"The association between global and specific measures of the therapeutic relationship": Erratum.

Reports an error in "The association between global and specific measures of the therapeutic relationship" by Nick F. Coady and Elsa Marziali (Psychotherapy: Theory, Research, Practice, Training, 1994[Spr], Vol 31[1], 17-27). This article contained, as Figure 1, an SASB model. The authorship and copyrights for the model were not acknowledged. The following acknowledgement should have been included: "From Benjamin (1983), Intrex User's Manual. Intrex Interpersonal Institute, P.O. Box 581037, Salt Lake City, UT 84158. Reprinted by permission." An apology is offered to the author, Dr. Lorna Smith Benjamin. The particular version used in the article was developed in collaboration with Clinton W. McLemore. (The following abstract of the original article appeared in record 1994-46203-001.) Examined the association between global and specific measures of the therapeutic relationship in Sessions 3, 5, and 15 of 9 cases of time-limited psychodynamic psychotherapy. L. S. Benjamin's (see PA, Vol 53:2991; see also, 1984) structural analysis of social behavior (SASB) model provided the specific measure of relationship. There were more consistent associations between ratings of client contributions to the alliance and SASB ratings of client behaviors than there were for the same therapist variables. Additionally, analyses show that external (i.e., nonself) judgments of client and therapist contributions to the alliance, rather than therapist or client self-ratings of contributions to the alliance, were most frequently associated with the SASB behavior codes. Finally, different therapist and client behaviors seemed to be associated with quality of the therapeutic relationship at different points in the therapeutic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Theoretical analysis of the relationship between regional and global measures of myocardial contractility

Contractile function of the left ventricle is often measured regionally, particularly in intact animals. In this paper I dispute the validity of the common assumption that regional shortening accurately reflects whole-heart mechanics, even when contractility is homogeneous, by using an ellipsoidal model of the left ventricle to examine the relationship between measures of regional function and whole-heart function. Segment shortening and wall thickening are the most common measures of regional function, while the end-systolic pressure-volume relationship, or Emax, is a well-validated index of contractility in the whole heart. Assuming that the arterial end-systolic pressure vs stroke volume relationship is constant, segment shortening shows a monotonically increasing, convex relation to Emax. If, in addition, myocardium is considered an incompressible material, then wall thickening also shows a monotonically increasing, convex relation to Emax. Thus, segment shortening and wall thickening are quite insensitive when measuring high contractility and overly sensitive when measuring low-contractility. Finally, I consider the non-linear relationship between regional measures of function and global contractility, and thereby resolve apparently contradictory findings regarding the inotropic responsiveness of stunned myocardium.     

The effects of a paradoxical intervention on therapeutic relationship measures.

Compared paradoxical (PIs) and nondirective interventions (NDIs) along core therapeutic conditions and therapist–client relationship issues (attractiveness, expertness, trustworthiness) in 2 experiments to explore criticisms that PIs are manipulative and not genuine. In Exp I, 4 advanced doctoral students rated 4 tapes (2 NDIs and 2 PIs with high- and low-core conditions) for levels of warmth, empathy, and genuineness. Results show that although both NDI and PI high-core-condition tapes were rated high in empathy, warmth, and genuineness, the NDI high-core-condition tape was rated higher. In Exp II, 133 undergraduates rated the same tapes for therapist–client relationship variables. Results show that the PI was rated higher than the NDI in counselor expertness. It is suggested that findings challenge criticisms that PI is contraindicated for use in therapy because of properties that might interrupt or undermine the therapeutic process. An excerpt from one tape is included. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between anxiety and oral word association performance.

To test the comparative validity of 2 theories of anxiety (Sarason's interfering response and Spence and Taylor's drive theory), associations to word stimuli were analyzed. According to drive theory, anxiety should interfere with the number of different associations to the same word. Words that stimulate few associations should result in short reaction times and few disturbance of responsiveness and rare responses. According to interference theory there should be an effect upon association without an interaction between the degree of association value of the word and anxiety level of S. The results were interpreted as supporting Sarason's theory. From Psyc Abstracts 36:04:4HK68G. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships between global and specified measures of novelty seeking.

Constructed 5 specified rational scales, 4 coordinated with 4 separate forms of the tendency toward novelty seeking, and 1 coordinated with desire for novelty to demonstrate the lack of comprehensive and representative coverage of the novelty domain by global self-report measures. Ss were 70 airmen. Results indicate that the 5 specified scales tend to be more homogeneous than 4 published measures of novelty or change to which they were compared. The specified scales were typically well differentiated, in contrast to the global measures which correlated substantially with each other and with 1 specified scale. The global measures examined do not appear to measure the cognitive and introceptive aspects of novelty experiencing or the desire or motivation for new experience. (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association between epidemiological measures of the occurrence of asthma

SETTING: The prevalence of asthma is useful for studying the causes of asthma. OBJECTIVE: To ascertain whether there is a relationship between the prevalence and incidence of asthma. DESIGN: The association between age and the occurrence of asthma was analysed in an epidemiological study of 15,813 persons. RESULTS: Different conclusions were reached depending on whether the point prevalence, cumulative prevalence or the incidence rates were studied. The relation between the incidence and prevalence of asthma is described in two epidemiological models, and none of the models seem to fit empirical data. Furthermore, it is shown that estimating incidence rates by prospectively measuring the point prevalences may introduce a considerable bias if the reliability of the diagnosis of asthma is around or below an agreement of 99%, which is probably usually the case. Including asthmatic symptoms during the last year in the definition of point prevalence means that there is no simple relation between incidence rates and point prevalences. CONCLUSION: The point prevalence may be a biased measure in the study of the etiology of asthma, as there is no simple relationship between the incidence and prevalence of asthma.     

The relationship between specific cognitive functions and falls in aging.

The current study examined the relationship between cognitive function and falls in older people who did not meet criteria for dementia or mild cognitive impairment (N = 172). To address limitations of previous research, the authors controlled for the confounding effects of gait measures and other risk factors by means of associations between cognitive function and falls. A neuropsychological test battery was submitted to factor analysis, yielding 3 orthogonal factors (Verbal IQ, Speed/Executive Attention, Memory). Single and recurrent falls within the last 12 months were evaluated. The authors hypothesized that Speed/Executive Attention would be associated with falls. Additionally, the authors assessed whether associations between different cognitive functions and falls varied depending on whether single or recurrent falls were examined. Multivariate logistic regressions showed that lower scores on Speed/Executive Attention were associated with increased risk of single and recurrent falls. Lower scores on Verbal IQ were related only to increased risk of recurrent falls. Memory was not associated with either single or recurrent falls. These findings are relevant to risk assessment and prevention of falls and point to possible shared neural substrates of cognitive and motor function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the relationship between the therapeutic bond and the phases of treatment outcome.

Examined the association between the therapeutic bond—an element of the therapeutic alliance—and treatment effectiveness. 114 psychotherapy clients completed self-report questionnaires at intake and throughout open-ended, psychodynamically oriented psychotherapy. Three bond scales, role investment (RI), empathic resonance (ER), and mutual affirmation (MA), were contrasted to session quality and the three phases of outcome (remoralization, remediation, and rehabilitation). Results indicated that different aspects of the bond predicted session quality and treatment outcome. Clients who felt motivated and invested in therapy (relatively high RI) and who reported that the therapeutic environment was friendly and affirmative (relatively high MA) were likely to rate the session as being helpful and productive. Clients who had a relatively high sense of understanding and of being understood (ER) experienced greater remoralization and remediation (but not rehabilitation). The results are placed within the context of recent research into the therapeutic alliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The positive therapeutic relationship as accreditation.

In formal accreditation ceremonies, one person acts by virtue of his or her position to confirm another person in a new position in a community. The new position, or "status," is such that the confirmed individual now enjoys expanded eligibilities for participation in that community. This article explores the power inherent in viewing the positive therapeutic relationship as an ongoing, informal rite of accreditation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Skin color and the therapeutic relationship.

Although issues pertinent to psychotherapy with ethnic minorities have been attended to increasingly over the past two decades, the issue of skin color has more or less been neglected in the psychotherapy literature. The idealization of light skin color in mainstream White and ethnic minority communities in the United States has impacted a wide range of societal and individual perceptions ranging from physical attractiveness to intellectual and social competence. The relevance of this impact in the psychotherapeutic relationship is explored in this article. Skin color is addressed within an historical context, and its influence on intrapsychic and interpersonal processes in the lives of clients and therapists are discussed. Clinical vignettes are presented to illustrate the dynamics of skin color in the therapeutic relationship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association between the negative effects attributed to ecstasy use and measures of cognition and mood among users.

In self reports, abstinent ecstasy/polydrug users claim that they experience certain ongoing affective and psychological changes including elevated anxiety, arousal, and depression. In addition, various aspects of cognition (e.g., everyday memory, reasoning, executive functioning) appear to be affected. The present paper investigated the link between these two psychological sequelae. Ninety-five ecstasy/polydrug users completed tests of reasoning, intelligence, information processing speed, executive functioning, and everyday memory. Affect was measured via a mood adjective checklist. Adverse effects attributed to ecstasy were measured via responses to adjectives reflecting changes in users since they started using the drug. In addition, indicators of sleep quality and daytime sleepiness were obtained. Users attributed a number of adverse effects to ecstasy, namely heightened irritability, depression, paranoia, and deteriorating health. Adverse effects were significantly and negatively correlated with aspects of intelligence, everyday memory, and sleep quality. Length of use of ecstasy use was positively correlated with adverse effects. While many users attribute a number of adverse affects to their use of ecstasy, it remains unclear whether these self-perceptions are a corollary of the psychopharmacological effects of the drug or reflect factors which in fact predate its use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The child's conception of confidentiality in the therapeutic relationship.

39 6–15 yr olds who were involved in individual counseling at a comprehensive community mental health center were interviewed using a questionnaire designed to assess their conception of confidentiality in the counseling experience. A significant main effect for age was found. Four variables were examined as potential predictors of S's confidentiality score. Two of the variables, which involved Ss' perception of the maintenance or violation of their confidentiality in either a past or current counseling experience, were significantly related to their overall confidentiality score. Results suggest that children gradually evolve a conception of confidentiality consistent with professional guidelines. The importance of an atmosphere of trust in the counseling relationship and the child's perception of the actual maintenance of trust in his/her own counseling experience are emphasized. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The importance of the therapeutic relationship in systematic desensitization.

To determine the importance of therapist warmth in effecting positive behavior change using systematic desensitization, 23 female snake-phobic undergraduates were assigned to 1 of 3 groups: warm therapist, cold therapist, or no-treatment controls. Ss in each group were matched on initial Snake Avoidance Test scores. Posttreatment evaluation on the Snake Avoidance Test occurred after 6 20-min desensitization sessions and follow-up scores were obtained 21/2 mo later. Results show that the warm therapist group improved significantly more than either the cold therapist or control group, with no significant differences between these latter 2 groups. Results suggest that therapist warmth is an important variable in systematic desensitization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consensus in the therapeutic relationship.

Analyzes the concept of consensus between patient and therapist in psychoanalytic psychotherapy. This topic has emerged in both psychotherapy research and analytic theory as an important construct and possible curative factor in psychotherapy. These independent lines of investigation are synthesized by considering consensus as a broader construct than simple agreement. Consensus is viewed as a creation of the dyad, based on an explicit and mutual effort to define the unique elements of the conscious and unconscious perspectives of patient and therapist. A theoretical understanding of the curative mechanisms of this process is proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of relationship and technique in therapeutic change.

This article discusses varying perspectives on the role of technique and the relationship in therapeutic change. The theoretical assumptions underlying the debate are briefly described, as are the positions of humanistic, behavioral, psychodynamic, and experiential orientations. Theory and research that consider the integration of relationship and technique are presented. It is then proposed that there are general principles of therapeutic change that are facilitated by both the relationship and technique. It is suggested that these principles of change should be seen as the active ingredients of therapy, thereby moving the field away from a debate about whether technique or the relationship is more important. Instead, an emphasis on studying general principles of change and the processes by which technique and relationship facilitate these principles is encouraged. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lack of association between outcome measures of nerve regeneration

Studies of nerve regeneration in rodents utilize at least one of three classes of outcome measures: electrophysiology, morphometry, and functional tests. The assumption that these measures are correlated was tested utilizing a data set of 16 variables. Significant correlations (Spearman's rho, P < or = 0.05) were found within variable classes; however, none were found between classes. The three commonly utilized outcome measures do not measure the same phenomenon but rather discrete aspects of nerve regeneration.     

The relationship between surface contour and vertebral body measures of upper spine curvature

STUDY DESIGN: In this study, parameters of sagittal cervical posture obtained from surface markers and from vertebral body locations were compared. OBJECTIVES: Several postural parameters were examined to establish the degree to which surface measures of cervical alignment reflect the underlying vertebral body alignment. SUMMARY OF BACKGROUND DATA: Previous studies of the relation between surface and vertebral alignment in the thoracic and lumbar regions have shown conflicting results. Some data suggest a connection between surface cervical posture and head and neck pain, but the relation between surface and vertebral posture in the cervical region has not been reported. METHODS: Lateral view radiographs of 24 healthy volunteers were used to give the surface alignment of skin markers and the locations of the geometric centers of vertebral bodies. Three angles describing sagittal alignment were investigated: 1) forward inclination of C2 relative to C7 (cervical inclination); 2) cervicothoracic kyphosis; and 3) cervical lordosis. RESULTS: A strong relationship between surface and vertebral data was not established. Two factors were identified as contributing to the observed differences: length of spinous processes and depth of soft tissue overlying the spinous processes at each spinal level. CONCLUSIONS: The assumption that the surface curve is the same as the vertebral curve is not supported by these results, suggesting caution is needed in inferring vertebral alignment from observed surface contours.     

Correlations between clinical findings and therapeutic measures and the course of diabetic retinopathy

A review is presented of recent literature on clinical findings and therapy in relation to the course of diabetic retinopathy. A report is then given on personal results with hypophysectomy in 15 diabetics with progressive retinopathy. The observation period is 16 years. The course of retinopathy is related to growth hormone findings, which have been determined in a longterm program. Mean survival after trans-sphenoidal hypophysectomy was 4 1/3 years (1 8/12 to 8). There is no clear evidence that impending blindness could be arrested in the whole group, but there was a temporary halt in individual diabetics. In one patient, growth hormone treatment was investigated as a means of improving renal function. The diabetic retinopathy findings did not change during growth hormone treatment.     

The adult client's conception of confidentiality in the therapeutic relationship.

50 outpatient psychotherapy clients, 26 inpatients, and 50 hospital employees completed a 20-item questionnaire concerning 4 areas relevant to privacy in psychotherapy. Scores on general attitudes revealed that Ss significantly valued confidentiality. Inpatients valued confidentiality significantly more than did the outpatient or nonpatient comparison groups. Data suggest that patients were generally unable to differentiate between privacy as an ethical concept and as a legal concept. Responses to casehandling questions revealed a low level of concern about these technical intrusions on privacy. Total scores for outpatients who perceived a violation in confidentiality in either a past or current therapy relationship were significantly lower than for Ss who indicated no history of past or current violations. Implications for client pretherapy preparation are discussed. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)