The treatment of sexual dysfunction: Some theoretical considerations

Journal of Contemporary Psychotherapy -     

Psychoanalytic supervision of the difficult patient

Control cases from the broad group of non-neurotic but potentially analyzable patients appear with increasing frequency. The intense, complex transferences they develop place great stress on the psychoanalytic relationship and evoke marked countertransference reactions in psychoanalytic candidates, which reverberate within the supervisory relationship. Through application of a case study method, common themes emerge in the candidate-supervisor dyad: idealization of the supervisor and of classical technique, identification with the patient, parallel process enactments, difficulty maintaining the analytic frame, and the importance of concurrent training analysis. Classical supervisory techniques must be adapted to the "difficult" (non-neurotic) control case. Complex countertransference issues must be carefully addressed while maintaining the teach/treat boundary.     

Changes in middle latency auditory evoked potentials during meditation

In the present study of middle latency auditory evoked potentials during Brahmakumaris Raja Yoga meditation there was a decrease in the peak latency of the Na wave (a negative wave between 14 and 19 msec.) during meditation. Since the neural generator of this wave lies at the midbrain-thalamic level, from the results one can infer that the meditation reduces conduction time at this level.     

Nine Months of Multicomponent Behavioral Treatment for ADHD and Effectiveness of MTA Fading Procedures

We examined 9-month data from the 14-month NIMH Multimodal Treatment Study of Children with ADHD (the MTA) as a further check on the relative effect of medication (MedMgt) and behavioral treatment (Beh) for attention-deficit/hyperactivity disorder (ADHD) while Beh was still being delivered at greater intensity than at 14-month endpoint, and conversely as a check on the efficacy of the MTA behavioral generalization/maintenance procedures. Intention-to-treat analysis at 9 months showed essentially the same results as at 14 months, after Beh had been completely faded; MedMgt and the combination (Comb) of medication and Beh were significantly superior to Beh and community care (CC) for ADHD and oppositional-defiant (ODD) symptoms, with mixed results for social skills and internalizing symptoms. All treatment-group differences examined as changes in slopes from 9 to 14 months were nonsignificant (we found general improvement for all groups). Slopes from baseline to 9 months correlated highly (r > .74, p < .0001) with slopes from baseline to 14 months for all groups. The time function from baseline to 14 months showed a significant linear, but not quadratic, trend for the main outcome measure (a composite of parent- and teacher-rated ADHD and ODD symptoms) for all groups. Findings suggest that in contrast to the hypothesized deterioration in the relative benefit of Beh between 9 and 14 months (after completion of fading), the MTA Beh generalization and maintenance procedures implemented through 9 months apparently yielded continuing improvement through 14 months, with preservation of the relative position of Beh compared to other treatment strategies.     

Misusing church brands: problems with the ownership and management of denominational brand imagery in the United Methodist Church

Trademarked images frequently play an important role in helping contemporary religious institutions establish and maintain a visual identity for their brands. But, these images and the subsequent decision to protect them legally also signify a clash of opinions on authority, theology and rights of ownership. Thus, disputes about trademarked images within religious communities are more than mere negotiations over who can and cannot use a particular symbol, but are ultimately conflicts that end up demarcating the boundaries of institutional membership and revealing a religious body’s (often unquestioned) allegiance to market-based principles. This article explores a case study regarding the United Methodist Church’s ‘Cross and Flame’ insigne, and investigates how tensions over the logo’s proper use uncover implicit statements about the denomination’s position on free market competition in a religious marketplace.     

Medication Administration By Family Members of Dependent Elders In Shared Care Arrangements

Twenty-three long-term care family caregivers whose care-recipients were enrolled in adult day care programs participated in face-to-face, semistructured interviews designed to learn more about their medication administration experiences. Two distinct styles of decision making were identified: self-directed and physician-directed. To help them with their medication administration responsibility, both groups used primary (physicians, pharmacists, or both) and secondary sources of information (the internet, information hotlines, nurses, more experienced caregivers, and family members with health backgrounds). Self-directed caregivers, who were significantly younger than the physician-directed caregivers, were twice as likely to report use of secondary sources of information to manage their medication administration tasks. Secondary sources of information appear to be important for the development of a caregiver's maturation and critical thinking skills over the long term and need more attention from formal providers in shared care relationships with family caregivers.     

Intellectual similarity of virtual twin pairs: Developmental trends

Virtual twins (VTs) are same-age unrelated siblings reared together from infancy who replicate twinship, but without the genetic relatedness. A 2005 report from the ongoing Fullerton Virtual Twin Study found an IQ intraclass correlation of .26 (p < .01, n = 113 pairs) and a within-pair difference of 13.22 IQ points. The average age of VTs in that study was 8.10 years (SD = 8.56, range: 4.01-54.84 years). An opportunity to retest members of 43 VT pairs, 1.70-8.96 years after their time 1 assessment, allowed additional analyses of genetic and environmental influences underlying general intellectual development. A decrease in the VT IQ correlation and an increase in the within-pair difference were indicated, consistent with increasing genetic and/or non-shared environmental influences and decreasing shared environmental influence on general intellectual development throughout childhood.     

Coping behavior: Implications for disabled infants and toddlers

This article discusses the coping process and examines issues concerning the influence of a handicapping condition on the development of coping competence in young children. A preliminary study is reported that investigated the differences between the coping behavior of 25 developmentally disabled and 25 nondisabled children who were 4 to 34 months of age. The Early Coping Inventory was used to assess three categories of behavior related to adaptive coping efforts (sensorimotor organization, reactive behavior, and self-initiated behavior). Results indicated that the nondisabled children, as a group, demonstrated more effective coping-related behavior than did their disabled peers. The disabled children were situationally effective, in that behavior used effectively in one type of situation was not generalized to other types of situations. Their coping behavior tended to be erratic, inflexible, or limited in the range of available management strategies. The greatest discrepancy between the two groups was in their self-initiated behavior. The findings suggest the need for intervention services to address the enhancement of coping behavior of infants and toddlers with disabilities.     

Assessment of mothers' working models of relationships: Some clinical implications

The parent-child relationship exerts a powerful influence upon child behavior. Thus, it has been suggested that psychiatric diagnoses of infants and young children should include a characterization of parent-child relationships and interactions. In this article, we discuss one way of characterizing relationships, which is based upon interviews of parents' childhood histories and their conceptualizations or working models of early experiences (Adult Attachment Interview, George, Kaplan, & Main, 1985). The associations between mothers' working models, their parenting behavior, and the behavior of their children are discussed. Patterns of parent-child relationships described in mothers' subjective histories are discussed with respect to the patterns of interactional behavior of the mothers and their children observed in a laboratory play session. Case examples are given to illustrate the patterns, and implications for clinical use of this system are discussed. The interview appears to be a reliable tool for characterizing parental histories, assessing the associations between subjective conceptualizations and parenting behavior, exploring parental contributions to child behavior, and outlining patterns of relationships.