Treating a Chronically Depressed Adolescent Female Using the Cognitive Behavioral Analysis System of Psychotherapy: A Case Study

A case is presented of an adolescent female with double depression who was treated using the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). CBASP is designed to teach a social problem-solving procedure called Situational Analysis (SA). Generalized treatment effects were measured through monitoring of diagnostic status, two administrations of the Minnesota Multiphasic Personality Inventory-Adolescent, weekly administrations of the Child Depression Inventory, and acquisition performance ratings on the SA task. The results showed that CBASP appeared to be an effective treatment. The double depressive disorder remitted, and the patient learned to identify behavioral consequences as well as target and attain her interpersonal goals. CBASP can be effective for adolescents, although modifications of the adult form of the therapy may be necessary.     

Development of rules and strategies: balancing the old and the new

The experiments described in the lead articles replicate findings from previous studies of development of knowledge about balance scales, add several new findings, and raise four key questions: (a) How can rule use best be assessed? (b) How can we reconcile systematic use of rules with variable use of strategies? (c) When do children begin to use rules? and (d) How do children generate new rules? In this Reflection, we summarize current understanding of development of knowledge about balance scales and consider each of the four questions.     

The Dental Subscale of the Children's Fear Survey Schedule: Predictive Value and Clinical Usefulness

This study reports on the predictive value and clinical usefulness of the Dutch parental version of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Parents of 718 children (4–12 years) completed this CFSS-DS version before or during the child's visit. The dentist rated the child's dental fear during treatment on a 5-point Likert-type Scale from 1 (not afraid at all) to 5 (very afraid). Reliability analysis was performed, and correlation coefficients between the two measures were calculated. The reliability of the scale proved to be high (Cronbach's = .93) and significant correlation coefficients were found (r = .58 and r = .68, p < .01). The negative predictive value of the CFSS-DS was high (.96), whereas its positive predictive value was relatively low (0.41). It was concluded that the CFSS-DS might be of clinical value as a screening device of dental fear, whereas its predictive value of fearful behavior should not be overestimated.     

Family Unification with Reactive Attachment Disorder Children: A Brief Treatment

This is a case study of a family with a child (age eight) with reactive attachment disorder and the subsequent individual and family therapy. Treatment of choice for the child was Eye Movement Desensitization and Reprocessing (EMDR) and supportive educational counseling for the parents and family. Qualitative evaluation of the process demonstrated that the parents observed an instant change in the child's attitude. The child reported that she felt better about family, school, and truthfulness, and stated about the therapy: It opened a window for me. A 12-month evaluation demonstrated continued positive effects.     

Animal spare parts? A Canadian public consultation on xenotransplantation

Xenotransplantation, or the use of animal cells, tissues and organs for humans, has been promoted as an important solution to the worldwide shortage of organs. While scientific studies continue to be done to address problems of rejection and the possibility of animal-to-human virus transfer, socio-ethical and legal questions have also been raised around informed consent, life-long monitoring, animal welfare and animal rights, and appropriate regulatory practices. Many calls have also been made to consult publics before policy decisions are made. This paper describes the Canadian public consultation process on xenotransplantation carried out by the Canadian Public Health Association in an arm’s length process from Health Canada, the ministry overseeing government health policy and regulation. Focusing on six citizen fora conducted around the country patterned after the citizen jury deliberative approach, the paper describes the citizen panelists’ recommendations to hold off on proceeding with clinical trials and the rationales behind this recommendation. The consultation process is discussed in the context of constructive technology assessment, a framework which argues for broader input into earlier stages of technology innovation, particularly at the technology design stage. This study was supported by a grant to the first author from the Social Sciences and Humanities Research Council in Canada.     

Beyond conflict of interest: the responsible conduct of research

This paper reports data and scholarly opinion that support the perception of systemic flaws in the management of scientific professions and the research enterprise; explores the responsibility that professional status places on the scientific professions, and elaborates the concept of the responsible conduct of research (RCR). Data are presented on research misconduct, availability of research guidelines, and perceived research quality. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland, 5–6 April, 2002. The opinions expressed herein are those of the author and do not necessarily represent the views of the Office of Research Integrity, the U.S. Department of Health and Human Services, or any other federal agency.     

Tyrannical omnipotence in the archetypal father

This paper sets the archetypal relationship between the tyrannical, devouring father and his sons in the context of a disjunction in the parental couple (syzygy) whereby the role of the maternal feminine is eclipsed and excluded. This is shown to originate in an omnipotent defence against infantile dependence on the mother. Successful liberation from the father's tyranny requires the restoration of mutuality between the internal couple. Although the main focus is on the internal world (and a detailed clinical illustration is given, showing the working out of this process in the analytical relationship), reference is also made to political tyranny, attitudes to the control of Nature by technological means and patriarchal forms of masculinity. The Chronos myth is amplified through the use of two modern variants in the films The Terminator and Star Wars.     

Assessment of weight and eating concerns in Norwegian adolescents

The aim of the present study was to test the properties of an instrument that assesses concerns about weight and eating without reference to dieting behavior. A short instrument, the Weight and Eating Concerns Inventory (WECI) was examined in a sample of 569 boys and 548 girls aged 11 to 15 years. Confirmatory factor analyses with LISREL showed a better fit with a version of the instrument that did not include a reference to dieting behavior, compared to a version that included such a reference. This was true for both boys and girls, irrespective of their age group. However, the results indicated that both versions should be used with caution for young boys. The internal consistency of the WECI (that is, the version without reference to dieting) was satisfactory, ranging from 0.78 to 0.86 for girls and from 0.68 to 0.73 for boys. The WECI correlated quite substantially with negative self-evaluations and depression for boys and girls in all the age groups assessed, suggesting that high scores on the WECI may indicate a problem that goes beyond worries or concerns, and should be taken seriously. In general, girls reported more of these concerns than boys, and the correlation between the WECI and dieting was stronger among girls compared to boys.     

Family Processes and Treatment Outcome in the MTA: Negative/Ineffective Parenting Practices in Relation to Multimodal Treatment

To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on teacher-reported outcomes (disruptive behavior, social skills, internalizing symptoms) in children with attention-deficit hyperactivity disorder (ADHD). Participants were 579 children with Combined-type ADHD, aged 7–9.9 years, in the Multimodal Treatment Study of Children with ADHD (MTA). We uncovered 2 second-order factors of parenting practices, entitled Positive Involvement and Negative/Ineffective Discipline. Although Positive Involvement was not associated with amelioration of the school-based outcome measures, reductions in Negative/Ineffective Discipline mediated improvement in children's social skills at school. For families showing the greatest reductions in Negative/Ineffective Discipline, effects of combined medication plus behavioral treatment were pronounced in relation to regular community care. Furthermore, only in combination treatment (and not in behavioral treatment alone) was decreased Negative/Ineffective Discipline associated with reduction in children's disruptive behavior at school. Here, children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized. Overall, the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practices at home; we discuss problems in interpreting the temporal sequencing of such process-outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting.