William G. Herron

Interpersonal perceptions of depressed and borderline inpatients

Distortions in interpersonal perceptions among patients with borderline personality disorder (BPD) were explored to investigate the validity of object relations theories. Depressed patients with BPD were compared to patients with major depressive disorder (MD) without BPD. Subjects were 77 male and female inpatients (BPD = 55, MD = 22). The mean ages were 30.5 for BPD subjects and 36.3 for MD subjects. Perceptions of patients, relatives, and interviewers were compared on the following measures: Structural Analysis of Social Behavior, Perceived Criticism Scale, and Camberwell Family Interview. Findings are consistent with object relations theory. BPD patients saw themselves as hostile, labile, and unstable. MD patients avoid acknowledging and responding to relatives criticallity.

Severity of Symptoms of Depression and Anxiety as Predictors of Duration of Psychotherapy

The present study explored predictors of the duration of therapy exclusive of outcome utilizing data on 77 patients at St. Johns University Center for Psychological Services. Measures of time in therapy were the total number of sessions attended and the number of sessions attended within the first six months of therapy. A bivariate Pearson product-moment correlation matrix was constructed, comprised of measures for time in therapy, severity of symptom measures, treatment modality (psychodynamic or cognitive-behavioral), age, and sex. There was a significant correlation between scores on state anxiety and the total number of sessions as well as between scores on state anxiety and number of sessions attended within six months, but no other correlations between measures of severity of symptoms and time in therapy were significant (p > .05). The results indicate that severity of symptoms does not significantly predict the duration of therapy.

Development of the ethnic unconscious.

The ethnic unconscious is conceptualized as repressed material shared by each generation with the next and with most people of that ethnic group. The material is derived from identifications that form ethnic character. Given limited attention in the past, the concept is gaining increased visibility and vitality as part of the total self to be analyzed. Attention is drawn to the role of the ethnic unconscious in the analytic process and its value for understanding transference, countertransference, and resistance.

Comparison of process-reactive measures in schizophrenia.

Studied 12 measures of process-reactive schizophrenia to determine their relative effectiveness in predicting outcome defined as symptomatic improvement. Each patient (N = 144) was rated on the process-reactive measures and at 3- and 6-month intervals on the Present State Examination to evaluate symptom change. Major findings were that the Ego-Strength, Stage of Illness, Kanto, Langfeldt, paranoid and chronicity criteria failed to predict outcome successfully. The first four criteria do not appear to be suitable process-reactive measures when the distinction is based on symptom change. However, paranoid-nonparanoid and chronic-acute criteria merit further investigation. The Ullmann-Giovannoni, Social Competence, Phillips scales, and marital status predicted outcome accurately at both 3- and 6-month evaluations. The Philips scale was the single best predictor of outcome at 3 months, while marital status was the best at 6 months. Overall, the Phillips scale was the most powerful and useful predictor of outcome.

The cost of psychotherapy.

This article examines the relationship between psychotherapy funding policies and concepts of mental health. Three levels of mental health - necessity, improvement, and potentiality - are proposed. Necessity represents basic adaptation, the current dominant level illustrated by brief psychotherapy funded through managed mental health care. Improvement is the phase beyond necessity aimed at prevention and heightened quality of life, and potentiality is the ideal. The latter two now receive limited funding and emphasis.

Urban poverty, ethnicity, and personality development

There are multiple factors which contribute to the development of the individuals personality. Many of these factors have been amply discussed in traditional theories of personality formation. An area that has been neglected in these discussions has been the role that poverty and ethnic and cultural factors may have in this regard. This paper offers a discussion of these issues with special emphasis on cultural, ethnic, and socioeconomic factors which tend to characterize the lives of Latino and Black individuals. Recommendations are made for a re-evaluation of the traditional theories of personality when applied to poor and minority individuals.

Comparability of Sex-Role Measures

5 current sex-role measures (the Bem Sex-role Inventory, the Personal Attributes Questionnaire, the Personality Research Form Andro Scale, the Masculinity and Femininity scales of the Adjective Checklist, and a set of socially undesirable sex-related characteristics) were compared for three samples. The scales have often been used interchangeably in the past, as they describe sex-role style in similar conceptual and psychometric terms. Yet some doubt had been raised recently as to the comparability of four of the scales for a college sample. The present study confirmed the limited comparability of the five scales in all samples tested (60 college students, 60 married adults, 60 psychiatric patients). The present analysis indicated that with current item content and classification procedure the measures cannot be used interchangeably.

MEANINGS OF SADISM AND MASOCHISM

The evolution of sadism and masochism from their origins in the 19th century until the present are described. Included are the pain-pleasure conception, dominance-submission, and sadistic and masochistic personality types. The need for differentiating types of sadism and masochism is emphasized.

The Dynamics of Managed Mental Health Care

Presented here is an exploration of the motivations involved in the development and application of managed mental health care to the private practice of outpatient psychotherapy. The interaction of management policy and psychotherapy is conceptualized in a dynamic model designed to provide insights into effective care policies. The model is described first, then the development of managed care, which appears defensive and is becoming symptomatic to the point of needing significant change. It is suggested that management policies providing choices of therapists and therapies will be the most effective in addressing ethical, fiscal, and psychological concerns of funders, consumers, and providers.

Necessary and Sufficient Conditions for Schizophrenia Research

31 articles on schizophrenia published during the first half of 1975 in four representative journals are thoroughly examined. The aim is to develop significant procedures and directions for subsequent research. The areas covered in order of frequency are thought disorder, responsiveness, methodology, treatment, and etiology. Such an approach provides a relatively rapid yet indicative overview of current trends. There are numerous methodological restrictions and the behavioral findings are highly specific. Recommendations are made that diagnostic criteria be specified and quantified, that sample characteristics be more extensive and precisely delineated, that the limitations of generalization from past findings be carefully acknowledged, that different designs and statistical treatments be employed, and that areas of concern be extended more often to personality variables of probable clinical significance.