutch sample of 1581 adolescents (average age 14.6?years) completed a questionnaire in 2010 about mental health problems, pro-social behavior, need for and use of support and the illness of family members and any care tasks performed by the respondent. Young people with a sick family member had more mental health problems than their counterparts without a chronically ill family member. They also reported a greater need for and use of help and support. Performing domestic tasks was found to be a predictor for overall mental health problems. The intensity of the help given was related to the need for help by the adolescent. It is concluded that growing up with a chronically ill family member and spending a lot time performing (domestic) tasks are risk factors for adolescent mental health problems and adolescents’ need for help. Special attention is warranted for those who need support but who do not translate that need into reality by seeking help.     

Persistent symptoms among survivors of Hodgkin's disease: an explanatory model based on classical conditioning.

Persistent symptoms of nausea, distress, and vomiting triggered by reminders of cancer treatment were examined among 273 Hodgkin's disease survivors, 1 to 20 years posttreatment. Prevalence rates were high for distress and nausea but low for vomiting. Retrospective report of anticipatory symptoms during treatment was the strongest predictor of persistent symptoms, suggesting that treatment-induced symptoms are less likely to persist if conditioning does not occur initially. Time since treatment was also a significant predictor, with patients more recently treated more likely to experience persistent symptoms. Thus, an explanatory model based on classical conditioning theory successfully predicted presence of persistent symptoms. Symptoms also were associated with ongoing psychological distress, suggesting that quality of life is diminished among survivors with persistent symptoms. Recommendations for prevention and treatment of symptoms are discussed.     

Psychometric properties of the Beck Depression Inventory for Youth in a sample of girls

A new measure has been developed to assess depressive symptoms, the Beck Depression Inventory for Youth (BDI-Y; J. S. Beck, A. T. Beck, & J. B. Jolly, 2001). This research extends previous validation research of BDI-Y total scores by examining internal consistency and convergent and predictive validity within a school-based sample (n=859) of girls 9-13 years old by age level and for selected races or ethnic groups. Scores had high internal consistency, and there was support for using the BDI-Y to assess depressive symptoms. Reliability was slightly lower for 9-year-olds, but reliability and validity estimates did not differ by race or ethnic group. Finally, confirmatory factor analysis results provide some support for unidimensionality of scores but also point toward possible refinements.     

The influence of visual experience on visual and spatial imagery

Differences are reported between blind and sighted participants on a visual-imagery and a spatial-imagery task, but not on an auditory-imagery task. For the visual-imagery task, participants had to compare object forms on the basis of a (verbally presented) object name. In the spatial-imagery task, they had to compare angular differences on the basis of the position of clock hands on two clock faces, again only on the basis of verbally presented clock times. Interestingly, there was a difference between early-blind and late-blind participants on the visual-imagery and the spatial-imagery tasks: late-blind participants made more errors than sighted people on the visual-imagery task, while early-blind participants made more errors than sighted people on the spatial-imagery task. This difference suggests that, for visual (form) imagery, people use the channel currently available (haptic for the blind; visual for the sighted). For the spatial-imagery task in this study reliance on haptic processing did not seem to suffice, and people benefited from visual experience and ability. However, the difference on the spatial-imagery task between early-blind and sighted people in this study might also be caused by differences in experience with the analogue clock faces that formed the basis for the spatial judgments.     

Differences between early-blind, late-blind, and blindfolded-sighted people in haptic spatial-configuration learning and resulting memory traces

The roles of visual and haptic experience in different aspects of haptic processing of objects in peripersonal space are examined. In three trials, early-blind, late-blind, and blindfolded-sighted individuals had to match ten shapes haptically to the cut-outs in a board as fast as possible. Both blind groups were much faster than the sighted in all three trials. All three groups improved considerably from trial to trial. In particular, the sighted group showed a strong improvement from the first to the second trial. While superiority of the blind remained for speeded matching after rotation of the stimulus frame, coordinate positional-memory scores in a non-speeded free-recall trial showed no significant differences between the groups. Moreover, when assessed with a verbal response, categorical spatial-memory appeared strongest in the late-blind group. The role of haptic and visual experience thus appears to depend on the task aspect tested.