Empirically and clinically useful decision making in psychotherapy: differential predictions with treatment response models

In the delivery of clinical services, outcomes monitoring (i.e., repeated assessments of a patient's response to treatment) can be used to support clinical decision making (i.e., recurrent revisions of outcome expectations on the basis of that response). Outcomes monitoring can be particularly useful in the context of established practice research networks. This article presents a strategy to disaggregate patients into homogeneous subgroups to generate optimal expected treatment response profiles, which can be used to predict and track the progress of patients in different treatment modalities. The study was based on data from 618 diagnostically diverse patients treated with either a cognitive-behavioral treatment protocol (n = 262) or an integrative cognitive-behavioral and interpersonal treatment protocol (n = 356). The validity of expected treatment response models to predict treatment in those 2 protocols for individual patients was evaluated. The ways such a procedure might be used in outpatient centers to learn more about patients, predict treatment response, and improve clinical practice are discussed.     

Age, memory load, and individual differences in working memory as determinants of class-inclusion reasoning.

We studied the effects of individual differences in speak-span scores and variations in memory demands on the class-inclusion performance of 10-, 13-, and 15-year-old children. The speak-span task was an age-appropriate modification of Daneman and Carpenter's (1980) reading-span task and was considered to be a measure of global resources. The age variable was assumed to be a global index of skill development, and some of the specific skills hypothesized to be important in class-inclusion reasoning were estimated using a mathematical model. The results from both regression analyses and the mathematical model indicated that differences in age, speak span, and memory load all affected performance. Surprisingly, the effects of speak span and memory load were independent. However, the effects of each of these variables depended on the age level of the participants. Based on these findings, we argued that (a) resources vary continuously with age, (b) both skill level and global resources should be varied in developmental studies of problem solving, and (c) resource theories (e.g., Norman & Shallice, 1986) should be modified to account for developmental change.     

Archetypes, complexes and self-organization

There has always been confusion and disagreement about the nature of the terms archetype and complex in Jungian circles, not to mention non-Jungian ones. Another ongoing concern is whether Jung's concept of the archetype and complex can be justified in terms of current scientific research, most notably that of neurophysiologists and others interested in the brain and consciousness. This paper proposes a theory of the formation of complexes, namely, that they are created through self-organization within the brain/mind. Self-organization is a process typical of large complex systems, and is generally accepted to operate within the brain and to be important in its functioning. Examples of self-organization in biology are related to the psychic processes that form the complexes. It is then natural to define the archetype in terms of the complex, and the authors propose a definition of the archetype as an equivalence class of complexes. On this view, the archetype is an emergent property of the activity of the brain/mind, and is, appropriately, defined at the level at which it emerges. This definition is in line with the original development of Jung's ideas, in that he derived the concept of the archetype from his earlier discovery of the feeling-toned complex.     

The effect of texture relief on perception of slant from texture

Texture can be an effective source of information for perception of slant and curvature. A computational assumption required for some texture cues is that texture must be flat along a surface. There are many textures which violate this assumption, and have some sort of texture relief: variations perpendicular to the surface. Some examples include grass, which has vertical elements, or scattered rocks, which are volumetric elements with 3-D shapes. Previous studies of perception of slant from texture have not addressed the case of textures with relief. The experiments reported here test judgments of slant for textures with various types of relief, including textures composed of bumps, columns, and oriented elements. The presence of texture relief was found to affect judgments, indicating that perception of slant from texture is not robust to violations of the flat-texture assumption. For bumps and oriented elements, slant was underestimated relative to matching flat textures, while for columns textures, which had visible flat top faces, perceived slant was equal or greater than for flat textures. The differences can be explained by the way different types of texture relief affect the amount of optical compression in the projected image, which would be consistent with results from previous experiments using cue conflicts in flat textures. These results provide further evidence that compression contributes to perception of slant from texture.     

Internal consistency of a diagnostic interview for children: The Child Assessment Schedule

The purpose of this study was to evaluate the internal consistency of the content scales of the Child Assessment Schedule (CAS). A total of 116 psychiatric patients with a mean age of 10 years were administered the interview, and 92 parents were administered the parent version. Coefficient alpha was calculated for each of the 11 content scales. High internal consistency was demonstrated for school, friends, worries, mood, physical complaints, and expression of anger. More moderate but acceptable alphas were observed for the family, fears, and self-image scales. The same general pattern of results was observed for both the child and parent interviews. Additional analyses revealed that the number of items in the CAS could be reduced up to 30% without sacrificing internal consistency. These results indicate that 9 of the scales yield reliable scores.     

Assessing parent-child relationships: a report of normative scores and revalidation of two clinical scales

Normative score performances on the Child's Attitude toward Mother and Child's Attitude toward Father scales by several adolescent subpopulations important to family therapists and researchers are reported for use in clinical assessment and future research. The instruments were administered to a representative sample of 2,419 Florida adolescents, and subpopulations were constructed based upon parental structure and sex. A previous study investigating psychometric properties of the two instruments was partially replicated. Results indicated that both scales are reliable and valid measures of the magnitude of problems in parent-child relationships from the child's point of view. The scales are recommended for both clinical and research applications.     

Time,quantum mechanics,and decoherence

State-reduction and the notion of actuality are compared to passage through time and the notion of the present; already in classical relativity the latter give rise to difficulties. The solution proposed here is to treat both tense and value-definiteness as relational properties or facts as relations; likewise the notions of change and probability. In both cases essential characteristics are absent: temporal relations are tenselessly true; probabilistic relations are deterministically true.The basic ideas go back to Everett, although the technical development makes use of the decoherent histories theory of Griffiths, Omnès, and Gell-Mann and Hartle. Alternative interpretations of the decoherent histories framework are also considered.I would like to thank Abner Shimony for valuable criticism.     

Intimacy-Anger and Insecure Attachment as Precursors of Abuse in Intimate Relationships1

One hundred and twenty men referred for treatment for wife assault and forty demographic controls completed self-report questionnaires assessing attachment patterns, anger, jealousy, Borderline Personality Organization, and trauma symptoms. This constellation, with the exception of attachment, has been found to represent a profile related significantly to the frequency of both verbal and physical abuse. In the present study, attachment was found to correlate significantly with these other measures. A measure of secure attachment correlated significantly, but negatively, with the constellation measures. A measure of fearful attachment correlated significantly and positively. A preoccupied attachment pattern correlated with the other measures less strongly than did the fearful measure. A dismissing measure was not correlated with any constellation measures. The role of attachment anger is discussed; it is suggested that fearful attachment could also be described as angry attachment. The concept of intimacy anger is introduced from early studies in attachment and applied to the explanation of assaultiveness in adult relationships.     

A supported routines approach to active treatment for enhancing independence,competence and self-worth

The traditionally accepted approach to treatment in residential facilities for adults with mental retardation is examined in terms of its impact on the lives of the intended recipients and its interaction with emerging standards for treatment. It is noted that the primary emphasis in traditional treatment providing services to meet individual needs often results in the preponderance of service being directed toward the acquisition of skills required for later independent living, rather than the immediate facilitation of independence. We offer several reasons why a heavy emphasis on skill building is not only impractical but also inappropriate for meeting the real needs of adults with retardation. We suggest that a functional definition of independence from the individual's perspective would be to have a daily routine that is as free of outside assistance as possible and that is rewarding to the individual. We suggest that many persons with mental retardation already exhibit a sufficient array of behaviors from which appropriate personal routines could emerge. It is argued that functional assessments of the need for new skills should be conducted only from within such routines. We conclude that active treatment provided in this way will improve individual self-worth because its focus is on producing immediate competence and independence, rather than perpetuating the ‘student’ status of adults in residential facilities. We refer to this as a ‘supported routines’ approach. The implementation of this approach within the current standards for ‘active treatment’ is discussed, as well as the individual's right to be supported in this way.