Testing the ability of children with attention deficit hyperactivity disorder to accurately report the effects of medication on their behavior

Children with attention deficit hyperactivity disorder (ADHD) are often treated with central nervous system stimulants, making the evaluation of medication effects an important topic for applied behavior analysts. Because assessment protocols emphasize informant reports and direct observations of child behavior, little is known about the extent to which children themselves can accurately report medication effects. Double-blind placebo-controlled procedures were used to examine whether 6 children with ADHD could recognize the effects of their medication. The children were given math worksheets to complete for 15 min during each of 14 sessions while on medication and placebo. Children completed a self-evaluation form at the end of each session, and ratings were compared to observed behavior and academic performance. Results indicated that 3 children were able to accurately report their medication status at levels greater than chance, whereas the accuracy of reports by all children was related to dosage level, differences in behavior, and the presence of adverse effects. The implications of these results for placebo-controlled research, self-monitoring of dosage levels, and accuracy training are discussed.     

Therapeutic Implications of a Social Interaction Model of Posttraumatic Stress

Out of the many aspects of posttraumatic adaptation the role of self-process is emphasized, where self is conceptualized as the representation of social interaction: Not only the messages conveyed by others, but also a person's inner response to that messages, forms ongoing self-processes. Traumatic experiences lead to distorted self-processes, to a great extent due to posttraumatic inner dialogues. Therapeutic implications and experiences from Bosnia are discussed, where this model has been applied.     

Reverie: between thought and prayer

Abstract:  Taking inspiration from a quotation by Lao Tzu, this paper considers 'reverie' as a dynamic process of containment as well as a state of mind. Reverie as a quality of thought akin to prayer is explored in the relationship between self and other. In infant observation, the paper contemplates the development of a baby's capacity to reach beyond the personal world to an archetypal experience of being held, where the creation of an internal space in mind could indicate the beginnings of spiritual awareness. 'Maternal/analytic reverie' views the passage of unconscious communication between patient and analyst as the result of a 'window' opening in the meniscus of the analyst's self. 'Paternal/supervisory reverie' reflects on the impact on a patient of an extra containing mind of a supervisor. 'Archetypal reverie' considers the transforming impact of numinous dreams on the psyche, and reflects on the power of prayer. Drawing on clinical examples from these four areas, the aim is to demonstrate the usefulness of the 'void within' and the perceptive function of emptiness in the 'doors and windows' of our mind.     

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.     

Motivating operations and terms to describe them: some further refinements

Over the past decade, behavior analysts have increasingly used the term establishing operation (EO) to refer to environmental events that influence the behavioral effects of operant consequences. Nonetheless, some elements of current terminology regarding EOs may interfere with applied behavior analysts' efforts to predict, control, describe, and understand behavior. The present paper (a) describes how the current conceptualization of the EO is in need of revision, (b) suggests alternative terms, including the generic term motivating operation (MO), and (c) provides examples of MOs and their behavioral effects using articles from the applied behavior analysis literature.     

Self Psychology, Dreams and Group Psychotherapy: Working in the Playspace

This paper presents one leadership style within a self-psychological approach to working with dreams in group psychotherapy. It stresses an empathic attunement, the creation of safety, and an experience-near playful relationship. Playful is not used lightly here. It is used in the spirit of Winnicott's intermediate space where a mother suspends questions of what is real or not real and what is me and not me. Freud's analogy to a playspace forms a metaphor for the creation of a special atmosphere in a group, or for that matter in individual work as well, that encourages exploration, risk taking, and vulnerability. Working with dreams in this playspace deepens the curative process, not only for the dreamer, but for the entire group.     

Is transference the ‘total situation’?

This paper examines through the detailed explication of analytic material the author's experience of a psychoanalytic and a Jungian way of understanding the interactions between him and his patient. This comparative approach considers where the differences lie with respect to timing and content of interpretations and where the differences are essentially tactical rather than theoretical.     

Why Don't People Change? What Stops Them from Changing? An Integrative Commentary on the Special Issue on Resistance

This commentary discusses the four papers from the vantage point of a cognitive-developmental view. Psychotherapeutic change involving changes in core cognitive structures is seen as threatening an individual's personal sense of identity as well as security and safety needs. Core cognitive constructs are laid down early via the principle of covariation of events and form the basis of our tacit knowledge base. Subsequent changes in this tacit knowledge is difficult because the core cognitive constructs act like a mental filter to screen in confirming data and screen out disconfirming data. Ambiguous stimuli tend to be interpreted on the basis of preexisting cognitive constructs, even when the match between event and interpretation is not ideal. Several suggestions are given for increasing the probability of changes occurring in core cognitive constructs.     

生物自然主义:塞尔对自由意志的解释

在对自由意志问题的解答中,传统的相容论和心理决定论都存在一定的缺陷,未能令人满意地回答这一问题。塞尔试图把自由意志的心理状态说明与神经生物学解释结合起来,认为在自由意志行为中存在间隔。在解释我们的自由意志行为时我们有必要先设一个不可约减的非休谟式的自我。这种阐释虽然符合我们的日常经验和科学说明,但却引发了一个新难题:我们的神经元系统的决定性是如何与意志自由行动中的间隔相一致的?     

How social connectedness affects guilt and shame: Mediation by hope and differentiation of self

We tested a mediation model of social connectedness and guilt and shame. Social connectedness was hypothesized to be related to greater hope and differentiation of self. Hope and differentiation of self, in turn, were expected to be related to less shame and more prosocial guilt. The results found that hope mediated the relationship between social connectedness and guilt, and differentiation of self mediated the relationship between social connectedness and shame. Alternative explanatory models were explored and taken into consideration in the interpretation of the results.