Clinical Psychology

Drawing on John Ellis's comparison between the screen - viewer relationship in Television and Cinema, this paper develops a reading of how players tend to relate to console games. Where the relationship to the screen of cinema is famously the gaze, Ellis argues television is the glance.
The player of console games is different again: not glance nor gaze, but glaze. The glaze is immersive (eyes glaze over), sticky (holding power); and self-reflective (identification with avatar).

Objective: In Malaysia, opioid abuse is an acknowledged problem with
severe health and economic repercussions. Until recently, drug addicts
were mainly criminalised and forcefully rehabilitated in correctional
facilities. However, the high relapse rates of this approach, coupled
with the high rates of blood borne infections among drug users, led to
increasing acceptance of a healthcare-based approach in the
rehabilitation of drug addicts. Methadone was among the medications
introduced as substitution maintenance therapy in 2005 and
Universiti Malaya Medical Centre (UMMC) is a centre for MMT.
This study aimed to determine the effects of MMT on quality of life in
patients here. Methods: The sample was 46 patients who attended the
Psychiatric outpatient clinic in fill in UMMC. The instrument used to
assess quality of life was the WHOQOL-BREF. Results: The study
design was cross-sectional with retrospective elements. Baseline QOL
scores were obtained from case records and follow-up scores from the
month of September 2007. Statistically significant improvements in all
four domains of WHOQOL-BREF were found. Physical: p<0.01, C.I.
1.46-3.05. Psychological: p<0.01, C.I. 1.44-3.11. Social: p=0.03, C.I.
0.66-3.05. Environmental: p<0.01, C.I. 0.85-2.24. Conclusion:
Methadone maintenance therapy substantially improves quality of life
in ex-opioid abusers. ASEAN Journal of Psychiatry, Vol.10, No.1 Jan
– June 2009: XX

As is common in much of the new videogame theory, the boundary distinction between videogames and cinema is central to our argument. We join those who insist that film studies and related methods of analysing old media can’t capture
what is essential about videogames. We suggest that in some ways, however, the oppositions often drawn between film and videogame are questionable in terms of various levels of immersion. We take an approach in arguing that the videogame is fundamentally 'contra-immersive' and in a sense is ontologically Brechtian, rather than locally in one text or another, as in film.

Important note: whenever you read 'present-at-hand', please replace this with 'unready-to-hand'.

Some therapists, as well as other commentators, have suggested that memories of horrific trauma are buried in the subconscious by some special process, such as repression, and are later reliably recovered. We find that the evidence provided to support this claim is flawed. Where, then, might these memory reports come from? We discuss several research paradigms that have shown that various manipulations can be used to implant false memories—including false memories for traumatic events. These false memories can be quite compelling for those who develop them and can include details that make them seem credible to others. The fact that a memory report describes a traumatic event does not ensure that the memory is authentic.

Purpose: There seems to be a relationship between nocturnal enuresis (NE) and behavioral problems. However, few NE treatment studies focus on psychological effects. Because it is important to obtain information from multiple informants during the evaluation process, the goal of this study is to compare parents’ reports of youth problems (PRYP) with adolescent problems self-reports (APSR) pre/post behavioral treatment based on the use of an urine alarm. Methods: Adolescents (N=19) with monosymptomatic (primary or secondary) nocturnal enuresis went through group treatment up to discharge criterion (8 weeks with consecutive dry nights). Wet nights were followed daily for 40 weeks. PRYP and APSR were scored by the CBCL and YSR. Results: Pre-treatment data: 1) Higher number of clinical cases based on parent report than on self-report for Internalizing Problems (IP) (13/19 vs. 4/19), Externalizing Problems (EP) (7/19 vs. 5/19) and Total Problem (TP) (11/19 vs. 5/19); 2) Mean PRYP scores for IP (60.8) and TP (61) were within the desviant range (T score≥60); while mean PRYP scores for EP (57.4) and mean APSR scores (IP=52.4, EP=49.5, TP= 52.4) were in the normal range. Difference between PRYP’ and APSR’ scores was sinificant. Post treatment data: 1) Discharge for majority of the participants (16/19); 2) Reduction in the number of clinical cases on parental evaluation: 9/19 adolescents were maintained within clinical range for IP, 2/19 for EP, and 7/19 for TP. 3) All post-treatment mean scores were within the normal range; the difference between pre and post evaluation scores was significant for PRYP. Conclusions: The behavioral treatment based on the use of an urine alarm for enuresis is effective in stopping bed-wetting for adolescents with mono-symptomatic (primary and secundary) nocturnal enuresis. Since the treatment also seems to have positive effects on other behavior problems, it is important to provide intervention for adolescent bed-wetting in order to avoid negative psychological consequences. The study favors the hypothesis that enuresis is a cause, not a consequence, of other behavior problems.

""Few studies have reported long-term follow-up data in adults and even fewer in adolescents. The purpose of this work is to report on the longest follow-up assessment in the literature on treatments for adolescents with social phobia. A 5-year follow-up assessment was conducted with subjects who originally received either Cognitive Behavioral Group Therapy forAdolescents(CBGT-A), Social EffectivenessTherapy forAdolescents—Spanish version (SET-Asv), or Intervencio´n en Adolescentes con Fobia Social—Treatment for
Adolescents with Social Phobia (IAFS) in a controlled clinical trial. Twenty-three subjects completing the treatment conditions were available for the 5-year follow-up. Results demonstrate that subjects treated either with CBGT-A, SET-Asv and IAFS continued to maintain their gains after treatments were terminated. Either the CBGT-A, SET-Asv and IAFS can provide lasting effects to themajority of adolescentswith social anxiety. Issues that may contribute to future research and clinical implications are discussed.""

"The reviews of recent literature in the field reveal a significant growth in
the number of research studies on social anxiety disorder (SAD) in children and
adolescents. However, there is a lack of information and on-going debates on
different issues related to this disorder. This paper presents a look ahead toward
critical steps to extend our knowledge and improve the understanding of this
disorder. In particular, this paper reviews the nature of social anxiety symptoms
as well as etiological explanations for the disorder. Additionally, the issue of
evidence-based assessment and treatment of SAD is discussed, with a particular
focus on cognitive-behavioral interventions. We conclude with a discussion of
future directions for the field."

Although social phobia is one of the most common mental disorders in adolescents, information on the need for normative data is missing. For this reason, this cross-sectional study aims at determining if there is a need to have normative data according to age and gender in socially anxious adolescents. Furthermore, this study analyzes if boys and girls differ in the nature of their social fears. The study population comprised 2,543 Spanish-speaking adolescents randomly recruited from 10 schools. The results point out that there is no need for different normative data based on age and gender. Moreover, our data indicate that even though there are quantitative differences between boys and girls, i.e. the girls reporting a higher percentage, a qualitative analysis reveals that boys and girls experience the same social fears and, therefore, the nature of the social anxiety-provoking situations is the same across gender. Implications for developmental theories and assessment are discussed.

Although social phobia is one of the most common mental disorders in adolescents, there are few reliable and valid assessment instruments for this age group. This study examined the factor structure and psychometric properties of a brief version of the Social Phobia and Anxiety Inventory (SPAI; Turner, Beidel, Dancu, & Stanley, 1989) in a sample of adolescents. Although the original 45-item SPAI has excellent psychometric properties, its utility is limited by its length. We developed and piloted a brief, 16-item version of the SPAI that has good psychometric properties, assesses cognitive, behavioral, and somatic symptoms, consistent with the original scale, which may be particularly useful as a screening measure. Limitations and suggestions for future research are discussed.

Creation and innovation have characterized the dynamic growth in the field of equine-facilitated psychotherapy/learning (EFP/L) in the last decade. Most of the leading-edge applications are occurring, however, outside academia. This paper explores the limits of current scholarly disciplinary discourse, the leading trends and widening scope of applications in this field, as well as how EFP/L may benefit from research approaches that integrate transdisciplinary perspectives into the understanding of this emergent field.

The main purpose of the present study was to establish reliability and validity of the final 28-item version of the Social Anxiety Scale for Adolescents (SASA, Puklek, 1997) in the sample of early and late Slovene adolescents. We also investigated the relation of social anxiety to positive imaginary audience and students' performance in an evaluative academic situation. Confirmatory factor analysis determined a two-factor structure of the SASA (Apprehension and Fear of Negative Evaluation - AFNE and Tension and Inhibition in Social Contact – TISC). Only AFNE correlated (positively) to imaginary audience. Although socially anxious students did not appear as academically less successful, students who scored higher on the SASA subscales reported higher intensity of distractive factors during oral examination than their socially less anxious age mates. Contrary to expectations, early and late adolescents did not differ in social anxiety and imaginary audience ideations. Female adolescents showed more worries and fears of negative evaluation (AFNE) than males. Males and females also differed according to the type of imaginary audience ideations.

This is the back copy from Duke:

What happens when a baby is born with “ambiguous” genitalia or a combination of “male” and “female” body parts? Clinicians and parents in these situations are confronted with complicated questions such as whether a girl can have XY chromosomes, or whether some penises are “too small” for a male sex assignment. Since the 1950s, standard treatment has involved determining a sex for these infants and performing surgery to normalize the infant’s genitalia. Over the past decade intersex advocates have mounted unprecedented challenges to treatment, offering alternative perspectives about the meaning and appropriate medical response to intersexuality and driving the field of those who treat intersex conditions into a deep crisis. Katrina Karkazis offers a nuanced, compassionate picture of these charged issues in Fixing Sex, the first book to examine contemporary controversies over the medical management of intersexuality in the United States from the multiple perspectives of those most intimately involved.

Drawing extensively on interviews with adults with intersex conditions, parents, and physicians, Karkazis moves beyond the heated rhetoric to reveal the complex reality of how intersexuality is understood, treated, and experienced today. As she unravels the historical, technological, social, and political forces that have culminated in debates surrounding intersexuality, Karkazis exposes the contentious disagreements among theorists, physicians, intersex adults, activists, and parents—and all that those debates imply about gender and the changing landscape of intersex management. She argues that by viewing intersexuality exclusively through a narrow medical lens we avoid much more difficult questions. Do gender atypical bodies require treatment? Should physicians intervene to control the “sex” of the body? As this illuminating book reveals, debates over treatment for intersexuality force reassessment of the seemingly natural connections between gender, biology, and the body.

Young adults face formidable challenges in emotional development. To become successful adults, they must learn to read emotion, understand emotion, manage emotion, and effectively use emotion in social interactions.  Young adult addicts have the added challenge of learning to manage their disease while trying to master the complexity of adulthood.

Modern digital games are a highly successful commercial form of entertainment, however it is only relatively recently that they have started to be taken seriously as a modern art form. A central aspect of game form is the active role held by the player, whose actions and behaviour create the gaming experience. The argument presented in this paper is that the playing of videogames is a performance act and that our understanding of this precocious dramatic form is enhanced by applying the lens offered by performance theory to more closely understand the dynamics that thrive in the dance between player and game.

This paper offers a position statement that outlines some starting points for exploring the unique aspects of digital game performance.

"Reviews of The Making of Psychotherapists:

“An insightful study of the training of psychoanalytic psychotherapists from an anthropological perspective…[and] a valuable contribution to ethnographies of professional socialization.”
- Journal of the Royal Anthropological Institute.

“A remarkable anthropological study via participant observation of the world of psychoanalysis and psychoanalytic psychotherapy. Davies has produced a tour de force of critical yet compassionate engagement covering all aspects of our institutional life, including the institution of the clinic itself…. Anyone involved with training or other work of any kind in psychoanalytic organisations who cares about the degree of self-knowledge and social awareness they bring to their jobs should read this work.”
- Professor Andrew Samuels (Analytical Psychology), University of Essex


"According to James Davies's fascinating book, the medicalized mental health landscape in which English psychoanalytic institutes currently operate...further discourages analysts from critically assessing their institutional systems, theoretical assumptions, and professional practices....This thought-provoking book, which is suitable for teaching at both the graduate and undergraduate level, should make even the most unreflexive analyst question traditional institutional practices. If such questioning ultimately leads to better patient care, then we all stand to benefit"
- Medical Anthropology Quarterly

“James Davies has produced an unprecedented book that is stimulating, challenging and unequivocal in its claims.”
- The United Kingdom Association for Psychotherapy Integration.

“His careful and well-written examination of the training process and the insights that he brings from anthropology offer us a timely and valuable contribution to meeting the many challenges now threatening the vitality and even very existence of our profession…. This groundbreaking new book dissects the way that the profession is taught and asks whether its very vitality is at stake.”
- The Foundation for Psychotherapy

“A wise, thoughtful, careful examination of a world often shrouded in secrecy. Davies is both a trained psychotherapist and a trained anthropological observer. As a result, his observations have a quite different feel than most of the literature in either field. Not only psychotherapists, but their clients (not to mention anthropologists) can look to this book to understand how this profession learns to see and respond to human pain.”
- Professor Tanya Luhrmann, (Anthropology and Psychology),
Stanford University

“Combining narrative and analytical skills, Davies provides a gripping story of life among trainee and professional psychoanalytic therapists and their patients. The clinic is the participant anthropologist's village and the dramatis personae are the individuals he studies, whose ambitions and problems punctuate their learning and experiences of psychotherapy.... While laying bare the sometimes unpalatable essence of such training, Davies conveys warmth and empathy for his fellow participants. The value of the study goes beyond the particular instance of psychoanalysis and tells us how small groups meet all kinds of unanticipated consequences as they transmit the knowledge on which their profession depends”.
- Professor David Parkin (Social Anthropology),
University of Oxford.

“I highly recommend this book to anyone interested in the field of psychoanalysis, in
the culture of institutions, and in how institutions foster change in their constituent members.”
- Contemporary Psychology (American Psychological Association).

“James Davies’ ‘The Making of Psychotherapists: An Anthropological Analysis’ is a thorough and thought provoking anthropological study of the culture of psychoanalytic training…. On his impressive juxtaposition of mastery of both anthropological and psychoanalytic theory, Davies points out that in a parallel development psychoanalysis developed the notion of countertransference and anthropology that of self-reflexivity….Davies’ book is well written, thoroughly and academically resourced and describes with acute detail the striving for the establishment of the doctrine of psychoanalysis…. It is essential reading for anyone involved in the therapy world who is interested in the understanding of the philosophical, historical, social and political implications of the construction of psychoanalysis in the twentieth century.”
- The European Journal of Psychotherapy and Counselling."

This paper was given at a College Art Association conference in 2000, in a session on the state and future of social art history chaired by Marc Gotlieb. The session was one of the big ones that year--maybe 300 people in attendance--and it was, by several standards, a total disaster. The respondent, Tom Crow, was annoyed by most of the papers; the conversation afterward was more about the history of social art history, and who owned it, than about Marc's questions; and the speakers addressed Marc's concerns in such different ways that I think few people could have gotten much out of the session as a whole.

This paper asks perhaps the most annoying question that can be asked about an historian's work. There is no doubt that historical writing is specific to the time and place of the historian, and informed by the historian's way of conceptualizing the world: that has been described beautifully, and repeatedly, by writers from Walter Benjamin to Dominic LaCapra. But strangely, writing on the subject of historians' subjectivity has not helped historians think about their own writing.

One assertion in this paper has had an afterlife: it's the idea that art history, in particular, has a shelf life of about thirty years. After that, the texts are likely to be consulted mainly for stray facts, and otherwise to be considered as products of their age. No one reads Dvorak or Friedlaender any more for information about the seventeenth century; they are read (when they are read) as writers who exemplify cultural currents in the first half of the twentieth century. In other words, historical accounts gradually become accounts of the time in which the historian lived. I proposed that thirty years is the cutoff point, and that we should try to do better.

Objective: The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). Method: The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder symptoms, general psychopathology, and CSA history at admission to hospital. Results: Thirty-seven patients (48%) reported a history of CSA before the onset of the eating disorder. Individuals with a history of CSA reported significantly greater psychiatric comorbidity, including higher levels of depression and anxiety, lower self-esteem, more interpersonal problems, and more severe obsessive-compulsive symptoms. Patients with the binge-purge subtype of AN (AN-BP) were significantly more likely to report a history of CSA prior to the onset of the eating disorder as compared with patients with the restricting subtype (AN-R) of the illness (65% of the AN-BP patients vs. 37% of the AN-R patients; p < .02). Contrary to our predictions, abused patients were not significantly more likely to dropout of treatment overall. However, patients of the binge-purge subtype (AN-BP) with a history of CSA were significantly more likely to terminate treatment prematurely as compared with the other patients. ଝ Conclusions: Consistent with previous findings, the present results indicate that the prevalence of CSA is high among individuals seeking inpatient treatment for AN. A history of CSA was associated with greater psychiatric disturbance overall and a higher rate of dropout for patients of the binge-purge subtype.

Resting state activity in the ventral cingulate may be an important neural marker of symptomatic improvement in depression. The number of task related functional magnetic resonance imaging (fMRI) studies correlating blood oxygenation level dependent (BOLD) response with symptomatic improvement is limited and methodologies are still evolving. We measured BOLD responses to sad and happy facial stimuli in 12 severely depressed individuals in the early stages of antidepressant treatment (Time 1) and 12 weeks later (Time 2) using event-related fMRI. We calculated correlations between temporal changes in BOLD response and changes in symptom scores. Most subjects improved markedly by Time 2. At Time 1, depression severity correlated positively with responses to sad stimuli in the right visual cortex, subgenual cingulate, anterior temporal pole and hippocampus and correlated negatively with responses to happy stimuli in left visual cortex and right caudate. Decreases in individual effect sizes of right subgenual cingulate and right visual cortical responses to sad, but not happy, facial stimuli were correlated with decreases in symptom scores. There are contrasting cortical and subcortical responses to sad and happy stimuli in severe depression. Responses to sad stimuli show the strongest correlates of clinical improvement, particularly in the subgenual cingulate.

Purpose – Earlier work on career choice has identified that career choice involves gendered processes which lead to differentiated career outcomes for women and men. However, this literature remained anaemic in offering career counselling strategies for addressing the negative impacts of these processes. The paper aims to explore the creativity cycle and other tools derived from personal construct psychology (PCP) and other feminist literature as potential means for dissolving gendered perceptions of various professions and organisational practices.

Design/methodology/approach – This is a conceptual paper.

Findings – The paper argues that PCP can provide a theoretical and methodological framework for discussing how dichotomous and gender identified the perceptions of professions can be and how such perceptions might be challenged.

Practical implications – This theory and its techniques allow us an exploration of the flexibility of one’s constructions system, which determines a person’s ability to construe alternative views and to develop new ways of understanding oneself and others.

Originality/value – The PCP’s potential as a technique to combat gendered perceptions of a career is examined.

En este trabajo pretendo corregir algunos de los “excesos” y simplificaciones de las teorías posmodernistas sobre la identidad. Trato de restituir al sujeto una ontología que no lo reduzca a meras determinaciones sociales, recuperar su carácter corpóreo-orgánico (embodiment) para su comprensión/construcción y, de este modo, retomar la cuestión de la unidad del sujeto (y de la unidad de/en su identidad) frente a la manida exaltación de su fragmentación (pluralidad de su identidad --en oposición a lo cual sostengo la idea de una ‘pluralidad de/en su identidad’).

Sample chapter available for download!

CONTENTS
Introduction - Psychiatry as Cognitive Neuroscience: An Overview (M.R. Broome and L. Bortolotti)

Psychiatry as Science
Chapter 1. Is Psychiatric Research Scientific? (R. Cooper)
Chapter 2. A Secret History of ICD and the Hidden Future of DSM. (K.W.M. Fulford and N. Sartorius)
Chapter 3. Delusion as a Natural Kind. (R. Samuels)

The Nature of Mental Illness
Chapter 4. Mental Illness is Indeed a Myth. (H. Pickard)
Chapter 5. Psychiatry and the Concept of Disease as Pathology. (D. Murphy)

Reconciling Paradigms
Chapter 6. On the Interface Problem in Philosophy and Psychiatry. (T. Thornton)
Chapter 7. What does Rationality Have to Do with Psychological Causation? Propositional attitudes as Mechanisms and as Control Variables. (J. Campbell)
Chapter 8. Mad Scientists or Unreliable Autobiographers? Dopamine Dysregulation and Delusion. (P. Gerrans)

Psychiatry and the Neurosciences
Chapter 9. When Time is Out of Joint: Schizophrenia and Functional Neuroimaging. (D. Lloyd)
Chapter 10. Philosophy and Cognitive-Affective Neurogenetics. (D. Stein)
Chapter 11. An Addictive Lesson: A Case Study in Psychiatry as Cognitive Neuroscience. (L. Stephens and G. Graham)

Phenomenology and Scientific Explanation
Chapter 12. Understanding Existential Changes in Psychiatric Illness: The Indispensability of Phenomenology. (M. Ratcliffe)
Chapter 13. Delusional realities. (S. Gallagher)

Delusions and Cognition
Chapter 14. Delusions: a Two-Level Framework. (K. Frankish)
Chapter 15. Explaining Pathologies of Belief. (A.M. Aimola Davies and M. Davies)

Moral Psychology and Psychopathology
Chapter 16. Mental Time Travel, Agency and Responsibility. (J. Kennett and S. Matthews)
Chapter 17. Motivation, Depression and Character. (I. Law)

Conclusion: The Future of Scientific Psychiatry. (L. Bortolotti and M.R. Broome)


One of the best books of 2009 for the Guardian, according to Mary Warnock:
http://www.guardian.co.uk/books/2009/nov/22/books-of-the-year-2009.

For reviews and other information about the book, go to: http://sites.google.com/site/lisabortolottiphilosophy/books/psychiatry

Table of contents:

Braddock & Lacewing, Introduction.

Part I. Psychoanalysis.
Brearley, What Do Psychoanalysts Do?
Budd, Reading and Misreading.
Rusbridger, Elements of the Oedipus Complex: A Kleinian Account.
Tuckett, Civilization and its Discontents Today.

Part II. Philosophy.
Cottingham, A Triangle of Hostility? Psychoanalysis, Philosophy and Religion.
Lacewing, Do Unconscious Emotions Involve Unconscious Feelings?
Harcourt, Guilt, Shame, and the ‘Psychology of Love’.
Braddock, Psychoanalysis as Functionalist Social Science: The Legacy of Freud’s ‘Project for a Scientific Psychology’.

III. Perspectives.
Rustin, How Do Psychoanalysts Know What They Know?
Robertson, Freud’s Literary Imagination.
Connors, Force, Figuration, and Repetition in Freud.
Fletcher, Gender, Sexuality and the Theory of Seduction.

Accurate diagnosis is key to providing quality services in community mental health. This research examined the ability of the Beck Anxiety and Depression Inventories to identify anxiety and depression in community settings. The diagnostic accuracy of these instruments was compared with the Structured Clinical Interview for DSM-IV in a sample of 288 distressed women seeking treatment for their children. Operating characteristic curves indicated the Beck Anxiety and Depression Inventories hold utility as screens for panic and major depressive disorder, respectively. Deploying these instruments as initial screens in a tiered diagnostic system may improve diagnostic accuracy in community settings.

Although schizophrenia has a biological basis, the presentation of symptoms and the understanding of the disorder vary among cultures. Service providers who understand these cultural variations are in a better position to provide effective crisis intervention. When a person with schizophrenia goes into crisis (often synonymous with the acute psychotic phase), the intersection of culture, diagnosis, developmental stage, and social setting can be overwhelming to the crisis worker. Roberts's Seven-Stage Crisis Intervention Model provides a useful framework within which to provide culturally competent crisis intervention. This article applies Roberts's model to a case involving an adolescent Latino male who has a diagnosis of schizophrenia. Included is a review of literature on mobile crisis intervention with youth, cultural competence, and schizophrenia. Specific treatment recommendations are made for understanding cultural variations, developmental influences, and service delivery with this population.

The importance of the interpersonal circle in organizing the interpersonal domain is complemented by its empirical relations with broader personality taxonomies and with more specific personality variables. Yet circumplex structure in interpersonal measures has often been investigated using the "eyeball test" rather than using circumplex criteria of known effectiveness. Simulations showed the effectiveness of 5 exploratory criteria (3 entirely new) that assess the properties of equal spacing, constant radius, and no preferred rotation. Along with Browne's (1992) criterion, these were applied to the Interpersonal

People may have open minds on whether a life-extending drug or technology is going to be developed before their sixties and may strongly desire that development. Do they therefore hope that it occurs? Do they hope for it in the substantive sense of "pinning their hopes" on the development? No, they do not. Hoping for a prospect in that sense certainly presupposes having an open mind on whether it will occur and having a desire for its occurrence. But, more crucially, it means investing the prospect with a characteristic, galvanizing, and orientating role: it involves setting aside doubts about the possible nonoccurrence of the prospect and acting accordingly. This article offers a characterization of hope in that substantive sense and argues both that it can be rational and that it is ubiquitous.

In two longitudinal studies, the authors examined the direction of the relationships between trait gratitude, perceived social support, stress, and depression during a life transition. Both studies used a full cross-lagged panel design, with participants completing all measures at the start and end of their first semester at college. Structural equation modeling was used to compare models of direct, reverse, and reciprocal models of directionality. Both studies supported a direct model whereby gratitude led to higher levels of perceived social support, and lower levels of stress and depression. In contrast, no variable led to gratitude, and most models of mediation were discounted. Study 2 additionally showed that gratitude leads to the other variables independently of the Big Five factors of personality. Overall gratitude seems to directly foster social support, and to protect people from stress and depression, which has implications for clinical interventions.

This article describes the development of a measure of dispositional authenticity and tests whether authenticity is related to well-being, as predicted by several counseling psychology perspectives. Scales were designed to measure a tripartite conception of authenticity, comprising self-alienation, authentic living, and accepting external influence, which was supported with exploratory factor analysis. Multigroup confirmatory factor analysis showed that the factor loadings were invariant across sample, ethnicity, and gender. The scale showed substantial discriminant validity from the Big Five personality traits, nonsignificant correlations with social desirability, and 2- and 4-week test–retest correlations ranging from r = .78 to .91. Each subscale was strongly related to self-esteem and aspects of both subjective and psychological well-being. This article provides the first direct test of several theoretical models that view authenticity as integral to well-being.

Erectile dysfunction (ED) affects approximately one in ten men at some point in their lives. ED can have profound effects on interpersonal relationships.This article describes its causes and the treatments available, and examines the effect it can have on those who experience the condition.

This paper describes a number of historical breaches of research ethics. Typically the victims of such breaches belong to vulnerable populations, such as prisoners, mentally disabled people, women and people in developing countries. This article provides a brief introduction to the main ethical approaches in bioethics. Subsequently it looks at a number of currently discussed ethical issues in clinical research ethics, notably the ethics standards of clinical trials in developing countries, the use of prisoners and incompetent people in clinical research, and the modus operandi of research ethics committees. 7

Attentional and perceptual differences between women with high and low levels of bulimic symptoms were studied with techniques adapted from cognitive science. Stimuli were pictures of young women varying in body size and facial affect. A multidimensional scaling analysis showed that the highsymptom women were significantly more attentive to information about body size and significantly less attentive to information about affect. In prototype classification tasks, the high-symptom women used significantly more information about body size and significantly less information about affect. There were strong associations between individual differences in attention in the similarity task and decision making in the classification tasks. The study shows the potential utility of cognitive science methods for the study of cognitive factors in psychopathology.

The author uses an anthropological perspective to consider how certain social conditions of training institutes, through the stresses they evoke, render trainees susceptible to the instruction of seniors. And depending on that which seniors advocate -'inclusive' or 'closed' therapeutic adherence -trainees will be influenced in that direction as practitioners. In this sense the internalization of clinical perspectives is facilitated by certain exacting conditions of psychotherapeutic training which generate this anxiety. This argument exposes for those desiring clinical reform two sites at which it might be profitably directed: at the social conditions of the training institute which arouse susceptibilities, or else at the instruction, which, by capitalizing on such susceptibilities, inculcates particular clinical values and perspectives. He concludes that if changes are to be brought to such perspectives then it is the social conditions of the training institute that need to be altered.

The article discusses a topical issue in contemporary Bulgaria: the crime among the underage offenders aged 14–17. National Statistical Institute data for a 17 year period is reconfigured, analyzed and then interpreted from the standpoints of sociology of delinquency and criminology. As a result a quantitative generalized profile of the juvenile offender is constructed and presented both in short and in detail.
The article also traces the structure and dynamics of the convicted underage offenders throughout the period. Using the correlation method of statistical analysis, the author offers a periodization of the transitional period. The periodization emerges on the basis of changing dynamics explained by the finding that the convicted criminal activity of underage and full age offenders is determined by different factors during the sub-periods. A number of hypothetical explanations, pending verification, are offered in relation to the changes in convicted criminal activity in Bulgaria. The periodization is exclusively based on data and statistical coefficients provided and estimated by the National Statistical Institute.
Furthermore, the article discusses the structure and dynamics of convicted underage offenders by a number of demographic and social attributes, e.g. sex, age, education, ethnicity, type of crime, family type, situation in the family, physical and mental health, and all types of inflicted punishments. As a result of all analyses and interpretations based on the available data it is generalized that there are approximately 190 underage (aged 14–17) offenders per year whom can be referred to as dangerous offenders active in Bulgaria.