Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

Touching Mortality, Touching Strength: Clinical Work with Dying Patients

This paper outlines some of the special stresses that must be shouldered by clinicians—physicians, nurses, chaplains, social workers, pastoral staff, and others—whose work focuses on dying and extremely vulnerable patients. The utility of a theory of generative death anxiety as a framework for interpreting the nature of these special stresses is suggested. Three common burnout reactions are examined. The paper concludes that positive acceptance of personal mortality may help clinicians avoid burnout and lead to better therapeutic practice. This framework for interpreting therapeutic practice demonstrates the integral role spirituality plays in work with this particular patient group.     

When religion may be an ethical issue

Though Americans are a religious people, there are times when religion or religious views may confound the ethical process. This article claims that religious values may be expressed as either principles or narratives, then seeks to establish a case for dealing with religious claims as principled narratives. Methods of evaluation are explored and then seven guidelines are offered for dealing with religion in ethics consultations.     

Auguste Comte on Positivism and Happiness

Auguste Comte (1798–1857) is the founder of a French school of thought that became famous for its encyclopaedic account of the sciences as well as for its exposition of what was designed as a way out of a state of intellectual and moral crisis. This essay demonstrates that there is a linkage between the diagnosis of crisis and the pursuit of happiness in Comte's foundation of positivism. It begins by distinguishing Comte's notion of positivism from that of a value-free science. In analysing Comte's peculiar usage of the term happiness, the essay shows that happiness is understood as the result of the convergence (consensus) of three components: a scientific conception of the world, the feelings of love and veneration, and a wisely ordered activity. The essay then demonstrates that the first of these components is of primary importance inasmuch as it is to frame a new horizon within which man is expected to return to a healthy state of mind, to reshape both his hopes and activities, and to discover his own participation in a supreme order acting through the laws of nature as well as through those of the civilization in which he lives. Conveying this new horizon to citizens of a lasting Republic is the sacred mission of sociology. The essay concludes by pointing out that Comte's conception of happiness can be assessed as unifying some main qualities of life as they are classified in Ruut Veenhoven's fourfold matrix.     

“The Dead”

Gabriel Conroy, central to James Joyce's novella, The Dead, keys the reader's experience of the evening portrayed. A third-person narration allows for distance, but Gabriel's closely depicted thought processes and actions, and his insistent self-consciousness, shape the story. As such they invite psychoanalytic interpretation and reward it. Gabriel's shocking discovery and reaction to it can be seen to be informed by rendered psychodynamics and a credible internalized past. Joyce and Freud, actual contemporaries, can be seen as contemporaneous in imagination as well.     

The Factor Structure of the Beavers Interactional Scales

Confirmatory factor analysis and regression analyses of the Beavers Interactional Scales did not appear to support the model offered by its developers, namely, several specified family attributes contributing respectively to two global factors of Family Competence and Family Style. Moreover, regression analysis indicated that only three of 12 items predicted raters' assessments of Global Family Health, and one of seven items predicted Global Family Style. Individuals interested in the family dynamic centripetal/centrifugal might best think of that as a unitary entity and rate it accordingly.     

Der “dritte Weg” der “neo-eurasischen” Zeitschrift “Elementy” -- zurück ins Dritte Reich?

Studies in East European Thought - Articulated in the twenties, the doctrines of the exiled Russian ‘Evrazijstvo’ movement are undergoing a renaissance in Russia today. As the...     

Adjusting To a New Racial Climate: Maintenance of Personal Integrity

This paper will focus on the writer’s experience as a native New Yorker relocating to Montgomery, Alabama. The writer will share how he adjusted and coped with overt discrimination and racism in the context of the high school in which he attended there-a majority white high school on the “other” side of town. The writer will share how he employed the following coping mechanisms as methods of adjusting to his new environment: translating emotional experiences into words (relaxation and talk therapy), involvement with other black positive peers, careful assessment before acting, withdrawal and avoidance, and consuming African-American literature.     

The Impact of Personality and Religion on Attitudes toward Alcohol among 16–18 Year Olds in Northern Ireland

Background: Previous research demonstrates a negative relationship between attitude toward alcohol and religiosity. However, what is less apparent is if this relationship may, at least in part, be a function of individual differences in personality, as previous research has demonstrated a relationship between certain measures of personality and both attitude toward alcohol and attitude toward religiosity. The aim of the present study was to explore the impact of personality and the relative efficacy of different markers of religiosity in predicting attitude toward alcohol among a sample of 16–18 year olds in Northern Ireland. Method: The Francis Scale of Attitude toward Alcohol (Francis, 1992c. Drug and Alcohol Dependence, 31, 45–50) was administered alongside the Abbreviated Revised Eysenck Personality Questionnaire (Francis, Brown, & Philipchalk, 1992. Personality and Individual Differences, 13(4), 443–449), the Francis Scale of Attitude toward Christianity (Francis & Stubbs, 1987. Personality and Individual Differences, 8, 741–743) and measures of frequency of personal prayer and church attendance among a sample of 243 16- to 18-year-old sixth-form students in Northern Ireland. Results and conclusion: The data demonstrate that a more prohibitive attitude toward alcohol was correlated with lower psychoticism scores (tendermindedness) and a more positive attitude toward Christianity. Multiple-regression analyses confirm the importance of attitude toward religion in predicting individual differences in attitude toward alcohol.     

A Lesson from My Father

Simple acts can heal. And God is present in those simple and humble acts. The following is a true story that illustrates these truths, told from the perspective of eyewitness, son, and physician.