Integrating Minuchin's Boundary Continuum And Bowen's Differentiation Scale: A Curvilinear Representation

The purpose of this article is to discuss an integration of Minuchin's boundary continuum and Bowen's differentiation scale. Minuchin's boundary continuum provides a framework for understanding proximity and distance within relationships. It graphically depicts health in relationships as being a dynamic middle ground between the extremes of enmeshment and disengagement. Bowen's differentiation scale illustrates differences in emotional health, such as the ability to distinguish between thoughts and feelings, associated with varying levels of differentiation. A curvilinear integration of Minuchin's continuum and Bowen's scale retains the advantages of each and also expands their understanding.     

Predictors of Psychosocial and Cognitive Adaptation in Children with Sickle Cell Syndromes

Examined the role of socioecological factors (family functioning and socioeconomic variables) in predicting behavioral and cognitive adaptation in children with sickle cell syndromes (SCD). Participants included 74 African American children and adolescents with SCD and their primary caretakers. Outcomes included internalizing and externalizing behavior symptoms, as rated by caretakers, as well as intellectual abilities and academic achievement, as assessed by individually administered standardized instruments. Family functioning consisted of both caretaker adjustment and family environment (i.e., family adaptability and cohesion). Hierarchical multiple regression analyses revealed that caretaker psychological adjustment predicted externalizing behaviors, while family environment (i.e., adaptability and cohesion) predicted neither behavioral nor cognitive functioning. Socioeconomic variables alone predicted intellectual abilities and academic achievement and also contributed to the prediction of child behavioral adaptation. Results are discussed in terms of relevant sociocultural issues and implications for family-level prevention and intervention.     

A Method for Introducing the Concepts of Chaos Theory to Medical Students

Chaos theory is beginning to find applications in the field of medicine. The theory of chaos should be introduced to students to help them as they make the transition from learning the scientific literature to actually applying this newly acquired knowledge in clinical situations. Chaos theory will give the students a powerful conceptual framework from which they can better understand the limits of predictability in clinical situations. Failure to understand the limits of predictability in chaotic natural systems will invariably lead to frustration in both patients and physicians.     

MULTICOMPONENT INTERVENTION FOR AGITATED BEHAVIOR IN A PERSON WITH ALZHEIMER'S DISEASE

We evaluated a multicomponent intervention for agitated behavior in a man with probable Alzheimer's disease. Hypotheses about variables controlling his agitated behavior guided intervention design. Based on staff interviews, direct observations, and brief experimental probes, intervention components were chosen to increase rate of reinforcement and decrease aversive aspects of his job. Intervention reduced agitated behavior without disrupting his work rate.     

Basic research needed for stimulating the development of behavioral technologies

The costs of disconnection between the basic and applied sectors of behavior analysis are reviewed, and some solutions to these problems are proposed. Central to these solutions are collaborations between basic and applied behavioral scientists in programmatic research that addresses the behavioral basis and solution of human behavior problems. This kind of collaboration parallels the deliberate interactions between basic and applied researchers that have proven to be so profitable in other scientific fields, such as medicine. Basic research questions of particular relevance to the development of behavioral technologies are posed in the following areas: response allocation, resistance to change, countercontrol, formation and differentiation/discrimination of stimulus and response classes, analysis of low-rate behavior, and rule-governed behavior. Three interrelated strategies to build connections between the basic and applied analysis of behavior are identified: (a) the development of nonhuman animal models of human behavior problems using operations that parallel plausible human circumstances, (b) replication of the modeled relations with human subjects in the operant laboratory, and (c) tests of the generality of the model with actual human problems in natural settings.     

Pseudodementia: A slow death

The clinical term pseudodementia has remained a permanent nosological entity in the literature for over 100 years. Indeed, recognition of the fact that clinical symptoms associated with reversible neuropsychiatric conditions can mimic irreversible disorders was known as early as the middle of the 19th century. The importance of the term lies in the inherent assumption that the presenting dementia is not real, or is at least reversible, and therefore treatable. Nonetheless, there continues to be controversy regarding the validity and appropriate clinical use of the term. This article reviews the evolution and clinical utility of the term pseudodementia and attempts to redirect investigative efforts toward an understanding of the neuroanatomical substrates that underlie depression and cognitive impairment in the elderly. Based on a critical analysis of the relevant literatures, a subcortical-frontal neuroanatomical substrate of late-life depression is supported. Further, the presence of leukoaraiosis, as measured by magnetic resonance imaging, is proposed as a potential neurobiological marker that contributes to the depressed mood, cognitive impairment, and later cognitive deterioration of some elderly depressed.     

Phenotypic and genotypic heterogeneity in gaucher disease: Implications for genetic counseling

Genetic counseling for Gaucher disease is complicated by the vast degree of clinical heterogeneity encountered in the disorder. Recent advances in our understanding of the molecular genetics of Gaucher disease are particularly relevant to genetic counseling. Although the identification of mutations in the glucocerebrosidase gene has enabled genotypic screening of Gaucher patients, the ability to reliably predict patient outcome on the basis of DNA studies is often limited. An appreciation of both the spectrum of clinical manifestations in Gaucher patients and the limitations of the available genotypic information is necessary when counseling patients, families and at-risk individuals.     

Current status of psychological research in organ transplantation

Research addressing the psychological concomitants of organ transplantation is reviewed. Specifically, cognitive, behavioral, and psychosocial correlates of kidney, heart, liver, and bone marrow transplantation in both children and adults are discussed. Despite several conceptual and methodological shortcomings of the psychologically-based research in this area, results seem to indicate that organ transplantation is associated with many psychological issues at pretransplantation, posttransplantation, and follow-up periods. Implications of these general findings for the advancing roles of the health psychologist in organ transplantation are discussed.     

Comparison of yes-no and latency measures of auditory intensity discrimination.

Rats discriminated auditory intensity differences of sinusoids at 3.0 kilohertz in a go/no-go signal detection procedure. Responses to the signal (hits) were reinforced with electrical brain stimulation, and misses produced a brief timeout. On intermixed noise trials, withholding of responses (correct rejections) was reinforced, and false alarms produced the time-out. In two test conditions, the signal was either the louder (100 decibels) or softer (90, 93, 96, or 99 decibels) of the pair of intensities presented within a set of trials. Each animal was first trained with signal value louder or softer, and reversed for the second condition so that the former noise value served as signal. Hits showed shorter latencies than false alarms, regardless of the relative intensity of signal and noise, and the magnitude of differentiation was proportional to signal-noise separation. Both hits and false alarms showed longer latencies as the discrimination became more difficult. Isosensitivity contours derived from the latencies showed close similarity across conditions; in comparison, the yes-no measure of detectability, d', showed greater variability. The similarity of latency differentiation across louder and softer signal conditions supports a detection model in which the observer's judgment is controlled by the distance of sensory effect from criterion on each trial, as opposed to the loudness of the tones per se.     

Early antecedents of emotion differentiation and regulation: Experience tunes the appraisal thresholds of emotional development in infancy

In this review, we synthesize evidence to highlight cognitive appraisal as an important developmental antecedent of individual differences in emotion differentiation and adept emotion regulation. Emotion differentiation is the degree to which emotions are experienced in a nuanced or “granular” way—as specific and separable phenomena. More extensive differentiation is related to positive wellbeing and has emerged as a correlate of emotion regulation skill among adults. We argue that the cognitive appraisal processes that underlie these facets of emotional development are instantiated early in the first year of life and tuned by environmental input and experience. Powerful socializing input in the form of caregivers’ contingent and selective responding to infants’ emotional signals carves and calibrates the infant’s appraisal thresholds for what in their world ought to be noticed, deemed as important or personally meaningful, and responded to (whether and how). These appraisal thresholds are thus unique to the individual child despite the ubiquity of the appraisal process in emotional responding. This appraisal infrastructure, while plastic and continually informed by experience across the lifespan, likely tunes subsequent emotion differentiation, with implications for children’s emotion regulatory choices and skills. We end with recommendations for future research in this area, including the urgent need for developmental emotion science to investigate the diverse sociocultural contexts in which children’s cognitive appraisals, differentiation of emotions, and regulatory responses are being built across childhood.