Intertraumatic Dissociative Attachment

SUMMARY

This article focuses on the treatment of couples with a collective personal history of multiple traumatic experiences, and central related concepts. Referred to as the intertrauma couples therapy (InTCT) model, this article outlines an approach to treating trauma victim couples in which each partner has suffered one or more traumatic experiences (i.e., war, rape, criminal assault, incest, community violence, etc.). InTCT is a structured five-phase model of care, derived from a long trauma treatment tradition, and the author's clinical experience in the treatment of multitrauma persons for over 20 years.

This comprehensive, integrative approach to treatment is designed to resolve chronic interpersonal hostility, isolation in marriage, fears of intimacy and engulfment, and the persistent revivifications of partners' traumatic memories as a painful product of daily relational encounters. Unfortunately, these encounters represent trauma structures interacting with trauma structures, with no end or relief to the mutual pain-generating interactional patterns. The phases of the treatment takes the couple from disorganization and intense emotional reactivity to stabilization through integration to an end phase with a post-integration life skills building program for lasting results. Also presented are issues such as attachment, specific trauma responses to include interactive concepts of trauma bonding and systems theory in the context of trauma and dissociation. The article also presents a multitrauma couple case study, and discusses the critical role of therapist's functions.     

Responding to negative health events: A test of the Bad News Response Model

People can respond to bad news in a variety of ways. The Bad News Response Model suggests that three aspects of bad news (the controllability, likelihood, and severity of negative consequences) predict which response (Watchful Waiting, Active Change, or Acceptance) people are likely to choose. This article presents an initial test of the predictions of the Bad News Response Model. College students (N = 234) and older adults (N = 116) read a scenario about a person with a suspicious mole that varied in the controllability, likelihood, and severity of the outcomes. Consistent with our predictions, people prefer Watchful Waiting when controllability, likelihood, and severity are low, Active Change when controllability and likelihood are high, and Acceptance when controllability is low. These findings provide support for the Bad News Response Model and suggest that responses to bad news may be foreseeable based on the type of news people receive.     

病耻感对于精神病患者的影响以及文化对策

本文分析三种类型歧视所造成的患者及其家属的痛耻感,论述我们应当如何利用适当的文化应对策略来消除歧视、减少病耻感,从而有效地克服病耻感对于患者及其家属的负面影响。文化差异与病耻感的形成直接相关,文化作为一个重要变量,影响着精神卫生问题以及相应的服务政策,深入研究和认识儒家文化的核心价值有助于减少对于精神病患者的歧视,帮助他们克服病耻感。中国道家文化推崇道法自然,无为而治,可以发展出有效的心理疗法,对于精神疾病是一剂对症的良药。     

Surviving the early loss of a mother: daughters speak,by Anne Tracey

The purpose of this study is to empirically evaluate a coping response that is thought to be unique among older Catholics–suffering in silence. Two hypotheses are examined. The first predicts that older Catholics will be more likely than older Protestants to suffer in silence when ongoing economic difficulty is encountered. The second hypothesis specifies that the potentially deleterious effects of financial problems on depressive symptoms will be offset for older adults who prefer to suffer in silence. Data from an ongoing nationwide survey of older people in the United States provide support for both hypotheses.     

Effect of Amount and Percentage of Reinforcement on Resistance to Extinction in Preschool Children

A correlational study of parental assimilation patterns revealed greater paternal compliance and greater maternal compliance and internalization in a sample of teacher-judged adjusted boys than in a comparison sample of unadjusted boys. Adjusted boys were more similar to their fathers in terms of their personal orientations toward child behavior. The generalized expectations of these boys were also more similar to their mothers' expectations. Data on intrafamilial perceptions were reported to illustrate the greater parental assimilation by the adjusted boys. These results lend additional support to the theorized importance of parental identification in the early development of behavior disorders.     

Evidence for retarded extinction of aversive learning in anxious children

The habituation to intense acoustic stimuli and the acquisition of differentially conditioned fear were assessed in 53 clinically anxious and 30 non-anxious control children and young adolescents. Anxious children tended to show larger electrodermal responses during habituation, but did not differ in blink startle latency or magnitude. After acquisition training, non-anxious children rated the CS+ as more fear provoking and arousing than the CS- whereas the ratings of anxious children did not differ. However, anxious children rated the CS+ as more fear provoking after extinction, a difference that was absent in non-anxious children. During extinction training, anxious children displayed larger blink magnitude facilitation during CS+ and a trend towards larger electrodermal responses, a tendency not seen in non-anxious children. These data suggest that extinction of fear learning is retarded in anxious children.     

Patterns of Coping Among Persons with HIV Infection: Configurations, Correlates, and Change

This study examines coping in response to HIV infection, using longitudinal data from a nationally representative sample (n = 2,864) of HIV-infected persons. We investigated configurations of coping responses, the correlates of configuration membership, the stability of coping configurations, and the relationship of coping to emotional well-being. Four coping configurations emerged from cluster analyses: relatively frequent use of blame-withdrawal coping, frequent use of distancing, frequent active-approach coping, and infrequent use of all three coping strategies (passive copers). Passive copers had few symptoms, high levels of physical functioning, and high emotional well-being; blame-withdrawal copers had the opposite pattern. Of those completing a second interview 1 year after baseline, 46% had the same coping configuration. Increases in the number of HIV-related symptoms raised the probability of blame-withdrawal coping at follow-up, whereas decreases raised the probability of passive coping. Infrequent use of coping responses at baseline was related to greater emotional well-being 1 year later. This result, in conjunction with the high levels of emotional well-being in the passive cluster, suggests that high levels of distress can induce blame-withdrawal coping whereas coping efforts are minimal when social support and emotional well-being are high. Results highlight issues in ascertaining the causal direction between coping and psychological outcomes, as well as in specifying the nature of stressful situations with which people are coping.     

Testing indirect effect with a complete or incomplete dichotomous mediator

Past methodological research on mediation analysis mainly focused on situations where all variables were complete and continuous. When issues of categorical data occur combined with missing data, more methodological considerations are involved. Specifically, appropriate decisions need to be made on estimation methods of the indirect effects and on confidence intervals for testing the indirect effects with accommodations of missing data. We compare strategies that address these issues based on a model with a dichotomous mediator, aiming to provide guidelines for researchers facing such challenges in practice.     

Effects of foreign mand training on the emergence of foreign tact and listener responses for Chinese-speaking children with autism spectrum disorder

In China, there is an increasing demand for preschool children with autism spectrum disorder (ASD) enrolled in general education to learn English vocabulary. The purpose of this study was to evaluate the effect of foreign mand training in English on the acquisition of mand responses, and the emergence of tact and listener responses for three Chinese-speaking preschool children (boys; 4–5 years of age) with ASD. Echoic-to-mand training was implemented to teach mands in English. The study employed a concurrent multiple-probe design across behaviors. The results of the study indicated that the training was effective in the acquisition of mand responses. Moreover, untaught tacts and listener responses for the same vocabulary emerged without explicit training. Implications for small-group mand training in foreign language acquisition were discussed.     

Instructional control of generalized relational matching to sample in children.

Three experiments examined the performance of 4-year-old children in matching geometric stimuli. Performance was developed as a simulation in which all components of the behavior were overt and directly measured. A correct match depended on the state of an instructional stimulus: the background color of the display. In the first two experiments, on nonidentity trials (signified by a green background) the next longer length, larger size, or greater distance was correct. With a blue background, a comparison identical to the sample was correct. In Experiment 3, red was added for which shorter, smaller, or nearer was correct. Also here, on nonidentity trials, if a comparison of the correct length was not presented, the children adjusted their search target to the comparison of the next succeeding size (larger or smaller) so as to maintain a constant matching relation. Subsequently, when exposure to the instructional stimulus was reduced to presentation only at the beginning of each trial, performance simulated matching based on instructions about abstract relations. In all experiments, accurate matching generalized across novel stimuli and reduced exposure to the instructional stimuli.