Treating a Chronically Depressed Adolescent Female Using the Cognitive Behavioral Analysis System of Psychotherapy: A Case Study

A case is presented of an adolescent female with double depression who was treated using the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). CBASP is designed to teach a social problem-solving procedure called Situational Analysis (SA). Generalized treatment effects were measured through monitoring of diagnostic status, two administrations of the Minnesota Multiphasic Personality Inventory-Adolescent, weekly administrations of the Child Depression Inventory, and acquisition performance ratings on the SA task. The results showed that CBASP appeared to be an effective treatment. The double depressive disorder remitted, and the patient learned to identify behavioral consequences as well as target and attain her interpersonal goals. CBASP can be effective for adolescents, although modifications of the adult form of the therapy may be necessary.     

The Late Life Reconstruction of Selfhood Analyzed in Peter Hall's Film She's Been Away

The film She's Been Away tells the story of an old woman who had been locked in a mental asylum while a teenager, for willfully violating repressive sexual codes. Sixty years later her ward is closed and she moves in with her nephew and his wife. Faced with what appears to be a hopeless situation, she manages to forge a sense of a meaningful closure to a misspent life. Through narrative, story structure, and characterization the film throws into focus coping mechanisms and ego strategies deployed by a triple disadvantaged person (woman, old, and mad) in her ascent to a reconstructed selfhood. As the protagonist ties both ends of her life, and faces the abyss in between she makes genuine adaptive use of so-called regressive, late-life development assets (available to a lesser degree to elderly people in normal life circumstances), primarily the abolition of linear time. Through this abolition she makes reminiscing an actual reality while still maintaining a functional separation between the real and the remembered. Her portrayal is a valuable document for gerontologists as it explores, through artistic imagination and intuition, the workings of an aging mind in search for a meaningful sense of closure.     

Psychopathy in Children and Adolescents: The Need for a Developmental Perspective

The current paper introduces the special issue on research attempting to extend the construct of psychopathy to child and adolescent samples. Past special sections and reviews have typically focused on the implications of this research for forensic research and practice. The current special issue focuses on topics relevant for integrating this research within the broader literature on childhood psychopathology. Papers included in this special issue focus on the structure of psychopathic traits in youth, the relation of these traits to other important psychopathological and personality constructs in children and adolescents, and the utility of these traits for identifying a distinct subgroup of antisocial youth who differ on important cognitive processes and on the severity and stability of their problem behavior. These empirical works are followed by commentary provided by two prominent scholars who outline the potential importance of the construct for advancing our understanding of childhood psychopathology. In addition, these scholars provide a discussion of important directions for future research.     

Doctor's Expertise and Managing Discrepant Information from Other Sources in Genetic Counseling: A Conversation Analytic Perspective

The study examines a recurrent interactional pattern in genetic counseling. It describes clinical geneticists' responses in situations in which clients have presented information from other sources that is potentially discrepant with information given by the doctor. The data consists of 12 video-recorded sessions of genetic counseling in Finland, and the method is conversation analysis. There are two primary ways the doctors respond: either they accept the client's information as such, but show that it is not discrepant with the doctor's information, or they reject the client's information. In the latter case they mitigate the ‘wrongness’ of the client's information. The clinical geneticists seem to be working with a dilemma: they need to find a balance between ensuring correct understanding of the information and showing respect for the expertise of others. A particularly complex case is also analyzed and reflected on.     

Care of the Self and Patient Participation in Genetic Discourse: A Foucauldian Reading of the Surgeon General's “My Family Health Portrait” Program

Critics of genetic discourse are concerned that deterministic and discriminatory views of genetics are increasingly becoming adopted. These views argue that current genetic discourse becomes a source of power whereby powerful institutions harm people with so-called “bad” genes. This essay argues that current analyses of the power of genetics discourse are grounded in an improper reading that disempowers patients. Deploying Michel Foucault's concept “care of the self,” this essay claims that genetics discourse is better understood as a way that patients take on power through rhetoric rather than a force that has power over patients. Through a close reading of the “My Family Health Portrait” program, this paper argues that patients experience a process of “subjection” wherein they become agents of and objects of genetics discourse both. This alternative mode of analyzing the power of genetics discourse has implications for our collective understanding of the operations of the care of the self and the uses of genetic information that we propose.     

Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.     

“Hands up Who Wants to Die?”: Primoratz on Responsibility and Civilian Immunity in Wartime

The question of the morality of war is something of an embarrassment to liberal political thinkers. A philosophical tradition which aspires to found its preferred institutions in respect for individual autonomy, contract, and voluntary association, is naturally confronted by a phenomenon that is almost exclusively explained and justified in the language of States, force and territory. But the apparent difficulties involved in providing a convincing account of nature and ethics of war in terms of relations between individuals has not prevented liberal theorists from attempting this task. This paper examines a recent attempt by Igor Primoratz to sketch out the implications of a consistent liberalism for just war doctrine and, in particular, as regards the question of who may be a legitimate target of attack in wartime. Primoratz’s paper itself is a critique of Michael Waltzer’s authoritative exposition of just war theory for failing to be sufficiently and consistently liberal. The debate between these two authors is a productive site for investigating the potential and limitations of liberal theories of just war.     

2003年诺贝尔医学奖给科学界的多重启示(上)

2003年诺贝尔医学奖授予了两位美英物理学家,劳特布尔和曼斯菲尔德,表彰他们在磁共振成像方面的发现.这些发现导致现代磁共振技术的开发,这一技术标志着医学诊断学和科学研究中的一项突破.该项发现建筑在核磁和核磁共振现象被发现的基础之上.核磁现象的发现及其应用导致了1943、1944和1952年诺贝尔物理学奖的获得.核磁共振现象的发现及其应用导致了1991年和2002年诺贝尔化学奖的获得.这意味着,2003年诺贝尔医学奖是该系列发现中第六个诺贝尔科学奖.     

The effects of noise and gender on children's episodic and semantic memory

The main objectives in the present study were to examine meaningful irrelevant speech and road traffic noise effects on episodic and semantic memory, and to evaluate whether gender differences in memory performance interact with noise. A total of 96 subjects, aged 13-14 years (n = 16 boys and 16 girls in each of three groups), were randomly assigned to a silent or two noise conditions. Noise effects found were restricted to impairments from meaningful irrelevant speech on recognition and cued recall of a text in episodic memory and of word comprehension in semantic memory. The obtained noise effect suggests that the meaning of the speech were processed semantically by the pupils, which reduced their ability to comprehend a text that also involved processing of meaning. Meaningful irrelevant speech was also assumed to cause a poorer access to the knowledge base in semantic memory. Girls outperformed boys in episodic and semantic memory materials, but these differences did not interact with noise.