ASSOCIATIVE OBLIGATIONS,VOLUNTARISM, AND EQUALITY

Samuel Scheffler has identified two important objections to associative obligations, the voluntarist objection and the distributivist objection. The voluntarist is concerned about protecting the autonomy of the agent who is supposed to have associative obligations. However, the appropriate account of the source of associative obligations reveals that they pose no threat to autonomy, if we understand autonomy in a weak rather than a strong sense. The distributivist is worried about the claims of outsiders being ignored as the result of insiders having associative obligations to one another. This objection loses much of its force when we understand the genuine implications of associative obligations.     

Gender and computers. II. The interactive effects of knowledge and constancy on gender-stereotyped attitudes

A number of studies have failed to find that gender constancy (understanding that one's gender is permanent) predicts gender-typed attitudes and behavior. This study (run with a predominantly white sample) tests the hypothesis that gender constant children are motivated to master gender roles, but that how well they do so depends on their knowledge of gender stereotypes. We predicted that attitudes toward computer use (a stereotypically male activity) would be less positive only for 5–9-year-old gender constant girls who also had rich gender stereotypes. Predictions were confirmed, especially for girls whose constancy had recently increased. These data thus suggest that the clearest picture of gender role development emerges when both the unique and interactive effects of gender constancy and gender schema development are assessed. They also indicate that gender differences in computer attitudes can develop through self-socialization processes.This research was supported in part by research Grant No. R37 MH37215 and Research Scientist Development Award No. 00484 from the National Institute of Mental Health to the third author. The first two authors gratefully acknowledge the support of the James S. McDonnell Foundation. All authors would also like to thank Tom Alfieri, Faith Greulich, and Lisa Cyphers for their help at various stages of this project.     

Dreams of traditional and nontraditional women: Are dream aggression and hostility related to higher levels of waking well-being?

In order to determine whether varying degrees of traditionality would be manifested in specific behaviors that would be present in women's waking and dreaming life, 100 women between the ages of 22 and 79, 12% of whom were African American, were administered a number of self-report measures of psychological well-being and were asked to complete ongoing dream diaries for a 2-week period. These instruments were then scored along with a variety of measures used to determine to what extent traditionality differentiated among the women. Randomly selected dreams from the dream diaries were scored for aggression, anxiety, emotion, hostility, self-efficacious problem-solving, and success/failure. While traditionality was not a significant factor among the self report scales, a number of significant relationships between traditionality and dream content scales were found. As predicted, nontraditionality was positively correlated with a high ratio of achievement-oriented success to failure interactions, self-efficacious problem-solving, and aggressive dream interactions. However, nontraditionality was also significantly correlated with higher overall dream hostility. The results are discussed within the context of recent dream function theory as well as within a broader sociocultural context on shifting gender roles.This research was completed in partial fulfillment of the first author's requirements for the doctoral degree in clinical psychology at Yeshiva University. The authors wish to thank Stan Fevens, Ph.D., for his enthusiastic support and encouragment as well as his invaluable assistance. An amended version of this paper was presented at the June, 1993 meeting of the Association of the Study of Dreams, Santa Fe, NM     

The effects of retention interval on preschool children's short-term memory of verbal items

The short-term recall of word-triads was tested, comparing retention over three types of intervals within 24 preschoolers. Retention was significantly lower in the 16 sec unfilled interval condition than in the immediate test condition. This result, predicted from preschoolers' rehearsal deficiency, differs from those obtained in previous adult and child studies. A filled interval condition, requiring irrelevant verbal activity during the 16 sec period, significantly reduced recall from that of the unfilled interval condition. Recognition of the word items on a subsequent recognition test was greater than chance and was not affected by interval condition. This suggests that the condition effects in short-term recall did not disrupt the long-term storage of the items.     

“I’ve got you under my skin”: Relational therapists’ experiences of patients who occupy their inner world

The aim of this study was to conduct an in-depth exploration of therapists’ experiences of patients who affect them more than others and occupy their inner world beyond the context of therapy sessions. A phenomenological analysis was performed on semi-structured interviews with five relational therapists. All the therapists had a strong experience of a particular patient getting “under their skin.” In all these cases, the patient was a traumatized woman. The distinctive characteristic of the phenomenon was a sense of blurred or too permeable boundaries between the therapist and the patient. This was associated with fear and anxiety, but also with feelings of love. The therapists’ reactions to having a patient “under their skin” varied from resistance to symbiotic relatedness. The therapists’ ideas of their professional role influenced how the experience of carrying the patient’s suffering was interpreted. The phenomenon of the patient’s presence in the therapist’s representational world might be interpreted as a distinct countertransference phenomenon when working in a more “thin boundary” manner with particular cases. The therapists’ ability to effectively manage their vulnerabilities, activated in the countertransference, seems to be crucial for therapeutic progress. Implications for research, clinical practice, and training are discussed.     

Family Coordination in Families who have a Child with Autism Spectrum Disorder

Little is known about the interactions of families where there is a child with autism spectrum disorder (ASD). The present study applies the Lausanne Trilogue Play (LTP) to explore both its applicability to this population as well as to assess resources and areas of deficit in these families. The sample consisted of 68 families with a child with ASD, and 43 families with a typically developing (TD) child. With respect to the global score for family coordination there were several negative correlations: the more severe the symptoms (based on the child’s ADOS score), the more family coordination was dysfunctional. This correlation was particularly high when parents had to play together with the child. In the parts in which only one of the parents played actively with the child, while the other was simply present, some families did achieve scores in the functional range, despite the child’s symptom severity. The outcomes are discussed in terms of their clinical implications both for assessment and for intervention.     

A Case-Series of Reflective Family Play: Therapeutic Process,Feasibility, and Referral Characteristics

Evidence-based interventions for infants and preschoolers, and their families, have largely focused on the mother-child dyad. In response to the increasing need to diversify treatment approaches in the under six population and include the whole family system, we have developed a new treatment approach called Reflective Family Play (RFP). A manualized, whole-family therapy, RFP allows for the involvement of two parents and siblings when working with infants or young children. In this case-series, we used a qualitative chart review to examine the therapeutic process, acceptability, and feasibility of RFP for 22 families with children ages 0–6, who participated in RFP. We also sought to better understand the referral characteristics of those families who participated in RFP by comparing them to families who were referred to and participated in an established dyadic approach during the same time-period. Session-by-session coding of clinician chart notes revealed evidence of positive shifts throughout the RFP process, including more whole-family play, improvements in coparenting, and better parental mentalization. Parents reported improvements in presenting concerns in all but one case. Improvements in coparenting, sibling relationships, and family alliance were also reported by parents after RFP. Clinical implications and directions for future research are discussed.     

Why Bioethics Should Be Concerned With Medically Unexplained Symptoms

Biomedical diagnostic science is a great deal less successful than we've been willing to acknowledge in bioethics, and this fact has far-reaching ethical implications. In this article I consider the surprising prevalence of medically unexplained symptoms, and the term's ambiguous meaning. Then I frame central questions that remain answered in this context with respect to informed consent, autonomy, and truth-telling. Finally, I show that while considerable attention in this area is given to making sure not to provide biological care to patients without a need, comparatively little is given to the competing, ethically central task of making sure never to obstruct access to biological care for those with diagnostically confusing biological conditions. I suggest this problem arises from confusion about the philosophical value of vagueness when it comes to the line between biological and psychosocial needs.