Constance Milbrath

Elaboration and Dyselaboration: Measures of Expression and Defense in Discourse

Elaboration and Dyselaboration are new measures for assessing emotional and defensive discourse. The measures can be applied to short segments and so may show the effects of shifts in the subjects state of mind within a session. The measures were reliable when scored on transcripts both from a single case in psychotherapy and from 30 cases in evaluation or therapy dialogues with clinicians. In the single case study these measures were sensitive and able to distinguish different topics of discourse. Results from the group of 30 cases indicated that both measures varied depending on whether the discourse was from therapy, and that some forms of dyselaboration covaried with level of patient distress. Elaboration categories showed convergent and discriminant validity with another relevant measure of therapy process, Depth of Experiencing.

Topics and Signs: Defensive Control of Emotional Expression.

This single-case study examined frank disclosure of important topics in a brief exploratory psychotherapy, including topics closely related to a recent, unintegrated stressor life event. Quantitative measures of emotion and control variables showed heightened levels of both emotionally and defensive control during discourse on the topic of the stressor event. In future studies, such measures of verbal and nonverbal signs of emotional expression and defensive control might be used to identify topics in an unresolved state.

Pathological grief: an intensive case study.

Pathological mourning is such an excessive, blocked, or distorted process that psychiatric signs and symptoms develop. Explanation of how and why these signs and symptoms form could deepen an understanding of both normal and pathological mourning. Because many variables are involved in such explanations, intensive case study is a desirable methodology because it permits a detailed look at how various factors interact (Brewer and Hunter 1989; Luborsky and Mintz 1972; Luborsky and Spence 1971; Nessleroade and Ford 1985). While a patient may complain of symptoms as experiences that endure or occur episodically over days and weeks, a clinician observes psychiatric signs in the here-and-now seconds and minutes of an interview. Relating signs and symptoms to each other and to other variables in order to form a theoretical model of their formation requires exploration of data across long and short time frames. It is important to understand how the here-and-now phenomena combine to form patterns across longer periods of the individuals life. Hence, we developed a combined macro- and microanalytic approach to intensive case studies.

Romantic Relationships Trajectories of African American Gay/Bisexual Adolescents

The interview study reported here sought to identify the perceived trajectory of romantic relationships of a cohort of Oakland African American gay/bisexual adolescents. Biographical interviews were used to identify cultural models of romantic relationships in the study sample and discovered a trajectory of four phases. In the antecedent to the trajectory, the youth enters the gay/bisexual social environment. In the first phase, the youth meets a male partner. In the second phase, the youth talks to the partner over a period of days or weeks. In the third phase, the couple enters into a boyfriend relationship and initiates sex. In the fourth phase, the couple experiences conflicts over infidelity and breaks up. As a consequence, the gay/bisexual youth experiences an aftermath that includes low self-esteem, trying to get back with the partner, and revenge sex. Each phase is described with informant quotations. Some implications for HIV prevention with these adolescents are discussed.

Predictors of complicated grief

Abstract This study examined whether process variables predict an outcome of complicated grief. A turbulent and prolonged grief was predicted to occur after the death of a spouse in subjects who had self-blame, used the deceased for an extension of self, had ambivalence toward the deceased, or overcontrolled emotional responses. Ninety subjects were examined at 6, 14, and 25 months after the loss via a self-report battery of process variables and a structured clinical interview designed to assess symptoms. Subjects with complicated grief were compared with those with normative grief. Predictions were supported only in tertiary data analyses; they were not supported well in the primary and secondary statistical analyses. The authors concluded that either self-reports of process variables are inadequate measures or the theory that led to these measures and predictions is in need of revision.