Is it acceptable for a physician to break confidentiality in the case of sexually transmitted diseases? A mapping of young Kuwaiti's views

IntroductionConfidentiality is essential for the establishment of trust between physicians and their patients.ObjectivesThe circumstances under which it is acceptable to young Kuwaiti for a physician to break confidentiality to protect the spouse of a patient with a sexually transmitted disease (STD) were examined.MethodA sample of 263 young Kuwaiti indicated the acceptability of breaking confidentiality in 48 scenarios that were all possible combinations of five factors: disease severity, time taken by the physician to discuss with the patient, the patient's intent to inform the spouse about the disease, the patient's intent to adopt protective behaviors, and the decision to seek the advice of an expert in infectious diseases before breaking confidentiality.ResultsThrough cluster analysis, four qualitatively different positions were found: Quite never acceptable (6% of the sample, mostly males), Depends on husband's willingness to inform (3%), Depends on husband's protective behavior (29%, mostly females), and Quite always acceptable (32%). The remaining participants did not express any clear view.ConclusionIn Kuwait, students’ trust in the medical profession is, therefore, not likely to be seriously undermined if, from time to time, and in well-specified cases, individual physicians decide to break confidentiality when facing dilemmas of the kind examined in the current study.     

Personality pathology severity,cluster type and specific therapeutic interventions in outpatient psychotherapy

We explored the relationship between severity of personality pathology, cluster type and therapeutic interventions (psychodynamic–interpersonal [PI] and cognitive–behavioural [CB]) in 76 outpatients across two early sessions (3rd and 9th) of psychodynamic psychotherapy, while accounting for patients' baseline global symptom severity. Pretreatment personality pathology severity was assessed using the Personality Disorder Index (PDI), where DSM‐IV Axis II PD was assigned a value of 2, subclinical traits and features were assigned a 1 and absence of Axis II psychopathology was assigned a 0. Interrater reliability of personality pathology severity was excellent (ICC [1, 1]: 0.85). Interrater agreement for Cluster A (κ = 0.75), Cluster B (κ = 0.92) and Cluster C (κ = 0.70) was high. Interventions were coded with Comparative Psychotherapy Process Scale (CPPS) from videotapes, and reliability was excellent (CPPS‐PI = 0.86; CPPS‐CB = 0.78). Stepwise linear regressions indicated that therapists' focus on mood shift/topic avoidance (B = 0.29, p = .009) and future events (B = ?0.26, p = .020) predicted Axis II severity. Overall use of PI techniques and Cluster A personality disorder (CLA) were positively correlated (r = .312, p = .006). Stepwise binomial logistic regressions indicated that therapists' focus on uncomfortable feelings (B = 1.915, p = .008) and explaining rationale behind approach (B = 1.276, p =. 038) predicted CLA. All results remained significant when controlling for patients' baseline general symptomatology (Brief Symptom Inventory‐Global Severity Index [BSI‐GSI]), except for the relation between explaining rationale and CLA. Discussion highlights how using psychodynamic treatment model, therapists' focus on patient's in‐session affect expression and explaining rationale behind approach are highly relevant when working with CLA patients.     

Early childhood mental health consultation: Care providers’ experiences of the consultative relationship

This article presents findings from a qualitative research study exploring child care teachers’ experiences receiving early childhood mental health consultation (ECMHC). As an emerging intervention in early childhood education, ECMHC is already yielding promising results, namely in helping teachers better address challenging behaviors in their classroom and promote a more nurturing classroom environment. However, there remains a lack of personal testimony from teachers who receive this intervention. Considering that teachers are the primary focus of most ECMHC interventions, the purpose of this study was to examine child care teachers’ personal experiences receiving consultation. Eight child care teachers were interviewed for this study. Results from this study illuminate key interpersonal processes in the development of the consultant–consultee relationship, indicate what teachers consider to be the most helpful components of consultation, and speak to the challenges that teachers experience in consultation. By examining the personal testimony of child care teachers who have received ECMHC services, consultants and researchers can consider ways to expand and improve future implementation of ECMHC.     

关系认知与善意认知对大学生人际信任的影响

采用投资博弈,以大学生为被试探讨关系认知（亲疏关系、阶层关系）和特质认知（以善意为例）对中国人人际信任的影响。结果发现,亲疏关系认知、阶层关系认知和善意认知都会影响中国人的人际信任。关系越近、阶层越高、越善意,信任水平越高。随着亲疏关系下降或善意降低,阶层关系对信任水平的作用之间的差异逐步减弱。亲疏关系认知和阶层关系认知存在交互作用,亲疏、阶层和善意也具有交互作用。人们对上位阶层的信任大于平位大于下位,但是当信任对象存在低善意特质或陌生人身份时,人们对上位阶层的信任会下降至和平位没有差异;当低善意特质和陌生人身份同时存在时,人们对上位、平位和下位的信任无差异。     

Online implementation of an event history calendar with formr: A tutorial

Event history calendars (EHCs) are popular tools for retrospective data collection. Originally conceptualized as face‐to‐face interviews, EHCs contain various questions about the respondents' autobiography in order to use their experiences as cues to facilitate remembering. For relationship researchers, EHCs are particularly valuable when trying to reconstruct the relational past of individuals. However, although many studies are conducted online nowadays, no freely available online adaptation of the EHC is available yet. In this tutorial, detailed instructions are provided on how to implement an online EHC for the reconstruction of romantic relationship histories within the open‐source framework formr. Ways to customize the online EHC and provide a template for researchers to adapt the tool for their own purposes are showcased.     

青少年早期身体攻击与关系攻击的异质性共发模式、稳定性及其与同伴关系的联系

采用整群抽样法选取1967名青少年被试（平均年龄13.22±0.36岁,男生1018人）进行三年追踪,运用个体定向方法考察青少年早期身体攻击和关系攻击的异质性共发模式及其稳定性、与同伴关系间联系。结果发现三时间点均存在5个身体—关系攻击共发模式组：高身体—关系攻击组、中等身体—关系攻击组、中下身体且低关系攻击组、低身体且中下关系攻击组、低身体—关系攻击组,表明两类攻击总体上表现出水平一致或类似的共发模式,且具跨年龄一致性。各共发模式身份表现出有差异的跨时间稳定性,低攻击组稳定性最高,其次是高攻击组、中等攻击组,低身体且中下关系攻击组转变概率最高。高攻击组同伴拒绝水平最高、同伴接纳最低,低攻击组反之,其他组同伴拒绝水平均显著高于低攻击组,为两类攻击亚组共发模式提供了效度证据。     

In Experiential Sessions, There Is No Therapist or Client: There Is a “Teacher” and a “Practitioner”

In virtually every kind of psychotherapy, therapist and client attend mainly to one another throughout almost the entire session. If each experiential session is to be successful in enabling the person to become the whole new person that the person can become, and to become free of the painful feeling in the painful situation, the radical alternative is for the experiential teacher–therapist and the person to attend mainly to the third thing that is the important center of attention for the person. An even more radical glimpse into the future includes the person having one's own sessions by oneself, complemented by skill-development sessions with the experiential teacher.     

Might Relationship “Techniques” Extend the Reach, Efficacy, and Efficiency of the Psychotherapies? The Challenge of Treatment-Resistant Outpatients

Study-based clinical observations and two premises are presented as indications for a need to identify therapeutic relationship techniques or the like that can extend the reach and efficiency of the psychotherapies. The premises are: (1) advances in psychotherapy practice and research now highlight one of the field's most longstanding challenges, signified by terms like treatment resistance; and (2) some proportion of outpatients whose problems are resistant to the psychotherapies (and medications) have marked limitations in the capacity to relate positively and productively to others, including therapists. Thus, ironically, they cannot optimally utilize a treatment modality that largely has developed to ameliorate problems relating to others.