Disintegrated experience: the dissociative disorders revisited

We present proposed changes to the dissociative disorders section of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders and review the concept of pathological and nonpathological dissociation, including empirical findings on the relations between trauma and dissociative phenomenology and between dissociation and hypnosis. The most important proposals include the creation of two new diagnostic entities, brief reactive dissociative disorder and transient dissociative disturbance, and the readoption of the criterion of amnesia for a multiple personality disorder diagnosis. We conclude that further work on dissociative processes will provide an important link between clinical and experimental approaches to human cognition, emotion, and personality.     

A simple BASIC program to generate values for variable-interval schedules of reinforcement

A BASIC program to generate values for variable-interval (VI) schedules of reinforcement is presented. A VI schedule should provide access to reinforcement with a constant probability over a time horizon. If the values in a VI schedule are calculated from an arithmetic progression, the probability of reinforcement is positively correlated with the time since the last reinforcer was delivered. Fleshler and Hoffman (1962) developed an iterative equation to calculate VI schedule values so that the probability of reinforcement remains constant. This easy-to-use program generates VI schedule values according to the Fleshler and Hoffman equation, randomizes the values, and saves the values in ASCII to a disk file.     

Adolescent Adjustment to Parental Divorce: An Investigation from the Perspective of Basic Dimensions of Structural Family Therapy Theory

This study, conducted within the framework of concepts of structural family therapy, examined the relationship of four family-based, clinical dimensions to the adjustment of 45 adolescents during the first 18 months of parental separation. There were two samples of mother-custody families: an Aided group that applied for treatment, and an Unaided group of paid volunteers. The inclusion of this variable addressed a major methodological deficit of previous studies. There was a significant association between perceived postseparation family structure and adolescent adjustment, demonstrating that individual adolescent adjustment is contingent on structural features of the contemporary postseparation family. Further, Aided families were perceived as more chaotic, disengaged, and enmeshed than Unaided families, while Aided adolescents were characterized by more behavior problems than Unaided adolescents. This suggests that divorce, as an unscheduled transition, might be within the realm of adaptation for many families and adolescents and is not necessarily "disastrous."     

Potential Perils of the Demonstration-Consultation Interview in Family Therapy: A Case Study of Contextual Confusion

This article focuses on a specific aspect of consultation in contemporary family therapy, namely, problems that arise in the context of a consultation that simultaneously serves as a demonstration of a particular model of therapy. The demonstration-consultation interview is used widely in family therapy, but has received little attention in the literature. We use a case example of the apparent persistent deterioration in the clinical state of a patient following such a family interview with a visiting expert, and examine the possible contribution to the patient's deterioration that the demonstration-consultation context creates for the various participants. We offer provisional guidelines to minimize the risk of negative effects of the demonstration-consultation interview, pending empirical research into this phenomenon.     

Anxiety induced by cardiac perceptions in patients with panic attacks: a field study

In panic disorder bodily sensations appear to play an important role as a trigger for anxiety. In our psychophysiological model of panic attacks we postulate the following vicious circle: individuals with panic attacks perceive even quite small increases in heart rate and interpret these changes as being catastrophic. This elicits anxiety and a further increase in heart rate. To evaluate this model we conducted a field study of 28 subjects with panic attacks and 20 healthy controls. A 24 hr ambulatory ECG was recorded and the subjects were instructed to report any cardiac perceptions during this period and to rate the anxiety elicited by these perceptions. The incidence of cardiac perceptions was about the same in both groups, but only subjects with panic attacks reported anxiety associated with such perceptions. Analysis of the ECGs revealed that in both groups heart rate accelerations preceded cardiac perceptions. Following cardiac perceptions, the healthy controls showed a heart rate deceleration, whereas the subjects with panic attacks had a further acceleration. This heart rate increase after cardiac perceptions was positively related to the level of anxiety elicited by the perceptions. These results provide clear evidence in support of the vicious circle model of panic attacks.     

Adolescent Smoking Behavior and the Recognition of Cigarette Advertisements1

In a study designed to assess the relationship between smoking status and correct identification of cigarette brands, junior high school students from two schools viewed cigarette and automobile advertisements with brand and model identification deleted. Results showed that adolescents with higher ad recognition scores were more likely to smoke cigarettes. In addition, a relationship was found between age and correct identification of cigarette advertisements, with older students identifying more ads correctly than younger students. No significant effects emerged for identification of automobile advertisements except for sex, with boys identifying more advertisements than girls. Additional findings indicated that even “experimental” smokers, who smoked as little as once per year, recognized significantly more cigarette advertisements than nonsmokers. These and other results are discussed in terms of their implications for prevention and policy issues. It is argued that society's allowance of printed cigarette advertising overlooks adolescents' heightened vulnerability to the kinds of appeals used in cigarette advertisements. Present policy also overlooks adolescents' relative unresponsiveness to the health risk information required in cigarette advertisements.     

Teaching cotherapy: Instructional and supervisory processes

A course on cotherapy for mental health practitioners is described. The authors strongly recommend that clinicians from all disciplines be taught and trained to do cotherapy, since it is a highly effective therapeutic modality in treating individuals, families and groups.