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The critical impact of Frantz Fanon and Henri Collomb: race, gender, and personality testing of North and West Africans.

In 2001, the U.S. Surgeon General declared publicly that culture counts in mental health care. This welcome recognition of the role of culture in mental health appears somewhat belated. In 1956, Frantz Fanon and Henri Collomb both presented culturally sensitive studies of the Thematic Apperception Test at the major French-language mental health conference. The contrast between these two studies and between the careers of Fanon and Collomb reveals some of the difficulties in creating cultural and gender sensitivity in psychiatry or psychology.

Africa, Northern↗

Need-gratifying object relations and psychopathology.

The authors tested hypotheses about a psychoanalytic model of a developmental continuum of object relations (from need-gratifying to mutual) by distinguishing persons that Goldberg (1972) classified as normal, sociopathic, and psychotic according to the Minnesota Multiphasic Personality Inventory (MMPI). A Thematic Apperception Test rating scale, Capacity for Emotional Investment (CEI), developed by Westen, Lohr, Silk, and Kerber (1989) was employed for this purpose. Results strongly support the hypotheses and lend support for convergent and discriminant validity of the CEI dimension.

Adult↗

Circumplex scales of interpersonal values: reliability, validity, and applicability to interpersonal problems and personality disorders.

Three studies describe the development, psychometric properties, and potential utility of a new self-report measure, the Circumplex Scales of Interpersonal Values (CSIV). The CSIV was designed to complement other interpersonal circumplex measures that assess interpersonal behavior by efficiently assessing a comprehensive set of agentic and communal values. The eight 8-item scales of the CSIV were shown to have good internal consistency and test-retest reliability and a circumplex structure. The CSIV showed convergent and discriminant validity with measures of interpersonal traits (the Bem Sex Role Inventory; Bem, 1974), interpersonal problems (the Inventory of Interpersonal Problems-Circumplex; Horowitz, 2000), implicit interpersonal motives (the Thematic Apperception Test; see Atkinson, 1958), and interpersonal goals (the Interpersonal Goals Inventory; Dryer & Horowitz, 1997). Finally, the locations of the MCMI-III (Millon, 1994) personality disorder scales on the CSIV circumplex generally mirrored the locations of personality disorders on other interpersonal circumplex measures.

Adolescent↗

Adapting projective tests for minority children.

Child abuse reporting laws have placed new demands upon law enforcement, human service agencies, and clinicians alike. For the clinician, these demands are compounded when minority children are involved. Few of the standardized measures seem to fit all cultural groups. In our situation the cultural mix involves Hispanic, Mexican, and American Indian children. We found a combination of two projectives, the Draw-A-Person/Draw-A-Family and the Thematic Apperception Test, to fit our multicultural needs. Specifically, we use the D-A-P drawings of the child and his/her family as "plates" and then apply the TAT "tell me a story about this picture" technique.

Child↗

Anger management style, degree of expressed anger, and gender influence cardiovascular recovery from interpersonal harassment.

The hypothesis that the degree to which individuals expressed anger during harassment would mediate relationships between anger management style and cardiovascular recovery from harassment was examined in a college sample of 31 men and 32 women. Subjects told stories about Thematic Apperception Test cards during nonharassment and harassment phases. Words spoken during the storytelling reflecting "aggressive behavior" and "angry/hostile affect" were coded from audiotapes. Responses on the Anger-out subscale (AOS) of the Anger Expression Inventory were positively correlated with expression of angry/hostile affect words, and with SBP increases during harassment. During recovery, high AOS men and low AOS women showed sustained SBP, while men who expressed much anger and women who expressed little anger showed sustained SBP. Additional tests provided support for the hypothesis: SBP responses of high AOS men and low AOS women during recovery were partly mediated by the degree to which subjects expressed anger during harassment.

Adaptation, Psychological↗

Coping and adaptation in parents of children suffering from acute lymphoblastic leukemia.

The coping and adaptation of 30 parents of children suffering from A.L.L. (during first remission), was studied with the Thematic Apperception Test (TAT--Indian modification). Emotional distress was evident in the stories of 83%, only 37% maintained an expectation of a positive outcome. Parents' psychiatric morbidity was found to be associated with the gender of the parent, employment status, and on the TAT--with the expectation of an unfavourable outcome, feelings of lack of self efficacy and emotional distress. Particularly depression. A significant association between the presence of psychiatric disturbance in the children and the parents was also found.

Adaptation, Psychological↗

Male pseudohermaphroditism due to primary 5 alpha-reductase deficiency: variation in gender identity reversal in seven Mexican patients from five different pedigrees.

In the present study, we describe the clinical, endocrinological, psychosexual and biochemical features of 7 Mexican male pseudohermaphrodites with primary 5 alpha-reductase deficiency in whom heterogeneity in the pattern of gender identity change at puberty was observed. The patients belonged to 5 different pedigrees from diverse locations in Mexico. Six of them were admitted to the Hospital during or after puberty. The one prepubertal subject was the sibling of a previously studied patient. Basal serum gonadotropins were determined by double antibody radioimmunoassay. Basal and choriogonadotropin (CG)-stimulated concentrations of androstenedione (A), testosterone (T) and dihydrotestosterone (DHT) were determined by radioimmunoassay after extraction and separation by celite chromatography. Urinary aetiocholanolone, androsterone and C19 and C21 5 beta/5 alpha metabolite ratios were analyzed by capillary gas chromatography. Enzyme activity and androgen receptors were studied in fibroblasts cultured from genital skin. Psychological assessment was performed using the Bender-Gestalt Wechsler Adult Intelligence Scale, the Rorschach Ink Blot and the Thematic Apperception Tests. All 7 patients were unambiguously reared as females; three spontaneously changed their gender identity and role from female to male after puberty, another one changed during psychotherapy at the end of puberty. Two patients (one prepubertal and the other pubertal) have been under therapy during 1.5 years, but due to familial and social factors a female gender has prevailed. The remaining patient consulted at age 15 because of virilization; her female gender identity did not change after more than one year of treatment and due to the fact she was depressed and had suicidal tendencies, the penis and testes were removed.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗

Relationships between motivation and depression in chronic marijuana users.

The "amotivational syndrome" which has been associated with marijuana use has not been examined systematically in relation to marijuana use and mental health. Light and heavy users were solicited by personal contact. They were asked to complete anonymous questionnaires which measured marijuana, alcohol and cocaine use, perceived states during marijuana intoxication, depressive symptoms in the last year, the Orientation to Life Scale and a modified form of the Thematic Apperception Test, from which Need for Achievement, Affiliation and Power were assessed. Several group comparisons were made: Chronic heavy-users (medians: daily use for 6 years) with and without significant symptoms of depression within the last year were compared with Light users (medians: several times per month for 4.5 years) with and without significant symptoms of depression within the last year. Subjects in all groups reported similar ratings of intoxication (being stoned) during marijuana use. No differences were found in alcohol or cocaine use among the comparison groups. Scores on Need for Achievement were significantly lower in heavy users with depressive symptoms when compared with all other groups. No effects were found among groups in measures of the Need for Affiliation and the Need for Power. Both light and heavy users with symptoms of depression had significantly lower scores than those without depressive symptoms, on the overall Orientation to Life questionnaire and on each subscale measuring Meaningfulness, Manageability and Comprehensibility. These data suggest that amotivational symptoms observed in heavy marijuana users in treatment are due to depression.

Adult↗

The image of self and of the environment in drug abusers: a comparative study using the TAT.

This study attempted to add to our understanding of the heroin abusers' identity problems, using images of the self and the environment. Murray's Thematic Apperception Test (TAT) was applied to a group of male drug users undergoing withdrawal treatment with methadone and also to a group of male, non-drug using controls. The needs of the subjects and the demands of the environment, plus interaction between the two, were compared between the two groups to obtain information about the self and lifestyle. Among the data which emerged, is an increased need for destructive aggression and an environment experienced as coercive and emarginating. Among the interactions we observed coerced imagination, difficulties in identification, personal relationships based on abandonment with persecutory projection of the female figure and a tendency toward immature defences such as avoidance, denial and acting out. This information is discussed in relation to possible means of treatment.

Adult↗

Repressed anger and patterns of cardiovascular, self-report and behavioral responses: effects of harassment.

We hypothesized that anger repressors would show discrepancies between self-reported anger and cardiovascular and behavioral responses only during harassment. Subjects (N=102) were assigned randomly to condition. In the nonharassment condition, subjects told stories about eight Thematic Apperception Test cards without any harassment. In the harassment condition, subjects told four stories without harassment, and then told four more stories with harassment. Words connoting aggressive behavior and angry/hostile affect were coded from story content. Subjects were classified into low anger expressor, anger repressor, high anger expressor, and defensive anger expressor categories based on median splits of the Anger-Out Subscale and Marlowe-Crowne Social Desirability Scale. Results showed that harassed anger repressors reported anger comparable to that of low anger expressors but less than high expressors, whereas their heart rate (HR) reactivity was comparable to high expressors, but greater than low anger expressors. Increases in anger words did not distinguish repressors from other groups. Repressed anger may represent a distinct anger management style characterized by a discrepancy between acknowledged anger and cardiovascular reactivity--effects that become fully manifest only during interpersonal provocation.

Acting Out↗

Fear of success in anorexic young women.

Eating Disorders Inventories (EDI) and Thematic Apperception Tests (TATs) scored for fear of success were compared for 26 normal females enrolled at Harvard University and 45 eating-disordered females (27 bulimic and 18 anorexic) at Massachusetts General Hospital. The relationship between eating disorders and fear of success (FOS) was examined. Analyses revealed statistically significant differences in fear of success among the three groups. The anorexic group scored higher in FOS than both the bulimic group and the control group. The bulimic group did not differ significantly from the control group. These findings may have important clinical implications because fear of success may be evident in young women for whom anorexia nervosa is still in a prodromal phase. Thus, fear of success may be a marker of risk of anorexia nervosa.

Achievement↗

Communication deviance in families of schizophrenic and manic patients.

Levels of communication deviance (CD) distinguish parents of schizophrenic patients from parents of nonpsychotic patients, but the prevalence of intrafamilial CD in other psychotic disorders has not been examined. Levels of CD were compared across biological parents of schizophrenic (n = 39) and bipolar manic (n = 16) patients and across patients themselves. CD ratings were based on Thematic Apperception Test protocols (parents only) and family interactions (parents and patients). Total levels of CD did not distinguish between groups of parents or patients. However, instances of odd word usage were more frequent among parents of manic patients than among parents of schizophrenic patients on both CD measures. Also, during the interaction task, odd word usage was more frequent among manic patients, whereas schizophrenic patients made more ambiguous references. Results suggest that high levels of intrafamilial CD are not unique to schizophrenia.

Adolescent↗

Parental communication deviance and schizophrenia: a cross-cultural comparison of Mexican- and Anglo-Americans.

Levels of parental communication deviance (CD), as measured on the Thematic Apperception Test (TAT), were compared among families of schizophrenic patients in two culturally distinct groups. Spanish-speaking Mexican-American parents of schizophrenics completed the TAT in their native language, and CD was coded from their stories by a Spanish-speaking rater. Mexican-American parents had levels of CD that were nearly identical to those of a carefully matched sample of English-speaking Anglo-American parents. Factor scores that measure distinct subtypes of CD also did not differ across groups. The data suggest that levels of CD, despite discriminating between parents of schizophrenics and nonschizophrenics, do not vary across different languages and cultures.

Adult↗

Object relations in childhood and adolescence: the development of working representations.

This article describes two studies based on an integration of theory and research in object relations and developmental social cognition. The following four dimensions were assessed in 2nd and 5th graders and in 9th and 12th graders using Thematic Apperception Test (TAT) responses and Ss' descriptions of meaningful interpersonal episodes: complexity of representations of people, affect-tone of relationship paradigms, capacity for emotional investment in relationships and moral standards, and understanding of social causality. In both studies, developmental differences emerged on all measures except affect-tone, as expected. Results document object-relational development beyond the preoedipal years and suggest the diagnostic importance of distinguishing multiple dimensions of object relations rather than considering object relations as a single or unitary developmental line.

Adolescent↗

Preschool antecedents of defense mechanism use in young adults: a longitudinal study.

Preschool antecedents of the use of defense mechanisms were longitudinally studied using data from 90 nursery school children who were again evaluated at age 23. Defense use was determined by coding Thematic Apperception Test (H.A. Murray, 1943) stories with a method previously shown to be reliable and valid. The findings indicated continuity between preschool personality and subsequent defense use for male participants but little continuity for female participants. Young men's use of the age-inappropriate defense of denial was predicted by indications at ages 3-4 of low ego resiliency and psychological difficulties in the areas of emotion, intellect, impulse control, and social interactions.

Adult↗