A successful trial utilizing the Leuzinger-Bohleber methodology for evaluation of psychoanalytic treatment: Preliminary report

Utilizing audio-recorded psychoanalytic interviews of both patients and their analysts, group discussions of these interviews, and the application of questionnaires commonly used in psychotherapy research, the authors investigate the potential use of the Leuzinger-Bohleber methodology as an objective evaluative instrument to assess the quality of psychoanalytic treatment. Preliminary study results were obtained through interviews conducted with seven analysts and their respective patients, three of whom were treated with psychoanalysis (three or more sessions per week, for a duration of no less than one year) and four with psychotherapy (one or two sessions per week, for a duration of no less than one year). Patients were found to be eager to participate, and no adverse experiences were reported by analysts, patients or the research team. In addition to the interviews, further data were obtained through review of mailed-in questionnaires completed by 21 patients. The authors present both preliminary observations regarding the methodology as a whole, as well as the detailed results of one specifi c case subject treated with psychotherapy. Review of study fi ndings supports the utilization of this methodology as an evaluative instrument which may ultimately advance current knowledge of the process and outcome of psychoanalytic treatment.     

Contextual Influences on Marriage

Abstract— Current proposals to promote and strengthen marriage among low-income populations focus on values and behavioral skills as primary targets of intervention. Marital research that examines contextual influences on marriage calls these emphases into question. Ethnographic and survey research reveal no evidence that populations experiencing higher rates of divorce value healthy marriages any less than other populations do. Longitudinal and observational research reveals two mechanisms through which the environment of a marriage may enhance or constrain effective relationship maintenance. First, some environments contain fewer sources of support and pose more severe challenges than others, presenting marriages in those environments with greater burdens than marriages in more supportive environments are faced with. Second, when demands external to the marriage are relatively high, even couples with adequate coping skills may have difficulty exercising those skills effectively. Together, such findings suggest that successful policies and interventions to strengthen marriages need to acknowledge the environments within which marriages take place.     

Misreading Islamist Terrorism: The "War Against Terrorism" and Just-War Theory

Abstract: The Bush administration's military war on terrorism is a blunt, ineffective, and unjust response to the threat posed to innocent civilians by terrorism. Decentralized terrorist networks can only be effectively fought by international cooperation among police and intelligence agencies representing diverse nation‐states, including ones with predominantly Islamic populations. The Bush administration's allegations of a global Islamist terrorist threat to the national interests of the United States misread the decentralized and complex nature of Islamist politics. Undoubtedly there exists a “combat fundamentalist” element within Islamism. But the threat posed to U.S. citizens by Islamist terrorism neither necessitates nor justifies as a response massive military invasions of other nations. Not only does the Bush administration's war on alleged “terrorist states” violate the doctrine of just war, but in addition these wars arise from a new, unilateral, imperial foreign‐policy doctrine of “preventive wars.” Such a doctrine will isolate the United States from international institutions and long‐standing allies. The weakening of these institutions and alliances will only weaken the ability of the international community to deter terrorism.     

The role of problem-solving appraisal in the process and outcome of career counseling

Because problem-solving appraisal has been demonstrated to be a critical variable in psychological adjustment, this study examined its potential role as both a static and dynamic client attribute influencing the process and outcome of career counseling. Participants were 151 adults who received an average of five sessions of naturally occurring career counseling; data were collected before, during, and after counseling. The results indicated that: (a) in line with a static attribute model, clients' pre-counseling problem-solving appraisal scores predicted post-counseling career and psychological outcomes as well as career decidedness even after partialling out clients' pre-decidedness scores; (b) in line with a dynamic attribute model, clients who experienced positive changes in problem-solving appraisal in counseling were more likely to have more positive career resources to use in their career transitions as well greater goal directedness; (c) participation in career counseling related to positive change in problem-solving appraisal scores at a level similar to problem-solving training workshops; and (d) clients' changes in problem-solving appraisal related to changes in the working alliance over time.     

Impact of the Political Context on Foreign Policy Decision-Making

One of the most pressing concerns in the study of international relations today is to develop a systematic account of the impact of domestic politics on foreign policy. This paper argues that domestic politics frequently influences foreign policy through a process of decision-making that grows out of the decision-maker's awareness of the requirements for effective action in the political context. It is therefore necessary to develop a theory that can explain how the political context's characteristic features affect decision-makers' thinking. In attempting to combine insights culled from the literature on political decision-making with psychological theories of decision-making processes, this paper offers a first step toward such a theory.     

医疗保健政策与医患关系

医疗保健政策深刻地影响着医患关系,并左右着医患关系的发展与变化.在实行"以公平为主,兼顾效益"的福利性的医疗保健政策时期,我国的医患关系是和谐的.但自从医疗保健政策向"经济导向型"方向转变之后,国家大幅度减少了对卫生事业的投入,医院必须从病人身上取得卫生发展必要的资金,医药费用上涨是必然的,也失去了公平和公正,并最终导致医患关系的恶化.调整医患关系不能仅从医、患两方面着手,建立符合医学伦理的卫生政策,才是问题的关键.     

Psychologists in Academic Health Settings: Key Contributors to Dynamic Interplay Among Research, Clinical Practice, and Policy Domains

Psychologists in academic health systems are in a unique position to impact the dynamic interplay among research, clinical practice, and policy domains. In addition to their specialty expertise in psychopathology, particular types of physical illness and disease, and health promotion, psychologists have substantial knowledge of human behavior, refined scientific skills, knowledge and experience in the effective delivery of clinical services, strengths in written expression, and a collaborative orientation. This combination of strengths makes psychologists extremely well-suited for (a) interdisciplinary efforts to develop and implement evidence-based assessment and intervention strategies with biological, psychological, behavioral, and social components, and (b) leadership and advocacy efforts that impact the quality and availability of health care services.     

体外循环所致炎性肺损伤机制及保护进展

肺损伤是体外循环心内直视手术的主要并发症之一。肺损伤的机制十分复杂,主要是全身炎性反应和缺血/再灌注损伤所致。肺保护的方法多种多样,其目的是降低全身炎性反应,减轻或避免缺血/再灌注损伤。本文探讨体外循环肺损伤的机制和保护进展。     

An outcome evaluation study of a psycho‐educational course in a primary care setting

Rationale: To date relatively little research has examined the effectiveness of psycho‐educational courses provided in a primary care setting to adults with mild‐to‐moderate mental health concerns. Aims: To determine whether group psycho‐education could be a viable alternative to individual counselling by (1) assessing the clinical effectiveness of an 8‐week psycho‐educational course, and (2) examining the group outcomes in comparison with individual treatment outcomes from a previous study in the same counselling service. Method: A total of 57 participants attending a psycho‐educational course provided data over a 36‐month period, using the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE‐OM) pre‐ and post‐intervention. A comparison was then made with the data of 58 previous participants of individual counselling evaluation, using the same CORE‐OM system. Results: Participants reported significantly lower levels of psychological distress after attending the course and these results are comparable to outcomes measured in the same service for individual counselling, indicating that group interventions could be considered a legitimate alternative to individual counselling, thus increasing cost effectiveness and reducing waiting times. Limitations of the study and implications for practice and further investigation are considered.