Self-regulation and the etiology of sexual deviance: evaluating causal theory

Recently introduced theories of sex offending, including the self-regulation model and the multimodal self-regulation theory, have implicated self-regulatory deficits as a key variable in the development of sexually inappropriate interests and behaviors. While dysregulation has been considered an important component of a variety of behavioral, emotional, and interpersonal disorders, sexual behaviors have rarely been conceptualized within this context. In this study, we have examined a number of variables linked to self-regulation and dysfunctional outcomes in a sample of 95 sex-offending men. Results of a path analysis demonstrated that self-regulatory deficits were significantly predictive of paraphilic and antisocial behaviors in this group. Implications for our understanding of the etiology of sexual deviance and future research in this area are discussed.     

Torrential Tears: The Relationship Between Memory Development, Early Trauma, and Dysfunctional Behavior

The purpose of this article is to illustrate how findings in memory research can significantly inform our understanding of dysfunctional behavior. It will demonstrate that specific forms of memory, which are expressed through procedures or behaviors, reveal through their presentation information of diagnostic significance. From a neuropsychosocial perspective, this article suggests that the time at which early trauma intersects with the development of memory structures, systems and functions can be significant to the motivation of dysfunctional behavior.     

Former Athletes' Illness Stories of Brain Injuries: Suspected Chronic Traumatic Encephalopathy and the Entanglement of Never-Aging Masculinities

Examining former athletes' health-related beliefs and behaviors on the long-term effects of concussions and potentially developing chronic traumatic encephalopathy (CTE) offers a domain to understand how men renegotiate their masculinities. In this paper, we explore how the cultural production of the concussion crisis shapes the ways in which men athletes make sense of self and their masculinity in the face of declining health. Drawing on in-depth interviews with 27 male, former athletes, this article examines the multiple ways in which gender shapes their experience and treatment of traumatic brain injuries or suspected CTE. We show how men are re-negotiating their aging masculinities through illness narratives and how the cultural production of the concussion crisis in sports shapes these narratives. We break down our analysis into three sections: (1) reflections of chaos narratives and stories of never-aging masculinities, (2) the ways the concussion crisis shapes their restitution narratives, and (3) quest narratives combining never-aging and aging masculinities. Whether or not these athletes have or are treated for CTE, we argue that they reformulate their masculinity to regain control over their manhood and to feel a sense of relief.     

How Ineffective Family Environments Can Compound Maldevelopment of Critical Thinking Skills in Childhood Abuse Survivors

The high stress of childhood abuse is associated with neurobiological detriments to executive function. Child abuse survivors may also be cognitively and relationally disadvantaged as a result of being raised in emotionally impoverished families that lack cohesion, organization, flexibility, self-expression, and moral and ethical values and fail to provide opportunities for effective learning. A review of literature demonstrates how dysfunctional family of origin environments common to child abuse survivors, concomitant with the extreme stress of overt acts of abuse, can act as a barrier to the development of higher-order critical thinking skills. The article concludes by discussing ramifications of critical thinking skill deficits in child abuse survivors and highlights the importance of integrating and prioritizing critical thinking skills training in treatment.     

Cocaine-Exposed Toddler-Caregiver Dyads During Free Play at 24 Months

Some women continue to use cocaine during pregnancy, placing their fetus at risk for developmental problems. While gross problems are not evident after controlling for experimental flaws, subtle effects continue to be found. Social interactions of cocaine-exposed and nonexposed toddlers and their caregivers were assessed during a Free Play test to determine if psychobehavioral deficits were clinically observable. Risk factors were evaluated to assess whether the child’s socioemotional-behavioral behaviors were related to exposure and/or interactions with caregivers or the environment. Twenty-four-month-old cocaine-exposed and nonexposed toddlers were evaluated with the Child Behavior Check List while they played with their caregivers. Caregivers’ vocalizations were scored as contingent pairs if they occurred within 3 seconds of the child’s. The proportion of pairs was compared by group. Quality of caregivers’ vocalizations was rated as positive or negative based on approval, encouragement, and criticism. General linear model analyses indicate that cocaine-exposed children showed more dysfunctional behaviors than noncocaine-exposed children. Deficits increased when income and number of dependents were included. Caregivers in the drug group emitted fewer vocalizations during play before receiving a toy, indicating fewer opportunities for learning. No effect of quality of caregiver communication or gender by cocaine exposure interaction emerged. Cocaine exposure predicts poor developmental outcomes, but the toddler-caregiver relationship and reduced access to resources are additional risks that had previously been attributed to cocaine exposure. Early intervention services are needed to reduce the impact of low income, increase preschool readiness, and optimize functioning of these fragile families.     

Effective management of adolescents with anorexia and bulimia

1. Anorexia and bulimia are common among adolescents, and both are complex, chronic disorders with high comorbidity and significant complications and mortality. 2. Eating disorders cultivate shame, denial, and lack of insight, making treatment difficult and necessitating careful development of a therapeutic alliance. 3. Treatment goals are to correct the biological and psychological sequelae, prevent or correct complications, restore normal eating patterns, reduce binging and purging, promote understanding and change in dysfunctional behaviors and attitudes, improve intrapersonal and interpersonal functioning, restore normal exercise patterns, and address comorbid psychopathology and psychological conflicts.     

Part I. Work hardening for warriors: Occupational therapy for combat stress casualties

Combat stress is an occupational hazard of the military. Soldiers who become job-ineffective due to combat stress are termed "battle-fatigued." Occupational therapy, in the form of work hardening, is an important part of the management of these soldiers. Occupational therapists possess specialized knowledge and skills which make them uniquely qualified for this role. These assets include knowledge of neuromuscular and psychosocial aspects of occupational performance; the ability to do task analyses; the ability to assess occupational performance deficits; the ability to synthesize appropriate therapeutic occupations to rehabilitate functional deficits and match these to the needs of dysfunctional soldiers. These same resources serve occupational therapists equally well in civilian work hardening settings. This paper reviews the management of combat stress casualties, describes the Army units which minimize the impact of combat stress reactions, and delineates the Army occupational therapists' roles of soldier, mental health practitioner, and work hardening coordinator.     

Caring: commitment to excellence or condemnation to conformity?

The art of caring to alleviate illness and to promote health is nursing's unique commitment to society and the health-care industry. How this practice is implemented dictates the success or failure of prescribed strategies. In addition, the way in which caring is implemented defines emotional maturity on both a personal and professional level. Several goals to rehabilitate the psychologically codependent person include: Developing an awareness of the origins of codependency and how early family experiences affect subsequent behavior and beliefs about oneself; Identifying the personal price and payoffs for continuing codependent behaviors; The ability to openly express personal needs, wishes, feelings, and opinions while respecting the rights of others; Learning to discriminate between loving/caring and the destructive control of codependency; and The ability to take responsibility for another rather than being responsible to another. Codependent behaviors are prevalent within professional nursing practice, as evidenced by examples provided from three specialty areas in nursing and the fact that women (who are traditionally assigned the cultural role of caring) constitute the majority of professional nurses. Therefore, it is a professional challenge to each nurse to ascertain whether practices are functional or dysfunctional: is the professional interpretation of caring a commitment to excellence or a condemnation to conformity in the unique delivery of health-care practice?     

Initial thoughts on viewing pathological gambling from a physiological and intrapsychic structural perspective

This paper is an effort to integrate the contributions of various theoretical orientations in psychology, psychiatry, and neuropsychology into a framework that facilitates the understanding and treatment of pathological gambling. It is the belief of the author that pathological gamblers in particular and perhaps addicted individuals in general lack elements in basic internal structures. Such deficits may involve a biological vulnerability as well as learned dysfunction that result in gaps in identity and ego constructs along with inadequate cognitive and emotional frameworks. Such structures make it difficult for individuals to manage many aspects of life, particularly negative affect, interpersonal relationships, intimacy, and behavioral consistency. The role of treatment begins with evaluation of existing internal structures in order to determine which are dysfunctional. Therapeutic interventions subsequently would be designed to assist patients in constructing more solid structural foundations on which they can build realistic and effective coping patterns and integrated identities. The relevance of a twelve step program in accomplishing therapeutic goals is also discussed.     

A PSYCHOEDUCATIONAL MODEL FOR WORKING WITH FAMILIES OF AUTISTIC CHILDREN*

Because of the well-documented effectiveness of paradigms which emphasize parental or family pathology in understanding and intervening with dysfunctional children, the temptation exists for applying them to other dysfunctional populations. Autism is a pervasive developmental dysfunction with life-long adverse sequelae for the child and family. This paper reviews evidence on the biological etiology of autism and other pervasive developmental deviations, and stresses the necessity for providing an early and accurate diagnosis for the family. The adverse implications of downplaying individual pathology and concentrating on parental or family dysfunction are then discussed. The natural evolution and specific components of a psychoeducational model for diagnosing autistic children and working with them and their families are then presented. Finally, some of the advantages of this multimodal, multidiscipline model in long-term work with these pervasively dysfunctional individuals and their families are considered.     

The Re-Creation Of Gender In A Male Workplace

This paper draws on participant observation in a male-dominated blue-collar job to understand how the concepts of masculinity and femininity are re-created through coworker interactions on the shopfloor and the effect of this on women. Men typecast women in these jobs as either feminine or unfeminine and treated them differently, but in both cases, women's presence was useful for defining–and in the case of sex-role appropriate women–enforcing masculinity. Such treatment isolated women from the on-going work culture and constrained them to certain behaviors.     

Repairing ego deficits in children with developmental disorders

Children with developmental disorders have ego deficits which must be addressed before one is able to work with them in traditional dynamic clinical treatment. A review of the literature explores the distortions in personality structure which accompany developmental disorders, a conceptual paradigm for integration of psychodynamic and social learning theory models for understanding this problem, and suggestions for working with these children and their families. Three specific ego functions must be repaired in the initial stages of treatment: control of drive activity, reality testing, and the capacity for identification. Two case examples are used to illustrate how the worker may repair deficits in these ego functions.     

Enhancing Health-Conscious Behaviors Among Clients in Substance Abuse Treatment Programs

The physical health of substance abuse clients significantly deteriorates because of the client’s prolonged abuse of alcohol and other drugs and accompanying behaviors. The purposes of this study are (a) to understand how substance abuse clinicians think about the health needs of their clients, (b) to identify the mechanisms through which clinicians seek to enhance health-conscious behaviors among their clients, and (c) to identify how substance abuse clinicians view their role in enhancing health-conscious behaviors among their clients. A qualitative study was conducted using in-depth, semistructured interviews with substance abuse clinicians (N = 16) from 4 substance abuse treatment centers. Using the theory of planned behavior as a framework for understanding the promotion of health-conscious behaviors in substance abuse treatment, the findings suggest that substance abuse clinicians are capable of enhancing health-conscious behaviors among clients in substance abuse programs.     

Treating the disconfirmed psychiatric client

Frequent disconfirmation behaviors have been documented in psychiatric clients. Individuals who demonstrate maladaptive patterns of disconfirmation can learn to understand and modify this dysfunctional sequence. Through one to one interactions and group discussions, psychiatric nurses can help clients learn more positive communication behaviors. This accomplishment will positively affect the client's interpersonal responsiveness and self-esteem.     

Parent-child aggression: association with child abuse potential and parenting styles

The present investigation predicted that greater use of corporal punishment as well as physical maltreatment would be associated with child abuse potential and selected parenting styles. Three independent studies were examined, two with community samples and a third with a clinical at-risk sample of parents. Parents across all studies anonymously completed the Child Abuse Potential Inventory, the Parent-Child Conflict Tactics Scale to assess physical discipline and maltreatment, as well as the Parenting Scale to measure dysfunctional parenting styles. Findings support that overall parent-child aggression, as well as physical maltreatment behaviors specifically, were associated with child abuse potential. Parent-child aggression was also related to dysfunctional parenting styles, particularly an overreactive, authoritarian parenting style. Permissive parenting was also identified as potentially associated with physical maltreatment, although the findings regarding such lax parenting styles are less clear. Intriguing findings emerged regarding the connection of psychological aggression to both child abuse potential and dysfunctional parenting style. Child abuse potential was also associated with dysfunctional parenting style, particularly harsh, overreactive approaches. Recommendations for future study with at-risk samples and additional research on permissive parenting and psychological aggression are discussed.     

Discipline and socialization of children in abusive and non-abusive families

This qualitative study examines how abusive parents' increasingly harsh administration of authoritative and punitive discipline socialized their children to act aggressively and asocially within their families' escalating interpersonal conflict. In comparison, non-abusive parents used successive instructive and authoritative discipline directing their children to engage in pro-social behaviors within their families' routine complementary role social interactions and mutual decision-making processes. These findings suggest that assessment procedures and interventive goals be changed to safeguard children in abusive families from both physical injury and dysfunctional socialization practices of their parents.     

The rationalization process of online game cheating behaviors

Online deviant behaviors have been prevalent since the Internet became ubiquitous, but research in this field is relatively scarce. The present study investigates a unique deviant behavior in online video gaming communities – game cheating – to further understand the scope of online deviant social behaviors. This paper aims to uncover how game players actively create and negotiate new meanings of game cheating in online games. Six focus groups were conducted to explore the rationalization process for engaging in game cheating among players of different online video games. It was discovered that elements of intentionality, utility, core gaming goals, evolving gaming norm, and social ties to gaming communities serve as important rationalizing process to justify game cheating behaviors. Through the discovery of these mental schemas for online game cheating, the paper discusses how online deviant behaviors are connected with social life online and form a unique online culture.     

Getting with the (evidence-based) program: An evaluation of the Incredible Years Parenting Training Program in child welfare

This study evaluates four group sessions of the Incredible Years (IY) Parenting Training Program used for the first-time in two child welfare agencies in New York State. Few studies have examined process and evaluation outcomes of evidence-based parenting programs in child welfare. Qualitative staff interviews and surveys on parenting behaviors were used to examine program processes, improvements in parenting behaviors, and participant satisfaction. Program participation was associated with less parental distress, defensive responding, dysfunctional parent-child interactions, child difficulty, total stress, and greater empathy and social support. The effectiveness of this evidence-based, parent education program in the context of a child welfare population, as well as implementation challenges and recommendations, are discussed.     

A Family Therapy Approach to Alcoholism*

Data accumulated from recent studies strongly suggest that family therapy is a promising method of treatment for alcoholism. In this paper a comprehensive treatment approach is proposed, based on known characteristics of alcoholic family systems and the author's clinical experiences in working with families of alcoholics. Specific strategies are described that can enhance treatment success by reducing resistances and maximizing changes in dysfunctional family interaction patterns. The relationship between the spouses is such as to perpetuate the need for alcohol. The major focus in therapy therefore is on understanding and changing the marital relationship.