Pathways to Medical Utilization

The role of psychologists in medical settings is evolving to include the development, delivery, and evaluation of psychosocial treatments for individuals who use disproportionate amounts of medical services. The primary purpose of this article is to present a model of psychological factors that drive health care utilization. A stepped care model of treatment delivery is also discussed along with a brief literature review depicting the impact of treatment approaches on high utilizing populations. This article concludes with recommendations for psychologists interested in providing treatment to medical utilizers.     

The long-term effects of ability grouping in mathematics: A national investigation

The complexities of school tracking have resulted in patchy explanations of how it might affect students’ academic success. We aim to develop a comprehensive understanding of tracking by investigating its long-term relationships with student outcomes. Our study is informed by sociological and social psychological theoretical perspectives that explain how this school practice may wield its influence. We use panel data from the National Education Longitudinal Survey (NELS:88) for a comprehensive analysis of the associations between ability grouping in the eighth grade and subsequent social psychological and academic variables in the 10th and 12th grades, respectively. By covering three waves of data that monitor the mathematics progress of middle school youngsters as they go through high school, we present the durable relationships of tracking. Our method compares students in tracked and untracked schools, and further partitions these students into high and low ability groups. Our results reaffirm that tracking has persistent instructional benefits for all students. Yet, high-achieving students who are tracked in middle school may suffer considerable losses in self-concept that subsequently depress their achievement, and mathematics course-taking. Implications are for a broad range theory of tracking and for further empirical work on the viability of heterogeneously-grouped classes.An earlier version of this paper was presented at the International Sociological Association (ISA) XV World Congress of Sociology, Brisbane, Australia, July 7th through 13th, 2002     

The Creative Dilemma: The Influence of Schiller''s Aesthetics on the Life and Work of Otto Rank

The impact of philosophical wisdom on the pioneers of psychoanalytic work is presented in this article, in particular the influence of Schiller's aesthetics on the theoretical and clinical work of Otto Rank. The essay will compare and contrast Schiller's major themes—in particular his notions of the aesthetic impulse, will, and his concept of harmonia—with aspects of Rank's contributions, namely, his notions of creativity and the art of living. Drawing from Schiller's aesthetic vision, Rank's notion that art and play are foundational sources for healing is described in the author's own clinical work.     

成就目标定向在学业自我概念与学业成绩关系中的调节作用:基于内/外参照模型

为了探究成就目标定向在学业自我概念与学业成绩关系中的调节作用,采用语文学业自我概念量表、数学学业自我概念量表和成就目标定向量表对1515名初中生进行测查。结果显示：(1)初中生语文-数学学业自我概念建构过程符合内/外参照模型(Internal/External Frame of Reference Model, I/EM);(2)掌握回避对I/EM的维度比较路径存在调节作用,掌握回避得分越高越易受维度比较效应的影响,该现象对于语文成绩和数学成绩相对差的学生更明显;(3)成绩回避对I/EM的社会比较路径存在调节作用,成绩回避得分越高越不易受社会比较效应的影响,该现象对于语文成绩和数学成绩相对好的学生更明显。本研究揭示了持有不同成就目标定向的初中生在学业自我概念建构过程中的差异,对引导初中生建构积极学业自我概念具有重要启示。     

Life satisfaction trajectories among junior high school students in China: The role of parent–child communication

A 3-year follow-up test (from grades 7 to 9) was administered to 807 junior high school students from two regions in Hunan Province, China, using multilevel analysis to examine trends in junior high school students' life satisfaction, differences by gender and location of life and the effects of father–child/mother–child communication on the development of life satisfaction. The results showed that (1) Chinese junior high school students' life satisfaction showed a decreasing trend from the seventh grade to the ninth grade, and there was a significant decreasing process in the eighth grade; (2) father–child communication and mother–child communication had a significant positive predictive effect on Chinese junior high school students' life satisfaction and (3) father–child communication and mother–child communication had a significant negative predictive effect on the decreasing trend of life satisfaction, in which the effect of mother–child communication was particularly significant.     

Art within analysis: scapegoat, transference and transformation

Through clinical example and pictorial illustration, the author examines ways in which art offers a particular means of psychological transformation in states which may otherwise be in expressable. A transference to the art work itself is proposed. It is submitted that, mediated within the transference/ countertransference dynamic, this 'scapegoat transference' facilitates a particular process of psychological differentiation. The aesthetic qualities of art presented within analysis will resonate with other countertransference affects. Clinical material demonstrates how observation of this--aesthetic countertransference--leads to a distinction between the 'diagrammatic' and the 'embodied image. The process of integration of shadow material is furthered by the temporary safe-keeping of the art work by the analyst.     

Is the heart preadapted to hypoxia? Evidence from fractal dynamics of heartbeat interval fluctuations at high altitude (5,050 m)

The dynamics of heartbeat interval time series over large time scales were studied by a modifed random walk analysis introduced recently asDetrended Fluctuation Analysis. In this analysis, the intrinsic fractal long-range power-law correlation properties of beat-to-beat fluctuations generated by the dynamical system (i.e., cardiac rhythm generator), after decomposition from extrinsic uncorrelated sources, can be quantified by the scaling exponent (α) which, in healthy subjects, for time scales of ∼10⁴ beats is ∼1.0. The effects of chronic hypoxia were determined from serial heartbeat interval time series of digitized twenty-four-hour ambulatory ECGs recorded in nine healthy subjects (mean age thirty-four years old) at sea level and during a sojourn at 5,050 m for thirty-four days (Ev-K2-CNR Pyramid Laboratory, Sagarmatha National Park, Nepal). The group averaged α exponent (±SD) was 0.99±0.04 (range 0.93–1.04). Longitudinal assessment of α in individual subjects did not reveal any effect of exposure to chronic high altitude hypoxia. The finding of α∼1 indicating scale-invariant long-range power-law correlations (1/f noise) of heartbeat fluctuations would reflect a genuinely self-similar fractal process that typically generates fluctuations on a wide range of time scales. Lack of a characteristic time scale along with the absence of any effect from exposure to chronic hypoxia on scaling properties suggests that the neuroautonomic cardiac control system is preadapted to hypoxia which helps prevent excessive mode-locking (error tolerance) that would restrict its functional responsiveness (plasticity) to hypoxic or other physiological stimuli. Editorial Note: A philosopher is, by definition, a lover of wisdom. In the following article, Dr. Dimitrov, as a philosopher, examines the principles that underlie being and thinking as performed by the structures of the brain. He reports his thoughts in a “virtual context.” Virtual, a word enjoying great popularity today, is derived from the Latin word for man; it describes manliness and implies apparent, but not actual, power. In his analysis of how information is dealt with by the human being, the author uses theoretical physics and mathematics that may seem arcane to some readers. A major aspect of his thesis declares that the effective performance of information systems relies not on the structures involved, but on the way they interact.     

Re-Collection in Existential Psychotherapy with Couples and Families Dealing with Death

Re-collection is a treatment dynamic in existential family therapy in which the client family is helped to remember and honor meanings that family members have previously actualized and deposited in the past. This shrinks the family meaning vacuum and those symptoms and problems that grow and flourish in a family meaning vacuum. In this article, an existential orientation to re-collection with families who are dealing with the death of a loved one is presented, described, and illustrated with case material.     

PSYCHOANALYSIS AS APPLIED AESTHETICS

The question of how to place psychoanalysis in relation to science has been debated since the beginning of psychoanalysis and continues to this day. The author argues that psychoanalysis is best viewed as a form of applied art (also termed applied aesthetics) in parallel to medicine as applied science. This postulate draws on a functional definition of modernity as involving the differentiation of the value spheres of science, art, and religion. The validity criteria for each of the value spheres are discussed. Freud is examined, drawing on Habermas, and seen to have erred by claiming that the psychoanalytic method is a form of science. Implications for clinical and metapsychological issues in psychoanalysis are discussed.