Where Is Group Treatment Going in the 21st Century?

The author contends that group psychotherapy can be a dynamic force for social change. He shows how group psychotherapists have developed tools that reach far beyond the limits of that particular profession; they deal with the basic interaction among all peoples everywhere in all societies. These tools can be demonstrated, taught, and experienced. In as much as they can be learned, group therapists have to start teaching them to people at the earliest levels of cognitive development. That means that it has to start in our school systems as part of the educational process. A particular kind of specialist has to be trained who can function within the system itself and yet think psychodynamically. The author maintains that this can be accomplished.     

The Clinical Challenges of Assimilative Integration

S. B. Messer (1992) introduced the notion of assimilative integration in psychotherapy, theorizing that integrative practitioners adhere to their preferred theoretical paradigms while judiciously blending aspects from other models. His assimilative approach offers a conceptual and clinical middle ground between technical eclecticism and a grand, unified theory of psychotherapy. However, the practice of competent assimilative integration is fraught with many challenges, both theoretical and clinical. The goal of the present paper is to explore the challenges of implementing assimilative integration. First, the theoretical and clinical barriers to assimilative approaches are considered. Second, the use of assimilative integration to avoid therapeutic failures is discussed. Finally, a case example is presented to illustrate the author's attempt to assimilate narrative, interpretive interventions within his preferred cognitive–behavioral treatment paradigm.     

Resistance to change and the law of effect

Three experiments using multiple schedules of reinforcement explored the implications of resistance-to-change findings for the response-reinforcer relation described by the law of effect, using both steady-state responding and responding recorded in the first few sessions of conditions. In Experiment 1, when response-independent reinforcement was increased during a third component, response rate in Components 1 and 2 decreased. This response-rate reduction was proportionately greater in a component in which reinforcer magnitude was small (2-s access to wheat) than in the component in which it was large (6-s access to wheat). However, when reinforcer rates in the two components were varied together in Experiments 2 and 3, response-rate change was the same regardless of the magnitude of reinforcers used in the two components, so that sensitivity of response rates to reinforcer rates (Experiment 2) and of response-rate ratios to reinforcer-rate ratios (Experiment 3) was unaffected by the magnitude of the reinforcers. Therefore, the principles determining resistance to change, described by behavioral momentum theory, seem not to apply when the source of behavior change is the variation of reinforcement contingencies that maintain the behavior. The use of extinction as a manipulation to study resistance to change is questioned.     

A one-way random effects model for trimmed means

The random effects ANOVA model plays an important role in many psychological studies, but the usual model suffers from at least two serious problems. The first is that even under normality, violating the assumption of equal variances can have serious consequences in terms of Type I errors or significance levels, and it can affect power as well. The second and perhaps more serious concern is that even slight departures from normality can result in a substantial loss of power when testing hypotheses. Jeyaratnam and Othman (1985) proposed a method for handling unequal variances, under the assumption of normality, but no results were given on how their procedure performs when distributions are nonnormal. A secondary goal in this paper is to address this issue via simulations. As will be seen, problems arise with both Type I errors and power. Another secondary goal is to provide new simulation results on the Rust-Fligner modification of the Kruskal-Wallis test. The primary goal is to propose a generalization of the usual random effects model based on trimmed means. The resulting test of no differences among J randomly sampled groups has certain advantages in terms of Type I errors, and it can yield substantial gains in power when distributions have heavy tails and outliers. This last feature is very important in applied work because recent investigations indicate that heavy-tailed distributions are common. Included is a suggestion for a heteroscedastic Winsorized analog of the usual intraclass correlation coefficient.     

步入涅槃还是走向终结?——对当代医学困境的原点审视和深层反思

当代医学在享受基因时代“圣餐”的同时,也在步入一个危机频发的“问题时代”。从原点审视,造成其危机和困境的“本因”,是其核心价值系统及其动力体系的根本缺陷所致,其基本的生命观、疾病观陷入到诸多哲学困惑和认识误区,其治疗观的“对抗性思维”更是有违自然伦理的法度,这是当代医学走向更高理论平台的战略切入点。     

Negotiating Muslim–Christian Relations in Kenya through Waqfs, 1900–2010

Waqfs provided socio-economic security for the progeny of endowers and for other social welfare causes. Being thus guaranteed socio-economic well-being, these beneficiaries were antithetical to ruling elites in Muslim dynasties and Christian colonial powers, which led to the establishment of policies and institutions to control waqfs and check their growing influence. This development was not only counter to normative precepts but also set minority Muslims in predominantly Christian societies at odds with non-Muslim states. To what extent did civil policies and judgements influence waqfs? How did Muslims negotiate the secular state constructs vis-à-vis waqf practices? How did secular state control of waqfs influence the dynamics of Christian–Muslim relations? This discussion, based on ethnographic research in Kenyan coastal areas, employs two theoretical frameworks – Asad's ‘Islam as a discursive tradition’ and Scott’s concept of ‘symbolic (ideological) resistance’. The article draws mainly on the perspective of the Muslim minority in Kenya and argues that state control of waqfs in Kenya did not only interfere with normative practices but also partly laid the ground for the present-day economic and political marginalization and exclusion of Muslims, leading to suspicion and ambiguous relations with their Christian compatriots.     

Resisting the Devil: The Case of Edward Dynham (1626) and Options for English Protestant Dispossession

To the displeasure of many puritans, the Church of England canons of 1604 restricted the casting out of Devils to prayer and fasting. Yet after that date not all possession cases disappeared, nor were all dismissed as false. This article explores ways that long-standing general Protestant as well as puritan theology and practices (especially related to ‘resisting the Devil’) informed post-1604 anti-demonic activity. With a clear biblical basis, and primarily as an individual rather than collective practice, resisting the Devil was embraced by people from a wide range of religious positions and remained unrestricted by the religious establishment. There was variation; not everyone approved of how resisting the Devil was applied in particular cases. Yet ample evidence suggests that dispossessions led by lay people, and by means other than prayer and fasting, did in fact have a place within (and influenced the development of) Protestantism in early-modern England.     

Response persistence: the effects of stimulus control on negatively reinforced problem behavior in a concurrent operant

In the context of instructional demands, compliance and problem behavior can be considered concurrent operants. Of applied interest is increasing one response (i.e., compliance) while decreasing the other (i.e., problem behavior). Strategic arrangement of reinforcement can alter response allocation accordingly. Such schedules can also influence response persistence and generalization. A case study is used to illustrate the effects of stimulus-reinforcer relations in a concurrent-operants arrangement involving an adult with developmental disabilities and problem behavior. Results are discussed in the context of basic operant research findings in the areas of stimulus control and behavioral persistence.     

慢性乙肝治疗路线图和HBV DNA、HBeAg、HBsAg定量的监测意义

慢性乙型肝炎病毒感染呈世界分布并且引起不良结局,是极为严重的健康问题。慢性乙型肝炎治疗最重要的目标是长期抑制病毒以改善预后,防止出现肝硬化、肝衰竭和肝癌。目前,抗病毒药物主要有干扰素和口服核苷（酸）类似物,核苷（酸）类似物的缺点主要在于长期治疗中出现耐药。路线图概念被用于监测耐药预测疗效。HBV DNA定量水平被作为路线图较好的监测指标。由于血清转换率及清除率过低,HBeAg、HBsAg定量检测不适合用于路线图监测,但对于使用聚乙二醇干扰素的慢性乙肝患者,可作为预测治疗应答的指标。     

内质网应激和胰岛素抵抗

2型糖尿病的发病机制主要涉及胰岛素抵抗,近年来研究表明内质网应激可诱导胰岛素抵抗的形成,并使与改善胰岛素受体敏感性相关的内质网应激标志物分子氧调节蛋白150和转录因子X盒结合蛋白-1表达增强,表明内质网应激对细胞具有双重作用,一方面可诱导胰岛素抵抗,另一方面激发对应激的适应反应。