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Concordance between two measures of dream bizarreness.

To assess the level of concordance between two published measures of dream bizarreness, 100 randomly selected dreams from 93 college students were scored for primary process using the Auld, Goldenberg, and Weiss scale and for dream distortion using Zepelin's scale. This analysis yielded a strong relationship between these measures, indicating adequate concurrent validity for the content analysis of the construct of dream bizarreness.

Adult

[Diagnosis of "cataphasia" based on a drawing].

Drawings done by a patient before examination led to the suspicion of cataphasia, in view of previous experience of similar pictures drawn by verbigerate patients, and this proved to be so. We assume that the verbigerate affection of the thinking process is pictorially reflected in spontaneous casual drawing. In a less spontaneous situation, on other hand, the patient will not be so completely disorganised, and thus the author of an utterly confused drawing can still retain some measure of mental control in the course of tests.

Adult

Pathogenesis of delusions.

This overview of attempts to shed light on the pathogenesis of delusions provides a sense of promise, because we are grappling with the right problems, and reasons for both optimism and skepticism. Optimism is justified because some of the approaches have yielded empirical support and can be tested profitably in research. Skepticism is warranted because we remain unclear about precisely what delusions are; and we have as yet no means of identifying them with a laboratory test. Hence, we must rely on the problematic nature of clinical observation of the inner experiences of patients to make progress. The different mechanisms proposed still require considerable testing, but scrutiny of current results suggests that anomalous experience as a stimulus for delusion formation has been better documented than proposals invoking disordered reasoning or motivational deviances. Nevertheless, no view is as yet established, and each may have some relevance to solving the delusion puzzle.

Delusions

Exploring the maze of adverse reactions to foods.

Nowhere in medicine is a test or battery of tests more needed than in the diagnosis of adverse reactions to foods. Such tests are not at present a reality. Research produces tests that individually appear to show validity, but when challenged with the entire range of possible adverse reactions and their results, the tests fall short. Considering the range of mechanisms involved in adverse reactions to foods, this is to be expected. There is a tendency to discount positive test results when they fail to cover all of the parameters desired. The inherent weakness in any test is that all available formats explore a single or limited reaction route. The reality is the presence of multiple routes, multiple target organs, and multiple external variables not subject to programming into a single test. Considering the range of possibilities, it is amazing that any existing tests show any clinical validity at all. We as scientists should not denigrate any study that shows a significant degree of reliability, even within a limited range. This simply halts progress. An encouraging study should be used as a stepping stone to a more comprehensive format for evaluating the overall range of adverse reactions and providing us with at least some inroads in coping with this most difficult problem. To quote Sir Peter Medawer on receiving the Nobel Prize in Science: "Nothing must be said or written that diminishes the likelihood that someone else will get at the truth."

Allergens

Does helplessness cause depression, or do only depressed people become helpless? Comment on Alloy and Abramson.

Alloy and Abramson reported that depressed people are accurate at assessing response-outcome contingencies, whereas normal people display various distortions. It is argued that such a finding causes problems for a learned helplessness theory of depression, because it suggests that people can only detect some of the conditions necessary for producing helplessness after they are already depressed. The presumed causal relation between helplessness and depression may be strengthened if one assumes that helplessness prevents the development of active hypothesis-testing strategies that would otherwise produced biased assessments of contingency.

Cognition

Pseudomemory in hypnotized and simulating subjects.

High hypnotizable (n = 23) and low hypnotizable simulating (n = 13) subjects received pseudomemory suggestions. High hypnotizable and low hypnotizable simulating subjects were equally likely to pass the target noise suggestion during hypnosis and were also equally likely (high hypnotizables, 47.83%; low hypnotizable simulators, 64.29%) to report pseudomemories when tested for pseudomemory after instructions to awaken. As in previous research with task-motivated subjects, pseudomemory rate (high hypnotizables, 47.48%; low hypnotizable simulators, 46.15%) was not reduced by informing subjects that they could distinguish fantasy and reality in a nonhypnotic state of deep concentration. At final inquiry, after deep concentration, high hypnotizable and low hypnotizable simulating subjects' pseudomemories remained comparable (43.48% and 38.46%, respectively). Unlike previous research, high hypnotizable subjects did not report more unsuggested noises and more pseudomemories of novel sounds than did awake low hypnotizable simulating subjects. Pseudomemory reports were generally consistent with subjects' ratings of whether the hypnotist expected them to believe the sounds were real or imagined.

Adult

Memory for actual and imagined events in OC checkers.

Information-processing theorists have suggested that obsessive-compulsive (OC) checking may be a function of either (1) an impaired memory of emotional events, (2) an attenuated ability to distinguish between real and imagined events or (3) a dissatisfaction with one's recall without actual memory impairment. These hypotheses were tested by having OC and control Ss engage in real and imagined actions. Some of the actions were designed to produce anxiety in the OC Ss while other events were designed to be emotionally neutral. No differences in reality-monitoring ability were found between OC and control Ss. Contrary to our prediction, OC Ss recall of their last actual behavior was superior to controls, but only for those actions that elicited anxiety. OC Ss, but not controls, reported that they desired higher levels of memory vividness than they were able to produce. The potential mechanism whereby dissatisfaction with memory vividness could contribute to repetitive checking is discussed.

Adult

Twenty-four hour reality orientation: changes for staff and patients.

A 24-hour reality orientation programme was initiated in a long-stay geriatric ward. Nursing and occupational therapy routines were changed specifically to meet the needs of the 20 patients participating in the programme. The assessments included the Clifton Assessment Procedures for the Elderly, the Holden Communication Scale, the Holden Orientation Facilities Scale, and the Oberleder Scale (adapted by Holden et al.). These scales were administered before, during and after completion of a study lasting 4 months. The CAPE scales showed no significant results. However, the Holden Communication Scale indicated that there were significant differences for certain groups of patients. Those patients with high scores initially tended to continue to have high scores and showed no real change. However, patients who had scores in the medium range initially, showed improvement. This finding indicated that severity at onset of the experiment was an important variable when considering outcome of treatment. Expectations regarding the future of the very elderly must be realistic, and to anticipate a return to previous vitality and total independence should not be expected. However, to find a means by which functional levels can be maintained, and even slightly improved, is desirable. It would seem that the 24-hour reality orientation programme achieved this goal.

Aged

Memory source confusions: effects of character rotation and sensory modality.

Eighty subjects viewed and visually imagined upright or rotated alphanumeric characters and later judged whether test characters were previously seen or imagined (reality monitoring). Identification and test characters were presented verbally or visually. When characters were identified and tested verbally, source confusions (misjudging a seen character as "imagined" and vice-versa) were infrequent and were comparable for rotated and upright characters. When characters were identified and tested visually, source confusions were more frequent and were influenced by character rotation. Memories for imagined characters were especially susceptible to source confusion. Also source confusions for seen characters increased when characters were rotated. These results are consistent with the proposal that increasing sensory similarity between perceived and imagined items increases source confusion and that perceived rotation generates cognitive operations similar to those generated when the subject imagines a character rotated.

Adult

An advanced test of theory of mind: understanding of story characters' thoughts and feelings by able autistic, mentally handicapped, and normal children and adults.

Research has suggested that the core handicaps of autism result from a specific impairment in theory of mind (ToM). However, this account has been challenged by the finding that a minority of autistic subjects pass 1st- and even 2nd-order ToM tests while remaining socially handicapped. In the present study, able autistic subjects who failed ToM tasks, those who passed 1st-order, and those who passed 2nd-order tasks were tested with a battery of more naturalistic and complex stories. Autistic subjects were impaired at providing context-appropriate mental state explanations for the story characters' nonliteral utterances, compared to normal and mentally handicapped controls. Performance on the stories was closely related to performance on standard ToM tasks, but even those autistic subjects who passed all ToM tests showed impairments on the more naturalistic story materials relative to normal adult controls.

Adolescent

[The psychology of chronic rheumatism patients based on the Rorschach test].

The objective of this research was to try to see if it was possible to find in a population of chronic rheumatickies (a great majority of P.C.E.) some specific psychologie characteristics or constants among these sicks. So we have used Rorschach test. On the based of 19 persons inspected, we have found 84% who present a pathological inhibition and 68% a pathological anxiety. They are datums more strikingness, but we have found others interesting indications. For example: 47% persons presented symptoms of a affectivity no stabilize egocentric and impulsive and had a perturbed thought by their affectives problems. 21% a deficient valuation of reality. We have terminated trying to discuss two others questions from datums collected.

Adult

Use of non-verbal construing and metaphor in psychotherapy.

This article begins by looking at the way we try to construe or make sense of the world in which we live. How in the very nature of such sense-making there is the potential for sowing the seeds of self-deception by trying to fit our (relatively simplified) bipolar constructs to a complex unitary universe. Non-verbal and verbal construing are compared. Verbal construing enables us to reach an even more sophisticated level of self-deception, via myths created by limiting metaphors--such as "man-the-machine." The institutions which we create and the people who are invested in them tend to solidify in-group myths, often with the help of metaphor. It is argued that personal, constructivist, and eclectic approaches to psychotherapy can be envisaged as enterprises to begin the process of demythologising clients in the safety of the therapeutic setting. In therapy, clients can experiment with empowering themselves in reconstruing the problem areas of their lives and actively testing out these new constructions against personal experience. Clients can also learn to explore the meaning behind symptoms, i.e., to give cognitive form to feeling with the help of their intuitive sensitivity.

Concept Formation

A second look at second-order belief attribution in autism.

Compared the performance of autistic and mentally retarded subjects, all of whom had passed a standard first-order test of false belief, on a new second-order belief task. 12 autistic and 12 mentally retarded subjects, matched on verbal mental age (assessed by PPVT and a sentence comprehension subtest of the CELF) and full-scale IQ were given two trials of a second-order reasoning task which was significantly shorter and less complex than the standard task used in all previous research. The majority of subjects in both groups passed the new task, and were able to give appropriate justifications to their responses. No group differences were found in performance on the control or test questions. Findings are interpreted as evidence for the role of information processing factors rather than conceptual factors in performance on higher order theory of mind tasks.

Adolescent

Genetic testing and insurance. The Ad Hoc Committee on Genetic Testing/Insurance Issues.

The rapid expansion of opportunities for genetic testing has been accompanied by complex questions about the appropriate relationships between providers, patients, and insurers. Some of these questions involve large public-policy decisions, such as whether the government should guarantee access to health care for all citizens. Universal access to health care, without regard to past, present, or future risk of disease, could eliminate risk-oriented underwriting in health-care coverage. A positive response to that question will ameliorate other problems. Until universal access is reality, genetic testing and genetic diagnosis will raise important issues for the practicing geneticist. How much does a client need to know about insurance implications before consenting to a genetic test? Should patients be counseled to purchase insurance before being tested? Should genetic information be excluded from medical records before their release to insurance companies for routine reimbursements or underwriting? What are the ethical and legal responsibilities of the geneticist?

Confidentiality

[Relations between intrapsychic and familial structures in schizophrenic patients].

The authors present the results of a research project that points out the connections of the clinical signs of schizophrenia with the intrapsychic space referring to the repertory-grid test and with the circumplex model of family dimensions (Olson-Faces II). The acute psychotic episode was connected with characteristic arrangements of the representational elements in groups and with disintegration of the family rules system. Also the postpsychotic phase displayed a characteristic constellation of the representational elements in the repertory-grid test. The results of the research project underline the important role of the affects during both the acute and the postpsychotic phase of schizophrenia as organizing and integrating factors of the affective-cognitive reference system described by Ciompi.

Adolescent

Reading and visual memory: remembering scenes that were never seen.

In Experiment 1 (N = 16), under conditions of high memory load (60 pictures and 50 paragraphs) and a 1-week retention interval, undergraduate subjects reported their memory for photographs of scenes (cued recall and free-recall tasks). Subjects frequently reported memory for photographs that they had actually never seen, but had read about in a brief paragraph. In Experiment 2 (N = 40), the same pattern of results was obtained with immediate testing. Experiment 2 also demonstrated that the likelihood of subjects falsely attributing scene memory (based on reading) to actually having viewed a photograph was reduced when metacognitive awareness of imaging during reading was made salient. Awareness of image creation was induced by requiring subjects to rate the paragraphs with respect to imagery vividness. Although other measures of memory remained the same, subjects in the induced-imagery condition made 50% fewer confusion errors than subjects who read the paragraphs without imagery instructions. The results are discussed in the context of Johnson and Raye's (1981) reality monitoring model.

Adult