Biofeedback

Theoretical Models of Biofeedback III. The Biofeedback Laboratory V. Current Research Findings in Biofeedback VI. Clinical Use of Biofeedback VII. Opportunities in and Future of Biofeedback Autonomic Nervous System The peripheral nervous system that includes neurons outside the bony enclosure of the spinal cord and skull comprised of the sympathetic nervous system and the parasympa-thetic nervous system. Electroencephalograph Instrumentation that monitors brain waves. Electromyograph...

Bibliography

T., Perkins, K. A., & Pierce, J. P. (1995). Marshaling the evidence for greater regulation and control of tobacco products A call for action. Annals of Behavioral Medicine, 17, 3-14. Kaplan, R. M., Sallis, J. F., & Patterson, T. L. (1993). Health and human behavior. New York McGraw-Hill. Matarazzo, J. D. (1980). Behavioral health and behavioral medicine Frontiers for a new health psychology. American Psychologists, 35, 807- 817. McGinnis, J. M., & Foege, W....

Components of the Biofeedback Laboratory

The biofeedback laboratory should be a quiet room free from visual distractions. A recliner chair allows the subject to rest comfortably. The laboratory equipment can vary depending on the goals of the clinician and purposes for which the biofeedback will be used. With the advances in technology, most biofeedback systems are quite compact and attractive. Some of these systems are integrated with a computer screen and will allow for printing of and or computer display of the feedback. A computer...

Cognitive Risk Factors In Suicide

Research on suicide risk was a natural outgrowth of Beck's depression research, and his prospective studies have contributed to the understanding of psychological processes in suicide, particularly the role of hopelessness in predicting suicide. Hopelessness is conceived of as a relatively stable schema, incorporating negative expectations of the future. Other researchers have identified additional cognitive risk factors for suicide that emerge even with the level of depression and degree of...

Conditional and Unconditional Behaviors

Conditional behaviors, also called conditioned behaviors, are behaviors that have come under the control of environmental stimuli or under the control of other external stimuli that in and of themselves do not elicit the given response. These conditional behaviors are either classically conditioned (Pavlovian conditioning) or instrumentally conditioned (operant or Skinnerian conditioning). Classical conditioning refers to the phenomenon in which a conditional stimulus (CS) (e.g., tone) is...

Albert Ellis and Rational Emotive Therapy

Like Wolpe (but without knowledge of his work), in the mid 1950s an internationally renowned American psychologist named Albert Ellis became discouraged because of his poor therapeutic results using psychoanalysis. Again like Wolpe, as a psychotherapeutic rebellion, Ellis developed a highly effective, authoritatively directive method of psychotherapy called Rational Emotive Therapy. The main stimulus for Ellis' new treatment method was the Greek stoic, emotional canon People do not get upset by...

Methodology for Glucose Metabolic Rate GMR

PET is a functional imaging technique based on the use of positron emitting radiotracers. A number of positron emitters can be used for PET but the two most commonly used for brain imaging are fluorine (18) and oxygen (15). F18, for example, can be attached to an analog of glucose, 2-deoxyglucose, to form fluorodeoxyglucose (FDG). When FDG is injected into a person's blood stream, the deoxyglucose part enters the glucose pool and is used by neurons for energy. The more a neuron fires, the more...

Psychological Therapies

There is a great deal of literature on the psychological approaches to the treatment of sexual dysfunction. Many authorities consider psychological therapy as the treatment of choice when help is sought for sexual dysfunction, although obviously there are instances where a physical approach might be more appropriate. Psychological therapies take different forms. Psy-chodynamic therapy aims to understand the presenting problem as a manifestation of an underlying, unconscious conflict or memory,...

Intracavernosal Injections

Phenoxybenzamine hydrochloride, papaverine hydro-chloride, phentolamine mesylate, and prostaglandin-E have been used as intracavernosal injections for erectile difficulties. Phenoxybenzamine usage had led to priapism or painful erections lasting for up to 3 days and has largely fallen into disuse. Papaverine hydro-chloride is a smooth muscle relaxant that, when injected intracorporeally, will result in active arterial dilation, corporeal smooth muscle relaxation, and venous outflow restriction...

Escape Avoidance

There are times when individuals fail to cope actively with a stressful situation and instead engage in efforts to avoid confronting the stressor. Attempts at escape and avoidance can take a variety of cognitive or behavioral forms, such as wishful thinking, distancing, denial, or engaging in distracting activities. For example, an individual may attempt to repress thoughts of a recently deceased spouse as a cognitive means of escape-avoidance. Likewise, one could immerse oneself in cleaning...

Axis IV Psychosocial and Environmental Problems

Axis IV is included for detailing psychological, social, and environmental problems that may be relevant to the presenting mental disorder. Such problems may have influenced the development of the disorder, may have developed as a consequence of the disorder, may be relevant to the selection of an appropriate treatment, or may influence the prognosis for recovery. Although both positive (e.g., job promotion) and negative (e.g., job loss) life events can be perceived as stressful, typically only...

Indirect Interventions or Injunctions

The changes that may result from direct interventions, as outlined in the section above, tend to be what are often referred to as ''first order change.'' This implies that although the behaviors of one or more family members have changed, there have not been the more fundamental changes in the family that may be needed and are implied by the term ''second order change.'' Direct interventions may leave the functioning of the family system fundamentally unchanged, even though communication may be...

How and Why Biofeedback Is Used in Clinical Settings

A major use of biofeedback is to teach relaxation skills. A second use of biofeedback is to alter pathophysiological processes such as blood flow or SNS arousal for migraine headache patients, to decrease the flow of gastric juices for ulcer patients, to decrease muscle tension and increase proper posture for the chronic back-pain patient. Biofeedback should be considered as a therapeutic tool that can help introduce the client to therapy in a concrete and nonthreaten-ing manner. It can be...

Depression Applied Aspects

University of California, San Francisco IV. Treatment of Major Depression VI. Healthy Mood Management A Developmental Perspective Depressed Mood A feeling state consisting of dejection, sadness, and demoralization, usually accompanied by diminished reaction to pleasurable events. Depressive Disorder A condition in which an individual exhibits a specified number of depressive symptoms of enough severity and duration to meet well-delineated and widely accepted diagnostic criteria. Emotion A...

Some Developmental Considerations

Research in cognitive development, social cognition, and child psychology lends further insight into what healthy cognitive functioning looks like. The unrealistic optimism and self-confidence apparent in well-adjusted adults has also been found in healthy children. Studies have compared helpless and mastery-oriented'' children in their responses to failure. Mastery-oriented children are those who have a sense of control over an experimental task helpless children have no such sense of control....

False Allegations of Sexual Abuse

The modest substantiation rate noted in the discussion of NCPCA findings raises the question of false allegations. Why are so many more cases being reported than are being substantiated Does this mean that two-thirds of the reports made are false It does not. There are many reasons that a case may not be substantiated, other than that someone made a false claim of sexual abuse. In studies conducted at the Kempe National Center on Child Abuse and Neglect, a very small proportion of...

The Beginning Of Psychoanalysis Sigmund Freud

Sigmund Freud established psychoanalysis as a combination of theory, mode of investigation, and technique of treatment. Dream work, multiple subpersonalities theory, recognition of unconscious determinants of behavioral patterns, hypnosis, and suggestive techniques were islands of fragmentary knowledge before Freud integrated them, added a developmental approach, described unconscious defensive mechanisms, and recognized transference and resistance. In initial work, Josef Breuer and Freud...

Rationale And Technique For Elicitation Of The Relaxation Response

A variety of techniques can be used to elicit the relaxation response, including meditation, progressive muscle relaxation, autogenic training, yoga, exercise, repetitive prayer, and the presuggestion phase of hypnosis. Although all of these strategies result in the same physiological response, two components appear to be essential to achieving the relaxation response mental focusing and adopting a passive attitude toward distracting thoughts. The following is an instructional set developed by...

Content and Comprehensiveness in Personality Questionnaires

Psychometric theory gives general guidelines for constructing and evaluating measures of psychological characteristics, but it gives little guidance about what should be measured. For decades, one of the central problems in personality psychology was the proliferation of hundreds of scales measuring aspects of personality that some researcher or theorist thought important in understanding human beings. Many of the most eminent personality psychologists were those who offered a system, a model...

Psychoneuroimmunology Stress and Health

There exists a long legacy of contradictory and sometimes confused thinking regarding the relationship between mind and body. At one time, the idea that external events and stressful situations could adversely impact health was not accepted by the medical establishment. Those who believed in such a connection could offer no plausible biological mechanism. For such a relationship to be possible, the relationship between the nervous system and the immune system must be understood. These systems...

Individual Differences

The Abbe Faria, another follower of Mesmer, recognized individual differences in response to animal magnetism as early as 1819, and there are large individual differences in response to hypnosis as well. Hypnosis has little to do with the hypnotist's technique and very much to do with the subject's capacity, or talent, for experiencing hypnosis. Hypnotizability is measured by standardized psychological tests such as the Stanford Hypnotic Susceptibility Scale or the Harvard Group Scale of...

John B Watson and Radical Behaviorism

Starting in the second decade of the twentieth century, John B. Watson (1878-1958) led American behavior-ists in continual rebellion against the other schools of psychology. The behaviorists' canons were (1) Behaviorism, a term coined by Watson, maintains that the concept of consciousness is merely an undefinable replacement of the religious concept of soul and therefore completely rejects it. (2) Behaviorism is a clean break with all of the current theories and traditional psychological...

The Mechanistic Conception of Unwanted Conduct

The history of science makes clear that the mid-nineteenth century witnessed tremendous progress in the science of biology. This progress was directly related to the mechanization of biology. All biological phenomena were to be explained in terms of the mechanistic transmission of physical and chemical forces. Scientific explorations sought principles that were invariant. During this period medical doctors took on the task of explaining abnormal behavior by extrapolating from the findings of...

Definition of Biofeedback

Biofeedback is any process in which an external device generates information to an individual about his or her physiological responses and that allows the individual to then regulate these responses and receive feedback on changes in the physiological responses. The physiological responses may be any responses that can be measured by an external device. The most common responses measured are muscle tension, heart rate, skin-temperature, and galvanic skin response. The feedback may be in a...

A PMS Symptoms and Their Timing

An immense number of symptoms have been attributed to PMS (Table II). The most common complaints include physical symptoms (breast swelling and tenderness, abdominal bloating, headaches, muscle aches and pains, weight gain, and edema), emotional symptoms (depression, mood swings, anger, irritability, and anxiety), and others (decreased interest in usual activities, fatigue, difficulty concentrating, increased appetite and food cravings, and hypersomnia or insomnia). Four temporal patterns have...

Personality Characteristics as Determinants of Coping

Clinicians and researchers alike have examined the role of personality in coping in an attempt to predict and explain which individuals are at risk for experiencing psychological maladjustment. The underlying assumption is that personality can influence how one copes with stress, and coping determines whether stress will have deleterious effects on health and well-being. A consistent set of personality traits have emerged as significant predictors of the ways in which people cope and the impact...

Differentiating Between Mental And Physical Health Problems

Perhaps the issue which has received the most attention in the literature concerns the differentiation between mental and physical health. Many mental health scales include physical symptoms, which may be relatively uncommon in younger populations and indicative of psychological distress. However, in older populations, with their greater incidence of chronic health problems, such instruments may yield very high rates of false positives. Further, mental health problems often have physiological...

Information Processing Model

In defining biofeedback training, the concept that the individual is fed back information about biologi- cal responses that he or she is not aware of is important. This information provides a sensory analog of the currently occurring physiological responses. Information is provided to the individual at the same instant that the physiological activity is occurring or after a very brief delay. Therefore, some part of the output of a process is now introduced into the input of a process so as to...

Eating Disorders

Eating disorders usually are characterized by a morbid fear of becoming fat and a preoccupation with body weight, food, and body image. Eating disorders include anorexia nervosa (restricting type and eating purging type) and bulimia nervosa (purging and non-purging type) and occur more commonly among females than among males. Anorexia nervosa is associated with a 5 to 18 premature mortality rate. In addition, these individuals are at risk for comorbid depression, mood disorders, and an...

Problem Focused Coping

Problem-focused coping includes those forms of coping that are geared directly toward solving the problem or changing the stressful situation. Most of the research examining problem-focused coping has been on planful problem-solving. Coping strategies based on planful problem-solving involve conscious attempts to determine and execute the most appropriate course of action needed to directly prevent, eliminate, or significantly improve a stressful situation. Making a plan of action and following...

Cognitive Model Of Anxiety Disorders

Whereas the cognitive themes in depression are deprivation, defeat, and loss, the cognitive theme in anxiety disorders is danger. Following the continuity hypothesis, anxiety reactions are on a continuum with normal physiologic responses, but are exaggerated reactions to perceived threat. Cognitive therapy views anxiety from an evolutionary perspective, as originating in the flight, freeze, or fight responses apparent in animal behavior. These innate responses to physical danger became less...

Transference as a Therapeutic Relationship

The typical transference relationship is one in which the patient directs toward the analyst an unusual de gree of attachment and affection that is not a realistic response to the relationship between them but can only be traced to wishful fantasies and idealizations that have remained unconscious. These fantasies are repeated in analysis as unresolved childhood attitudes and affects that are anachronistic and inappropriate, in part because repressed material necessarily contains infantile...

Situational Specificity in Coping

Currently, there is much interest among researchers in studying the factors within a given situation that de termine how an individual will cope, how the chosen coping strategies influence mental health, and how this process varies from situation to situation. In 1984, Lazarus and Folkman identified a number of dimensions of stressful situations that are important determinants of the stress and coping process. Novelty (has the individual coped with this type of stressor in the past ),...

Nonsexual Symptoms of Sexual Abuse

Nonsexual symptoms are less definitively linked to sexual victimization because they are more likely than sexual symptoms to derive from other experiences and traumas. For example, while such behavioral and emotional symptoms can come from being sexually victimized, they can also be the result of physical abuse, neglect, divorce, auto accidents, or natural disasters. Nevertheless, Table III lists nonsexual symptoms and, where relevant, their possible relationship to subgroups of victims. Table...

Rationales For The Implementation Of Support Groups

The theoretical rationale that usually introduces studies on the use of support groups to maintain and promote mental health is based on the broad fabric of evidence, reviewed by Cohen and Wills in 1985, revealing that the support of one's personal community of associates has health protective effects. They concluded that it is largely perceived support that cushions the impact of a wide range of stressful life events and transitions. In addition, in 1988, House, Landis, and Umberson reviewed a...

Galvanic Skin Response Biofeedback

A feedback dermograph measures the electrical conductance or electrical potential in the individual's skin. The galvanic skin response (GSR) biofeedback machine can monitor minute changes in the concentration of salt and water in sweat gland ducts. The natural metabolism of cells produces a slight voltage that varies as sweat gland activity changes. The lower the measurable voltage, in millivolts, the less there is of sweat gland activity. With skin conductance techniques an imperceptible...

The Relaxation Response And Behavior Change

Relaxation-response training can be used to facilitate behavior modification goals. Most patients who begin a diet or a smoking cessation program are able to stay with the program for short periods of time. When stresses arise, however, it generally becomes more difficult to maintain the new routine. Coping with stress and anxiety has a psychic cost that takes the form of a diminished capacity for self-regulation. Presum Meditation and the Relaxation Response ably, the cause of this stress...

The Relaxation Response In Psychotherapy

For many patients with psychological disturbances, who might be hesitant to enter therapy, relaxation-response training is a nonthreatening intervention that can be introduced prior to other more rigorous forms of therapy such as cognitive therapy or medication. Meditation and other modes of eliciting the relaxation response can be a means of preparing for standard psychotherapy by allowing the patient to observe thoughts and mental events. In 1985, Kutz and colleagues were the first to...

Rationale for Randomization

The basic rationale for randomization is that we ideally want to know what would have happened to subjects had they not been assigned to the experimental treatment, a hypothetical counterfactual. Of course, because we cannot both assign and not assign at the same time, a direct assessment of this counterfactual is impossible. Randomly assigning people so that the expectation is that they are equivalent on variables that might affect outcome but in which we are not interested is the best...

Early Historical Roots Of Behavior Therapy

Attempts to help people solve behavioral problems, with maneuvers similar to those used in today's behavior therapy have a long history. Pliny the Elder, in first-century Rome tried to cure alcohol abuse by putting putrid spiders in the drinking glasses of alcohol abusers. Today that maneuver would be called aver-sive conditioning. The eighteenth-century ''Wild Boy of Averyron'' was taught spoken language with maneuvers that today would be called modeling, prompting, positive reinforcement, and...

Differentiating Depression from Dementia

Some depressive symptoms mimic cognitive impairment, especially in the elderly. In particular, psycho-motor retardation and memory lapses in the elderly are usually attributed to dementing processes, but actually may reflect depression. Pseudodementias can result from a wide variety of disorders, including nutritional deficiencies, prescribed medications, alcohol and substance abuse, and surgical procedures. Thus, assessment of the occurrence of problems of this type may be an important...

Appendices to the DSMIV

Included in the DSM-IV are 10 appendices. The appendices include a guide to facilitate differential diagnosis, a glossary, alphabetical and numerical listings of the diagnoses described in the manual, a summary of changes between the DSM-IV and the previous version of the DSM, comparisons of DSM-IV codes to the codes in two editions of the International Classification of Diseases, and a listing of contributors. Worth special mention are two other appendices, Criteria Sets and Axes Provided for...

Axis II Personality Disorders and Mental Retardation

On Axis II are listed Personality Disorders and Mental Retardation. These disorders, by definition, are present for a substantial period of time (i.e., years). Although Axis I disorders may also be present for similar lengths of time, enduring symptoms are fundamentally part of these Axis II disorders. Also listed on Axis II are other traits or prominent features of a person's personality that a clinician deems maladaptive (e.g., frequent use of denial, excessive impulsivity). In addition to...

Documenting Support Group Processes

There is no dearth of hypotheses about the mediating processes or mechanisms at work in support groups. Biological pathways include alterations in immune system function, blood pressure, and urinary cortisol, whereas behavioral changes range from improved adherence to recommended dietary and drug regimens to changes in modes of coping, including the use of community services. The psychological factors that have been cited most frequently as potential mediators include the 10 listed at the...

The Ground Rules And Context Of Psychoanalytic Treatments

The goal of therapy is to improve the future for the patient. Each party to the treatment has tasks in relation to this goal. The patient is asked to speak truth fully and completely about memories, fantasies, associations, images, dreams, bodily feelings, wishes, and fears that are usually not told to others. The therapist and the patient together observe what it feels like to do this, how it is done, what is communicated, and what the process does to their relationship. The therapist puts...

Hypnosis and the Psychological Unconscious

Dissociation and Subconscious Processing Automatic Processes Perceptual-cognitive processes that are initiated involuntarily, executed outside phenomenal awareness, and consume no attentional resources. Data-Driven Processes Perceptual-cognitive processes that are based on the perceptual structure of a stimulus. Episodic Memory Memory for personal experiences, each associated with a unique spatiotemporal context (see contrasting Semantic Memory). Explicit Memory Conscious recollection, as...

Meditation The Relaxation Response And Physiological Changes

Benson and his colleagues were among the first to use Western experimental standards to study the physiology of meditation and its potential clinical benefits. In experiments involving Transcendental Meditation conducted at the Harvard Medical School and at the University of California at Irvine, physiological parameters were monitored in subjects in both meditative and nonmeditative states. Measures of blood pressure, heart rate, rectal temperature, and skin resistance as well as...

Calculation of Inter Rater Reliability

In assessing inter-rater reliability, one could simply calculate the overall proportion of agreement between two independent raters. This approach, however, fails to account for the proportion of time that two raters would agree merely by chance. For example, imagine that two raters agree on the presence or absence of depression 70 of the time. Although this might appear promising, one needs to compute the likelihood that they would agree by chance alone. To illustrate, imagine that these two...

Biophysiological Factors

Presenting problems may be related to neurological or biochemical factors. Such factors may place boundaries on how much change is possible. Malnutrition, hypoglycemia, and allergic reactions have been associated with hyperactivity, learning disabilities, and mental retardation. Biochemical abnormalities are found in some children with serious behavior disturbances such as those labeled autistic. However, this only establishes that abnormalities in biochemistry are present, not that they cause...

Continuity Hypothesis

The cognitive model of psychopathology emphasizes well-being on a continuum. Various psychopathologi-cal syndromes are viewed as exaggerated and persistent forms of normal emotional responses. Thus, there is continuity between the content of normal reactions and the excessive responses seen in psychological disorders. This hypothesis fits an evolutionary perspective, for it suggests that disorders are extreme manifestations of adaptive strategies. In addition, the notion of continuity makes...

Meditation and the Relaxation Response

Richard Friedman, Patricia Myers, and Herbert Benson II. Physiology of Stress and the Relaxation Response III. Meditation, the Relaxation Response, and Physiological Changes IV. Rationale and Technique for Elicitation of the Relaxation Response V. The Relaxation Response in Psychotherapy VI. The Relaxation Response and Behavior Change VII. Integrating the Relaxation Response into Health Care Fight-or-Flight Response Physiological arousal of the sympathetic nervous system which prepares an...

Axis I Clinical Disorders and Other Conditions That May Be a Focus of Clinical Attention

Almost all mental disorders or conditions that may be a focus of clinical attention appear on Axis I, with a few exceptions that appear on Axis II. Axis I organizes mental disorders into 15 major groups of disorders, as presented in Table I. Most of the groups in Table I were created based on the similarity of symptoms of disorders within that group, although in some cases disorders are grouped together because of the typical age at which symptoms first appear (Disorders Usually First Diagnosed...

Follicular Phase and Ovulation

The follicular phase begins on the first day of menstruation and lasts until approximately Day 14, based on a 28-day cycle. During this phase, a number of ovarian follicles, each typically containing a single ovum, develop under the influence of follicular stimulating hormone (FSH) produced by the anterior pituitary, a deep, midline endocrine organ in the brain. This hormone is produced and delivered in response to the pulsatile release of a neurohormone, gonadotropin releasing hormone (GnRH),...

Family Therapy

University of Calgary and Alberta Children's Hospital I. The Development of Family Therapy Circular Causation A causal chain in which there is a series of events, each influencing another, the process continuing in a circular manner. Disengagement The opposite of enmeshment (see below). Enmeshment The close emotional involvement of two or more people. Family Structure The ways in which the different family members, or groups of members, are allied, and the nature and strengths of the alliances....

Distinguishing Schizophrenia from Dementia

While the onset of schizophrenia typically occurs in adolescence or young adulthood, schizophrenia may also occur in late life. Schizophrenia with a late life onset is often called paraphrenia, and may occur in individuals who have a history of eccentricity and are socially isolated. However, dementia can also produce hallucinations and delusions, and thus, like depression, it is important to distinguish between the two conditions. Assessment of Mental Health in Older Adults Given that...

Challenges To Validity And Future Directions In Diagnosis

The DSM-IV, like its predecessors, has adopted a descriptive categorical approach to diagnosis, which assumes that there exist discrete categories of mental illness that can be defined for most diagnoses primarily on the basis of observable symptoms. Discrete categories of illness dichotomize individuals into those who do, and those who do not, have the illness borderline cases are categorized into one or the other category (or given one of the may NOS diagnoses). When the etiology of an...

Classifying Mental Disorders Nontraditional Approaches

University of California, Santa Cruz Bucknell University II. The Purposes of Classification III. The Traditional Approach to Classification IV. The Contextualist Construction of Deviant Conduct V. Assumptions and Alternatives VI. Diagnosing within a Contextualist Framework Contextualism A worldview that requires taking into account the entire context in which actors' behavior takes place. For human beings, the context is largely symbolic and languaged so that one must consider the meanings that...

O

Objective test, in personality assessment, 235, 237-238 Older populations, see Elderly Operant conditioning biofeedback model, 38 definition, 37 historical perspectives, 13 -15 Optimism coping responses, 141, 145-146 health benefits, 28, 110 positive illusion, 145 -146 Oral contraceptives, premenstrual syndrome intervention, 259 removal for premenstrual syndrome intervention, 259 Ovulation, description, 245, 247-248

What Does Healthy Cognitive Functioning Look Like

Cognitive therapy is derived from research on clinical populations, particularly depressed patients. Characteristics of the diagnostic groups studied are assumed to be extreme manifestations of qualities that are also found in normal people. Among depressed patients, for example, thinking is characterized by cognitive distortions or errors in logic, by cognitive rigidity, and by maladaptive core beliefs. Does this mean that the thinking of nondepressed people is free of distortions or an...

Cognitive Model Of Depression

The cognitive model posits that in nonendogenous, unipolar depression, life events activate highly charged negative schemas which override more adaptive schemas and set negatively biased cognitive processing in motion. The activation of schemas is the mechanism by which depression occurs, not its cause. Depression may be caused by any combination of genetic, biological, stress, or personality factors. Regardless of its cause, the same cognitive changes occur in depression. Cognitive distortions...

Sexual Sequelae

William Friedrich, a clinician and researcher at the Mayo Clinic, has played a leadership role in cataloging the sexual effects and researching differences in the rates of sexualized behaviors in children with and without a history of sexual abuse. Table II is drawn from version 3 of Friedrich's Child Sexual Behavior Inventory (CSBI). Table II Items from the Child Sexual Behavior Inventory 1. Dresses like the opposite sex. 3. Talks about wanting to be the opposite sex. 4. Touches sex (private)...

Community Mental Health

Edward Seidman and Sabine Elizabeth French I. Origins of the Community Mental Health Movement in Twentieth-Century America Deinstitutionalization The movement to reduce the number of patients kept in mental institutions by releasing them to the care of the community. The original intention of this movement was to maintain former patients in the community with a wide array of comprehensive and supportive services. Inoculation Programs Programs that are designed to build and strengthen skills in...

Diagnosis

Each woman is unique in terms of her physical experience of menstrual cycle events, her cognitive inter- Table IV Diagnostic Evaluation of Premenstrual Syndrome Current medical and psychological issues Medications prescribed and over-the-counter Past medical and psychiatric history Habits e.g., exercise, sleep, and eating patterns, smoking, alcohol, and drugs Preventative health care e.g., immunizations, cholesterol levels, pap smears, mammography Developmental and social history Sexual history...

Quasi Experiments

The alternatives to standard randomized trials often involve matching or some type of quasi-experiment that can lead to plausible but not ''highly justifiable results. Consider, for example, a study using a matching strategy to attempt to assess the effect of having an abortion. We might have two groups of women experiencing unwanted pregnancy who are alike in many of the respects we think may be relevant to how an abortion will affect them e.g., religion, social class, education, political...

Projective Techniques

The single most influential theory of personality is psychoanalysis, a complex system developed by Sigmund Freud and elaborated by a host of his followers. Briefly, psychoanalysis sees human personality as the result of conflict between the individual's sexual and aggressive impulses and society's demand for their control. In the course of early development, people evolve characteristic ways of resolving these conflicts which guide their adult behavior, particularly their interpersonal...

Extended Family Systems Therapy

The extended family systems approach is sometimes referred to as the ''three generational approach.'' Therapists of this school pay particular attention to the extended families of their patients. They are impressed by the way behaviors and ways of relating seem to be handed down from one generation to the next. They emphasize the role of the families of origin of the family members in influencing current family functioning and they play close attention to the ongoing relationships the families...

Characterological Formulation

The theories of psychoanalysis are an aid to explaining characterological aspects of personality problems and to planning how they may be changed. Therapists combine theory with observation in order to develop a patient-specific set of hypotheses. Typically, in psychoanalytic case formulation, it is assumed that symptoms and problems in living are caused by the interaction of multiple processes at biological, social, and psychological levels. At the level of the individual's psychology, the...

Physiology Of Stress And The Relaxation Response

More than 50 years ago, Cannon observed that mammals faced with life-threatening situations respond with predictable physiological arousal of the sympathetic nervous system SNS that prepares them to either face the threat or run away from it. He labeled this the now-familiar ''fight-or-flight response. This response stimulates physiological changes to facilitate vigorous skeletal muscle activity. SNS arousal, mediated by the release of epinephrine and norepinephrine, increases heart rate and...

Axis III General Medical Conditions

On Axis III are listed general medical conditions that may be relevant to the disorder s listed on Axes I and II. The presence of Axis III should not be taken to suggest a mind-brain dualism, with Axes I and II representing problems of the mind in the absence of a physiological basis. On the contrary, mental experience is rooted in the function of the brain. Axis III is included in the DSM to encourage a comprehensive evaluation and a consideration of the various ways in which a general medical...

Incidence of Reported Sexual Abuse

Incidence refers to the number of reports of a particular phenomenon, usually occurring during a circumscribed time frame. In the United States, there are governmental and nongovernmental initiatives to gather incidence data on child sexual abuse. Illustrative of governmental efforts is a provision in the Child Abuse Prevention and Treatment Act of 1974, which requires that the federal government collect annual statistics on reports of child maltreatment received by local Child Protection...

Psychodynamic Family Therapy

In a sense, this is a contradiction in terms, since family therapy is concerned with family systems, and not primarily with the psychopathology of family members. But many of the figures who played major roles in the early development of family therapy came to it from a psychoanalytic background. As far as there is such a thing as psychodynamic family therapy, it seems to be therapy that aims to help family members gain insight into themselves and how they react with each other. See...

Psychopharmacology versus Behavioral Pharmacology

Within any field different camps develop for a variety of reasons, some historical, some conceptual, some methodologic, and some personal. The study of drugs and psychology is no exception to this truism. Whereas psychopharmacology has come to refer to a broad rubric of issues, methods, and topics, behavioral pharmacology has a narrower focus. This particular sub-field is mentioned here because it is so important to the broader topic and it has made so many contributions to knowledge of drugs...

Burrhus F Skinner and Operant Conditioning

Skinner 1904-1990 , extended, modified and perfected Thorndike's reward learning theory as operant conditioning. In Skinner's 1953 book with Lindsley and Solomon, the term behavior therapy was introduced into the psychology literature. Skinner however, had worked with nonhuman animals so that term may have been used in reference to the past work of Mary Cover Jones. It may also have referred to the exciting new, non-Freudian hypothesis of Joseph Wolpe that neurotic fears are learned...

Maxie C Maultsby Jr and Rational Behavior Therapy RBT

While still a psychiatric resident, Maxie C. Maultsby, Jr., studied briefly with Joseph Wolpe in 1967 and with Ellis for the following 7 years. At the 1975 Chicago National Conference of Rational Emotive and Behavior Therapists, Maultsby described his unique method of psychotherapy called Rational Behavior Therapy, or RBT. Then RBT was and probably still is the only method of psychotherapy that is based on the well-established facts about the mental activities of normal human brains that make...

Paraphiliacs

Those with paraphilias, or variant sexual desires and practices, sometimes present with sexual dysfunction. Paraphiliacs seeking treatment in this way are almost always male, reflecting the vast preponderance of males over females among paraphiliacs. In their presentation, they often complain of difficulties in non-paraphiliac sexual relationships. For example, a man with a strong shoe fetish might seek help for an inability to obtain or maintain an erection in sex without contact with a...

Coping with Stress

Determinants of Coping Responses Coping Cognitive and behavioral efforts to manage stress. Emotion-Focused Coping Coping responses that are geared toward managing one's emotions during stressful episodes. Problem-Focused Coping Coping responses that are geared toward directly changing some aspect of the stressful situation. Relationship-Focused Coping Coping responses that are geared toward managing and maintaining one's social relationships during stressful episodes. Stress Situations that...

Edward L Thorndike Reward Learning Theory

Thorndike 1874-1949 , was the most influential non-Pavlovian American behaviorist in the first three decades of the twentieth century. His popular 1898 book, Animal Intelligence, made him one of the earliest internationally renowned American psychologists. However, his subsequent work had a lasting effect on American psychology mainly because it was the professional ''springboard'' for the research of B. F. Skinner. Skinner was Thorndike's most famous and productive student....

E O Hobart Mowrer and Two Factor Learning

More than the research and writings of any other single pioneer, behavioral psychologist, those of O. Hobart Mower made contemporary, comprehensive behavior therapy possible. He believed that to be clinically useful, any explanation of human behavior has to pass the human test of empirical common sense. Consequently, Mowrer was intrigued by this paradox Watson was accepted as the quintessential empirical scientist. Yet the basis for Watson's behaviorist revolution against then-contemporary...

Ivan P Pavlov and Classical Conditioning

Pavlov 1849-1936 , the Russian physician and physiologist, and 1904 Nobel Prize laureate, ser-endipitously discovered classical or respondent conditioning in the late nineteenth century. Here is the standard procedure for producing it. First, select a neutral stimulus and an animal human or nonhuman , for example, a dog. Animals often respond with a startle response to unusual stimuli. So, it is important to make sure that a selected stimulus is really neutral, that is, one the animal...

Assessment of Mental Health in Older Adults

Levenson I. Heterogeneity in Older Populations II. Differentiating between Mental and Physical Health Problems III. Assessing Factors Affecting Mental and Physical Health IV. Assessing Positive Mental Health Age Effects Statistical relationships due solely to the effect of chronological age. Cohort Effects Statistical relationships due primarily to the effect of year of birth, for example, having lived through a particular historical era at a specific age....