DSM-IV Major Depressive Episode criteria: An evaluation of reliability and validity across three different rating methods.

This study examined the reliability and validity of the DSM-IV Major Depressive Episode (MDE) symptoms in a sample of outpatients based on clinician ratings of assessment interviews, videotape of these interviews, and chart information. A group of 44 patients admitted to a university based outpatient community clinic were rated by trained clinicians on the nine MDE symptom criteria (A1-A9). Patients also completed a self-report measure of depressive symptomatology.

Further reliability, convergent and discriminant validity of overall defensive functioning.

The reliability, convergent and discriminant validity of the Defensive Functioning Scale (DFS) and the overall defensive functioning score (ODF) has been previously examined. This study aims to address gaps in the literature as well as to replicate and extend the initial positive clinical validity data emerging on the DFS ( Blais et al., 1996; Hoglend and Perry, 1998; Lingiardi et al.

The observing ego as voyeur.

A resistance to self-observation and self-reflection is discussed in which there is a perversion of the observing ego. The observing ego has been unconsciously recruited in the service of enacting an unconscious fantasy: the fantasy of being an excited observer of a primal scene who is punished for making forbidden observations. This voyeuristic observing ego is pathologically enmeshed in a love triangle with the patient's seductive superego (i.

Short-term psychodynamic psychotherapy for depression: an examination of statistical, clinically significant, and technique-specific change.

This study investigates the effectiveness of short-term psychodynamic psychotherapy (STPP) for depression in a naturalistic setting utilizing a hybrid effectiveness/efficacy treatment research model. Twenty-one patients were assessed pre- and post-treatment through clinician ratings and patient self-report on scales representing specific DSM-IV depressive, global symptomatology, relational, social, and occupational functioning. Treatment credibility, fidelity, and satisfaction were examined, all of which were found to be high.

The impact of the recent Supreme Court rulings in Pegram and Rush Prudential on state regulation of managed care organizations.

Over the past two decades, the Employee Retirement Income Security Act of 1974 (ERISA) has shielded managed care organizations (MCOs) from liability for negligent treatment or coverage decisions. This Article examines the Supreme Court jurisprudence in the area of ERISA preemption, and assesses the impact of these recent decisions on state regulation of MCOs. The author concludes that recent decisions in Pegram v.

Psychological assessment of adult survivors of childhood sexual abuse within a naturalistic clinical sample.

This study investigates the long-term effects of childhood sexual abuse (CSA). Differences between abused and nonabused individuals in psychiatric symptomatology, interpersonal functioning, social and occupational functioning, personality dynamics, and therapeutic alliance were examined. The relationship between abuse severity and long-term effects was also analyzed.

Existential issues in group psychotherapy.

Existential issues in group psychotherapy derive from existential thought both as a philosophy and as a value system. Its origins derive from the weakening of traditional values and the growing alienation of man from himself. The unique features of existentialism can be applied to all forms of therapy.

The seductive superego: the trauma of self-betrayal.

The author describes a pathological manifestation of the approving superego that functions as a perversely seductive superego. In this process, the seductive superego rationalises and makes ego-syntonic a gratification of forbidden wishes that will result in unconscious punishment. The author argues that the seductive superego torments the self by teasing it with the presence of a tantalising but forbidden object of desire and then by inflicting shame on the self for its timidity, which prevents it from pursuing the object in spite of the dangers.

The analyst's knowledge and authority: a critique of the "new view" in psychoanalysis.

A critical assessment is presented of positions recently taken by Mitchell and Renik, who are taken as representatives of a "new view" in psychoanalysis. One article by Mitchell and two by Renik are examined as paradigmatic of certain ways of construing the nature of mind, the analyst's knowledge and authority, and the analytic process that are unduly influenced by the postmodern turn in psychoanalysis. Although "new view" theorists have made valid criticisms of traditional psychoanalytic theory and practice, they wind up taking untenable positions.

Self-criticism and the psychic surface.

It is postulated that the surface of the mind reflects a variety of shifting self-syntonic and self-dystonic contents striving to achieve a stable homeostatic balance. Shifts between self-syntonic and self-dystonic contents are seen to reflect an underlying intrasystemic conflict within the superego between conflicting superego injunctions. These shifts possess a cyclical quality, as self-syntonic contents become self-dystonic and as self-dystonic contents become self-systonic.

Women, violence with intimates, and substance abuse: relevant theory, empirical findings, and recommendations for future research.

Evidence from the disparate domains of anthropology, criminology, psychology, and sociology indicates that women are involved in many of the same acts of aggression and violence as men, and that substance use may play an important role in these acts. Yet little is known of the pathways between violence and drugs for women. The aims of this paper are threefold: 1) To review and integrate existing literature addressing female violence and substance abuse, presenting available epidemiology, theories, and research applicable to the study of this problem.

Identifying dissociative identity disorder: a self-report and projective study.

This study compared 21 female adult psychiatric patients diagnosed with dissociative identity disorder (DID) with 21 female adult nondissociative psychiatric patients to determine whether DID patients exhibit a distinguishing set of clinical features, and perceptual, attentional, and cognitive processes. Participants were assessed with the Dissociative Disorders Interview Schedule to assess diagnostic status. Group scores on the Dissociative Experiences Scale, Tellegen Absorption Scale, Childhood Trauma Questionnaire, Brief Symptom Inventory, and the Rorschach test were compared.

Entitlement and counterentitlement in group therapy.

Groups may provide fertile ground for observing, understanding, and working through feelings and fantasies of being special or exceptional. Such manifestations of the psychology of entitlement, which traditionally have been referred to as an aspect of narcissism and a problem of the patient, may be studied in the interactional field encompassing therapist, supervisor, and group. Entitlement may represent both normal and pathological processes, the former relating to self-affirmation, the latter, to the expression of omnipotent thinking and controlling behavior.

The view from the tip of the iceberg.

In recent years there has been a growing interest in refining the technique of ego defense analysis. All of these approaches share in common an attempt to work closely with the patient's free associations, to interpret at a level that is accessible to the patient's consciously observing ego, and to avoid bypassing the analysis of the patient's most surface-level resistances in an effort to understand unconscious conflict. These innovations reflect a commendable effort to work in a way that is rigorously empirical, that respects the patient's autonomy, and that minimizes the pressure of the analyst's transferential authority in the patient's acceptance of the analyst's interpretations.

Psychological impact of breast cancer on the patient and the family: A clinical perspective.

Breast cancer is the most frequently occurring cancer in women, with 182,000 new cases diagnosed in 1993. Breast cancer will strike a sizable percentage of women during the child-rearing years impacting, therefore, not only on the woman, but on the significant others in her life. This article explores the impact of breast cancer for the patient's life partner, parents, and children.

The self-comparison process and self-discrepant feedback: consequences of learning you are what you thought you were not.

In 4 experiments, college students received bogus personality-test feedback that they possessed an actual-self, ideal-self (desired but unpossessed), or rejected-self (unwanted and unpossessed) trait. When the test had low credibility, rejected-self feedback produced positive mood (PM), whereas ideal-self feedback produced negative mood (NM). Self-comparison of the feedback with self-representations apparently revealed the falsity of the feedback, making salient Ss' virtues or shortcomings.

Olfactory identification deficits in Down's syndrome and idiopathic mental retardation.

We investigated olfactory identification in children and adults with Down's syndrome (DS) and idiopathic mental retardation (IMR) and in age-matched normal controls (NC). Identification was assessed with a four alternative-forced-choice task modified from the University of Pennsylvania Smell Identification Test (M-UPSIT) and a yes/no task yielding measures of discrimination and response bias for the same stimulus material. Control tactile identification tasks were also administered.