The triumph of American psychiatry: How it created the modern therapeutic state

Over the past 170 years, American psychiatry has progressively asserted its authority over a larger segment of the American population. From the mid-1800s to the end of World War II, psychiatry had authority over the asylum population, which markedly increased in the first half of the twentieth century due to the influence of eugenics, an ideology that argued the ‘mentally ill’ had to be segregated from society. After the war, American psychiatry adopted Freudian conceptions of mental disorders, which enabled it to begin treating people in the community who were ‘neurotic’ in some way, which dramatically expanded its influence in society. Then, in the 1970s, when many in American society were questioning psychiatry’s legitimacy as a branch of medicine, the American Psychiatric Association (APA) responded by adopting a disease model for diagnosing mental disorders, which it set forth in the third edition of its Diagnostic and Statistical Manual. There were no scientific discoveries that led to this new model, but soon the APA was informing the American public that mental disorders were diseases of the brain, and that psychiatric drugs helped fix those diseases, ‘like insulin for diabetes.’ The APA, in concert with pharmaceutical companies, has successfully exported this belief system to much of the developed world. In order to break free of this ‘therapeutic state,’ the public needs to understand the history of how it came to be, and see the social injury it has caused.     

Stressors, Quality of the Child–Caregiver Relationship, and Children's Mental Health Problems After Parental Death: The Mediating Role of Self-System Beliefs

Investigated whether three self-system beliefs, fear of abandonment, coping efficacy, and self-esteem, mediated the relations of stressors and caregiver–child relationship quality with concurrent and prospective internalizing and externalizing problems in a sample of children who had experienced parental death in the previous 2.5 years. The cross-sectional sample consisted of 340 children ages 7–16 and their surviving parent/current caregiver; the longitudinal analyses employed a subset of this sample that consisted of 100 children and their parents/caregivers who were assessed at three time points. A multirater, multimethod measure of caregiver–child relationship quality and a multirater measure of children's mental health problems were used. The cross-sectional model supported a mediational relation for fear of abandonment, coping efficacy, and self-esteem. The three-wave longitudinal model showed that fear of abandonment at Time 2 mediated the relation between stressors at Time 1 and internalizing and externalizing problems at Time 3. Implications of these findings for understanding the development of mental health problems in parentally bereaved children and designing interventions for this at-risk group are discussed.

Underlying correlation structures of parental stress, general health and anxiety

A partial least square regression (PLSR) was performed on the Swedish Parenthood Stress Questionnaire (SPSQ) sum score and subscales on incompetence, role restriction, social isolation, spouse relationship and health problems, using 42 items from the General Health Questionnaire (GHQ) and 20 items from the State Anxiety Inventory (STAI-X1). The dataset contained 227 fathers and 301 mothers of children aged 1.0-6.6 years from a population-based study on parental psychological distress in the general Norwegian population, and all items correlated positively with SPSQ. Subscales on spouse relationship, incompetence, social isolation and role restriction related to items on state anxiety and depression. The SPSQ subscale on health problems related to GHQ items on somatic symptoms and social dysfunction. The STAI-X1 item "not feeling rested" had a particularly important effect on parental stress. Underlying correlation structures between parental stress and items from STAI-X1 and GHQ were explored, but only the SPSQ sum score could be acceptably predicted. PLSR as a statistical methodology was found useful for health and psychometric data.     

Stress at encoding,context at retrieval,and children’s narrative content

Research concerning the relations between stress and children’s memory has been primarily correlational and focused on memory volume and accuracy. In the current study, we experimentally manipulated 7- and 8-year-olds’ and 12- to 14-year-olds’ experienced stress during a to-be-remembered event to examine the effects of stress on the content of their memory. We further manipulated the degree of interviewer support at retrieval to determine whether it moderated the effects of stress at encoding on memory. Children’s age, gender, stress at encoding, and interviewer support all influenced the type of information included in their narrative reports. Most notably, across ages, children who experienced a more stressful event but were questioned in a supportive manner provided the largest ratio of terms representing internal states such as those about cognitions and emotions. Results suggest that how children process past events may be influenced by both the nature of the event itself and the context within which it is recalled.     

Gender Differences in Adolescent Self-Esteem: An Exploration of Domains

The relationship between gender and global self-esteem in adolescence, while modest, has been well established, with boys consistently scoring higher than girls. In the present study, we sought to understand gender differences in adolescent self-esteem in terms of its component parts. With a relatively large (n = 545) sample of adolescents, drawn from Grades 8, 10. and 12, we specified 8 domains of adolescent self-esteem (personal security, home/parents, peer popularity, academic competence, attractiveness, personal mastery, psychological permeability, and athletic competence) across a number of different instruments and brought them together into a common assessment superstructure. Gender differences as well as the relative contributions of the different domains to overall self-esteem scores were measured. As predicted, boys attained slightly higher global self-esteem scores than girls did, by a difference of .22 standard deviation units. Contrary to our expectation of more balanced domain effects, boys significantly outperformed girls in 6 of 8 domains, whereas the 2 remaining domains exhibited no significant gender differences. There were no main or interaction effects for grade level. In terms of relative contribution of these domains to global self-esteem for the 2 genders, global self-esteem in boys and girls is predicted in very similar strengths and in the same order of magnitude by identical domains of self-esteem: home/parents, personal security, academic competence, attractiveness, and personal mastery—yielding multiple R ²s from .88 to .91.     

Self-Esteem Accuracy and Externalizing Problems in Preschool-Aged Boys

Although the existing literature addressing the relation between self-esteem and externalizing problems is inconsistent, it appears that accuracy of self-esteem ratings may be an important factor to consider. However, no studies to date have explored this with preschool-aged children. In this study, the authors investigated differences in externalizing problems between underraters, realistic raters, and overraters of self-esteem of 5-year-old boys in three domains: cognitive competence, physical competence, and peer acceptance. Compared to teacher ratings of competence, boys who overrated their cognitive competence and peer acceptance were more likely to be rated by teachers as exhibiting more externalizing problems the following year. Findings suggest that overconfidence may have important implications for the development of externalizing problems in young children.     

To Pass or Not to Pass: A Mathematical Model for Competitive Interactions in Rugby Union

ABSTRACT. Predicting behavior has been a main challenge in human movement science. An important step within the theory of coordination dynamics is to find out the rules that govern human behavior by defining order parameters and control parameters that support mathematical models to predict the behavior of a system. Models to describe human coordination have been focused on interlimb coordination and on interpersonal coordination in affiliative tasks but not on competitive tasks. This article aims to present a formal model with two attractors to describe the interactive behavior on a 2v1 system in rugby union. Interpersonal distance and relative velocity critical values were empirically identified and were included as task constraints that define the attractor landscape. It is shown that using relative velocity as a control parameter the model offers reasonable prediction concerning the decision-making process. The model has the plasticity to adapt to other settings where interpersonal distances and relative velocities amongst system components act as significant task constraints.     

A Developmental Analysis of Performance Ratings

In this study, we examined the performance appraisal process from a developmental perspective. Components of cognitive structure, measured in terms of differentiation and hierarchic integration, were obtained from 45 American students representing three different academic levels at three times during a 15-week semester. These students' performance evaluations (ratings) of their psychology instructors were collected during the first and final sessions. The results indicated that although both differentiation and hierarchic integration seemed to change systematically, even over a short period of time, there was no corresponding change in the halo inherent in the raters' ratings. We present possible explanations for the failure of developmental changes in cognitive structure to be reflected in the halo inherent in the performance ratings, as would be predicted by Schneier's (1977) cognitive compatibility hypothesis. Increased emphasis on developmental aspects of the performance appraisal process is recommended.     

Evaluation of the factor structure of the Rosenberg Self-Esteem Scale in older adults

The Rosenberg Self-Esteem Scale is the most utilized measure of global self-esteem. Although psychometric studies have generally supported the uni-dimensionality of this 10-item scale, more recently, a stable, response-bias has been associated with the wording of the items (Marsh, Scalas, & Nagengast, 2010). The purpose of this report was to replicate Marsh et al.’s findings in a sample of older adults and to test for invariance across time, gender and levels of education. Our results indicated that indeed a response-bias does exist in esteem responses. Researchers should investigate ways to meaningfully examine and practically overcome the methodological challenges associated with the RSE scale.     

Countertheses: Communication,material conditions,and future sociocultural development

Chaos in brain function. Edited by Erol Basar Springer‐Verlag, 1990, Berlin. Softcover, 176 pp., 66 figures, index.