A Pilot Study of Psychotherapist Trainees' Alpha-Amylase and Cortisol Levels During Treatment of Recently Suicidal Clients With Borderline Traits

Psychotherapists often experience stress while providing psychotherapy, in particular when working with difficult presentations such as suicidality. As part of a larger study on the treatment of recently suicidal college students with borderline traits, 6 therapists in training collected their own salivary samples for alpha-amylase (AA) and cortisol (C) analyses immediately before and after sessions with 2 selected clients. On average, samples were collected for the same therapist-patient dyad throughout the year-long study to ensure that data reflected therapist responses across stages of treatment. Therapists also completed a working alliance questionnaire and rated perceived session difficulty immediately after each selected session. Contrary to expectations, therapists demonstrated elevated levels of stress as measured by AA and C at presession relative to postsession levels. Greater session difficulty was related to more pronounced declines in AA, whereas a stronger working alliance was linked to more pronounced reductions in C. Results suggest that physiological stress responses while working with recently suicidal clients with borderline traits occur primarily in terms of session anticipatory anxiety, whereas AA and C changes may be affected differently by factors such as session difficulty and working alliance. This is a pilot study, limited by its sample size, but the design, findings, and inclusion of physiological measures present an initial step in an essential line of research.     

Child abuse and the limits of confidentiality: forewarning practices

Confidentiality is widely considered to be of great importance in psychotherapy. With few exceptions, the breaching of confidentiality is an ethical violation and grounds for litigation. One such exception is the mandated reporting of known or suspected child abuse, representing a legally sanctioned limitation of confidentiality. Because clients generally expect unlimited confidentiality in therapeutic relationships, many therapists have begun to "forewarn" clients as a matter of informed consent. This research report: (a) briefly reviews issues surrounding mandatory reporting and confidentiality as they relate to forewarning, (b) defines and discusses forewarning as contrasted with "informing," (c) examines state statutes, case law and ethical guidelines relevant to forewarning, and (d) presents a survey of 428 mental health providers (MHPs) on their forewarning practices in which 36.9% forewarned all clients, 36.4% informed clients only upon suspicion of abuse, and 20.6% informed only after receiving a disclosure of abuse. The implications of these findings are discussed.     

Does the use of dolls facilitate children's memory of visits to the doctor?

Age differences in children's recall of salient experiences have frequently been documented, but these findings have routinely been based on studies in which verbal interviews have been employed. Because verbal interview protocols may underestimate the memory of young children, the purpose of this research was to compare the effectiveness of such an interview with two alternative protocols that involved the use of a doll. Using these contrasting protocols, 3-and 5-year-old children were asked to remember the details of a routine physical examination. Neither doll protocol facilitated 3-year-olds' recall of the features of the check-up. In contrast, 5-year-olds who were asked to demonstrate with a doll what happened in their examination showed enhanced recall. The inclusion of a doll had no effect on older or younger children's provision of elaborative detail about their visits to the doctor. Various measures of individual differences (e. g. temperament, language skill) predicted some aspects of the children's recall and elaboration. The findings are discussed in terms of the cognitive skills necessary for effective use of dolls in the assessment process, and are related to problems associated with interviewing young children who are involved in legal proceedings.     

Verbal and Numerical Expressions of Probability: "It's a Fifty-Fifty Chance"

When estimating risks, people may use "50" as an expression of the verbal phrase "fifty-fifty chance," without intending the associated number of 50%. The result is an excess of 50s in the response distribution. The present study examined factors determining the magnitude of such a "50 blip," using a large sample of adolescents and adults. We found that phrasing probability questions in a distributional format (asking about risks as a percentage in a population) rather than in a singular format (asking about risks to an individual) reduced the use of "50." Less numerate respondents, children, and less educated adults were more likely to say "50." Finally, events that evoked feelings of less perceived control led to more 50s. The results are discussed in terms of what they reveal about how people express epistemic uncertainty. Copyright 2000 Academic Press.     

The Psychology of Terrorism: An Agenda for the 21st Century

Research on political terrorism, which began in the early 1970s, faces some persistent problems. These involve defining the concept, collecting empirical data, building integrative theory, and avoiding the attribution of terrorism to personality disorders or "irrationality." Furthermore, analysis risks being driven by events or the concerns of policymakers. Nevertheless, it is generally accepted that psychological explanations of terrorism must take multiple levels of analysis into account, linking the individual to the group and to society. Future research should critically examine the assumption that a "new terrorism" has appeared at the end of the 20th century. Analysts should also take advantage of 30 years of history to develop comparisons and developmental studies that look not only at the causes of terrorism but at changes in terrorist strategy, the termination of terrorist campaigns, government decision-making, and policy effectiveness.     

Cardiovascular Reactivity During Marital Conflict in Laboratory and Naturalistic Settings: Differential Associations with Relationship and Individual Functioning Across Contexts

Cardiovascular reactivity during spousal conflict is considered to be one of the main pathways for relationship distress to impact physical, mental, and relationship health. However, the magnitude of association between cardiovascular reactivity during laboratory marital conflict and relationship functioning is small and inconsistent given the scope of its importance in theoretical models of intimate relationships. This study tests the possibility that cardiovascular data collected in laboratory settings downwardly bias the magnitude of these associations when compared to measures obtained in naturalistic settings. Ambulatory cardiovascular reactivity data were collected from 20 couples during two relationship conflicts in a research laboratory, two planned relationship conflicts at couples’ homes, and two spontaneous relationship conflicts during couples’ daily lives. Associations between self‐report measures of relationship functioning, individual functioning, and cardiovascular reactivity across settings are tested using multilevel models. Cardiovascular reactivity was significantly larger during planned and spontaneous relationship conflicts in naturalistic settings than during planned relationship conflicts in the laboratory. Similarly, associations with relationship and individual functioning variables were statistically significantly larger for cardiovascular data collected in naturalistic settings than the same data collected in the laboratory. Our findings suggest that cardiovascular reactivity during spousal conflict in naturalistic settings is statistically significantly different from that elicited in laboratory settings both in magnitude and in the pattern of associations with a wide range of inter‐ and intrapersonal variables. These differences in findings across laboratory and naturalistic physiological responses highlight the value of testing physiological phenomena across interaction contexts in romantic relationships.