Commentary: Writing About Clients: Ethical and Professional Issues in Clinical Case Reports

From the standpoint of a former journal editor and long‐time professional, this commentary challenges the direction of the profession as demonstrated in this special section. The ongoing creation of more and more ethical constraints not only harms the profession but also loses sight of fundamental ethical principles.     

Self-Knowledge of Personality: Do People Know Themselves?

The intuition that we have privileged and unrestricted access to ourselves – that we inevitably know who we are, how we feel, what we do, and what we think – is very compelling. Here, we review three types of evidence about the accuracy of self-perceptions of personality and conclude that the glass is neither full nor empty. First, studies comparing self-perceptions of personality to objective criteria suggest that self-perceptions are at least tethered to reality – people are not completely clueless about how they behave, but they are also far from perfect. Second, studies examining how well people’s self-perceptions agree with others’ perceptions of them suggest that people’s self-views are not completely out of synch with how they are seen by those who know them best, but they are also far from identical. Third, studies examining whether people know the impressions they make on others suggest that people do have some glimmer of insight into the fact that others see them differently than they see themselves but there is still a great deal people do not know about how others see them. The findings from all three approaches point to the conclusion that self-knowledge exists but leaves something to be desired. The status of people’s self-knowledge about their own personality has vast implications both for our conception of ourselves as rational agents and for the methods of psychological inquiry.     

A benevolent conceptualization of marital power: The case of depression

Treatment of the depressed client with low self-esteem, external locus of control, and an absent spouse often is frustrating due to the limitations of modifying the social context. An approach to the problem using a systemic view which is based on examining the notion of power and examining the problems in their context is presented. Interventions which sidestep the temptation of emphasizing self-esteem of the client and, instead, utilize client strengths and interactional dynamics within the marriage are presented.     

Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention-deficit hyperactivity disorder

Twenty-four boys with attention deficit-hyperactivity disorder (ADHD) participating in an intensive summer treatment program each received b.i.d. placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed with two classroom settings: a behavior modification classroom including a token economy system, time out and daily home report card, and a regular classroom setting not using these procedures. Dependent variables included classroom observations of on-task and disruptive behavior, academic work completion and accuracy, and daily self-ratings of performance. Both MPH and behavior modification alone significantly improved children's classroom behavior, but only MPH improved children's academic productivity and accuracy. Singly, behavior therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted in maximal behavioral improvements, which were nearly identical to those obtained with 0.6 mg/kg MPH alone.The authors gratefully acknowledge the assistance of Patricia Donovan, Michelle Berry, Mary Ingram, Patricia Wells, Beth Gnagy, Karen Greenslade, Mary Hamilton, and the entire staff of the Western Psychiatric Institute and Clinic ADHD Summer Treatment Program.     

Marital satisfaction and family stress as predictors of classroom behaviors

The purpose of this research was to examine the relationship between parents' perceptions of marital satisfaction and family stress and their third grade children's classroom behavior. Twenty-one married couples completed questionnaires during home visits. Behavior observations were made from videotapes of children recorded in their classroom during lunch and group academic periods on each of three days. Frequencies of peer interactions, solitary behaviors, and teacher interactions were coded. Regression analyses showed that mothers' level of marital satisfaction (but not fathers') predicted their children's frequency of peer interactions during lunch. Fathers' level of perceived family stress (but not mothers') predicted their children's frequency of peer interactions during lunch. Neither measure for either parent was related to the frequency of peer interactions, solitary behaviors, or teacher interactions observed during the academic sessions. These findings highlight the importance of assessing the potential differential relation of parent variables to children's trans-situational behaviors, and the examination of these variables in relation to different social-environmental contexts in which children participate outside the home.     

Social and life skill competence in potential early school-leavers

Competencies in social and life skills of a group of students expecting to leave school at the end of Grade 10 in Australia is compared with groups expecting to continue. Academic performance and skills were also assessed. The results of the study indicated that the potential early school-leavers were disadvantaged both socio-economically and academically. But, surprisingly, the findings indicated that they were not significantly different from the other two groups of students targeted in the study in terms of their social and life skills. The results imply that potential early leavers in school populations may be unnecessarily disadvantaged because school programmes, in concentrating on a narrow range of cognitive skills, do not build on personal competency skills already possessed by students of all levels of ability. Whilst this is the case, potential early school-leavers will be likely to continue to be disaffected and disadvantaged educationally.     

Cardiovascular reactivity and interpersonal influence: active coping in a social context

Previous studies have demonstrated that effortful attempts to secure positive outcomes or avoid negative outcomes produce significant increases in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR). Although these effects of active coping on cardiovascular reactivity are central in current psychosomatic theories, virtually all of the research to date has used impersonal, asocial tasks. Our two studies examined the cardiovascular effects of effortful attempts to influence other people. In Study 1, male subjects attempting to influence the opinions of their discussion partner to improve their own chances of winning money displayed significantly greater SBP, DBP, and HR reactivity. In Study 2, we obtained similar effects on SBP and DBP reactivity in men and women, while both preparing an influence attempt and making that attempt. Furthermore, reactivity levels were larger as the magnitude of incentive for successful persuasion increased. Implications of this interpersonal equivalent of active coping for the development of cardiovascular disease are discussed.     

Children's affective,behavioral, and cognitive responses to social comparison

Relative outcomes in social commerce with peers are potent determinants of cognitions and behavior in young children. Although there has been considerable attention given to the behavioral consequences of social comparisons following the receipt of rewards, there has been less concern with cognitive or affective consequences. Additionally, little is known about the accrued effects of multiple social comparison experiences that may be consistent or inconsistent with one another. In the present study, young children received a constant level of reward but the amount they saw a peer receive was varied. There were two sequences of reward distribution, and in a given sequence children received either the same number of rewards as the peer (=), more (+), or fewer (?). In a 3 × 3 factorial design all possible combinations occurred. A negative inequality in reward distribution, no matter where it fell in a sequence, made children sad and inclined children to distribute fewer rewards to peers. When a sequence contained an initial experience of positive inequality, children decreased subsequent levels of self-reward. Experiencing a comparison that revealed a negative inequality in reward distribution also disrupted children's accuracy in appraising the overall distribution of rewards: even when an initial negative inequality was completely offset by an equivalent experience of positive inequality, children inaccurately concluded that they had received fewer rewards than their peers.     

PRODUCING GENERALIZED JOB INITIATIVE IN SEVERELY MENTALLY RETARDED SHELTERED WORKERS

The development of generalized job initiative was examined with three severely retarded men working in an industrial assembly area of a sheltered workshop. Interventions included discrimination training, role-play training, and self-monitoring. For each participant, training was applied sequentially to three sets of job initiative behaviors. Intensive training was required to establish the first set of job initiative behaviors; however, the second and third sets of job initiative behaviors were learned with only discrimination training. The discussion summarizes the findings and suggests research needed to develop more powerful learning-to-learn paradigms.