Psychoanalytic patients in the U.S., CANADA,and Australia: I. DSM-III-R disorders,indications, previous treatment,medications, and length of treatment

To determine the demographics, DSM-III-R disorders diagnosed, indications used in recommending psychoanalysis, previous treatment histories, use of medication, and length of treatment in patients in psychoanalysis in the U.S., Canada, and Australia, a mail survey of practice was sent to every other active member of the American Psychoanalytic Association and every member of the Australian Psychoanalytical Society. This supplemented an earlier survey sent to all Ontario psychoanalysts. The response rates were 40.1 % (n = 342) for the U.S., 67.2% (n = 117) for Canada, and 73.9% (n = 51) for Australia. Respondents supplied data on 1,718 patients. The employment rate for patients increases as analysis progresses (p < .0001). The mean number of concurrent categories of disorders (Axis I, Axis II, and Disorders First Evident in Childhood) per patient at the start of treatment is 5.01 (SD = 3.66; median = 4; mode = 3). There are no statistically significant differences across countries. Mood, anxiety, sexual dysfunction, and personality disorders are most common. American Psychiatric Association / American Psychoanalytic Association peer review criteria for indicating psychoanalysis are followed for 86.5% of patients. Over 80% of patients in all three countries had undergone previous treatments prior to analysis. In the U.S., 18.2% of analysands are on concurrent psychoactive medication; in Australia, 9.6%. The mean length of analyses conducted in the U.S. is 5.7 years, in Australia 6.6, and in Canada 4.8. Psychoanalytic patients in all three countries have similar rates of DSM-III-R psychopathology, and many indications of chronicity.     

Psychological characteristics of aggressive drivers with and without intermittent explosive disorder

We compared two groups of aggressive drivers, those who met criteria for Intermittent Explosive Disorder (IED) (n=10) and comparable aggressive drivers who did not meet IED criteria (n=20), to a group of non-aggressive driving controls (n=20) on measures of psychological distress, anger, hostility, and Type A behavior as well as measures of aggressive driving and driving anger and their driving records. There were few differences between the aggressive drivers with IED and those without IED. The IED positive aggressive drivers endorsed more assaultiveness and resentment as well as more impatience and showed trends to have more hostility and angry temperament. When all aggressive drivers were compared to controls, differences emerged on anxiety, hostility, and anger as well as on measure specific to aggressive driving (competitiveness) and driving anger (at slow drivers and traffic obstructions).     

Thought-shape fusion in anorexia nervosa: an experimental investigation

Cognitive biases and cognitive distortions have been implicated as important factors in the development and maintenance of many disorders. The concept of thought-shape fusion (TSF) in eating disorders was developed by Shafran, Teachman, Kerry, and Rachman (British Journal of Clinical Psychology 38 (1999) 167) as a variant of thought-action fusion, described by Shafran, Thordarson and Rachman (Journal of Anxiety Disorders 10 (1996) 379). TSF occurs when thinking about eating certain types of food increases a person's estimate of their shape and/or weight, elicits a perception of moral wrongdoing, and/or makes the person feel fat. Shafran et al. (1999) examined both the psychometric and experimental properties of TSF in an undergraduate sample. This paper reports an extension of this work to a clinical group (N=20) of patients with anorexia nervosa. After completing a set of relevant questionnaires, participants were asked to think about a food which they considered extremely fattening. They were then asked to write out the sentence, "I am eating--.", inserting the name of the fattening food in the blank. After being asked to rate their anxiety, guilt, feelings about their weight, morality, etc., participants were given the opportunity to neutralize their statement in any way they chose. The majority of the participants neutralized in ways consistent with the findings of Shafran et al. (1999). The results are discussed in terms of cognitive-behavioural formulations of eating disorders, and of the influence of cognitive biases and cognitive distortions on the processing of information relevant to food, weight and shape in anorexia nervosa.     

Affirmation of personal values buffers neuroendocrine and psychological stress responses

Stress is implicated in the development and progression of a broad array of mental and physical health disorders. Theory and research on the self suggest that self-affirming activities may buffer these adverse effects. This study experimentally investigated whether affirmations of personal values attenuate physiological and psychological stress responses. Eighty-five participants completed either a value-affirmation task or a control task prior to participating in a laboratory stress challenge. Participants who affirmed their values had significantly lower cortisol responses to stress, compared with control participants. Dispositional self-resources (e.g., trait self-esteem and optimism) moderated the relation between value affirmation and psychological stress responses, such that participants who had high self-resources and had affirmed personal values reported the least stress. These findings suggest that reflecting on personal values can keep neuroendocrine and psychological responses to stress at low levels. Implications for research on the self, stress processes, health, and interventions are discussed.     

Expectancies for Sexually Abused Children: Evidence of Perceiver Bias

We investigated perceiver bias in relation to children labeled as sexually abused. Building on recent research indicating that adults perceive children with such a label as having more behavioral problems and lower achievement, we replicated and expanded upon an earlier study. We tested undergraduate students (N = 699), who judged a six-year old child's aggressive behavior in vignettes that varied on severity of the aggressive behavior, child gender, and family history (sexually abused, mother dying of cancer, normal). Perceiver bias was related to family history label for internalizing behavior problems and competence issues and child gender for internalizing behavior problems and externalizing behavior problems. Implications for educators and practitioners are discussed as well as routes for future research.     

Dimensions of impulsivity and aggression associated with suicide attempts among bipolar patients: a preliminary study

Impulsivity and hostility are often thought to be interrelated among depressed patients with suicidal behavior, but few studies have examined this relationship empirically. In this study, we assessed trait impulsivity and hostility among 52 DSM-IV bipolar subjects with and without histories of suicide attempts. Impulsivity and hostility were correlated among attempters (r = .41, p = .03) but not non-attempters (r = .22, p = .28). As compared to non-attempters, attempters had significantly higher levels of overall hostility, more extensive subcomponents of hostility, and a trend toward higher overall impulsivity. Associations between lifetime suicide attempts and overall hostility were significant while controlling for current depression severity and lifetime illness duration. Aggression and impulsivity appear linked among bipolar patients with lifetime suicide attempts but may be independent constructs among non-attempters. The presence of both factors may elevate risk for suicidal behavior.     

A meta-analytic review of gender variations in children's language use: talkativeness, affiliative speech, and assertive speech

Three sets of meta-analyses examined gender effects on children's language use. Each set of analyses considered an aspect of speech that is considered to be gender typed: talkativeness, affiliative speech, and assertive speech. Statistically significant average effect sizes were obtained with all three language constructs. On average, girls were slightly more talkative and used more affiliative speech than did boys, whereas boys used more assertive speech than did girls. However, the average effect sizes were either negligible (talkativeness, d=0.11; assertive speech, d=0.11) or small (affiliative speech, d=0.26). Larger effect sizes were indicated for some language constructs depending on either the operational definition of the language measure, the method of recording, the child's age level, the interaction partner (adult or peer), group size, gender composition, observational setting, or type of activity. The results are interpreted in relation to social-developmental and social-constructionist approaches to gender; these views are presented as complementary--rather than competing--meta-theoretical viewpoints.     

Smoking withdrawal dynamics: II. Improved tests of withdrawal-relapse relations

In this article, the authors assessed whether continuously scaled symptom parameters derived from growth models (T. M. Piasecki et al., 2003) are linked to smoking at long-term follow-up by using data from a large-scale clinical trial (N = 893). Results revealed that higher withdrawal intercepts, positive linear slopes, and greater volatility were all positively associated with relapse, and cigarette coefficients (indicating smoking-induced withdrawal reduction) were negatively related to relapse. In models keyed around the first lapse to smoking, those destined to lapse reported more severe withdrawal during abstinence, and withdrawal patterns discriminated groups defined according to lapse duration. The findings complement earlier heterogeneity studies in implicating the pattern of changing withdrawal symptoms over time as a factor strongly associated with smoking relapse.     

Thought suppression in spider-fearful and nonfearful individuals

The authors examined the suppression of spider-related thoughts in spider-fearful (n = 23) and nonfearful (n = 22) individuals. Participants were primed with vivid pictures of spiders and a story about spiders. Next, they were randomly assigned to 1 of 2 conditions: (a) suppression of thoughts associated with the previously presented spider-related stimuli or (b) free expression of any thoughts, including those related to the spider-related stimuli. All participants completed a subsequent free-expression exercise. Results indicated that spider-fearful individuals expressed thoughts about the spider-related stimuli for a longer length of time than did nonfearful individuals, particularly in the suppression condition. Participants in both groups demonstrated a rebound of thoughts associated with the spider-related stimuli following suppression. The authors propose that the priming of feared stimuli makes suppression of fear-related thoughts particularly difficult for fearful individuals, perhaps by activating a state of heightened arousal.     

Variation in black anti-white bias and target distancing cues: factors that influence perceptions of "ambiguously racist" behavior

Experiment 1 indicated that when the White supervisor's negative treatment of a Black subordinate was unconstrained, participant race had no impact on attributions. Conversely, when the treatment was constrained, Black participants reported greater racist attributions than did White participants. Experiment 2 indicated that when the supervisor reported no response or a minimal negative response (i.e., indicating that he did not support his actions) after his negative treatment of the Black subordinate, Black participants reported greater racist attributions than did White participants. Conversely, when the supervisor's negative treatment was followed by a more extreme negative response, participant race had no impact on attributions. Experiment 3 indicated that Black participants were less likely than White participants to perceive a minimal negative response as reflecting a White supervisor's lack of support for his negative actions. Conversely, participant race had no impact on attributions of a Black supervisor's negative actions.