Clinical work with adolescents and their parents during family transitions: Transference and countertransference issues

This paper describes specific transference and counter-transference issues that commonly emerge in therapeutic work with adolescents and parents who are in the midst of family transitions such as divorce and remarriage. Psychoanalytic understanding and definitions of transference and countertransference are applied to short-term family-centered cases in which the parent-adolescent relationship is at particular risk. Case vignettes are presented in order to illustrate how transference and countertransference may guide or interfere with clinical interventions that are especially indicated with adolescents whose family structure has changed. Such interventions as well as the use of consultation are briefly described.At the time this paper was prepared, Ms. Springer was Associate Director and a senior clinician at the Center for the Family in Transition in Corte Madera, California. Funds for the research and clinical work that provided the basis for this paper were supplied by grants from the San Francisco Foudation. An earlier version of this paper was presented at the 66th Annual Meeting of the American Orthopsychiatry Association, New York City, March 31–April 4, 1989.     

Domains of convergence for the EM algorithm: a cautionary tale in a location estimation problem

The EM algorithm is a popular method for maximizing a likelihood in the presence of incomplete data. When the likelihood has multiple local maxima, the parameter space can be partitioned into domains of convergence, one for each local maximum. In this paper we investigate these domains for the location family generated by the t-distribution. We show that, perhaps somewhat surprisingly, these domains need not be connected sets. As an extreme case we give an example of a domain which consists of an infinite union of disjoint open intervals. Thus the convergence behaviour of the EM algorithm can be quite sensitive to the starting point.     

The psychodynamically oriented clinical social worker as sports consultant: A preliminary report

This paper explores an unusual and innovative application of psychodynamically oriented clinical social work method to the sports area. The coach of a national Olympics team requested a clinical consultation because he suspected that there might be psychosocial reasons why a certain number of world class atheletes he was coaching were not performing up to their full potential.     

Correlates of female crime

This article discusses the complexity of developing correlates of female crime in the comparative context of Western and Indian literature. It selectively reviews the findings of American and Indian studies of female crime and concludes with the author’s own findings from a study of 120 women prisoners conducted in a federal women’s prison in India. The author’s main contention is that whereas broad contours of offender profiles can be drawn, it is difficult to draw statistically significant relationships and infer from them predictable variables of criminality.     

Summary of the Workshop on Issues in Risk Assessment: Quantitative Methods for Developmental Toxicology

This report summarizes the proceedings of a conference on quantitative methods for assessing the risks of developmental toxicants. The conference was planned by a subcommittee of the National Research Council's Committee on Risk Assessment Methodology ⁴ in conjunction with staff from several federal agencies, including the U.S. Environmental Protection Agency, U.S. Food and Drug Administration, U.S. Consumer Products Safety Commission, and Health and Welfare Canada. Issues discussed at the workshop included computerized techniques for hazard identification, use of human and animal data for defining risks in a clinical setting, relationships between end points in developmental toxicity testing, reference dose calculations for developmental toxicology, analysis of quantitative dose-response data, mechanisms of developmental toxicity, physiologically based pharmacokinetic models, and structure-activity relationships. Although a formal consensus was not sought, many participants favored the evolution of quantitative techniques for developmental toxicology risk assessment, including the replacement of lowest observed adverse effect levels (LOAELs) and no observed adverse effect levels (NOAELs) with the benchmark dose methodology.     

Significance of the Dermal Route of Exposure to Risk Assessment

The skin is a route of exposure that needs to be considered when conducting a risk assessment. It is necessary to identify the potential for dermal penetration by a chemical as well as to determine the overall importance of the dermal route of exposure as compared with inhalation or oral routes of exposure. The physical state of the chemical, vapor or liquid, the concentration, neat or dilute, and the vehicle, lipid or aqueous, is also important. Dermal risk is related to the product of the amounts of penetration and toxicity. Toxicity involves local effects on the skin itself and the potential for systemic effects. Dermal penetration is described in large part by the permeability constant. When permeability constants are not known, partition coefficients can be used to estimate a chemical's potential to permeate the skin. With these concepts in mind, a tiered approach is proposed for dermal risk assessment. A key first step is the determination of a skin-to-air or skin-to-medium partition coefficient to estimate a potential for dermal absorption. Building a physiologically-based pharmacokinetic (PBPK) model is another step in the tiered approach and is useful prior to classical in vivo toxicity tests. A PBPK model can be used to determine a permeability constant for a chemical as well as to show the distribution of the chemical systemically. A detailed understanding of species differences in the structure and function of the skin and how they relate to differences in penetration rates is necessary in order to extrapolate animal data from PBPK models to the human. A study is in progress to examine anatomical differences for four species.     

One parent or two? The intertwining of American marriage and fertility patterns

Marriage and fertility in the United States have become less firmly entwined as more women bear children without marrying and more couples with children divorce. Today a sizeable number of children are expected to spend a portion of their childhood in one-parent households. Despite the trends in illegitimacy and divorce, the actual effect of out-of-wedlock childbearing on the living arrangements of children has not been fully explicated. Using the National Survey of Family Growth Cycle III, this paper estimates the probability that children aged 0–13 in 1982 are living in two-parent households, controlling for their mothers' marital statuses at their births. We find that marital status at birth is an important predictor of household structure at later ages for both white and black populations; however, the childhood environment is actually quite elastic as women marry, divorce, remarry, and redivorce.     

RURAL POVERTY, URBAN POVERTY, AND PSYCHOLOGICAL WELL-BEING

Data from the National Survey of Families and Households are used to compare the psychological well-being of the rural and urban poor. Overall, the urban poor are higher in perceived health than the rural poor, although no differences are apparent in happiness or depression. Significant interactions are present between rural/urban poverty and sex, race, and family status. The psychological well-being of poor African Americans is higher in rural than urban areas, whereas the well-being of poor whites is higher in urban than rural areas. This trend is especially pronounced for depression among males. In addition, single men without children have especially high depression scores in rural areas, whereas married women without children have especially low depression scores in urban areas. The results are interpreted in terms of the environmental quality of inner-city neighborhoods and attitudes toward poverty in urban and rural communities.     

Cognitive and behavioral therapies for pathological gambling

The purpose of this paper is to provide an overview of behavioral and cognitive treatment approaches in the management of pathological gambling disorders. Disappointingly, the literature to date contains only one controlled outcome study in which two differing behavioral techniques were compared. Although research in general has focussed on identifying the nature of cognitive distortions in gambling, findings from these studies have not been systematically translated into treatment programs. It is concluded that methodological limitations including small sample size, absence of control groups, multiple concurrent interventions and poorly defined outcome criteria preclude conclusive statements to be drawn regarding the active ingredient of either behavioral or cognitive strategies. The program offered within the Impulse Disorders Research Centre is outlined.The authors wish to gratefully acknowledge the assistance and contribution of Zachary Steel, Research Assistant, in the preparation of this paper.