What is a difficult mental health case? An empirical study of relationships among domain variables

A difficult case in psychotherapy can be defined in many ways. This study proposes a model for that definition, in which three domains (patient characteristics, case characteristics, and therapist characteristics) are considered to impact on that definition. A total of 264 professionals received a questionnaire to assess the relative importance of a series of variables within and across these domains. Wilcoxon Matched-Pairs Signed-Ranks tests indicated that patient characteristics were considered more important than therapist or case characteristics in defining a difficult case. Case characteristics were considered more important than therapist characteristics. Pearson correlations, however, suggested that the three domains in the model are related. Correlations (for years of experience) and Kruskal-Wallis one-way ANOVA for ranks (for professions) also indicated that participants were able to identify variables within domains as important in that definition regardless of years of experience or professions. Across domains, the most important variables included the motivation of the client (a patient characteristic), dropout/attrition and multiple diagnoses (case characteristics), and the degree of therapist-client racial similarity (a therapist characteristic).     

INCREASING CALORIE CONSUMPTION IN CHILDREN WITH CYSTIC FIBROSIS: REPLICATION WITH 2-YEAR FOLLOW-UP

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.     

Child protection dilemmas in a 'not-existing' pattern of abuse

Three cases from a larger review of child abuse inquiry reports are discussed. The abuse the children suffered is termed 'not-existing' because they had been shut away until they perished. Interaction between the children's caretakers and the child protection professionals is examined within a revised framework of the double-bind.     

Nonshared environmental influences and personality differences in adult twins

The twin design was used to examine the importance of different experiences of siblings within the family and to identify relations between twins' personality differences and their differential experiences. A sample of 161 monozygotic and 74 dizygotic twin individuals between the ages of 18 and 75 years retrospectively reported on their different experiences when growing up. The Sibling Inventory of Differential Experience (SIDE) was used for the first time with a sample of twin siblings. In addition, the twins provided self-report measures of affect and personality. In contrast to results from a sibling adoption design, this study of twins showed greater evidence for genetic variance in the SIDE scales. Nevertheless, the SIDE showed significant associations with differences in personality and affect for monozygotic twins, which reflect pure environment-behavior relations.     

Grading the ‘cultural literacy’ project

The essay examines the argument advanced by E.D. Hirsch, Jr., for instituting ‘cultural literacy’ as a fundamental priority of schools. A number of confusions and equivocations in Hirsch's reasoning are identified, and the propensity of his project to indoctrinate is exposed. Among the features of Hirsch's argument shown to be troubling are his shifting construal of ‘language’, his inconsistency about the requirements of cultural literacy, and his uncritical relation to traditional images of the American past and present. The upshot is to raise the question why Hirsch's project has elicited wide support and praise.     

Predicate-argument structure as a link between linguistic and nonlinguistic representations

We present a study wherein a severe Broca's aphasic patient was trained to learn symbols representing both pure transitive and dative predicates--predicates differing in argument structure--in a visually based artificial language (c-ViC). We found a decrease in performance when two symbols, rather than one, were used to depict these "verbs." However, this decrease in performance was more pronounced for symbols representing pure transitive verbs--those that allow only one argument structure--than for symbols representing dative verbs--those that allow two different argument structures. Also, dative "verbs" yielded better performance when they were inserted in more complex, three-argument "sentences" than when they were inserted in two-argument "sentences." The opposite pattern was found for pure transitives. These results are discussed in terms of our claim that argument structure serves as a point of connection between linguistic information and non-linguistic visual information and in terms of the possibility that argument structure entries are shaped by the form in which visual information is parsed.     

Referenzsemantik in der Partnermodellierung

How can we explain that an assertion on something perceived can be understood in the same manner by somebody who cannot perceive that scene? This problem bases the interest in computational linguistics in how listener modeling could possibly be harmonized with reference semantics. Mental images substituting real perception appear as a way out. The architecture of the listener model has to be adapted to the creation and use of such pictorial data structures. Furthermore, the relation between the latter and a verbal (i. e., propositional) representation must be understood. The resulting architecture of a listener model with reference semantics can be employed to solve communicational problems from three general classes in a better way, as is demonstrated by an example implementation.     

Determinants of Condom Use Among High-Risk Heterosexual Adults: A Test of the Theory of Reasoned Action1

The research presents tests of traditional and augmented versions of Fishbein and Ajzen's Theory of Reasoned Action (TRA), applied to condom use among adult clients of a sexually transmitted disease clinic. In a longitudinal survey, predictor variables suggested by Ajzen and Fishbein (1980), plus gender and condom use self-efficacy, were measured at Time 1. Condom use at Time 2, 3 months later, was regressed onto these variables. The traditional TRA worked well to predict condom use intentions and behavior. Support was also found for inclusion of gender and self-efficacy in the prediction of intention to use condoms, but not behavior. Implications for interventions to increase condom use among those at high risk for AIDS and other STDs are discussed.