Course of Treatment During a Cohort-Based Inpatient Program for Posttraumatic Stress Disorder

This study examined one group of veterans with post-traumatic stress disorder (PTSD) over the course of a four month inpatient treatment program. The aim of the study was to examine treatment process factors that may contribute to the generally poor outcome reported in previous studies. Group members made weekly ratings in the domains of PTSD symptoms, morale, interpersonal relationships, and physical problems. Results contrasted with clinical assumptions usually made regarding the treatment process in these programs. Despite an appearance of cohesion among group members, variation of scores on functional domains was explained largely by individual differences. Progress through the program showed a strongly linear pattern, with no phase effects. Somatic complaints did not increase during the phase when traumatic material was explored. Degree of improvement or worsening was best predicted by level of PTSD symptoms at admission, indicating that more symptomatic veterans did worse in the program. Additional factors of race, combat exposure, childhood abuse, and application for disability had no effect on the process variables measured.     

The Strengths and Limitations of Case Record Reviews in Examining Family Preservation Outcome Formulation and Treatment Planning

Much debate has centered on what are reasonable outcomes of the short-term intensive family preservation services (IFPS). However, little attention has been given to how therapists actually formulate outcomes in their practices. The files of 98 families who used IFPS were reviewed to determine how therapists formulated outcomes and whether formulated outcomes varied by service sector (child welfare or mental health) and child age. It was found that formulated outcomes in mental health were more likely than those in child welfare to have a child focus and an interpersonal locus. Variation in outcome formulation in child welfare by child age was found, with outcomes of younger children more likely to be parent-focused than were outcomes of older children. The issues pointed out by these findings are discussed. Since case records are a potential data source for researchers, the paper concludes with a discussion of the strengths and limitations of case record reviews for research purposes.     

Conduct Disorder in Girls: A Review of the Literature

The study of Conduct Disorder (CD) has primarily been limited to boys. The lack of research resulted from a premise that CD in girls was rare. However, CD in girls is a relatively common psychiatric diagnosis, and appears to be associated with several serious outcomes, such as Antisocial Personality Disorder and early pregnancy. Understanding gender differences in the course and severity of CD may lead to important information about etiology. Empirical studies on precursors, developmental course, risk factors and treatment for CD in girls are reviewed, while highlighting similarities and differences between girls and boys. Generally, CD symptoms in girls are stable. Precursors to CD in girls probably include Oppositional Defiant Disorder and temperamental factors, but also may include certain negative cognitions. What distinguishes CD in girls is the high risk they have to develop comorbid conditions, especially internalizing disorders. Risk factors for CD in girls partly overlap with those known for boys, but some factors appear to be highly salient for girls. Finally, there may be some significant effects of gender on treatment efficacy. Implications of these findings for future etiologic research are discussed.     

Evaluation of antecedent stimulus parameters for the treatment of escape-maintained aberrant behavior

We evaluated a methodology for identifying the range of stimulus features of antecedent stimuli associated with aberrant behavior in demand contexts in natural settings. For each participant, an experimental analysis of antecedents (Phase 1) was conducted to confirm the hypothesis that task instructions occasioned increases in aberrant behavior. During Phase 2, specific stimulus features associated with the presentation of task instructions were assessed by evaluating the child's behavior across two distinct settings, therapists, and types of tasks in a sequential fashion. Aberrant behavior occurred immediately across settings and therapists, presumably because the presence of a discriminative stimulus for escape-maintained behavior (the delivery of a task instruction) occasioned aberrant behavior. However, aberrant behavior decreased initially across tasks, suggesting that familiarity with the task might be a variable. During Phase 3, an experimental (functional) analysis of consequences was conducted with 2 participants to verify that aberrant behavior was maintained by negative reinforcement. During Phase 4, a treatment package that interspersed play with task instructions was conducted to disrupt the ongoing occurrence of aberrant behavior. Immediate and durable treatment effects occurred for 2 of the 3 participants.     

Eternity in an hour: experiences of time related to psychotherapy sessions

In this paper I consider the individual nature of the way a person develops senses of time. I suggest that something of a patient's early, unvoiced, experience is revealed through the temporal rhythms of interaction with the therapist. I refer to development, cycles of experience, metabolism, transgenerational emotions, experiences of beginnings and endings, early interactions with (m)other, together with narrative and its relation to unconscious processes. Experiences of time within the session indicate the nature of the feelings that are being lived, or refused life. I consider the paradox of living in the present and its relation to chronology. Lastly I give an example of the difficulty of timing comments when there is no flow of feeling, which is, itself, a communication.     

Mothers’ attuned responses to infant affect expressivity promote earlier achievement of language milestones

To investigate infants’ affective expressivity and maternal attuned responsiveness to infant expressivity in relation to early language achievement, 77 dyads were visited in their homes at 9 and 13 months, and mothers were interviewed about their children’s language between 9 and 21 months. Maternal responses that were attuned to infant affect, by selectively matching either the gradient features or the valence of infants’ affective expressions, were more predictive of children’s language achievement than maternal nonmatching responses; and maternal matching responses at 9 months were more predictive of children’s language achievements than maternal responses at 13 months. Moreover, maternal matching responses at 9 months predicted second-year language achievements over and above infant affect expressivity at 9 and 13 months, and over and above maternal matching responses at 13 months. Infants’ affective expressivity per se was not predictive.     

Well I May Be Exaggerating But Self-Qualifying Clauses in Negotiation of Opinions Among Japanese Speakers

The present study investigates the ways in which Japanese speakers negotiate their opinions in conversational interaction. On the one hand, speakers are apt to exaggerate a particular aspect of a given issue in asserting their opinion, on the other hand, they may also incorporate a self-qualification admitting a potential problem in their claim. By expressing their awareness of the problem before it is pointed out by the co-participants, the speakers seem to get license to proffer an exaggerated or overgeneralized claim and to increase their chance of receiving an affiliative response. This study explicates the mechanism through which such a self-qualifying clause emerges in the development of opinion-negotiation sequences. Further, as a contribution to a growing body of research on "interaction and grammar" (Ochs, Schegloff, and Thompson, 1996), this study explores the use of "contrastive" markers, -kedo and demo, in constructing turns and sequences in opinion-negotiation. The data demonstrate these two structurally different types of markers play distinct roles in differentiating and yet conjoining the speakers' assertion and self-qualification.     

Grammer and Social Interaction in Japanese and Anglo-American English: The Display of Context, Social Identity and Social Relation

This paper employs conversation analysis to examine the inter-connection between grammar and displays of contextual understanding, social identity, and social relationships as well as other activities clustering around turn-endings in Japanese talk-in-interaction, while undertaking a restricted comparison with the realisation of similar activities in English. A notable feature of turn-endings in Japanese is the particular salience of grammatical construction on the interactional activities they accomplish. Complete turns which are also syntactically complete are shown to be associated with the explicit display of contextual features, whereas syntactically incomplete turns are designed to circumvent or minimise such displays. The explicit or implicit display of one's social and contextual relationship to the interactional environment is therefore seen to be an integral part of the performance of social actions in Japanese. On the other hand, in English, it is more difficult to establish a clear association between grammar and the inclusion or avoidance of contextual displays.     

Introduction to Grammer and Interaction Papers

The present study reports on the use of a linguistic category "interrogative," which has been traditionally associated with the act of questioning, and its use in argument talk in Japanese. Based on the observation that interrogative utterances in argument data are regularly followed by non-answers, it is argued that interrogative utterances in argument sequences may not be designed/interpreted as doing questioning. Such use of interrogatives can become an orderly practice to which participants orient themselves in social activities recognizable as arguments. However, though an answer is not expected, the recipient invariably provides some form of response, or the initial speaker seeks such a response when none is provided. Thus the nature of interrogatives as a grammatical category seems to reside in the basic structural unit of social interaction [recipient-oriented action]-[response]. In general, this study is intended to show the dynamically interlocking relationship between grammar and interaction by exploring the intricate interplay between a local action for which interrogative grammar is employed, and the sequential environment and activity framework in which the action takes place.