Psychodynamic Psychotherapy Process Research: A quick ride through what you should know about process (research)

This paper gives an overview of psychoanalytic process research, which brings to light the complexity of psychotherapy sessions. This complexity is so rich that many instruments intended to make the process measurable failed in the past because they initially used a strategy of complexity reduction. This method however did not help to further our understanding of the complexity involved. Three former presidents of the Society for Psychotherapy Research (Stiles, Hill, Elliot 2015) decided to solve the following equivalence paradox: many therapies work successfully though they all follow different theories, produce a heterogeneity of processes and often enough a misfit between what theories maintain to be a good process and their realization in the treatment room. As theories are often compared to maps, a driver would wonder which route to take. But therapists‐as‐drivers go undaunted ‐ and nevertheless achieve their goals together with their patients. Norcross and Wampold (2018) found that good therapists invent new therapies with every new patient. They hypothesize that it is because of conversation. This is in accord with the 3 former presidents’ proposal to return to detailed single case analyses including the micro‐analytic power of conversation analysis of which a few insights are outlined in this article.     

Normativity and Desirability in Observational Assessments of Family Interaction

Issues of normativity (responding in a typical or average fashion) and desirability (the tendency for raters to endorse positive characteristics rather than neutral or more negative ones) are common in areas of the social sciences that frequently utilize profile correlations to measure dyadic similarity. They have implications for family scholars as well. In the present study, a pre‐existing data set was used to make an initial, though limited, investigation into potential confounds of normativity and desirability for macrolevel observational assessments of family interaction. An empirical example is presented using q‐sort ratings of family interaction, with variance in observational assessments decomposed into component parts. High levels of both normativity and desirability were found, indicating possible problems in terms of both reliability and validity of assessment. While the results provide an interesting beginning, they are limited due to the use of a q‐sort methodology as well as an instrument with limited background and use. These limitations are discussed, as well as alternative interpretations for normativity and desirability and implications for future research.     

Neuroticism and Marital Satisfaction During the Early Years of Chinese Marriage: The Mediating Roles of Marital Attribution and Aggression

On the basis of three annual waves of data obtained from 268 Chinese couples, we tested an actor–partner interdependence mediation model in which spouses’ neuroticism was linked to their own and partners’ marital satisfaction through both intrapersonal processes (i.e., marital attribution) and interpersonal processes (i.e., marital aggression). Considering intra‐ and interpersonal processes simultaneously, four indirect, mediating pathways were identified: Time 1 Wives’ Neuroticism → Time 2 Wives’ Attribution or Aggression, while controlling for Time 1 Wives’ Attribution or Aggression → Time 3 Wives’ or Husbands’ Marital Satisfaction, while controlling for Time 1 Wives’ or Husbands’ Marital Satisfaction. This study not only adds to a limited body of research examining why neuroticism is associated with conjugal well‐being, but also extends prior research by focusing on Chinese couples and utilizing a longitudinal, dyadic mediation model. Such findings have important practical implications. Couples involving neurotic partners may benefit from interventions based on cognitive‐behavioral approaches. When working with couples challenged by neuroticism, practitioners need to help them address dysfunctional interactive patterns as well as distorted cognitive styles.     

Parental Perceptions of Individual and Dyadic Adjustment as Predictors of Observed Coparenting Cohesion: A Cross‐National Study

Over the past 20 years, systemically guided approaches to understanding early family processes have helped to provide greater clarity concerning the interplay among individual, dyadic, and family level processes. Parental depression, marital functioning, and child adjustment in particular appear to be reliable predictors of coparental and family level functioning. Indeed, cohesion at the level of the family group covaries in theoretically meaningful ways with these indicators of individual and dyadic adjustment. In this study, two collaborating research groups (one in Switzerland, the second in the United States) partnered to examine whether similar patterns of relationships exist among individual and marital adjustment and coparenting processes in families of 4‐year‐old children. Using similar constructs but disparate and occasionally dissimilar measures, both groups measured parent‐reported depression, marital satisfaction, and child behavior problems. Coparenting cooperation and warmth were observed during family interactions. Despite differences between samples and evaluation tools, similar results were found for the Swiss and U.S. samples. A model with depression, marital satisfaction, and child symptoms as predictors of a latent factor of observed coparenting cooperation and warmth showed good fit to data in both samples, suggesting the model was relevant for each. Parameter estimation showed that higher coparenting cooperation and warmth was predicted by lower maternal depression and higher child internalizing symptoms. The common significant effects despite differences in assessment paradigms and instrumentation are of substantive interest. Future directions pertinent to the coparenting questions addressed in this research are discussed.     

Treatment‐as‐Usual for Couples: Trajectories Before and After Beginning Couple Therapy

Couple therapy has been shown to be a meaningful way to improve couples’ relationships. However, less information is known about couples’ functioning prior to entering treatment in community settings, as well as how their relationship functioning changes from initiating therapy onward. This study examined 87 couples who began community‐based couple therapy during a longitudinal study of couples in the military. The couples were assessed six times over the course of 3 years, including time points before and after starting couple therapy. Using an interrupted‐time series design, we examined trajectories across the start of couple therapy in relationship satisfaction, divorce proneness, and negative communication. The results demonstrated that couples’ relationship satisfaction was declining and both divorce proneness and negative communication were increasing prior to entering couple therapy. After starting couple therapy, couples’ functioning on all three variables leveled off but did not show further change, but previous experience in relationship education moderated these effects. Specifically, those who were assigned to the relationship education program (vs. control) demonstrated greater reductions in divorce proneness and greater increases marital satisfaction after starting therapy; however, they also started more distressed.     

临床思维的逻辑性

临床思维是临床能力的核心和基础,是成为一名合格医生的前提条件。临床思维是按照逻辑规律反映疾病的思维方式。在临床思维活动过程中最重要的就是医学假说的提出、验证、推理和遵守逻辑思维的过程。逻辑思维能力对于医学工作者是至关重要的,作为医学工作者应该不断加强逻辑修养,不断提升我们临床思维水准。     

Human reasoning: Some possible effects of availability

This paper discusses some possible ways in which the availability heuristic (Tversky and Kahneman, 1973) may mediate subjects' responses to experimental ‘reasoning’ tasks. A brief review of some effects of availability in other areas is given and then the application of availability to reasoning data is considered with respect to problems employing both ‘thematic’ and ‘abstract’ content.In the case of thematic content, it is argued, with reference to a variety of studies, that to produce a differential effect (to abstract content), the content must provide available cues, resulting from the subjects' experience. Differential effects of content are thus interpreted as differential effects of availability. When abstract content is used, there are cues available from the experimental situation itself, and it is shown that several known error tendencies readily lend themselves to an explanation in terms of availability.In the final section, it is pointed out that a focus on available cues, rather than logical structure, provides a psychological, rather than logical, approach to human reasoning. It is argued that a bias may be psychologically, although not logically, optimal in that it may often produce correct responses in ‘real life’. Accordingly, the possible real life utility of availability is considered, and several ways in which the bias may lead to usually correct decisions are discussed. Given this, it is argued that availability is an effective heuristic and that observed biases on a range of experimental tasks may thus be interpreted as resulting from the application of a behavior that is optimal within the limits of human cognition. However, it is concluded that limitations in both deterministic and probabilistic problem solving may lead to a consistent, but erroneous, view of the world.     

Differential effectiveness of explicit verbal feedback on children's communication skills

In order to specify by which combination of content and form dimensions the explicit verbal feedback comes to be most effective in enhancing communication skills, a training experiment was designed where both dimensions were factorially manipulated. Forty children (mean age, 5–10) were randomly assigned to one of four treatment conditions: Interrogative Cognitive feedback, Declarative Cognitive feedback, Interrogative Perceptual feedback, and Declarative Perceptual feedback. The Cognitive type of feedback specified the successive cognitive steps underlying the comparison activity whereas the Perceptual type of feedback stressed only the necessity of describing perceptual differences when communicating. These two contents of feedback were either provided by a set of standardized questions or of declarative statements, after each trial of a speaking training task. Subjects were given a pretest, and immediate and delayed posttests comprised of a speaking task and a listening generalization task. A 2 (Contents) × 2 (Forms) × 2 (Tasks) × 2 (Post-tests) analysis of variance showed that all subjects performed significantly better on the speaking task than on the listening generalization task and that subjects in the Interrogative Cognitive condition performed better than subjects in the three other conditions, on both post-test tasks. Results emphasize the mutual facilitating effects of the Interrogative Form and the Cognitive Content of explicit feedback and are discussed in terms of the generalization and stability of the induced learning.