Treatment recommendations for mentally disordered offenders: More than roulette?

Clinical judgments on the treatability and prognosis of mentally disordered offeenders (MDO) may strongly influence legal dispositions and the availability of treatment resources. This study examined 1,238 discharge summaries for MDOs referred for court assessments. Psychiatrists evidenced marked variability in how often they recommended treatment and how frequently they judged patients to have a poor prognosis. Two logit analyses suggested that diagnosis and consultation by other clinicians were associated with (a) treatment recommendations (i.e., Axis I diagnosis and social work consultations) and (b) prognosis (i.e., Axis II diagnosis and psychology consultations).     

Neutrality, interpretation, and therapeutic intent.

Neutrality is a central concept within the theory of psychoanalytic technique. We spell out the major controversies in which the concept has become embroiled, and provide a definition that we believe coincides with actual psychoanalytic practice. We discuss its merits and weaknesses, noting also the negative consequences of relying on older definitions. We relate neutrality to the interpretive process, indicating ways interpretation protects neutrality and is made more effective by it. We discuss the complex and controversial relation between neutrality and the analyst's therapeutic intent.     

From front line to home front: a study of secondary traumatization.

While the long-term effects of combat trauma on veterans have been studied extensively, its impact on veterans' wives has yet to be investigated. This study examined the implications of combat-induced psychopathology--wartime combat stress reaction (CSR) and current posttraumatic stress disorder (PTSD)--in a sample of 205 wives of Israeli combat veterans of the 1982 Lebanon war. Results show that both CSR and PTSD were associated with increased psychiatric symptoms in the wives. In addition, current PTSD was particularly found to contribute to impaired social relations among veterans' wives in a broad range of contexts, from inner feelings of loneliness, through impaired marital and family relations, and extending to the wider social network. Implications of these findings for treatment and further research are discussed.     

Developmental and individual differences in preschoolers' recognition memories: The influences of gender schematization and verbal labeling of information

Eighty-three 37-92-month-old children's gender schematization and recognition memories for gender-typed content were assessed. Verbal labeling of stimuli and age were positively associated with children's memories. Highly gender schematic children displayed better memories for gender-role consistent information and committed more gender transformation errors than less gender schematic children. Interactions between children's gender schematization, age, and labeling condition were observed. Labeling of stimuli facilitated less schematic children's memories for gender-role consistent information. Gender schematization was positively associated with younger children's memories, suggesting younger children's memories are more strongly mediated by gender schematization than older children's. Results support the position that studies of gender schema development require an integrated approach recognizing individual and developmental differences in gender schematic processing.Completion of this project was facilitated by funds received while the author was a National Institute of Mental Health Postdoctoral Fellow at the University of Denver: Grant 5T32 MH 15780-09. This support is gratefully acknowledged. An earlier version of this paper was presented at the Conference on Human Development, Charleston, South Carolina, 1988. The author would like to thank the faculty and staff of the Tiny Tot, Jack & Jill, Little Learners II, Plymouth and Upstate preschools for their assistance and cooperation. The author wishes to recognize James Aber, Rosanne David, Melisa Shack, and Susan Zigelbaum for their exceptional service in conducting the project; and would also like to thank Joan Barth, D. Bruce Carter, Gail S. Goodman, Carol L. Martin, William J. Meyer, Kathy Park, Ralph J. Roberts, Jaipaul L. Roopnarine, Margaret L. Signorella, and the anonymous reviewers for their comments and suggestions on earlier drafts of this article.     

Negativism and countertransference

The purpose of this work is to explore the phenomenon of negativism and the analyst's response to it during the course of analytic work with a patient in whom negativism is a central behavioral pattern. Melville's short story, "Bartleby the Scrivener," describing in telling detail the response of a sympathetic lawyer to profound and pervasive negativism in his legal scribe, is discussed as a literary analogy to the analyst-analysand dyad. Aspects of the concept of negativism within psychoanalysis are discussed. The potential usefulness of understanding certain unexpected countertransference responses to pervasive negativism is explored, as this is a relatively neglected area of psychoanalytic technique. A case is presented describing the analysis of a patient whose character, like Bartleby's, is a mixture of profound negativism along with schizoid, obsessional, and masochistic elements.