Association between substance use disorders and self- and other-directed aggression: An integrated model approach

Our study's objective is to determine whether substance use disorders’ association with aggression differs according to the type of substance and/or the form of aggression, within the same population. We used data from the National Survey on Drug Use and Health across 2008–2014, with a pooled sample of 270,227 adult respondents. We used regression models to estimate the odds ratios for those having alcohol and/or drug use disorder(s) perpetrating (a) each form of aggression compared with no aggression and (b) other-directed compared with self-directed aggression. Alcohol use disorder alone and drug use disorder(s) alone were both associated with significantly increased odds of committing self-directed, other-directed, and combined aggression. Individuals with drug use disorder(s) alone were more likely to commit other-directed than self-directed aggression (adjusted odds ratio = 1.46, 95% CI = 1.04–2.05). Individuals with alcohol use disorder alone were not likely to commit one over the other (adjusted odds ratio = 1.20, 95% CI = 0.90–1.61). In conclusion, the integrated model of aggression based on the stress–diathesis model is a relevant framework to study risk factors for aggression. Further research is needed to identify longitudinal predictors of directionality of aggression.     

Gruppenpsychotherapie für Brustkrebspatientinnen

Zusammenfassung  Der Brustkrebs erzwingt geradezu unsere Aufmerksamkeit mit seiner hohen Prävalenz—30% aller Krebsneuerkrankungen bei nordamerikanischen Frauen sind Brustkrebs—, und er ist die zweithäufigste Todesursache bei Frauen in Nordamerika. Weiße nordamerikanische Frauen haben ein Risiko von 1:9, im Laufe ihres Lebens an Brustkrebs zu erkranken. Es gibt zahlreiche Anknüpfungspunkte, darunter genetische und familiäre Prädisposition, primäre Krebserkrankung/Langzeitüberleben und rezidivierende oder metastasierende Krankheit. Brustkrebs ist eine Krankheit, bei der jede Form der Krebsbehandlung eingesetzt wird—Chirurgie, Chemotherapie, Bestrahlung, Hormontherapie und die viel versprechenden, kürzlich entwickelten immunologischen Interventionen. Zugleich ist die Brust als Körperteil kulturell hochgradig besetzt und als Symbol der Weiblichkeit, der Attraktivität, der Sexualität und der Fortpflanzung aufmerksam und emotional viel beachtet. In der vorliegenden Arbeit wird die Anwendung von Gruppenpsychotherapien auf dieses Spektrum klinischer Belange diskutiert.

Biomedical research and mining of the poor: The need for their exclusion

Almost all ethical guidelines and legislative policies concerning biomedical research involving human subjects contain provisions about relevance of research for the participating populations, informed consent, adequate care for research induced injuries and several other safeguards but the poor continue to suffer. Globalization has further aggravated poor people’s vulnerability by exposing them to international markets. Since the developing countries are abode of higher population of the poor they have become the unholy mines of this human ore for researchers. In this paper I examine various dimensions of poverty and analyze the international ethical responses in the area of biomedical research involving human subjects in order to determine their adequacy to protect the poor against exploitation and misuse and conclude that in view of the poor’s inherent and extreme vulnerability and the failure of ethical pronouncements to protect them from misuse and exploitation, they should be excluded from being enrolled as research subjects This paper was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005.     

Sociology and psychology within the scope of scientific dishonesty

A survey is undertaken based on qualitative analyses of the cases of scientific misconduct from the Danish Committee on Scientific Dishonesty’s first five years of collecting data, with additional information from selected international sources, in which underlying psychological motivations can be judged. An carlier version of this paper was presented at a symposium, Scientific Misconduct. An International Perspective, organised by The Medical University of Warsay, 16 November, 1998.     

On self-disclosure: The vulnerable therapist

The therapist may stimulate the family's growth by sharing his personal experiences directly with them. This helps by providing the family with a model of a real (versus symbolic) person and encouraging them to respond in new and competent ways. As a result, the emotional commitment of the therapeutic system may deepen, while unconscious conflicts that have been causing impasses may surface and be resolved. The therapist hopes that his self-disclosure will benefit the therapy, but understands that there are risks involved. Specific guidelines can help in deciding when not to share, what kinds of problems can be revealed, and what attitudes best strengthen this endeavor. Self-disclosure is discussed here in an experiential frame-work. The author illustrates the above points with examples from his own personal clinical and supervisory experiences.The author would like to thank his wife, Linda Barth Garfield, MSS, without whose sustaining support this paper could not have been written, and his partner, Ellen Berman, MD, for her valuable comments and encouragement. The masculine pronoun is used in this paper for convenience, and because the author is often referring to himself.     

Symbolic experiential journeys: An introduction

This introductory article describes the origins of this special issue on Symbolic-Experiential Family Therapy. It goes on to elaborate the basic assumptions of Carl Whitaker's approach which emerge as unifying themes in the contributors' articles. It concludes with a tribute to Whitaker.The author wishes to acknowledge Linda Barth Garfield, MSS, and Ellen Berman, MD, for their helpful assistance and editorial comments in the development of this paper.     

In defense of strategic therapy

The practice of strategic therapy has raised a number of critical issues and has stimulated criticism of various sorts. Among the criticisms leveled at strategic therapy are that it involves the taking of too many risks, that it is deceptive, that it is controlling and manipulative, that it is disrespectful, and that it is superficial and narrow. Each of these five major areas of concern is discussed and addressed with case examples to illustrate a rationale and justification for the use of these less conventional methods.     

The child sexual abuse victim: Assessment and treatment issues and solutions

Particular attention is given in this paper to the assessment process with child sexual abuse victims and recommendations are made regarding practical issues both in the assessment and the treatment phases of therapeutic work with child victims.     

Using psychodynamic concepts in strategic family therapy: A suicidal adolescent case

This paper describes the treatment of a suicidal adolescent with strategic family therapy. The cotherapists conceptualized the case psychoanalytically and systemically. They propose that their understanding of psychodynamics enhanced their ability to tailor their interventions to the family's unique style and capacities. Rather than dismiss psychodynamic concepts as irrelevant to strategic family therapy, they maintain that an appreciation of individual members' ego strengths, defenses, affects, and unacknowledged impulses leads to the construction of more effective metaphors and a set of interventions more isomorphic to family patterns.