Nepenthe Theory of Defense Mechanism Functioning and Defensive Behavior in African-U.S. People With Replication and Extension to Psychological Africanity (Racial Identity)

Ego mechanisms of defense were studied in a sample of 140 African-U.S. college students using for theoretical approaches Michael Bond’s defense style hierarchy and Daudi Ajani ya Azibo’s nepenthe theory. Each framework was supported in the data. Also, previous findings from an earlier exploratory study were replicated including greater defense style scoring compared to Caucasian norms and association between defense style scores and depression. In addition, this study incorporated measures of normal and abnormal psychological Africanity (racial identity). Defense style scores predicted indices of psychopathologic psychological Africanity (African-U.S. culture?focused mental disorders). Own-race negation and abjuration indices predicted defense style scores. ANOVAs found highest defense style scores for participants classified as having correct psychological Africanity orientation (highest psychological Africanity/racial identity scores) compared to diffused and incorrect lower classifications. It was concluded that the study of defensive behavior among African-U.S. persons might be tempered by nepenthe theory.     

The Role of Metacognition in Pathological Gambling: A Mediation Model

Pathological gambling involves multitudinous costs related to financial, legal, and public health care aspects, as well as to specific psychological disorders. Despite the overall evidence suggesting that comorbid disorders represent a risk factor for pathological gambling, there is scant evidence on the appropriate treatments for gamblers with such disorders. In this context, metacognitive therapy is an interesting approach because it considers psychological disorders as a result of the activation of perseverative cognitive processes and attentional strategies in response to inner events. Several studies report that metacognition is associated with different psychological problems. This study investigated the relationship among comorbid disorders, metacognition, and pathological gambling. 69 pathological gamblers at the first hospital admission and 58 controls drawn from general population (matched for age, gender, education) completed a battery of self report instruments: Symptom Checklist-90-R, Metacognition Questionnaire 30, South Oaks Gambling Scale. Compared to controls, pathological gamblers showed higher level of comorbid symptomatology and metacognition. Correlation analyses showed that: comorbid symptomatology and metacognition were positively and significantly correlated with pathological gambling; metacognition was positively and significantly associated with comorbid symptomatology. Mediation analysis indicated that dysfunctional metacognitive strategies could have an indirect effect on pathological gambling mediated by concurrent psychological disorders. These findings provide some implications for gambling treatment programs: pathological gamblers should be screened for psychiatric disorders, and metacognitive therapy could be considered a correct treatment of pathological gamblers. Metacognitive therapy might lead to the reduction of the pathological gambling by the diminishing of the concurrent psychological disorders.     

The implementation of motor learning principles in designing prevention programs at work

Occupational therapy practitioners offer services to workers in the workplace to prevent musculoskeletal disorders (MSDs), to help the injured worker restore function, and to recover capacities needed to return to the job. Despite the existence of some evidence about the efficacy of prevention programs, there is uncertainty and even disagreement among health professionals, about the outcome of prevention programs for people with MSDs. It is proposed that principles of motor learning can assist the therapist in structuring prevention programs to facilitate the workers learning of correct movement patterns. This paper discusses basic concepts of motor learning emphasizing characteristics of the learner, the type of task, the structure of practice and application to prevention programs at work settings. We present a four-stage model for prevention programs based on principles of both motor learning and ergonomics. This model coincides with the broad perspective suggested in current occupational therapy models which focuses on the person, the environment, the occupation and their effects on occupational performance.     

The treatment of strabismus in the four to ten year old child

Approximately 6% of children have strabismus, a condition where the eyes are not straight and do not work together. The condition is described and the problems created are discussed, including its effect on appearance and performance. Treatments available to correct strabismus and their success rates are presented. Most children can be treated effectively to restore normal appearance and binocular function.a Diplomate in Binocular Vision and Perception, American Academy of Optometry, Fellow, College of Optometrists in Vision Development, and in private practice, Garden City, New York.     

Borderline and antisocial personality scores as mediators between attachment and intimate partner violence

Court-mandated male batterers (n = 192) attending an intervention program completed measures examining adult attachment orientations (anxious and avoidant), personality disorders (borderline and antisocial), type of violence (psychological and physical), and social desirability. Structural equation modeling was used to determine whether there were significant relationships between anxious attachment and physical and psychological violence that are mediated by either borderline or antisocial personality disorders. Social desirability was included in both models as a covariate. Results indicated that personality disorders fully mediated the relationship between avoidant attachment and physical as well as psychological violence. Personality disorders only partially mediated the relationship between anxious attachment and psychological violence. Implications for intervention are discussed.     

An Empirical Study of Personality Disorders Among Treatment-Seeking Problem Gamblers

The primary aims of this study were to examine the prevalence of personality disorders in problem gamblers, to explore the relationship between personality disorders and problem gambling severity, and to explore the degree to which the psychological symptoms highlighted in the biosocial developmental model of borderline personality disorder (impulsivity, distress tolerance, substance use, PTSD symptoms, psychological distress and work/social adjustment) are associated with problem gambling. A secondary aim was to explore the strength of the relationships between these symptoms and problem gambling severity in problem gamblers with and without personality disorder pathology. Participants were 168 consecutively admitted problem gamblers seeking treatment from a specialist outpatient gambling service in Australia. The prevalence of personality disorders using the self-report version of the Iowa Personality Disorders Screen was 43.3 %. Cluster B personality disorders, but not Cluster A or C personality disorders, were associated with problem gambling severity. All psychological symptoms, except alcohol and drug use, were significantly higher among participants with personality disorder pathology compared to those without. Finally, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for problem gamblers with personality disorder pathology, while impulsivity, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for those without personality disorder pathology. High rates of comorbid personality disorders, particularly Cluster B disorders, necessitate routine screening in gambling treatment services. More complex psychological profiles may complicate treatment for problem gamblers with comorbid personality disorders. Future research should examine the applicability of the biosocial developmental model to problem gambling in community studies.     

The effectiveness of intervention strategies used to educate clients about prevention of upper extremity cumulative trauma disorders

The increased prevalence of work-related cumulative trauma disorders (CTDs) of the upper extremity highlights the need for effective prevention programs. This paper examines the effectiveness of different intervention strategies used to educate workers about the prevention of upper extremity CTDs. The articles reviewed include primary prevention and reinjury prevention interventions in both clinical and workplace settings. The current research findings are inconclusive. Intervention strategies may include discussion, demonstration, or practice of proper posture and body mechanics. Practice of correct techniques may not be necessary to achieve improved hand-use patterns in assembly-line workers. However, practice with intensive feedback may be necessary to achieve the best performance of hand-wrist position, but not sitting posture, in computer operators. The effects of practice on correct hand use may depend on the type of job task. Further research is needed to clarify the role of practice and feedback in CTD prevention.     

Family Process and Child Development in Unlabeled (Normal) Families*

Preliminary data are reported from an ongoing project devoted to the study of normal families. The research emphasizes the effects of system-level variables and the micro patterns of conversational interaction on the development of children within the family. Our theoretical model focuses on the individuation process, and the way in which accuracy of interpersonal perception and mutual validation among family members contribute to and are affected by the personal development and functioning of individual family members. The data derive from two-hour interviews with 99 families in their homes, plus psychological, sociometric and achievement data on an adolescent girl in each family. We have found both structural factors and patterns of conversational interaction among parents that distinguish families of the adolescent girls who score high on the individual functioning measures from families of adolescent girls who score low on these same measures.     

Tracing disorder across theories of autism,empathy, and mental health care

Abstract

Categories of mental disorders are generally understood through a biomedical paradigm of clinical research, diagnosis, and intervention. Here, diagnoses operate as professional tools, facilitating care organization and information exchange across diverse social contexts. In this article, I focus on how the diagnosis of autism-spectrum disorder operates in this manner. Autism conceived as a biomedical disorder is then contrasted with proposals by the neurodiversity movement, who understand core qualities of autism as alternative expressions of otherwise normal processes of brain development. Finally, I supplement these conversations with insights from Gerald Edelman’s theory of neural plasticity and Felix Guattari’s paradigm of ethico-aesthetic care. Understood together, these allow mental disorders and community care generally to be reconceived in terms of networks of expressive, embodied, and dynamically embedded rhythms that transcend individual persons. This serves, additionally, to illustrate a concept of empathy that traverses neurological, psychological, and sociocultural domains.     

Teenage dyslexia: stürm und drang

Adolescence, a time of emotional risk for all children, is especially difficult for children with learning disabilities. Academic, social and psychological problems frequently result in extended dependency and derivitive complications. Helping adolescents with learning disabilities achieve social and academic success and psychological well being are important goals of treatment. This paper addresses the special problems youngsters with learning disabilities face during adolescence. Professional interventions are suggested.     

The Long-Term Consequences of Childhood Incestuous Victimization upon Adult Women's Psychological Symptomatology

Current estimates of the prevalence of incest suggest that 16-20% of the women in the United States may be victims of such sexual abuse by the age of 18. The long-term consequences of incestuous victimization appear lo be numerous, producing in its victims feelings of powerlessness, stigmatization, and betrayal many years after the abuse. Some of the diagnostic consequences of childhood sexual abuse include affective disorders, substance abuse, eating disorders, anxiety disorders, dissociative disorders, post-traumatic stress disorder. and sexual dvsfunction. Therefore. the vumse of the present study was to comp&e adult women who were'viciims of childhood incest to various control groups to determine whether there were differences in psychological symptomatology. The results of this study suggest that the long-term consequences of incest are numerous and varied. Adult incest survivors reported greater levels of psychological distress as well as more types of symptomatology when compared to all three control groups. Overall. the data describing the incest survivors indicated that they were significantly more dcpressed, alienated, inhibited. socially introverted, and yet interpersonally more sensitive than other groups studied.     

Patterns of intimate partner violence: correlates and outcomes

Battered women experience different constellations of violence and abusive behavior characterized by various combinations of physical violence, sexual violence, psychological abuse, and stalking. The goals of the current study were to determine whether it was possible to identify empirically derived and meaningful patterns of intimate partner violence (IPV) and to examine correlates and outcomes of the IPV patterns. Three IPV patterns were identified using cluster analysis. Pattern 1 was characterized by moderate levels of physical violence, psychological abuse, and stalking but little sexual violence. Pattern 2 was characterized by high levels of physical violence, psychological abuse, and stalking but low levels of sexual violence. Pattern 3 was characterized by high levels of all violence types. IPV Pattern 3 was associated with the highest prevalence of posttraumatic stress disorder and depression, and IPV Pattern 2 had the highest levels of revictimization during the year following recruitment. The clinical and policy implications of the findings are discussed.     

大学生心理危机的识别与预警

心理危机的识别与预警既是预防心理危机发生的重要策略，也是对危机当事人和相关人进行生命教育和促进生命成长的重要机会。心理危机产生的原因具有复杂性，发生过程具有阶段性，危机现象具有特殊性，危机爆发具有极端性，危机发生也具有一定规律性。因此，在进行生命教育过程中，需要关注不同类别的生命个体、不同阶段的生命现象、处在规律中的独特生命个体，同时要注意识别生命危机信号和生命求救信号。     

Pathological Gambling,Co-occurring Disorders,Clinical Presentation,and Treatment Outcomes at a University-Based Counseling Clinic

It is the intent of this study to examine the relationship between the number of co-occurring disorders in a sample of pathological gamblers and variables associated with clinical presentation and treatment outcomes. Participants were given screening tools for four common psychological disorders: the hands depression screen, the Mood Disorder Questionnaire, the Carroll-Davidson generalized anxiety disorder screen, and the Sprint-4 PTSD Screen. The number of co-occurring disorders, as indicated by the results of these screening instruments, was compared to severity of gambling problems at outset of treatment, as measured by the NORC diagnostic screen for gambling problems-self administered. The number of co-occurring disorders was also compared to psychosocial functioning at the outset of treatment, as well as level of improvement in psychosocial functioning through treatment. Psychosocial functioning was measured using the Outcome Questionnaire 45 (OQ-45). The number of co-occurring disorders was compared to participant satisfaction with the therapeutic relationship as measured by the working alliance inventory-short form. Results suggest that co-occurring disorders are commonplace among treatment seeking pathological gamblers. Over 86 % of the sample screened positively for at least one of the four targeted psychological disorders. Furthermore, the number of co-occurring disorders was found to be positively related to severity of gambling problems at outset of treatment and negatively related to level of psychosocial functioning at outset of treatment. However, the number of co-occurring disorders was not found to be significantly related to level of improvement in psychosocial functioning through treatment. Overall, those that attended at least six sessions reported significantly improved psychosocial functioning by the end of their sixth session. Finally, the number of co-occurring disorders was not found to be significantly related to participants’ reported level of satisfaction with the therapeutic relationship.     

War-related mental health problems of today's veterans: new clinical awareness

1. Veterans of the military conflicts in Iraq and Afghanistan may have been exposed to significant psychological stressors, resulting in mental and emotional disorders. 2. Posttraumatic stress disorder (PTSD) is characterized by symptoms in three domains: reexperiencing the trauma, avoiding stimuli associated with the trauma, and symptoms of increased autonomic arousal. 3. Treatment of PTSD often requires both psychological and pharmacological interventions. 4. In addition to PTSD, other mental disorders may be precipitated or worsened by exposure to combat, including depression, anxiety, psychosis, and substance abuse.     

Prevalence of alcohol-use disorders and alcohol-related problems in a college student sample

Most studies of alcohol consumption patterns and alcohol-related problems among college students have failed to include a diagnostic measure based on Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Applying the DSM-IV standards would facilitate an analysis of the prevalence of alcohol-use disorders and individual symptoms of those disorders. A structured diagnostic interview based on DSM-IV criteria (the alcohol section of the Substance Abuse Module) and several alcohol screening instruments were administered to 306 undergraduate students at an urban commuter campus. The prevalence of current and lifetime alcohol-use disorders, individual symptoms of those disorders, and other alcohol-related problems are reported, as well as data regarding alcohol consumption patterns and binge drinking. The data are analyzed in terms of demographic variables, including sex, ethnicity, year in school, age, and marital status of those in the sample.     

Transforming normality into pathology: the DSM and the outcomes of stressful social arrangements

The sociology of stress shows how nondisordered people often become distressed in contexts such as chronic subordination; the losses of status, resources, and attachments; or the inability to achieve valued goals. Evolutionary psychology indicates that distress arising in these contexts stems from psychological mechanisms that are responding appropriately to stressful circumstances. A diagnosis of mental disorder, in contrast, indicates that these mechanisms are not functioning as they are designed to function. The American Psychiatric Association's Diagnostic and Statistical Manual, however, has come to treat both the natural results of the stress process and individual pathology as mental disorders. A number of social groups benefit from and promote the conflation of normal emotions with dysfunctions. The result has been to overestimate the number of people who are considered to be disordered, to focus social policy on the supposedly unmet need for treatment, and to enlarge the social space of pathology in the general culture.     

Modularity in philosophy, the neurosciences, and psychiatry

The neurosciences are generating new findings regarding genetic and neurobiological aspects of the pathophysiology of mental disorders. Especially, certain genetic risk factors like neuregulin-1 seem to predispose individuals to a psychotic phenotype beyond the limits of traditional classificatory boundaries between organic psychoses in Alzheimer’s disease, bipolar affective disorder and schizophrenia. Little, however, is known about how such genetic risk factors actually confer an increased risk for psychosis in an individual patient. A gap between neuroscientific findings and psychopathological phenomena exists. The main hypothesis how this gap may be bridged is that mental disorders arise as a consequence of dysfunctions of normal mental functions. Modularity may provide a useful conceptual framework in that temporally and/or spatially stable neural circuits subserve certain physiological functions of the human brain, which become the target of pathophysiological effectors. The idea of a modular construction of the human brain is based on neurobiological evidence regarding the columnar architecture of the cerebral cortex, which provides certain elementary analytical functions. Modular dysfunctions may be assessed with methods of experimental psychopathology, in which subsystems of brain functions are tested with standardized experimental psychological techniques (functional psychopathology). The main questions here are how to define a module, and whether the classical neuroscientific definitions can be used to characterize higher integrative functions of the human brain.     

Patterns of Racial Socialization and Psychological Adjustment: Can Parental Communications About Race Reduce the Impact of Racial Discrimination?

This study uses two waves of data to examine the relations among racial discrimination experiences, patterns of racial socialization practices, and psychological adjustment in a sample of 361 African American adolescents. Using latent class analyses, we identified four patterns of child‐reported racial socialization experiences: Moderate Positive, High Positive, Low Frequency, and Moderate Negative. Experiencing racial discrimination was associated with higher levels of depressive symptoms, more perceived stress, and lower levels of well‐being. On average, adolescents who experienced High Positive patterns of racial socialization reported the most positive psychological adjustment outcomes, while adolescents in the Low Frequency and Moderate Negative clusters reported the least favorable outcomes. Results suggest that High Positive racial socialization buffers the negative effects of racial discrimination on adolescents' perceived stress and problem behaviors. Together, the findings suggest that various patterns of racial socialization practices serve as risk, compensatory, and protective factors in African American adolescent psychological adjustment.     

Emotional Correlates of Caregiving

This study examined correlational patterns among psychological measures administered to caregivers who participated in a training program to prevent elder abuse. Seventy caregivers of persons aged 50 years or older were administered the Cost of Care Index, Anger Inventory, Brief Symptom Inventory, and the Rosenberg Self-Esteem Scale. Results suggest that perceptions of caregiving burden are related to psychological distress and self-esteem but not to anger. Implications of these findings for caregiver training and elder abuse prevention are discussed.