Integrating Cognitive and Existential Treatment Strategies in Psychotherapy With Dependent Patients

A dependent personality orientation is associated with increased risk for a broad array of Axis I and Axis II disorders. Although traditional treatment interventions have modest ameliorative effects on problematic dependency, the multifaceted nature of dependency suggests that integrated treatment strategies may hold more promise than traditional treatment approaches. This article outlines one potentially useful integrated treatment strategy, combining elements of cognitive and existential therapy to alter dependency-related thought, behavior, and emotional responding. Procedures for implementing an integrated cognitive-existential treatment model are outlined, and challenges in use of the model are discussed.     

Assessment of parental sensitivity towards pre-school children born with very low birth weight

The article introduces the Parental Sensitivity Assessment Scale (PSAS) and examines the influence of the PSAS score and other factors on the general cognitive level in pre-school children born with very low birth weight (VLBW). McCarthy general cognitive index (GCI) was obtained for 102 VLBW and 92 normal birth weight (NBW) control children in Denmark in the mid-1980s. The mean ages of the two groups were 52.4 vs. 53.1 months. Parental sensitivity was assessed using PSAS. There was no significant difference in the mean PSAS score between the two birth weight groups (p > 0.3). Birth weight group (p < 0.001) and mother's schooling (p= 0.026) significantly correlated with GCI in the children. The PSAS score was highly significantly correlated to the variance of the GCI (p < 0.001), which was not explained by VLBW and mother's schooling. We found no interactional effect between parental sensitivity and birth weight group (p > 0.5) - the prematurely born children were not more affected by low parental sensitivity than were the control children.     

Naming our concerns about neuroscience: a review of Bennett and Hacker's philosophical foundations of neuroscience

Bennett and Hacker use conceptual analysis to appraise the theoretical language of modern cognitive neuroscientists, and conclude that neuroscientific theory is largely dualistic despite the fact that neuroscientists equate mind with the operations of the brain. The central error of cognitive neuroscientists is to commit the mereological fallacy, the tendency to ascribe to the brain psychological concepts that only make sense when ascribed to whole animals. The authors review how the mereological fallacy is committed in theories of memory, perception, thinking, imagery, belief, consciousness, and other psychological processes studied by neuroscientists, and the consequences that fallacious reasoning have for our understanding of how the brain participates in cognition and behavior. Several behavior-analytic concepts may themselves be nonsense based on thorough conceptual analyses in which the criteria for sense and nonsense are found in the ways the concepts are used in ordinary language. Nevertheless, the authors' nondualistic approach and their consistent focus on behavioral criteria for the application of psychological concepts make Philosophical Foundations of Neuroscience an important contribution to cognitive neuroscience.     

Vulnerability schemas of individuals in couples relationships: a cognitive perspective

The professional literature has recently given attention to addressing individual schemas in couples relationships, with particular emphasis on the fact that individual vulnerability has a significant impact on couples relationships. This article addresses how this vulnerability can be restructured during the course of couples therapy. Case vignettes are used to illustrate how the model can be applied. Some of the implications of this model are considered in the discussion section.Authors note: Portions of this article were published in Norwegian by the first author and appear in Nordby, T.T. (2002): Kognitiv parterapi. En tilnærming som ivaretar betydningen av den individuelle sårbarheten i samspillet. Reprinted by permission of Fokus på familien 30, 46–60.     

Free Will and Therapeutic Change

Much of psychology has minimized, or disregarded, the notion of free will. However, it remains a critical construct in most theories of behavioral and religious change. This paper briefly examines the free will/determinism debate and the construct of free will from the perspective of postmodern/narrative psychology, as well as integrating recent developments in the field of cognitive neuroscience. Finally, the implications of this analysis on personal responsibility in pastoral psychology are discussed.     

Cultural Values Underlying Psychometric Cognitive Testing

It is proposed that culture (values, beliefs, styles of behavior) can affect neuropsychological testing.Cognitive testing represents a social situation that-as any social situation, it is one governed by implicit cultural rules. At least eight different culture-dependent values underlie cognitive testing: (1)One-to-one relationship, (2) Background authority, (3) Best performance, (4)Isolated environment (5) Special type of communication, (6) Speed, (7) Internal or subjective issues, and (8) The use of specific testing elements and strategies. In addition, it is proposed that“the distance” (e.g., gender, age, ethnicity) between the examiner and the examinee may potentiallyimpact the testing situation. A special analysis regarding the function of instruction in cognitive tests is also presented emphasizing that test instruction interpretation is also culture-dependent. Some potential avenues of research are finally proposed.     

The Relation Between Sluggish Cognitive Tempo and DSM-IV ADHD

To test the relation between sluggish cognitive tempo (SCT) and DSM-IV ADHD symptoms, parent and teacher ratings of the 18 DSM-IV ADHD items and five potential SCT items were obtained in a community sample of 8-18 year-old twins that was overselected for ADHD and learning disabilities (n = 296). Confirmatory factor analyses revealed that a three-factor model provided the best fit to the data for both parent and teacher ratings. DSM-IV inattention and hyperactivity-impulsivity symptoms loaded on two factors consistent with the DSM-IV model, and five SCT symptoms loaded primarily on a third factor. The SCT and inattention factors were highly correlated, whereas SCT and hyperactivity-impulsivity were weakly related. Both raters indicated that children meeting symptom criteria for the combined and inattentive subtypes exhibited significantly more SCT symptoms than those meeting symptom criteria for hyperactive-impulsive type and the comparison group without ADHD. Children meeting symptom criteria for the inattentive type exhibited significantly more SCT symptoms than those meeting criteria for the combined type, based on teacher ratings. These results suggest that SCT is an internally consistent construct that is significantly associated with DSM-IV inattention.     

Interpretation and judgmental biases in social phobia

Previous research demonstrated that social phobia is characterized by content-specific interpretation and judgmental biases. The present study investigated whether this interpretation bias occurs not only in ambiguous, but also in positive and negative social events, and whether social phobic patients (SPs) are more characterized by a judgmental bias in costs than in probability. Besides, we argued that the judgmental bias observed in former studies could also be attributed to accurate estimations of SPs (of, for example, stuttering). Therefore, we assessed judgmental bias by the ratings of probability and costs of a negative evaluation (e.g. ‘people dislike me’) and not, as in previous studies, of negative social events (e.g. ‘stuttering’). SPs (n=228) and normal controls (n=33) were presented social and non-social events ranging from positive to profoundly negative. They ranked four different interpretations on likelihood to assess interpretation bias, and rated the profoundly negative interpretation on probability and cost to assess judgmental bias. SPs demonstrated content-specific interpretation and judgmental biases that also occurred in positive and negative social events. In contrast with expectations, SPs were characterized by a judgmental bias in both costs and probability.     

In Search of a Conceptualization of Multiple Sclerosis: A Historical Perspective

A thorough understanding of Multiple Sclerosis (MS) is necessary to offer individuals informed options for treatment and planning. To assist in this quest, the following historical analysis examined how MS has been conceived from the 14th century through the early 20th century. Primary sources were consulted whenever possible, and many of the original archival materials were accessed by the first author (MB) during an on-site visit to the Rare Book Room of the New York Academy of Medicine. There is a striking similarity between how MS symptoms have presented throughout history compared with the 21st century. Sensorimotor and cognitive sequelae have been observed in patients since the 1800s. Cognitive symptoms were acknowledged in the 1800s, but disregarded in the early 1900s and were not given recognition again until the latter part of the 20th century. If conceptualizations of MS are inaccurate, patients will not be served well. In contrast to the shared symptomatology across time, early conceptualizations of etiology and treatment choices differed dramatically from today, a genuine reflection of the times in which they were created.     

What Front-Line CBO Staff Can Tell Us About Culturally Anchored Theories of Behavior Change in HIV Prevention for Asian/Pacific Islanders

Few rigorously tested primary prevention programs have been developed to prevent HIV infection among immigrant communities in the United States. This is in part because of the lack of culturally specific behavioral theories that can inform HIV prevention for immigrant communities in the United States. This article aims to develop such theories for a population—Asian/Pacific Islanders (A/PIs) immigrant communities—who have been overlooked in theory development and program evaluation. Frontline community-based organization (CBO) peer educators, an underutilized source of expertise regarding cultural factors specific to HIV infection among A/PI communities, are the sample of study Asian/Pacific Islander peer educators working at an urban AIDS service organization devoted to health promotion for this population; (N=35). They were interviewed to examine (1) detailed narratives describing instances of behavior change and (2) culturally anchored theories of behavior change which the narratives imply. Theories of the influence of positive cultural symbols on the taboo of HIV/AIDS, moderators of the effectiveness of social network influences on behavior change, and setting- and community-level processes predicting HIV risk behavior were implicit in the peer educators' narratives. Implications for future research, methodology and prevention practice are discussed.