Trans Accio Nal

1: Harv Bus Rev. 2005 Jul-Aug;83(7):106-14, 192.
Manage your human sigma.

Fleming JH, Coffman C, Harter JK.
Gallup Organization, Princeton, NJ, USA. fleming_hs@gallup.com
If sales and service organizations are to improve, they must learn to measure
and manage the quality of the employee-customer encounter. Quality improvement
methodologies such as Six Sigma are extremely useful in manufacturing contexts,
but they're less useful when it comes to human interactions. To address this
problem, the authors have developed a quality improvement approach they refer to
as Human Sigma. It weaves together a consistent method for assessing the
employee-customer encounter and a disciplined process for managing and improving
it. There are several core principles for measuring and managing the
employee-customer encounter: It's important not to think like an economist or an
engineer when assessing interactions because emotions inform both sides'
judgments and behavior. The employee-customer encounter must be measured and
managed locally, because there are enormous variations in quality at the
work-group and individual levels. And to improve the quality of the
employee-customer interaction, organizations must conduct both short-term,
transactional interventions and long-term, transformational ones. Employee
engagement and customer engagement are intimately connected--and, taken
together, they have an outsized effect on financial performance. They therefore
need to be managed holistically. That is, the responsibility for measuring and
monitoring the health of employee-customer relationships must reside within a
single organizational structure, with an executive champion who has the
authority to initiate and manage change. Nevertheless, the local manager remains
the single most important factor in local group performance. A local manager
whose work group shows suboptimal performance should be encouraged to conduct
interventions, such as targeted training, performance reviews, action learning,
and individual coaching.
PMID: 16028821 [PubMed - indexed for MEDLINE]
2: J Appl Psychol. 2005 May;90(3):509-22.
Leadership, collective personality, and performance.
Hofmann DA, Jones LM.
Kenan-Flagler Business School, University of North Carolina, Chapel Hill, NC
27599-3490, USA. dhofmann@unc.edu
By viewing behavior regularities at the individual and collective level as
functionally isomorphic, a referent-shift compositional model for the Big 5
personality dimensions is developed. On the basis of this compositional model, a
common measure of Big 5 personality at the individual level is applied to the
collective as a whole. Within this framework, it is also hypothesized that
leadership (i.e., transformational, transactional, and passive) would predict
collective personality and that collective personality would be significantly
related to collective performance. The results supported these hypotheses using
a sample of franchised units. On the basis of recent research at the individual
level, several interactions among the various personality dimensions were
hypothesized and supported. Implications are discussed.

3: J Nurs Adm. 2005 May;35(5):228-37.
Comment in:
J Nurs Adm. 2005 May;35(5):217-9.
Nurse executive transformational leadership and organizational commitment.
Leach LS.
Versant RN Residency, Childrens Hospital Los Angeles, Calif 90027, USA.
lleach@chla.usc.edu
OBJECTIVE: To investigate the relationship between nurse executive leadership
and organizational commitment among nurses in acute care hospitals. BACKGROUND:
A key challenge for organizations is to maximize the contributions of all
workers by cultivating their commitment. Nurse leaders are in a position to
influence organizational commitment among nurses. METHODS: The theoretical
constructs underlying this study are the transformational leadership theory and
the Etzioni's organizational theory. A cross-sectional, field survey of nurse
executives, nurse managers, and staff nurses was conducted to assess nurse
executive transformational and transactional leadership and their relationship
to organizational commitment. Hypotheses were tested using correlational
analysis, and univariate statistics were used to describe the sample. RESULTS:
An inverse relationship between nurse executive transformational and
transactional leadership and alienative (highly negative) organizational
commitment was statistically significant. A positive association was
demonstrated between nurse executive leadership and nurse manager leadership.
CONCLUSIONS: This study supports the effect of nurse executive leadership on
nurse manager leadership and on organizational commitment among nurses despite
role distance. To the extent that transformational leadership is present,
alienative organizational commitment is reduced. This relationship shows the
importance of nurse executive leadership in organizational involvement among
nurses in the dynamic context of contemporary hospital settings.
Publication Types:
Review
4: Health Serv Manage Res. 2005 Feb;18(1):1-12.
Valuing empathy and emotional intelligence in health leadership: a study of
empathy, leadership behaviour and outcome effectiveness.
Skinner C, Spurgeon P.
Department of Nursing and Public Health, Edith Cowan University, Joondalup
Drive, Joondalup, Perth, WA 6027, Australia.
This article examines the relationship between health managers' self-assessed
empathy, their leadership behaviours as rated by their staff, and staff's
personal ratings on a range of work satisfaction and related outcome measures.
Empathy was conceived of as four distinct but related individual dispositions,
namely empathic concern (EC), perspective taking (PT), personal distress (PD)
and empathic matching (EM). Results showed three empathy scales (EC, PT and EM)
were, as postulated, positively related to transformational behaviour (inspiring
followers to achieve more than expected). The same three measures, also as
expected, showed no relationship to transactional behaviour (motivating
followers to achieve expected results) and were negatively associated with
laissez-faire leadership (an absence of leadership style). Relationships between
empathy scales and outcome measures were selective and moderate in size.
Strongest empathy association was evident between the PT scale and most outcome
measures. Conversely, the extra effort outcome appeared most sensitive to the
range of empathy scales. Where significant relationships did exist between
empathy and outcome, leadership behaviour was in all cases a perfect mediator.
Whilst not denying the smaller dispositional effects on leadership outcomes,
leadership behaviour itself, rather than individual traits such as empathy,
appear to be major influencing factors in leadership effectiveness.
5: J Health Commun. 2005 Mar;10(2):105-25.
"If we didn't use humor, we'd cry": humorous coping communication in health care
settings.
Wanzer M, Booth-Butterfield M, Booth-Butterfield S.
Communication Studies Department, Canisius College, Buffalo, New York 14208,
USA. wanzerm@canisius.edu
Folkman and Lazarus's transactional theory of emotion and coping was used to
explain how humor influences job satisfaction among health care providers. One
hundred forty-two nurses completed measures of humor orientation (HO), coping
efficacy, job satisfaction, and open-ended questions about their use of humor to
relieve job tensions. This produced 9 categories of producing humor and 8 types
of work situations identified in which humor was used to cope. Nurses (21.4%)
reported using humor the most often during "patient care" situations (e.g.,
providing medicines, moving patients, physical therapy, and so on). More than
one third (38.66%) of the nurses reported using "word-play/language" as a
humorous coping strategy. Higher HO was associated with higher ratings of humor
effectiveness, greater self-perceived coping efficacy, and higher emotional
expressivity. Path analysis demonstrated that, as the transactional theory would
predict, trait HO influences job satisfaction through its effect on heightened
coping efficacy. Study limitations include the use of self-report methods and
the limited number of responses to the open-ended items. Subsequent research in
this area should attempt to validate the categories identified in this study and
determine the most effective means of coping. Researchers also should explore
differences in health care providers' coping communication based on gender,
years of experience, and profession.
6: Clin Psychol Rev. 2005 May;25(3):341-63.
Potential roles of parental self-efficacy in parent and child adjustment: a
review.
Jones TL, Prinz RJ.
Department of Psychology, University of South Carolina, Columbia, SC 20208, USA.

This review examines the potential roles of parental self-efficacy (PSE) in
parent and child adjustment and the role of parental cognitions in understanding
behaviors and emotions within families. The areas in this review include
parental competence and psychological functioning, as well as child behaviors,
socio-emotional adjustment, school achievement, and maltreatment. There is
strong evidence linking PSE to parental competence, and more modest linkage to
parental psychological functioning. Some findings suggest that PSE impacts child
adjustment directly but also indirectly via parenting practices and behaviors.
Although the role of PSE likely varies across parents, children, and
cultural-contextual factors, its influence cannot be overlooked as a possible
predictor of parental competence and child functioning, or perhaps an indicator
of risk. PSE may also be an appropriate target for prevention and intervention
efforts. Limitations in the literature include measurement problems, variability
in conceptualizations and definitions of the construct, and the lack of research
exploring causality. Future research should focus on clarifying the measurement
of PSE, studying potential bias in self-report of PSE, and utilizing
experimental and longitudinal designs to untangle the issues of causal direction
and potential transactional processes.
Publication Types:
Review
7: Qual Health Res. 2005 Mar;15(3):346-64.
An application of the transactional model to the analysis of chronic illness
narratives.
Lee AM, Poole G.
University of Florida, Gainesville, USA.
The authors' aim in this study was to describe the chronic illness experience
and its relationship to the concept to finding meaning. They conducted
interviews using a narrative approach with 15 adults experiencing various
chronic illnesses and analyzed narrative data using a combination of
holistic-content and categorical-content approaches. The three major categories
were the context of the chronic illness experience, personal reactions, and
coping efforts. These categories were best interpreted in terms of a
transactional model. The authors categorized finding meaning under cognitive
coping strategies and described it as a strategy that was part of a larger
coping repertoire.
8: J Nurs Manag. 2005 Mar;13(2):137-46.
Leadership style and choice of strategy in conflict management among Israeli
nurse managers in general hospitals.
Hendel T, Fish M, Galon V.
Nursing Department, School of Health Professions, Sackler Faculty of Medicine,

Tel Aviv University, Tel Aviv, Israel. tdhendel@zahav.net.il
AIMS: To identify conflict mode choices of head nurses in general hospitals and
examine the relationship between leadership style, choice of strategy in
handling conflicts and demographic characteristics. BACKGROUND: Nurse managers
deal with conflicts daily. The choice of conflict management mode is associated
with managerial effectiveness. The ability to creatively manage conflict
situations, towards constructive outcomes is becoming a standard requirement.
METHODS: Head nurses (N = 60) in five general hospitals in central Israel were
surveyed, using a 3-part questionnaire: The Thomas-Kilmann Conflict Mode
Instrument, the Multi-factor Leadership Questionnaire, Form 5X-Short (MLQ 5X)
and demographic data. RESULTS: Head nurses perceive themselves significantly
more as transformational leaders than as transactional leaders. Compromise was
found to be the most commonly used conflict management strategy. Approximately
half of the nurses surveyed used only one mode in conflict management.
Transformational leadership significantly affected the conflict strategy chosen.
CONCLUSION: Head nurses tend to choose a conflict-handling mode which is
concerned a form of a Lose-Lose approach. Preparation in conflict management
should start from undergraduate education.
9: J Nurs Manag. 2005 Mar;13(2):128-36.
Transformational leadership: a cascading chain reaction.
Murphy L.
Waterford Regional Hospital, Waterford, Ireland and MSc Student, UCD, Dublin,
Ireland. lorraine@registerednurses.com
Historical influences still permeate contemporary nursing practise. These are
mirrored in organizational philosophies, transactional and autocratic leadership
styles and disempowered staff. Whilst there is disparity amongst the theorists'
definitions of leadership, there is consensus pertaining to the attributes
necessary to realize effective leadership. Transformational leadership is
heralded as new criterion for nurse managers, and can be achieved through
training, education and professional development in key leadership competencies.
To achieve a chain reaction, charismatic transformational leaders espouse
intellectual stimulation and individual consideration to empower staff and
enhance patient care. Nurse managers that develop and foster transformational
leadership can surmount oppressive traditions and confidently navigate a complex
and rapidly changing health care environment.
Publication Types:
Review
Review, Tutorial
10: Dev Psychopathol. 2004 Fall;16(4):1095-117.
Developmental properties of transactional models: the case of life events and
mastery from adolescence to young adulthood.
Shanahan MJ, Bauer DJ.

Department of Sociology, University of North Carolina at Chapel Hill, Chapel
Hill, NC 27599, USA. mjshan@unc.edu
That behavior reflects ongoing transactions between person and context is an
enshrined proposition of developmental theory, although the dynamic properties
of these transactions have not been fully appreciated. In this article, we focus
on reciprocal links between the Pearlin mastery scale and life events in the
transition to adulthood, a strategic relationship given that control
orientations are thought to mediate links between stressors and a range of
indicators of distress, and given that life events become increasingly likely in
young adulthood. Drawing on 12 waves of data from the Youth Development Study,
spanning ages 14-15 to 26-27, we examine a series of growth curve models that
interrelate mastery and life events. Results for females reveal that mastery
during the senior year of high school predicts life events for the following
4-year period, which in turn predicts mastery over the 5-year period spanning
ages 21-22 to 26-27. For males, mastery during the senior year (and perhaps the
sophomore year) predicts subsequent life events, which in turn have short-term
implications for mastery. Thus, transactions between life events and mastery are
observed, although the temporal patterns of these exchanges are complex. These
findings are discussed in terms of the developmental properties of transactions
between person and context.
11: Soc Psychiatry Psychiatr Epidemiol. 2005 Feb;40(2):139-48.
The stress process perspective and adaptation of people with schizophrenia--an
exploratory study.
Lecomte Y, Mercier C.
Teluq (tele-universite), 4750 Henri-Julien, bureau 100, Montreal, QC, Canada,
H2T 3E4.
BACKGROUND: Adaptation of people suffering from schizophrenia still raises
numerous questions left unanswered by correlational studies and predictive
models. A theoretical framework likely to bring new answers is the stress
process perspective. Using the transactional model of coping, to which
psychological and social variables have been added, this exploratory research
studies the adaptation of 101 people with schizophrenia. METHOD: The research
design is correlational with only one crosswise measure. RESULTS: The model
predicts 60.7% of variance of adaptation and gives support that the
transactional model of coping contributes to this variance. Five variables show
a significant effect and account for 48% of the variance, and three interaction
effects (two two-way and one three-way) add another 12.7% to the explained
variance. CONCLUSION: Results give support to the significant impact of the
variables education, age and negative symptoms on adaptation. They highlight the
importance of accommodation, a cognitive strategy used by people with
schizophrenia to increase their adaptation. They also challenge the broadly
accepted assumption of a negative influence of life events on adaptation.
Finally, the interaction effects allow us to better understand the mutual
effects of variables on adaptation and confirm their relevance.
12: Psychol Addict Behav. 2004 Dec;18(4):350-61.

A transactional model of parent-infant interactions in alcoholic families.
Eiden RD, Leonard KE, Hoyle RH, Chavez F.
Research Institute on Addictions, University at Buffalo, State University of New
York, Buffalo, NY 14203, USA. eiden@ria.buffalo.edu
This study examined the transactional nature of parent-infant interactions over
time among alcoholic and nonalcoholic families. The sample consisted of 222
families assessed at 12, 18, and 24 months of child age. Results indicated that
infant behavior did not influence parental behavior across time, but parental
behavior was longitudinally predictive of infant behavior during play
interactions. Higher paternal alcohol consumption at 12 months was
longitudinally predictive of negative parental behavior at 24 months. Other
significant risk factors included marital conflict, fathers' depression, and
fathers' education. Results highlight the nested nature of risk in alcoholic
families and the direction of influence from parent to child during interactions
and suggest that 1 pathway to risk among these children is through negative
parent-infant interactions. Copyright 2005 APA.
13: Sex Transm Dis. 2004 Dec;31(12):719-26.
A comparison between audio computer-assisted self-interviews and clinician
interviews for obtaining the sexual history.
Kurth AE, Martin DP, Golden MR, Weiss NS, Heagerty PJ, Spielberg F, Handsfield
HH, Holmes KK.
Center for AIDS and STD, University of Washington, Seattle, Washington
98195-7266, USA. akurth@washington.edu
OBJECTIVE: The objective of this study was to compare reporting between audio
computer-assisted self-interview (ACASI) and clinician-administered sexual
histories. GOAL: The goal of this study was to explore the usefulness of ACASI
in sexually transmitted disease (STD) clinics. STUDY: The authors conducted a
cross-sectional study of ACASI followed by a clinician history (CH) among 609
patients (52% male, 59% white) in an urban, public STD clinic. We assessed
completeness of data, item prevalence, and report concordance for sexual history
and patient characteristic variables classified as socially neutral (n=5),
sensitive (n=11), or rewarded (n=4). RESULTS: Women more often reported by ACASI
than during CH same-sex behavior (19.6% vs. 11.5%), oral sex (67.3% vs. 50.0%),
transactional sex (20.7% vs. 9.8%), and amphetamine use (4.9% vs. 0.7%) but were
less likely to report STD symptoms (55.4% vs. 63.7%; all McNemar chi-squared P
values <0.003). Men's reporting was similar between interviews, except for ever
having had sex with another man (36.9% ACASI vs. 28.7% CH, P <0.001). Reporting
agreement as measured by kappas and intraclass correlation coefficients was only
moderate for socially sensitive and rewarded variables but was substantial or
almost perfect for socially neutral variables. ACASI data tended to be more
complete. ACASI was acceptable to 89% of participants. CONCLUSIONS: ACASI sexual
histories may help to identify persons at risk for STDs.
Publication Types:
Evaluation Studies
14: Vertex. 2004 Dec-2005 Feb;15(58):287-94.
[A cognitive approach of the borderline personality disorder]
[Article in Spanish]
Keegan E.
Segunda Catedra de Clinica Psicologica y Psicoterapias, Facultad de Psicologia,
UBA, Avda. Santa Fe 5099, 6to. A, (1425) Buenos Aires. ekeegan@psi.uba.ar
The development of cognitive models and treatments for borderline personality
disorder over the last two decades has been remarkable. This article presents
the main ideas of the models developed by Aaron T. Beck and Arthur Freeman,
Jeffrey Young and Marsha Linehan. These theories have generated psychotherapies
that have proven their efficacy in controlled empirical studies in a difficult
to treat population. The models of Beck Freeman and Young are based on the
concept of schema. Linehan's dialectical behavior therapy is based on a
biosocial transactional conception of the disorder. All these models emphasize
the importance of negative experiences in early development. The article
presents the structure of these treatments and describes their specific
interventions.
15: Pers Soc Psychol Rev. 2004;8(4):402-16.
On traits, situations, and their integration: a developmental perspective.
Roberts BW, Pomerantz EM.
Department of Psychology, University of Illinois, Urbana-Champaign, IL 61820,
USA. broberts@s.psych.uiuc.edu
The question of whether the person or the situation is largely responsible for
behavior has plagued psychology intermittently for the last half century.
Studies of the heritability, stability, and consensual validity of traits have
clearly demonstrated the existence of traits. However, there is continuing
controversy about the role of traits and situations in the enterprise of
personality psychology. The goal of this article is to describe how insights
yielded from adopting a developmental approach can foster the successful
integration of the person and the situation across the life span. Five key
lessons are described: (a) age matters--studying different age groups can lead
to biases for and against traits and situations; (b), if age matters, time
matters more--longitudinal and within-participant designs demonstrate that
traits and situations are reciprocally related; (c) examine multiple types of
change--focusing on one type, such as mean-level change, can lead to
inappropriate conclusions about the merits of persons or situations; (d) be
sensitive to levels of analysis--the relative breadth of persons and situations
may determine the relative influence of the two; (e) pay attention to
process--process models lead inextricably to transactional explanations.

16: Child Psychiatry Hum Dev. 2004 Winter;35(2):163-81.
An ecological-transactional model of significant risk factors for child
psychopathology in outer mongolia.
Kohrt HE, Kohrt BA, Waldman I, Saltzman K, Carrion VG.
Division of Child & Adolescent Psychiatry and Child Development, Stanford
University School of Medicine, 401 Quarry Road, MC 5719, Stanford, CA 94305,
USA. kohrt@stanford.edu
The present study examined significant risk factors, including child
maltreatment, for child psychopathology in a cross-cultural setting. Ninety-nine
Mongolian boys, ages 3-10 years, were assessed. Primary caregivers (PCG)
completed structured interviews including the Emory Combined Rating Scale (ECRS)
and the Mood and Feelings Questionnaire (MFQ). Structural equation modeling
identifies eight risk factors affecting child psychopathology: Three with direct
effects (severity of physical punishment, PCG's MFQ score, and PCG's education),
three with indirect effects (cultural acceptance of violence as discipline,
presence of community violence, and contact with extended family), and two with
direct and indirect effects (quality of marriage/presence of spousal abuse, and
household size). Results support the ecological-transactional theory of
developmental psychopathology in a cross-cultural setting. Structural equation
modeling provides a useful technique to isolate specific sites for intervention,
while maintaining a comprehensive perspective of risk factor interaction.
Publication Types:
Validation Studies
17: Qual Saf Health Care. 2004 Dec;13 Suppl 2:ii45-51.
Leadership for safety: industrial experience.
Flin R, Yule S.
Industrial Psychology Research Centre, University of Aberdeen, King's College,
Old Aberdeen AB24 2UB, UK. r.flin@abdn.ac.uk
The importance of leadership for effective safety management has been the focus
of research attention in industry for a number of years, especially in energy
and manufacturing sectors. In contrast, very little research into leadership and
safety has been carried out in medical settings. A selective review of the
industrial safety literature for leadership research with possible application
in health care was undertaken. Emerging findings show the importance of
participative, transformational styles for safety performance at all levels of
management. Transactional styles with attention to monitoring and reinforcement
of workers' safety behaviours have been shown to be effective at the supervisory
level. Middle managers need to be involved in safety and foster open
communication, while ensuring compliance with safety systems. They should allow
supervisors a degree of autonomy for safety initiatives. Senior managers have a
prime influence on the organisation's safety culture. They need to continuously
demonstrate a visible commitment to safety, best indicated by the time they

devote to safety matters.
Publication Types:
Review
Review, Tutorial
18: Schizophr Res. 2005 Jan 1;72(2-3):279-81.
The contribution of a modified transactional model to the adaptation of
schizophrenics living in the city of Montreal.
Lecomte Y, Stip E, Caron J, Renaud S.
Publication Types:
Letter
19: Qual Manag Health Care. 2004 Oct-Dec;13(4):278-84.
Transactional versus transformational style of leadership--employee perception
of leadership efficacy in public and private hospitals in Kuwait.
Al-Mailam FF.
Hadi Clinic, Hawally, Kuwait. dr.faten@hadiclinic.com
OBJECTIVES: To determine whether employees working for a transformational leader
perceive their leader as more effective than do those working for a
transactional leader. To assess whether employees in private hospitals are more
likely to perceive their leaders as transformational than are employees in
public hospitals. DESIGN: A questionnaire study of a random sample of employees
working at 4 hospitals (private and public) in Kuwait; 266 respondents included.
RESULTS: Analysis of varience and regression analysis showed that the
transformational style of leadership was linked to high level of employee
perception of leadership efficacy. Also, the employees in private hospitals were
more likely to perceive their leaders as transformational than were employees in
public hospitals. CONCLUSIONS: Hospitals in Kuwait may benefit by recruiting
leaders with a transformational style, as it is directly related to quality,
employee satisfaction, increased productivity, and employee perception of
leadership efficacy.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
20: J Appl Psychol. 2004 Oct;89(5):901-10.
Personality and transformational and transactional leadership: a meta-analysis.
Bono JE, Judge TA.

Department of Psychology, University of Minnesota, Minneapolis 55455, USA.
jbono@umn.edu
This study was a meta-analysis of the relationship between personality and
ratings of transformational and transactional leadership behaviors. Using the
5-factor model of personality as an organizing framework, the authors
accumulated 384 correlations from 26 independent studies. Personality traits
were related to 3 dimensions of transformational leadership--idealized
influence-inspirational motivation (charisma), intellectual stimulation, and
individualized consideration--and 3 dimensions of transactional
leadership--contingent reward, management by exception-active, and passive
leadership. Extraversion was the strongest and most consistent correlate of
transformational leadership. Although results provided some support for the
dispositional basis of transformational leadership--especially with respect to
the charisma dimension--generally, weak associations suggested the importance of
future research to focus on both narrower personality traits and
nondispositional determinants of transformational and transactional leadership.
(c) 2004 APA, all rights reserved
Publication Types:
Meta-Analysis
Transformational and transactional leadership: a meta-analytic test of their
relative validity.
Judge TA, Piccolo RF.
Department of Management, Warrington College of Business, University of Florida,
Gainesville 32611-7165, USA. tjudge@ufl.edu
This study provided a comprehensive examination of the full range of
transformational, transactional, and laissez-faire leadership. Results (based on
626 correlations from 87 sources) revealed an overall validity of .44 for
transformational leadership, and this validity generalized over longitudinal and
multisource designs. Contingent reward (.39) and laissez-faire (-.37) leadership
had the next highest overall relations; management by exception (active and
passive) was inconsistently related to the criteria. Surprisingly, there were
several criteria for which contingent reward leadership had stronger relations
than did transformational leadership. Furthermore, transformational leadership
was strongly correlated with contingent reward (.80) and laissez-faire (-.65)
leadership. Transformational and contingent reward leadership generally
predicted criteria controlling for the other leadership dimensions, although
transformational leadership failed to predict leader job performance. (c) 2004
APA, all rights reserved
Publication Types:
Meta-Analysis
22: J Dev Behav Pediatr. 2004 Oct;25(5):311-7.

Latina mothers' stances on stimulant medication: complexity, conflict, and
compromise.
Arcia E, Fernandez MC, Jaquez M.
Department of Research, Mt. Sinai Medical Center, Miami Beach, Florida, USA.
earcia@sbab.dade.k12.fl.us
This study was undertaken to understand and describe Latina mothers' cognitions
and attitudes toward the use of medication for their young children's behavior
problems under the premise that these factors are determinants of noncompliance
and inadequate adherence to medication treatments. Quantitative and qualitative
data were extracted from a multimethod study of professional help seeking.
Participants were 62 mothers from Cuba, Puerto Rico, and the Dominican Republic.
Findings indicated that mothers overwhelmingly preferred treatment options other
than medication primarily because they understood medication to be addictive,
dulling of cognitive processes, and inappropriate for behavior problems.
Inadequate adherence was common and logically consistent with maternal
cognitions. Maternal choices with respect to the use of medication were
transactional and quite complex in nature and changed over time. The strongest
agents in this process were schools and the mothers' immediate family.
Implications for clinical practice are presented.
23: Pflege Z. 2004 Aug;57(8):555-9.
[Schulz von Thun communication model: 4 ears are not enough]
[Article in German]
Sachweh S.
svenja.sachweh@gmx.de
24: J Am Acad Child Adolesc Psychiatry. 2004 Sep;43(9):1089-97.
Mother-Child touch patterns in infant feeding disorders: relation to maternal,
child, and environmental factors.
Feldman R, Keren M, Gross-Rozval O, Tyano S.
Department of Psychology, Bar-Ilan University, Israel. feldman@mail.biu.ac.il
OBJECTIVE: To examine mother and child's touch patterns in infant feeding
disorders within a transactional framework. METHOD: Infants (aged 9-34 months)
referred to a community-based clinic were diagnosed with feeding disorders (n =
20) or other primary disorder (n = 27) and were case matched with nonreferred
controls (n = 47). Mother-child play and feeding were observed and the home
environment was assessed. Microcoding detected touch patterns, response to
partner's touch, and proximity at play. Relational behaviors were coded during
feeding. RESULTS: Compared with infants with other primary disorder and
case-matched controls, less maternal affectionate, proprioceptive, and

unintentional touch was observed in those with feeding disorders. Children with
feeding disorders displayed less affectionate touch, more negative touch, and
more rejection of the mother's touch. More practical and rejecting maternal
responses to the child's touch were observed, and children were positioned more
often out of reach of the mothers' arms. Children with feeding disorders
exhibited more withdrawal during feeding and the home environment was less
optimal. Feeding efficacy was predicted by mother-child touch, reduced maternal
depression and intrusiveness, easy infant temperament, and less child
withdrawal, controlling for group membership. CONCLUSIONS: Proximity and touch
are especially disturbed in feeding disorders, suggesting fundamental
relationship difficulties. Mothers provide less touch that supports growth, and
children demonstrate signs of touch aversion. Touch patterns may serve as risk
indicators of potential growth failure. Copyright 2004 American Academy of Child
and Adolescent Psychiatry
25: Soc Sci Med. 2004 Oct;59(8):1581-92.
Transactional sex among women in Soweto, South Africa: prevalence, risk factors
and association with HIV infection.
Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD.
Department of Epidemiology, University of Michigan, 611 Church Street, Ann
Arbor, MI 48109-3028, USA. kdunkle@umich.edu
Sex workers have long been considered a high-risk group for HIV infection, but
to date little quantitative research has explored the association between HIV
risk and exchange of sex for material gain by women in the general population.
The objective of this study was to estimate the prevalence of such transactional
sex among women attending antenatal clinics in Soweto, South Africa, to identify
demographic and social variables associated with reporting transactional sex,
and to determine the association between transactional sex and HIV serostatus.
We conducted a cross-sectional study of women seeking antenatal care in four
Soweto health centres who accepted routine antenatal HIV testing. Private
face-to-face interviews covered socio-demographics, sexual history and
experience of gender-based violence. 21.1% of participants reported having ever
had sex with a non-primary male partner in exchange for material goods or money.
Women who reported past experience of violence by male intimate partners,
problematic substance use, urban residence, ever earning money, or living in
substandard housing were more likely to report transactional sex, while women
who reported delayed first coitus, were married, or had a post-secondary
education were less likely to report transactional sex. Transactional sex was
associated with HIV seropositivity after controlling for lifetime number of male
sex partners and length of time a woman had been sexually active (OR = 1.54, 95%
CI: 1.07, 2.21). Women who reported non-primary partners without transactional
sex did not have increased odds of being HIV seropositive (OR = 1.04, 95% CI:
0.75, 1.43). We conclude that transactional sex may place women at increased
risk for HIV, and is associated with gender-based violence, substance use and
socio-economic disadvantage. Research, policy and programmatic initiatives
should consider the role of transactional sex in women's HIV risk, with
attention to the intersecting roles of violence, poverty, and substance use in
shaping women's sexual behaviour.

26: J Psychoactive Drugs. 2004 May;Suppl 2:147-56.
California drug courts: a methodology for determining costs and avoided costs.
Byrne F, Schauffler R, Lightman L, Finigan M, Carey S.
Administrative Office of the Courts, San Francisco, California 94102, USA.
francine.byrne@jud.ca.gov
A significant body of outcome evaluation research on drug courts exists;
however, few studies have investigated the cost implications of these
collaborative justice models. This study focuses on creating a sound research
design that can be utilized for a statewide and national cost-assessment of drug
courts by conducting an in-depth case study of three adult drug courts in
California. A transactional costs analysis (TCA) approach was utilized, allowing
the researcher to calculate costs based on every individual's transactions
within the drug court and the traditional criminal justice system. This model
allows for the identification of each agency's resource contribution to the
system and their avoided costs due to system outcomes. Cost results in all three
sites indicate that participation in drug court, regardless of graduation
status; saves taxpayers significant money over time. Expenditure and savings
varied considerably among the agencies involved. Some agencies, such as the
Department of Corrections, contribute little to the drug court system but
experience substantial costs avoidance due to a reduction in recidivism among
drug court participants. In order to validate study results and test the
research design, the TCA methodology will be applied in six additional courts in
the second phase of the project.
27: Psychol Bull. 2004 Jul;130(4):664-68; author reply 677-83.
Comment on:
Psychol Bull. 2004 Jul;130(4):631-63.
Psychotherapy process: the missing link: comment on Westen, Novotny, and
Thompson-Brenner (2004).
Ablon JS, Marci C.
Department of Psychiatry, Massachusetts General Hospital, Newton, MA 02458, USA.
sablon@sprintpcs.com
In this comment, J. S. Ablon and C. Marci argue that focusing on the empirical
validation of manualized treatment packages misses important information about
what is efficacious about a given treatment. Psychotherapy process has
demonstrated that treatments may promote change in ways other than their
underlying theories claim. Manualized therapies may appear distinct despite
important similarities in dyadic interaction. These functional similarities in
the emergent transactional process between therapist and patient may help
explain the difficulty demonstrating differential outcomes across brands of
brief therapy. Rather than focus on treatment packages targeting patient
symptomatology, the authors recommend a shift in focus to the empirical
validation of change processes coconstructed by therapist and patient in
naturalistic settings.
Publication Types:
Comment
28: Clin Psychol Rev. 2004 Aug;24(4):441-59.
Mutual influences on maternal depression and child adjustment problems.
Elgar FJ, McGrath PJ, Waschbusch DA, Stewart SH, Curtis LJ.
Cardiff Institute of Society, Health and Ethics, Cardiff University, 53 Park
Place, CF10 3WT, Wales, UK. ElgarF@Cardiff.ac.uk
Often undetected and poorly managed, maternal depression and child adjustment
problems are common health problems and impose significant burden to society.
Studies show evidence of mutual influences on maternal and child functioning,
whereby depression in mothers increases risk of emotional and behavioral
problems in children and vice versa. Biological mechanisms (genetics, in utero
environment) mediate influences from mother to child, while psychosocial
(attachment, child discipline, modeling, family functioning) and social capital
(social resources, social support) mechanisms mediate transactional influences
on maternal depression and child adjustment problems. Mutual family influences
in the etiology and maintenance of psychological problems advance our
understanding of pathways of risk and resilience and their implications for
clinical interventions. This article explores the dynamic interplay of maternal
and child distress and provides evidence for a biopsychosocial model of
mediating factors with the aim of stimulating further research and contributing
to more inclusive therapies for families.
Publication Types:
Review
29: AIDS Care. 2004 May;16(4):458-70.
Psychosocial factors associated with adherence to antiretroviral medications in
a sample of HIV-positive African American drug users.
Harzke AJ, Williams ML, Nilsson-Schonnesson L, Ross MW, Timpson S, Keel KB.
WHO Center for Health Promotion and Prevention Research University of Texas
Health Science Center at Houston, Texas 77030, USA. AHarzke@sph.uth.tmc.edu
The purpose of the study was to investigate factors affecting antiretroviral
adherence among African American drug users, specifically to identify
associations between self-reported adherence levels and psychosocial measures
selected with guidance from the Transactional Model of Stress and Coping (TMSC).
The study was conducted using data collected from 137 HIV-positive African
American drug users who were receiving antiretroviral medications at the time
they were interviewed. Bivariate associations were investigated using
correlational analyses and variables showing a significant correlation with
adherence were entered into a multivariate regression model. The multivariate
model showed only perceived efficacy of antiretrovirals and one measure of

perceived barriers, simply forgetting to take medications, were independently
related to adherence. These preliminary findings suggest that theoretical
approaches to understanding antiretroviral adherence must address a range of
variables, including but not limited to behavioural practices, cognitive
appraisals, affective responses and social support. Further studies using the
complete TMSC are recommended.
30: Subst Use Misuse. 2004 Apr;39(5):671-98.
Parent/child transactional processes predictive of resilience or vulnerability
to "substance abuse disorders".
Kumpfer KL, Bluth B.
Department of Health Promotion and Education, University of Utah, Salt Lake
City, Utah 84112, USA. karol.kumpfer@health.utah.edu
This article discusses implications of a theoretical model of resilience--the
Resilience Framework, including the impact of parent/child transactional
processes in moderating or mediating a child's biological or environmental risks
and later substance misuse. Research is presented on behavioral and emotional
precursors of substance abuse disorders in children of substance users.
Detrimental processes within dysfunctional family environments are presented
followed by a listing of strategies for increasing resilience in youth by
improving family dynamics. The value in elucidating these interactive processes
is to increase our understanding of ways to reduce the impact of risk factors.
Prevention providers should use these strategies as benchmarks for selecting or
developing effective family-focused prevention programs. Resources are presented
for finding effective family interventions as well as an example of a family
intervention based on resilience principles, namely the Strengthening Families
Program. Recommendations are made for future research and better dissemination
of evidence-based family interventions.
31: Int J Behav Med. 2004;11(1):48-55.
The role of spirituality in the psychological adjustment to cancer: a test of
the transactional model of stress and coping.
Laubmeier KK, Zakowski SG, Bair JP.
Department of Psychology, Finch University of Health Sciences, Chicago Medical
School, 3333 Green Bay Road, North Chicago, Illinois 60064, USA.
klaubmeier@hotmail.com
Recent studies in the oncology literature have shown that spirituality, defined
as the combination of existential and religious well-being (RWB), is related to
both emotional well-being and quality of life. Indeed, spirituality may be
particularly important in coping with the potential life threat of the disease.
Based on Frankl's (1963) existential theory, in this study, we examined whether
the relations between spirituality and emotional well-being are moderated by
degree of perceived life threat (PLT). In addition, in this study, we examined
the relative importance of religious versus existential well-being in relation

to psychological adjustment. Patients diagnosed with various types of cancer (N
= 95) completed questionnaires assessing spirituality, PLT, quality of life, and
distress. Contrary to theoretical predictions, spirituality was associated with
less distress and better quality of life regardless of PLT. Interestingly,
existential but not RWB accounted for a major portion of the variance in these
outcomes. Taken together, these findings suggest that spirituality, particularly
the existential component, may be associated with reduced symptoms of distress
in cancer patients regardless of life threat.
32: J Clin Child Adolesc Psychol. 2004 Jun;33(2):400-11.
Parental mental disorder and children's functioning: silence and communication,
stigma and resilience.
Hinshaw SP.
Department of Psychology, University of California, Berkely, CA 94720-1650, USA.
hinshaw@socrates.berkeley.edu
In this article I argue that narrative accounts of the effects of parental
mental disorder (particularly mood disturbance) on children's functioning may
provide unprecedented windows on crucial issues of silence, stigmatization,
diagnosis, etiology, and treatment, which can mutually inform empirical research
efforts. In publishing a book-length account of the life of my father, The Years
of Silence are Past (Hinshaw, 2002b), I departed from my usual academic writings
and gave voice to a complex and troubling life history, marked by misdiagnosed
bipolar disorder and misguided treatment that lasted 40 years. Herein, I focus
on the ramifications of this narrative for scientific and clinical efforts in
the field, including the still-prevalent stigmatization and silence surrounding
mental disorder, the great need for accurate diagnosis and responsive treatment,
the complex and transactional web of biological and environmental risk factors
that exist for mental disturbance, the blending of inner experience with social
realities regarding symptom content, the resilience and strength that can
accompany mental disorder, and the ways in which parents with mental disturbance
can promote active communication with their offspring. Narrative accounts may be
particularly important in reducing silence and in framing the next generation of
empirical research questions; blending qualitative and quantitative methods may
help address crucial goals related to child functioning in the presence of
parental mental disorder.
33: Lancet. 2004 May 1;363(9419):1415-21.
Comment in:
Lancet. 2004 May 1;363(9419):1410-1.
Gender-based violence, relationship power, and risk of HIV infection in women
attending antenatal clinics in South Africa.
Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD.
Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.
kdunkle@umich.edu
BACKGROUND: Gender-based violence and gender inequality are increasingly cited
as important determinants of women's HIV risk; yet empirical research on
possible connections remains limited. No study on women has yet assessed
gender-based violence as a risk factor for HIV after adjustment for women's own
high-risk behaviours, although these are known to be associated with experience
of violence. METHODS: We did a cross-sectional study of 1366 women presenting
for antenatal care at four health centres in Soweto, South Africa, who accepted
routine antenatal HIV testing. Private face-to-face interviews were done in
local languages and included assessement of sociodemographic characteristics,
experience of gender-based violence, the South African adaptation of the Sexual
Relationship Power Scale (SRPS), and risk behaviours including multiple,
concurrent, and casual male partners, and transactional sex. FINDINGS: After
adjustment for age and current relationship status and women's risk behaviour,
intimate partner violence (odds ratio 1.48, 95% CI 1.15-1.89) and high levels of
male control in a woman's current relationship as measured by the SRPS (1.52,
1.13-2.04) were associated with HIV seropositivity. Child sexual assault, forced
first intercourse, and adult sexual assault by non-partners were not associated
with HIV serostatus. INTERPRETATION: Women with violent or controlling male
partners are at increased risk of HIV infection. We postulate that abusive men
are more likely to have HIV and impose risky sexual practices on partners.
Research on connections between social constructions of masculinity, intimate
partner violence, male dominance in relationships, and HIV risk behaviours in
men, as well as effective interventions, are urgently needed.
34: Br J Educ Psychol. 2004 Mar;74(Pt 1):83-107.
Appraisal and coping strategy use in victims of school bullying.
Hunter SC, Boyle JM.
Department of Psychology, University of Strathclyde, Glasgow, UK.
BACKGROUND: Transactional models of coping (Lazarus & Folkman, 1984) can
contribute to our understanding of why some children cope effectively with
bullying while others suffer negative outcomes. However, previous research has
relied on coping measures that are not comparable with adult measures,
restricting investigation of developmental trends. Additionally, previous
research has not included appraisals when measuring coping using an established
coping measure. AIMS: To examine the factor structure of a coping measure that
is directly comparable with the adult literature; to examine the content of
pupils' threat and challenge appraisals concerning bullying; and to examine the
relationships between appraisals and coping strategy use within the victims of
school bullying. SAMPLE: Participants were 459 children aged 9 - 14 years.
METHOD: A self-report bullying questionnaire, incorporating Halstead et al.'s
(1993) adolescent version of the Ways of Coping Checklist, was completed by
participants. Also included were control, threat and challenge appraisal items.
RESULTS: Confirmatory factor analysis confirmed that Halstead et al.'s
four-factor model of coping is valid for a population of school bullying
victims. Content validity of items used to measure threat and challenge
appraisal was demonstrated. Ambiguity of challenge appraisal influenced the use
of Wishful Thinking, Seeks Social Support and Problem Focused coping. Wishful
Thinking was also influenced by control appraisal. Avoidance coping was not
influenced by the appraisals measured. CONCLUSION: Halstead et al.'s Revised

Ways of Coping Checklist can be used to measure coping amongst child and
adolescent victims of bullying. Furthermore, including appraisal variables
improves our understanding of individual differences between victims' coping
strategy choices.
35: Psychol Rep. 2004 Feb;94(1):307-13.
Why do people perform thrilling activities? A study based on reversal theory.
Legrand FD, Apter MJ.
Universite de Reims, France. fabien.legrand@univ-reims.fr
The present study was aimed at testing the assumption based on reversal theory,
according to which people perform frightening activities to induce high anxiety,
which in turn can give rise to pleasant excitement, provided that a
metamotivational reversal occurs. The Tension and Effort Stress Inventory was
administered to 46 individuals just before and just after a frightening ride on
a cable (Fantasticable). A 30-subject control group was given the same inventory
in a safe context, with a 2-min. rest between the two periods of completion.
Ratings of Tension Stress, Anxiety, and overall Unpleasant Emotions were
significantly decreased after the ride for the Fantasticable group. Conversely,
significant increases in Preferred Arousal, Excitement, Transactional Emotions,
and overall Pleasant Emotions were found after the ride. Also, pre-activity
anxiety correlated with postactivity excitement (r = .79) for the Fantasticable
group only. This supports the reversal theory contention about how one's
involvement in arousal-seeking leisure may improve one's emotional state. No
time effect was noted in the ratings for the control group, suggesting an
association of participation in a frightening activity and emotional
enhancement.
36: Psychol Rep. 2004 Feb;94(1):3-18.
Sex and leadership styles: a meta-analysis of research published in the 1990s.
van Engen ML, Willemsen TM.
Faculty of Social and Behavioral Sciences, Department of Human Resource Studies,
Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.
M.L.vEngen@uvt.nl
Empirical research on sex differences in leadership styles, published between
1987 and 2000 in peer-reviewed journals, is reviewed by means of a
meta-analysis. The leadership styles examined are interpersonal, task-oriented,
democratic versus autocratic, and transformational and transactional leadership.
Analysis showed that evidence for sex differences in leadership behavior is
mixed, demonstrating that women tend to use more democratic and transformational
leadership styles than men do, whereas no sex differences are found on the other
leadership styles. Sex differences in leadership styles are contingent upon the
context in which male and female leaders work, as both the type of organization
in which the leader works and the setting of the study turn out to be moderators
of sex differences in leadership styles.

Publication Types:
Meta-Analysis
37: J Appl Psychol. 2004 Apr;89(2):311-21.
Psychological contract and organizational citizenship behavior in China:
investigating generalizability and instrumentality.
Hui C, Lee C, Rousseau DM.
Department of Management, Chinese University of Hong Kong, Kowloon, Hong Kong,
China.
This study examined the generalizability of psychological contract forms
observed in the West (D. M. Rousseau, 2000) to China. Using 2 independent
samples, results confirmed the generalizability of 3 psychological contract
forms: transactional, relational, and balanced. This study also examined the
nature of relationships of psychological contracts with organizational
citizenship behavior (OCB). In particular, this study explored the role of
instrumentality as a mediating psychological process. The authors found evidence
that instrumentality mediates the relationship of relational and balanced forms
with OCB; however, the transactional contract form is directly related to OCB.
The authors discuss the implications of these results for the meaning of
psychological contracts and OCB in China and raise issues for future research.
Publication Types:
Evaluation Studies
38: AIDS. 2004 Apr 9;18(6):917-25.
Comment in:
AIDS. 2004 Apr 9;18(6):945-7.
Transactional sex is the driving force in the dynamics of HIV in Accra, Ghana.
Cote AM, Sobela F, Dzokoto A, Nzambi K, Asamoah-Adu C, Labbe AC, Masse B, Mensah
J, Frost E, Pepin J.
Centre for International Health, University of Sherbrooke, 3001 12th Avenue
North, Sherbrooke, Quebec, Canada J1H 5N4.
OBJECTIVE: To delineate the population attributable fraction (PAF) of
transactional sex in prevalent cases of HIV infection in the male adult
population of Accra, Ghana. DESIGN AND METHODS: Cross-sectional study of clients
who visited a sex worker (SW), of boyfriends of SW and of male personnel in
prostitution venues. A questionnaire was administered and urine obtained for
detection of anti-HIV antibodies. The PAF of prevalent HIV acquired from SW was
calculated using a combination of data from this survey of clients, from
on-going SW surveys, the national HIV surveillance system and the national
census. RESULTS: HIV prevalence was 4.9% (8/162) among clients of mobile SW,
15.8% (53/335) among clients of home-based SW, 17.5% (10/57) among personnel and
32.1% (9/28) among boyfriends. A condom was used in 90% of intercourses,
according to clients. Non-use of a condom was clustered in selected locations
and independently associated with older age of client, frequency of intercourse
with SW in the last year and current urethritis. Among the male population of
Accra aged 15-59 years, 84% of prevalent cases of HIV were attributable to
transactional sex. A sensitivity analysis showed that under various assumptions
PAF varied between 47% and 100%. CONCLUSIONS: In Accra, approximately
four-fifths of prevalent cases of HIV in adult males were acquired from SW.
Comprehensive interventions providing education, condoms and treatment for
sexually transmitted diseases for SW and their clients should be approached as
other public health priorities and provided in all cities, large and small, of
West Africa.
39: Twin Res. 2004 Feb;7(1):27-32.
A behavior genetic investigation of the relationship between leadership and
personality.
Johnson AM, Vernon PA, Harris JA, Jang KL.
The University of Western Ontario, London, Ontario, Canada. ajohnson@uwo.ca
Phenotypic research on leadership style has long considered the importance of
individual differences in personality when identifying the behaviors associated
with good leaders. Although leadership and many personality traits have been
separately shown to be heritable, these constructs have not been examined with
genetically informative data to identify common sources of heritability in the
two domains. A logical extension to current research, therefore, is to examine
the extent to which factors of personality are predictive of leadership
dimensions and the extent to which unique genetic contributions to the
relationship between personality and leadership style may be identified. Adult
twin pairs (183 MZ and 64 same-sex DZ) completed the Multifactor Leadership
Questionnaire (MLQ) and the Personality Research Form (PRF). Univariate analyses
indicated that both leadership factors (transformational and transactional
leadership) and all five of the "Big Five" factors (openness, conscientiousness,
extraversion, disagreeableness, and neuroticism) were best fit by genetic
models. Multivariate genetic analyses suggest that transformational leadership
shows a statistically significant positive genetic correlation with
conscientiousness, extraversion, and openness to experience. Transactional
leadership shows a significant negative genetic correlation with
conscientiousness and extraversion, and a significant positive genetic
correlation with disagreeableness. These results underscore the importance of
conscientiousness and extraversion in predicting leadership style, and
illustrate important differences between transformational and transactional
leaders.
Publication Types:
Twin Study
40: Encephale. 2003 Nov-Dec;29(6):507-18.
[Multidimensional assessment of coping: validation of the Brief COPE among

French population]
[Article in French]
Muller L, Spitz E.
Doctorant en Psychologie, Laboratoire de Psychologie, Universite de Metz, 57045
Metz cedex 1.
This Article aims to introduce the translation and the validation of a
multidimensional measure of coping strategies: the Brief COPE, in a French
population. The coping concept comes from psychological studies that were
conducted on stress. In the conceptual analysis of stress by Lazarus and
Folkman, coping works with two cognitive appraisals performed by the person
concerning the perception of a threatening situation and his or her available
resources to deal with it. Coping is defined as "cognitive and behavioural
efforts to master, reduce, or tolerate the internal and/or external demands that
are created by the stressful transaction". The Brief COPE is the abridged
version of the COPE inventory and presents fourteen scales all assessing
different coping dimensions: 1) active coping, 2) planning, 3) using
instrumental support, 4) using emotional support, 5) venting, 6) behavioural
disengagement, 7) self-distraction, 8) self-blame, 9) positive reframing, 10)
humor, 11) denial, 12) acceptance, 13) religion, and 14) substance use. Each
scale contains two items (28 altogether). This inventory has the advantage of
being built from acknowledged theoretical models (Lazarus' transactional model
of stress, 1984; behavioral self-regulation model, Carver and Scheier, 1981,
1998). It can be used to assess trait coping (the usual way people cope with
stress in everyday life) and state coping (the particular way people cope with a
specific stressful situation). As is the COPE inventory, the Brief COPE is a
measure used for many health-relevant studies: drugs addiction, ageing, breast
cancer, depression, AIDS. Both measures are widely used in Anglophone countries
and translated in many Languages. Today, the COPE inventory has been validated
among Estonian, Croatian, Chinese, and Italian populations and the Brief COPE is
also validated among Spanish people. Thus, the worldwide use of this coping
inventory should allow a broad comparison of medical and psychological research
for coping strategies regarding every kind of pathologies. Thus, we were led to
present the translation and the validation of this measure in a French
population. Two studies are presented in this Article: the first one describes
the validation of the inventory in a dispositional format (trait coping) and the
second one the validation of the inventory in a situational format (state
coping). The French version of Brief COPE, which was used for both studies, was
back-translated and analysed by the Brief COPE Author: Charles S. Carver. For
study 1, 834 first Year university students answered the Brief COPE in its
dispositional format. To study the factor structure of the Brief COPE, we used
structural equation modeling and the LISREL software. Results show that the
expected theoretical structure and the observed one fit adequately (c2=606,
p<0,05, RMSEA=0,04, GFI>0,95, AGFI>0,92, RMR<0,03). In order to study convergent
and discriminant validity of Brief COPE, self-esteem (SEI, Rosenberg, 1979),
perceived stress (PSS, Cohen et al., 1983), and psychological distress (GHQ-12,
Goldberg, 1972) measures were used. Results show that functional coping
strategies (eg, active coping) are linked to good self-esteem, to lower
perceived stress, and to lower psychological distress, whereas less functional
strategies (eg, denial or self-blame) are widely linked to poor self-esteem, to
a high perceived stress, and to psychological distress. Study 1 shows also
several significant gender differences. Study 2 describes the Brief COPE
validation in its situational format. 178 additional students answered this

version. The method that was used is the same the one developed by Lazarus and
his colleagues for the WCC validation. Participants were asked to recall and
think about the most stressful event they had experienced during the past two
Months. They were also to give an account of how much that situation mattered to
them. They had to evaluate their capacity to control the situation and indicated
whether they felt the situation was amenable to change. The study includes only
peoples only people who labeled an event as "important" or "very important".
Here again LISREL was used to study the factor structure of the Brief COPE. The
results emphasise - as in study 1 - that the expected theoretical structure and
the observed one fit adequately (c2=391, p<0,05, RMSEA<0,05, GFI=0,87,
AGFI=0,80, RMR<0,06). Differences among means showed how the perceived control
of the situation and how the perception of its favourable evolution influenced
the coping strategies used (eg, humour or denial). Results in both studies
indicate good psychometric properties for the Brief COPE in its French version,
whatever the format (ie, dispositional or situational). Thus French searchers
have a relevant tool on hand to measure as accurately as possible the coping
strategies someone used in everyday life (strategies interfering on health, on a
long scale), or in distressful situations (eg, serious illness, traumas). The
fact that this easy-to-use coping measure is worldwide spread among medical and
psychological studies allows a better broadcast and comparison of results
whatever the pathology.
Publication Types:
Validation Studies
41: J Clin Child Adolesc Psychol. 2004 Mar;33(1):69-81.
Comment in:
J Clin Child Adolesc Psychol. 2004 Mar;33(1):82-7.
Temperament and adolescent substance use: a transactional analysis of emerging
self-control.
Wills TA, Dishion TJ.
Department of Epidemiology and Population Health, Albert Einstein College of
Medicine, Bronx, NY 10461, USA. tomd@uoregon.edu
Presented is a conceptual framework linking the construct of temperament with
environmental factors that covary with the onset and escalation of substance
use. We propose that transactions between temperament characteristics of the
child in family and peer contexts influence the development of self-control
ability, a mediating factor for onset and possible transition to abuse in later
adolescence. Risk-promoting dimensions may influence the emergence of
self-control by amplifying relationship processes that detract from competence
development. Emergence of good self-control can serve as a resilience factor and
is linked with health-promoting cognitions. We also suggest that temperament and
self-control moderate links between parenting, peer associations, and substance
use. Implications of the transactional model for clinical intervention and
research are discussed.
Publication Types:
Review

42: Ann N Y Acad Sci. 2003 Dec;1008:149-59.
Impulsivity, emotion regulation, and developmental psychopathology: specificity
versus generality of linkages.
Hinshaw SP.
Department of Psychology, Tolman Hall #1650, University of California-Berkeley,
Berkeley, CA 94720, USA. hinshaw@socrates.berkeley.edu
Impulsivity, closely related to the construct of response (dis)inhibition, is
central to conceptions of both attention-deficit/hyperactivity (ADHD) and
aggressive-spectrum or disruptive behavior disorders. The multifaceted nature of
inhibitory deficits requires careful specification in any explanatory accounts
of psychopathology. A host of brain regions and neural interconnections are
involved in response inhibition; neural models are likely to be complex at the
levels of neurotransmitter systems and white-matter tracts. Despite the
substantial heritability of ADHD and the substantial continuity of early-onset
forms of aggression, developmental processes (including gene-environment
correlations and interactions) and transactional models are crucial to the
unfolding of regulated versus dysregulated behavioral outcomes. Thus, stressful
prenatal and childhood environments must be investigated with as much precision
as genetic loci and neural pathways. Differentiating executive inhibition
(believed to be largely dopaminergic and frontal/frontal-striatal in nature)
from motivational inhibition (believed to be largely noradrenergic/serotonergic
and limbic in nature) is necessary to distinguish subtypes of youth with
attentional and aggressive problems, and to differentiate key etiologic
processes. Indeed, the executive function deficits in children with ADHD appear
to independent of their emotion dysregulation, which is specific to an
aggressive subgroup. Sex differences in response inhibition and sex differences
in its linkages to psychopathology are relatively unexplored. For progress in
subsequent research to occur, the following are required: precision in
measurement at both biological and behavioral levels; contrasts with clinical
comparison samples and comorbid groups (as well as normal control samples);
prospective longitudinal investigations; and attention to both developmental
processes and contextual variables, including stressful life events,
socialization practices, and cultural parameters.
43: Autism. 2003 Dec;7(4):347-60.
Social play and autistic spectrum disorders: a perspective on theory,
implications and educational approaches.
Jordan R.
School of Education, University of Birmingham, Edgbaston, UK.
The article considers the nature of the presumed social play deficit in autistic
spectrum disorders (ASDs). The nature of play and its typical development is
outlined and discussed in relation to play development in ASDs. It is suggested
that social play is a confluence of two strands of development that are affected
in autism: social and emotional development, and the cognitive development of

play. It is shown that social play develops in a transactional way and in ASDs
initial social difficulties prevent the development of social interaction, with
its role in eliciting and enriching spontaneous play. At the same time,
cognitive and affective difficulties prevent the play of children with autism
developing to the extent of attracting other children and being of a complexity
from which social play might develop. This cycle of impoverished play
opportunities for children with ASDs may be broken through direct teaching and
there are encouraging models of teaching social play with some success.
Publication Types:
Review
Review, Tutorial
44: Psychosom Med. 2003 Nov-Dec;65(6):1003-11.
Hostility, interpersonal interactions, and ambulatory blood pressure.
Brondolo E, Rieppi R, Erickson SA, Bagiella E, Shapiro PA, McKinley P, Sloan RP.
Department of Psychology, St. John's University, New York, NY, USA.
brondole@stjohns.edu
OBJECTIVE: This study examined aspects of the transactional model of hostility
and health by investigating relationships among hostility, interpersonal
interactions, and ambulatory blood pressure in a healthy community sample.
MATERIALS AND METHODS: Participants included 65 female and 39 male healthy
adults between the ages of 18 and 46 years. Ambulatory blood pressure (ABP) and
diary data on mood and social interactions were obtained every 20 minutes for 1
day. Mixed models regression analyses were used to evaluate the relationships
among hostility, interpersonal interactions, and ABP. RESULTS: Trait hostility
was positively associated with the frequency and intensity of negative
interactions and was negatively associated with the frequency and intensity of
positive interactions. Interacting with others was associated with increases in
systolic blood pressure (SBP) and diastolic blood pressure (DBP). The magnitude
of the increase in blood pressure was positively associated with the degree to
which the interaction was perceived as negative. Hostility was not directly
associated with ABP/heart rate (HR) or ABP/HR responses during any interactions
or negative interactions. However, there was an interaction between hostility
and negative interaction intensity for DBP, suggesting that hostility moderates
the effects of negative interactions on DBP. Specifically, increases in the
intensity of negative interactions were associated with increases in DBP for
participants with high, but not low, hostility. CONCLUSIONS: The results provide
partial support for the notion that hostility may be associated with risk for
cardiovascular disease through its effects on interpersonal interactions and
their cardiovascular correlates.
45: Krankenpfl Soins Infirm. 2003;96(7):12-3.
[5 models for effective communication]
[Article in German]
Wilhelm J.
Publication Types:
Interview
46: Health Promot Pract. 2003 Jul;4(3):336-9.
Health educators are leaders: meeting the leadership challenge.
Fertman CI.
School of Education, University of Pittsburgh, Pennsylvania, USA.
Each of the certified health education specialist responsibilities and
competencies for health educators has a leadership element. Health educators
demonstrate leadership in a variety of roles with individuals, organizations,
and programs. In this article, transformational and transactional leadership
qualities are presented as reflection points on leadership for health educators.
47: Dev Psychopathol. 2003 Summer;15(3):773-810.
Moving research on resilience into the 21st century: theoretical and
methodological considerations in examining the biological contributors to
resilience.
Curtis WJ, Cicchetti D.
Mt. Hope Family Center, University of Rochester, NY 14608, USA.
wjcurtis@psych.rochester.edu
Empirical investigations of resilience over the past 30 years have examined a
wide range of psychosocial correlates of, and contributors to, this phenomenon.
Thus far, theoretical treatments of resilience have focused almost exclusively
on psychosocial levels of analysis to derive explanatory models. However, there
have been no formal discussions of either theory or research that have examined
the biological contributors to, or correlates of, competent functioning despite
the experience of adversity. This paper seeks to fill this gap and sets forth a
preliminary theoretical framework and outline of empirical strategies for
studying the biological underpinnings of resilience. The initial sections of the
paper discuss the particular suitability of a transactional organizational
theoretical perspective as a conceptual foundation for including a biological
level of analysis within the extant theoretical framework of resilience.
Subsequently, other important theoretical considerations for the inclusion of a
biological perspective on resilience are discussed, including the avoidance of
an approach that would reduce resilience to merely a biological process, the
application of the constructs of multifinality and equifinality to a biological
perspective on resilience, as well as a general discussion of the potential for
utilization of brain imaging and other technologies in the study of resilience.
The possible relation between the mechanisms of neural plasticity and resilience
are examined in some detail, with specific suggestions concerning research
questions needed to examine this association. Sections of the paper discuss the
likely relation of several areas of brain and biological functioning with

resilience, including emotion, cognition, neuroendocrine and immune functioning,
and genetics. The paper concludes with a discussion of the implications of a
biological perspective on resilience for preventive interventions.
Publication Types:
Review
Research strategies for capturing transactional models of development: the
limits of the possible.
Sameroff AJ, Mackenzie MJ.
Center for Human Growth and Development, University of Michigan, Ann Arbor
48109-0406, USA. sameroff@umich.edu
Transactional models have informed research design and interpretation in studies
relevant to developmental psychopathology. Bidirectional effects between
individuals and social contexts have been found in many behavioral and cognitive
domains. This review will highlight representative studies where the
transactional model has been explicitly or implicitly tested. These studies
include experimental, quasiexperimental, and naturalistic designs. Extensions of
the transactional model have been made to interventions designed to target
different aspects of a bidirectional system in efforts to improve developmental
outcomes. Problems remain in the need to theoretically specify structural models
and to combine analyses of transactions in the parent-child relationship with
transactions in the broader social contexts. Longitudinal studies with
sufficient time points to assess reciprocal processes continue to be important.
Such longitudinal investigations will permit identifying developmental periods
where the child or the context may be most influential or most open to change.
Publication Types:
Review
49: J Pediatr Psychol. 2003 Oct-Nov;28(7):453-62.
The influence of parental distress on child depressive symptoms in juvenile
rheumatic diseases: the moderating effect of illness intrusiveness.
Wagner JL, Chaney JM, Hommel KA, Page MC, Mullins LL, White MM, Jarvis JN.
Department of Psychology, Oklahoma State University, 215 North Murray Hall,
Stillwater, OK 74078, USA. stern@okstate.edu
OBJECTIVE: To examine the role of children's illness-related cognitive
appraisals in the parent-child adjustment relationship in a sample of children
and adolescents with juvenile rheumatic disease (JRD). Specifically, we tested
the moderating effect of children's perceived illness-induced barriers (i.e.,
illness intrusiveness) in the parent distress-child depressive symptom
relationship. METHODS: Participants were 45 children and adolescents (ages 9-17)
diagnosed with JRD. Children completed measures of depressive symptoms

(Children's Depression Inventory), functional disability (Juvenile Arthritis and
Functional Assessment Report), and illness intrusiveness (Illness Intrusiveness
Scale-adapted for children); parents completed a brief measure of global
distress (Brief Symptom Inventory). The pediatric rheumatologist provided
functional disability ratings following a routine physical exam. RESULTS: Both
increased parental distress and child illness intrusiveness were associated with
greater child depressive symptoms. Direct effects were qualified by a
significant Parent Distress x Illness Intrusiveness interaction. The influence
of general parental distress on child depressive symptoms was enhanced under
conditions of increased child-reported illness intrusiveness. CONCLUSIONS:
Results support transactional conceptualizations of child adjustment to chronic
illness. Findings also emphasize the need to examine the interaction of parent
and child variables, particularly cognitive appraisals, in child adjustment.
Results and treatment implications for children with JRD are discussed in terms
of reinforcement theories of depression.
50: Krankenpfl Soins Infirm. 2003;96(7):40-3.
["One can no longer communicate"]
[Article in French]
Luthi U.
51: Emotion. 2002 Dec;2(4):315-40.
Fundamental dimensions of subjective state in performance settings: task
engagement, distress, and worry.
Matthews G, Campbell SE, Falconer S, Joyner LA, Huggins J, Gilliland K, Grier R,
Warm JS.
Department of Psychology, University of Cincinnati, Ohio 45221, USA.
matthegd@email.uc.edu
Subjective state constructs are defined within the traditional domains of
affect, motivation, and cognition. Currently, there is no overarching state
model that interrelates constructs within the different domains. This article
reports 3 studies that provide converging evidence for 3 fundamental state
dimensions labeled task engagement, distress, and worry that integrate
constructs across the traditional domains. Study 1 differentiated the state
dimensions by factor analysis of the scales of the Dundee Stress State
Questionnaire (G. Matthews et al., 1999). Study 2 showed differential state
response to performance of tasks making different cognitive demands. Study 3
showed that states are correlated with differing patterns of appraisal and
coping. The 3 stress state dimensions provide a general descriptive framework
consistent with transactional accounts of stress and performance.
52: J Gerontol B Psychol Sci Soc Sci. 2003 Jul;58(4):S234-43.
Becoming "at home" in assisted living residences: exploring place integration

processes.
Cutchin MP, Owen SV, Chang PF.
School of Allied Health Sciences, University of Texas Medical Branch, Galveston,
77551-1142, USA. mpcutchi@utmb.edu
OBJECTIVES: This study explores the roles of place attachment, nonfamily social
involvement, place valuation, and individual characteristics in the process of
becoming at home in assisted living residences. METHODS: Purposive sampling and
cross-sectional data by means of a questionnaire completed by current assisted
living residents in four states (N = 297) were used to estimate a structural
equation model to explain becoming at home. RESULTS: Place attachment to town
and community is a necessary but not sufficient explainer of older adults'
process of becoming at home. Nonfamily social involvement plays a pivotal role
through which place attachment works to explain becoming at home. Both place
valuation and nonfamily social involvement exhibit direct positive effects on
the outcome. DISCUSSION: Findings support a transactional interpretation of
assisted living as home. The relationship between place attachment to one's
community and full integration into assisted living is more complex than
currently acknowledged.
53: Cyberpsychol Behav. 2003 Jun;6(3):309-14.
Sonic intelligence as a virtual therapeutic environment.
Tarnanas I, Adam D.
Department of Psychology and Informatics, Aristotle University of Thessalonica,
Thessalonica, Greece. ioannist@psy.auth.gr
This paper reports on the results of a research project, on comparing one
virtual collaborative environment with a first-person visual immersion
(first-perspective interaction) and a second one where the user interacts
through a sound-kinetic virtual representation of himself (avatar), as a
stress-coping environment in real-life situations. Recent developments in coping
research are proposing a shift from a trait-oriented approach of coping to a
more situation-specific treatment. We defined as real-life situation a
target-oriented situation that demands a complex coping skills inventory of high
self-efficacy and internal or external "locus of control" strategies. The
participants were 90 normal adults with healthy or impaired coping skills, 25-40
years of age, randomly spread across two groups. There was the same number of
participants across groups and gender balance within groups. All two groups went
through two phases. In Phase I, Solo, one participant was assessed using a
three-stage assessment inspired by the transactional stress theory of Lazarus
and the stress inoculation theory of Meichenbaum. In Phase I, each participant
was given a coping skills measurement within the time course of various
hypothetical stressful encounters performed in two different conditions and a
control group. In Condition A, the participant was given a virtual stress
assessment scenario relative to a first-person perspective (VRFP). In Condition
B, the participant was given a virtual stress assessment scenario relative to a
behaviorally realistic motion controlled avatar with sonic feedback (VRSA). In
Condition C, the No Treatment Condition (NTC), the participant received just an

interview. In Phase II, all three groups were mixed and exercised the same tasks
but with two participants in pairs. The results showed that the VRSA group
performed notably better in terms of cognitive appraisals, emotions and
attributions than the other two groups in Phase I (VRSA, 92%; VRFP, 85%; NTC,
34%). In Phase II, the difference again favored the VRSA group against the other
two. These results indicate that a virtual collaborative environment seems to be
a consistent coping environment, tapping two classes of stress: (a) aversive or
ambiguous situations, and (b) loss or failure situations in relation to the
stress inoculation theory. In terms of coping behaviors, a distinction is made
between self-directed and environment-directed strategies. A great advantage of
the virtual collaborative environment with the behaviorally enhanced
sound-kinetic avatar is the consideration of team coping intentions in different
stages. Even if the aim is to tap transactional processes in real-life
situations, it might be better to conduct research using a sound-kinetic avatar
based collaborative environment than a virtual first-person perspective scenario
alone. The VE consisted of two dual-processor PC systems, a video splitter, a
digital camera and two stereoscopic CRT displays. The system was programmed in
C++ and VRScape Immersive Cluster from VRCO, which created an artificial
environment that encodes the user's motion from a video camera, targeted at the
face of the users and physiological sensors attached to the body.
54: Psychol Bull. 2003 Jul;129(4):569-91.
Transformational, transactional, and laissez-faire leadership styles: a
meta-analysis comparing women and men.
Eagly AH, Johannesen-Schmidt MC, van Engen ML.
Department of Psychology, Northwestern University, Evanston, Illinois 60208,
USA. eagly@northwestern.edu
A meta-analysis of 45 studies of transformational, transactional, and
laissez-faire leadership styles found that female leaders were more
transformational than male leaders and also engaged in more of the contingent
reward behaviors that are a component of transactional leadership. Male leaders
were generally more likely to manifest the other aspects of transactional
leadership (active and passive management by exception) and laissez-faire
leadership. Although these differences between male and female leaders were
small, the implications of these findings are encouraging for female leadership
because other research has established that all of the aspects of leadership
style on which women exceeded men relate positively to leaders' effectiveness
whereas all of the aspects on which men exceeded women have negative or null
relations to effectiveness.
Publication Types:
Meta-Analysis
55: J Psychosom Res. 2003 Jul;55(1):67-75.
A transactional model of oppositional behavior: underpinnings of the
Collaborative Problem Solving approach.
Greene RW, Ablon JS, Goring JC.

Department of Psychiatry, Massachusetts General Hospital and Harvard Medical
School, Boston, MA 02114, USA. greene@helik.mgh.harvard.edu
Oppositional defiant disorder (ODD) refers to a recurrent pattern of
developmentally inappropriate levels of negativistic, defiant, disobedient, and
hostile behavior toward authority figures. ODD is one of the most common (and
debilitating) comorbid disorders within Tourette's disorder (TD). Diverse
psychosocial treatment approaches have been applied to children's ODD-related
behaviors. In this paper, the authors articulate a transactional developmental
conceptualization of oppositional behavior and describe a cognitive-behavioral
model of intervention-called collaborative problem solving (CPS)-emanating from
this conceptualization. The specific goals of the CPS approach are to help
adults (1). understand the specific adult and child characteristics contributing
to the development of a child's oppositional behavior; (2). become cognizant of
three basic strategies for handling unmet expectations, including (a).
imposition of adult will, (b). CPS, and (c). removing the expectation; (3).
recognize the impact of each of these three approaches on parent-child
interactions; and (4). become proficient, along with their children, at CPS as a
means of resolving disagreements and defusing potentially conflictual situations
so as to reduce oppositional episodes and improve parent-child compatibility.
Summary data from an initial study documenting the effectiveness of the CPS
approach (in comparison to the standard of care) are also presented.
Publication Types:
Review
Review, Tutorial
56: J Am Med Inform Assoc. 2003 Sep-Oct;10(5):454-62. Epub 2003 Jun 4.
Development of a clinical data warehouse for hospital infection control.
Wisniewski MF, Kieszkowski P, Zagorski BM, Trick WE, Sommers M, Weinstein RA.
MSN, Division of Infectious Diseases, Cook County Hospital, 1901 West Harrison
Street, Suite 124 Durand, Chicago, IL 60612, USA. wise@aol.com
Existing data stored in a hospital's transactional servers have enormous
potential to improve performance measurement and health care quality. Accessing,
organizing, and using these data to support research and quality improvement
projects are evolving challenges for hospital systems. The authors report
development of a clinical data warehouse that they created by importing data
from the information systems of three affiliated public hospitals. They describe
their methodology; difficulties encountered; responses from administrators,
computer specialists, and clinicians; and the steps taken to capture and store
patient-level data. The authors provide examples of their use of the clinical
data warehouse to monitor antimicrobial resistance, to measure antimicrobial
use, to detect hospital-acquired bloodstream infections, to measure the cost of
infections, and to detect antimicrobial prescribing errors. In addition, they
estimate the amount of time and money saved and the increased precision achieved
through the practical application of the data warehouse.

57: Cyberpsychol Behav. 2003 Apr;6(2):161-70.
The process of sharing social support in cyberspace.
Tichon JG, Shapiro M.
Centre for Online Health, University of Queensland, Australia. jtichon@uq.edu.au
Mutual support is an interactional communication process. Taking an
interactional approach to support requires group participants be viewed not only
as targets and recipients but also as sources and providers of various types of
support. An analysis was performed on the interactions of a group listserve and
model of online interactional support. The aim was to explore the communication
process children follow. The analysis revealed self-disclosure was used in the
support group in three distinct ways. Its function for the support recipient is
to initiate a transactional relationship with another member for the purpose of
attracting social support through the open expression of concerns and
frustrations. It is then used by the support provider to demonstrate that coping
is possible for the recipient through the reciprocal self-disclosure of similar
concerns and situations with which the member has successfully dealt. The third
use of self-disclosure was to share reciprocal social companionship
relationships.
58: J Intellect Disabil Res. 2003 May-Jun;47(Pt 4-5):217-30.
Pre-school children with and without developmental delay: behaviour problems and
parenting stress over time.
Baker BL, McIntyre LL, Blacher J, Crnic K, Edelbrock C, Low C.
Department of Psychology, University of California, Los Angeles, CA 90095, USA.
baker@psych.ucla.edu
BACKGROUND: Children with intellectual disability are at heightened risk for
behaviour problems and diagnosed mental disorder. METHODS: The present authors
studied the early manifestation and continuity of problem behaviours in 205
pre-school children with and without developmental delays. RESULTS: Behaviour
problems were quite stable over the year from age 36-48 months. Children with
developmental delays were rated higher on behaviour problems than their
non-delayed peers, and were three times as likely to score in the clinical
range. Mothers and fathers showed high agreement in their rating of child
problems, especially in the delayed group. Parenting stress was also higher in
the delayed group, but was related to the extent of behaviour problems rather
than to the child's developmental delay. CONCLUSIONS: Over time, a transactional
model fit the relationship between parenting stress and behaviour problems: high
parenting stress contributed to a worsening in child behaviour problems over
time, and high child behaviour problems contributed to a worsening in parenting
stress. Findings for mothers and fathers were quite similar.
59: Health Info Libr J. 2003 Jun;20(2):95-103.
Non use of health information kiosks examined in an information needs context.

Williams P, Nicholas D, Huntington P.
Internet Studies Research Group, City University, London, UK. pw@soi.city.ac.uk
Whilst great emphasis has rightly been placed on the increased availability and
use of health information, little research has been undertaken into the non use
of such material, particularly with regard to electronic sources. Computer
transactional log data from health information touch screen kiosks, collected as
part of an ongoing Department of Health-funded study being carried out by City
University, showed that females in the 55-74 age group were particularly
under-represented as users. To explore reasons for this, in-depth interviews
were carried out with 13 non-kiosk-using, primary-care out-patients fitting this
profile, at a surgery which had a kiosk that was being monitored. Subjects were
interviewed at length about their information needs and information-seeking
behaviour, to determine reasons (if any) they might have had for non-kiosk use.
The study utilized an interview schedule and technique loosely based on the
'Sense-Making' methodology of Brenda Dervin (Talk Presented at the International
Communication Association Annual Meeting, May 1983, Dallas, Texas, USA.
Available from:
http://communicationsbsohio-stateedu/sense-making/art/artdervin83html.).
Findings elicited many factors accounting for non use of the system. The first
and major source of information remained the doctor, with written or other
sources only being consulted where recommended or provided. There was evidence
that patients wanted little more than the minimum information or instructions
required to deal with their condition. Many appeared unaware of the presence of
the kiosk and others assumed either that it was not for patient use or that it
would not serve their needs. The methodology proved itself, with certain
caveats, to be an appropriate vehicle for this kind of exploratory work.
60: Scand J Psychol. 2003 Apr;44(2):153-9.
School-related stress, social support, and distress: prospective analysis of
reciprocal and multilevel relationships.
Torsheim T, Aaroe LE, Wold B.
Research Centre for Health Promotion, University of Bergen, Norway.
torbjoern.torsheim@psych.uib.no
This three-wave prospective study investigated the reciprocal relationships
among school-related stress, school-related social support, and distress in a
cohort of 767 secondary school students (mean age 13.9 years). Stress, support,
and distress were measured at three occasions with six-month lags between.
Reciprocal relationships were analyzed with multivariate multilevel modeling
(MLwiN). Each of the three factors at baseline predicted change in one or two of
the other factors at subsequent measurements, indicating a complex pattern of
reciprocal relationships among stress, support, and distress across time. A high
level of distress at baseline predicted a lower level of support and a higher
level of stress six months later. High levels of stress at baseline predicted a
higher level of distress and a lower level of support 12 months later. The
results are consistent with a transactional and dynamic model of stress,
support, and distress, and indicate the need to view school-related stress,
support, and distress as mutually dependent factors.
61: Am J Health Behav. 2003;27 Suppl 1:S66-79.
Empowerment as fostering positive youth development and citizenship.
Cargo M, Grams GD, Ottoson JM, Ward P, Green LW.
Margaret Cargo, Centre hospitalier de l'Universite de Montreal & Culture, and
Mental Health Research Unit, McGill University, Montreal, Quebec, Canada.
margaret.cargo@umontreal.ca
OBJECTIVE: To develop a theoretical framework of youth empowerment in the
context of a participatory community health promotion intervention, a
longitudinal qualitative study was conducted. METHODS: Individual and group
interviews, documents, and observations were analyzed using the constant
comparative method and theoretical sampling. RESULTS: Practitioners created an
environment conducive to adolescents' taking responsibility for their
quality-of-life issues by welcoming and enabling youth. Power was transferred to
youth as responsibility for voicing, decision making, and action. This led to
positive changes in youth development and their social integration into
community. CONCLUSION: Empowerment emerged as a transactional partnering process
between adults and youth.
62: Am J Community Psychol. 2003 Mar;31(1-2):129-41.
The violent matrix: a study of structural, interpersonal, and intrapersonal
violence among a sample of poor women.
James SE, Johnson J, Raghavan C, Lemos T, Barakett M, Woolis D.
The National Center on Addiction and Substance Abuse at Columbia University, New
York 10017, USA. sjames@casacolumbia.org
One goal of this paper is to present an integrated tripartite model of violence,
with a focus on structural violence within an oppression paradigm. Using
qualitative and quantitative data from 27 women (70% African American and 30%
European American) who participated in a national substance abuse treatment
demonstration program, we describe a model of violence in which structural
violence is presented within a transactional relationship with interpersonal,
and intrapersonal violence. We suggest that the effects of structural,
interpersonal, and intrapersonal violence are magnified when race and poverty
are considered. The second goal of the paper is to present a preliminary test of
the new model of violence. Results indicated that different levels and types of
violence are interrelated. Implications of these findings for empowering
solutions are suggested.
Predicting unit performance by assessing transformational and transactional

leadership.
Bass BM, Avolio BJ, Jung DI, Berson Y.
Center for Leadership Studies and School of Management, Binghamton University.
How do leadership ratings collected from units operating under stable conditions
predict subsequent performance of those units operating under high stress and
uncertainty? To examine this question, the authors calculated the predictive
relationships for the transformational and transactional leadership of 72 light
infantry rifle platoon leaders for ratings of unit potency, cohesion, and
performance for U.S. Army platoons participating in combat simulation exercises.
Both transformational and transactional contingent reward leadership ratings of
platoon leaders and sergeants positively predicted unit performance. The
relationship of platoon leadership to performance was partially mediated through
the unit's level of potency and cohesion. Implications, limitations, and future
directions for leadership research are discussed.
64: Psychoanal Q. 2003 Apr;72(2):287-323.
Psychoanalysis: the transformation of the subject by the spoken word.
Rizzuto AM.
arizzuto@massmed.org
Psychoanalysis recruits the power of the spoken word to modify the subject's
relationship with his or her own unconscious psychic processes. It helps the
analysand to reclaim for his or her words the psychic integrity that was lost or
never achieved due to the power of defensive dissociation and repression. The
psychoanalytic dialogue and the working through mediated by it lead to the
elaboration of self-narratives and interpretive understandings, which contribute
to the transformation of the subject's self-experience. Such transformation is
conditioned by earlier integration of experiences of satisfaction in the context
of bodily dialogues and speech with primary objects.
65: Adm Policy Ment Health. 2002 Nov;30(2):97-108.
Transformational leadership and the mental health team.
Corrigan PW, Diwan S, Campion J, Rashid F.
University of Chicago Center for Psychiatric Rehabilitation, Tinley Park, IL
60477, USA. pcorriga@mcis.bsd.uchicago.edu
Bass's (1990) multifactor model contrasts transformational and transactional
styles of leadership with an essentially ineffective style: laissez-faire
leadership. This study examines the relationship between these leadership styles
and measures of organizational culture and staff burnout in mental health
services teams. There were 236 leaders and 620 subordinates from 54 mental
health teams who provided their perceptions of leadership style, organizational
culture, and burnout in their program. Results show transformational leadership

to be positively associated with a cohesive organizational culture and
negatively associated with burnout. Moreover, leaders and subordinates differ in
their ratings of transformational leadership-leaders viewed themselves more
positively. These findings are helpful for understanding the central role of
leaders in the organizational structure of teams.
66: AIDS. 2002 Dec;16 Suppl 3:S42-9.
Mobile populations and HIV/AIDS in Central America and Mexico: research for
action.
Bronfman MN, Leyva R, Negroni MJ, Rueda CM.
Avenida Universidad 655, Col Sta Maria Ahuacatitlan, CP 62508, Cuemavaca,
Morelos, Mexico. mbronfman@correo.insp.mx
OBJECTIVE: To present a multi-centre study that analyses the socioeconomic,
cultural and political contexts that give rise to population mobility, and its
relationship to vulnerability to sexually transmitted infections (STI)/HIV/AIDS,
in order to provide information that can be used to design appropriate and
focused interventions. METHODS: In each of 11 transit stations (border towns,
port cities, areas where mobile populations congregate) in Central America and
Mexico, a household survey of the local population was conducted to analyse
demographic, socioeconomic characteristics, and information known and opinions
held about HIV/AIDS and mobile populations. In-depth interviews with key
informants, community members and mobile populations were held to ascertain
knowledge about prevention and transmission of STI/HIV/AIDS. Likewise, an
ethnographic study was undertaken to identify interactions between local and
mobile populations. RESULTS: The transit stations share low educational levels
among the local population, few public services, repeated human rights
violations, violence, poverty and corrupt authorities. Within this social
context, transactional sex, sex for survival, rape and non-professional
commercial sex happen in conditions that increase the risk of the transmission
of STI/HIV, such as infrequent condom use. Migrant women and sex workers are
particularly vulnerable in this context. A wide gap exists between information
about STI/HIV transmission and reported prevention practices. CONCLUSION: Given
the conditions that exist in these transit stations, interventions should be
multisectoral, sustainable, and should defend the human rights of various
groups, including women and people living with HIV/AIDS.
Publication Types:
Multicenter Study
67: J Psychiatr Ment Health Nurs. 2003 Apr;10(2):199-202.
'No suicide contracts' in community crisis situations: a conceptual analysis.
Farrow TL.
School of Nursing, Christchurch Polytechnic Institute of Technology,
Christchurch, New Zealand. farrowt@cpit.ac.nz
'No suicide contracts' are commonly used in community crisis situations with
suicidal people in New Zealand. These take the form of a 'guarantee of safety',
along with a 'promise' to call specified persons if the suicidal ideation
becomes unmanageable. This article describes the use of 'no suicide contracts'
in community crisis situations, analyses the use of the tool within this
context, and, in particular, argues that the theoretical base (transactional
analysis) of the 'no suicide contract' is likely to be deleterious in the
community crisis situation.
68: Dev Psychol. 2003 Mar;39(2):372-8.
Comment on:
Dev Psychol. 2003 Mar;39(2):222-45.
Dev Psychol. 2003 Mar;39(2):246-60.
Commentary: causal processes leading to antisocial behavior.
Rutter M.
Social, Genetic and Developmental Psychiatry Research Center, Institute of
Psychiatry, Demark Hill, London, United Kingdom. jwickham@iop.kcl.ac.uk
Conceptual, and empirical, questions are raised regarding the notion that
physical aggression is the main individual risk factor for antisocial behavior,
that language impairment also constitutes a risk factor, the meaning of the male
preponderance for antisocial behavior, the findings on environmentally mediated
risk; the role of biosocial interplay; social context effects; the construct of
antisocial behavior, developmental trends; processing of experiences; and
transactional effects. The main blocks to using research to develop policy are
the lack of evidence on (a) the mediators of the causal processes, (b) what is
needed to bring about change, (c) ways to ensure that individuals who need
interventions actually receive them, and (d) differences in levels of antisocial
behavior.
Publication Types:
Comment
Review
69: Dev Psychol. 2003 Mar;39(2):349-71.
A biopsychosocial model of the development of chronic conduct problems in
adolescence.
Dodge KA, Pettit GS.
Center for Child and Family Policy, Duke University, Durham, North Carolina
27708-0264, USA. dodge@pps.duke.edu
A biopsychosocial model of the development of adolescent chronic conduct
problems is presented and supported through a review of empirical findings. This
model posits that biological dispositions and sociocultural contexts place
certain children at risk in early life but that life experiences with parents,
peers. and social institutions increment and mediate this risk. A transactional
developmental model is best equipped to describe the emergence of chronic
antisocial behavior across time. Reciprocal influences among dispositions,
contexts, and life experiences lead to recursive iterations across time that
exacerbate or diminish antisocial development. Cognitive and emotional processes
within the child, including the acquisition of knowledge and
social-information-processing patterns, mediate the relation between life
experiences and conduct problem outcomes. Implications for prevention research
and public policy are noted.
Publication Types:
Review
70: Prax Kinderpsychol Kinderpsychiatr. 2003 Feb;52(2):71-87.
[Coping with acute psychological traumas in childhood]
[Article in German]
Landolt MA.
Universitats-Kinderspital, Steinwiesstr. 75, CH-8032 Zurich.
markus.landolt@kispi.unizh.ch
While there is increasing knowledge about predictors of posttraumatic stress
reactions in adults, much less is known in children. Importantly, the
theoretical integration of research findings and the development of models of
post-trauma adaptation have been neglected. After some introducing remarks on
the classification and the prevalence of posttraumatic stress reactions, this
paper aims to integrate current research findings within a trauma adaptation
model that is based on transactional stress theory. Characteristics of the
trauma, the child and the social context are assumed to predict posttraumatic
adaptation. The effect of these variables on trauma adaptation may be direct or
indirect, i.e. mediated by appraisals and coping processes. Based on the
proposed theoretical model current research findings are presented and discussed
in detail. Finally, the usefulness of the model for the planning and the
development of psychosocial interventions after trauma is shown.
Publication Types:
Review
Review, Tutorial
71: Soc Sci Med. 2003 Mar;56(5):1061-72.
The M-C-M' cycle and social capital.
Hean S, Cowley S, Forbes A, Griffiths P, Maben J.
Florence Nightingale School of Nursing and Midwifery, Kings College London,
James Clerke Maxwell Building, 57 Waterloo Road, SE1 8WA, London, UK.
sarah.hean@kcl.ac.uk
Social capital has become a popular term over the past two decades amongst
researchers, policy makers and practitioners from varied disciplines. This
popularity, however, has resulted in a great deal of confusion over the nature
and application of social capital in different contexts. This confusion has made
it difficult to identify and measure social capital within the evaluation of
specific social and health programmes, one of the aims of which may be to
stimulate social capital. This paper identifies a theoretical model that seeks
to capture the dynamic nature of social capital to assist in the development of
research methods that will facilitate its measurement and exploration within
such programmes. The model reported in the paper identifies the key components
of social capital and expresses the relationship between those components in a
dynamic system based on Marx's description of the process of capital (economic)
exchanges expressed in the M-C-M' cycle. The M-C-M' cycle is the transformation
of money (M) into commodities (C), and the change of commodities back again into
money (M') of altered value. The emphasis within the paper is on the capital
element of the concept and its transactional nature with the aim of avoiding the
pitfall of attributing social capital in relation to social behaviours in
isolation of context and interaction. Importantly, the paper seeks to
distinguish the central elements of social capital from some of the antecedent
factors and outcomes often attributed to and confused with social capital adding
to the problem of providing valid measurement. The model is presented as the
basis for the measurement of social capital within a transactional process
involving the investment of social resources in a cyclical process, which may
result in net gains or losses. This process is described as the R-C-R' cycle
following Marx's model of economic capital, with the focus being on the transfer
of social resources (R) rather than money (M). R represents an internal resource
held by individuals, C the external resource or commodity they obtain from the
network and the R' the internal resource of altered value. The possibilities of
the model in assisting in the measurement of social capital specifically in
assessing formal networks are explored.
72: Nurs Leadersh Forum. 2002 Summer;6(4):100-7.
Nurse executives' values and leadership behaviors. Conflict or coexistence?
Perkel LK.
School of Nursing, Barry University, Miami Shores, FL 33161, USA.
lperkel@mail.barry.edu
Nurse leaders struggle to provide for the delivery of humanistic and holistic
healthcare that is consistent with nursing values in a changing economic
environment. There is concern that nurse executives find it increasingly
difficult to reconcile the differences between organizational economics and
their personal and professional identities. The purpose of this study was to
examine the relationship between nurse executives' perceived personal and
organizational value congruence and their leadership behaviors (i.e.,
transformational, transactional, and laissez-faire). Four hundred and eleven
nurse executives employed by American Hospital Association hospitals located
east of the Mississippi participated in the study. Findings provide insight into
the values held by nurse executives, personal and organizational value
congruence and conflict perceived by nurse executives, and the leadership
behaviors used by nurse executives. For example, the findings indicate there is
a moderate degree of value congruence between nurse executives' personal and

organizational values; however, the degree to which specific values are
important is significantly different. Nurse executives report that they most
often engage in transformational leadership behaviors, but there was no
relationship between their leadership behavior and the degree of personal and
organizational value congruence. Implications for nursing and nursing research
are discussed.
73: J Nurs Manag. 2003 Mar;11(2):107-20.
The psychological contracts of National Health Service nurses.
Purvis LJ, Cropley M.
Department of Psychology, School of Human Sciences, University of Surrey,
Guildford, GU2 5HX, UK. l.purvis@surrey.ac.uk
AIMS: Following the psychological contract model of the employee-employer
exchange relationship is offered as a means of understanding the expectations of
a UK sample of 223 National Health Service (NHS) nurses in association with
their leaving intentions. DESIGN AND METHODS: A pilot study involving 21 NHS
nurses, using the repertory grid technique was conducted to elicit contract
expectations. Twenty-nine categories of expectation were identified through
content analysis. The study proper, employed a survey developed on the basis of
results from the pilot study to identify contract profiles among 223 nurses from
three London/South-east NHS hospitals, using the Q-sort method. Type of contract
held (relational/transactional), satisfaction (job and organization), and
leaving intentions were also examined. RESULTS: Q-analysis yielded four contract
profiles among the nurses sampled: 'self-development and achievement';
'belonging and development'; 'competence and collegiality' and 'autonomy and
development'. Correlation analysis demonstrated that leaving intentions were
associated with a need for personal autonomy and development, and the violation
of expectations for being appreciated, valued, recognized and rewarded for
effort, loyalty, hard-work and achievement, negative endorsement of a relational
contract, positive endorsement of a transactional contract, and job and
organizational dissatisfaction. CONCLUSION: Findings illustrate the diagnostic
utility of the term psychological contract for understanding the expectations of
NHS nurses. The potential significance of these findings for managing nurse
retention is highlighted.
74: J Nurs Manag. 2003 Mar;11(2):73-9.
Dare to be different: transformational leadership may hold the key to reducing
the nursing shortage.
Thyer GL.
Aged Care Nursing, Hunter Institute of Technology, TAFE New South Wales,
Australia. genevieve_thyer@optusnet.com.au
Health care leadership continues to run under a transactional style that may be
causing nurses to leave the system. Nurses no longer wish to stay in the
profession perhaps because they struggle ideologically with the system in which
they work. However, nurses may hold the key to transforming health care and
dragging it into the 21st century in terms of work practices and reform. This is
because nurses are visionary, creative, involved in decision making at patient
level and have gender based qualities, and communication strategies that the
health care sector needs. In contrast to transaction leadership,
transformational leadership and team development has a positive affect on
communication and team building. The later style is ideologically suited to
nurses and may ensure the future of nurses and nursing in the health care
sector. The case study described in this paper was an actual working environment
and one that I came across all too often as a registered nurse and clinical
educator.
75: Ergonomics. 2002 Nov 15;45(14):1001-4; discussion 1042-6.
Comment on:
Ergonomics. 2002 Nov 15;45(14):966-87.
Transactional perspectives on subjective rating scales.
Matthews G.
Department of Psychology, University of Cincinnati, OH 45221, USA.
matthegd@email.uc.edu
Publication Types:
Comment
76: Am J Psychother. 2002;56(4):585-602.
Family therapy and dialectical behavior therapy with adolescents: Part II: A
theoretical review.
Woodberry KA, Miller AL, Glinski J, Indik J, Mitchell AG.
Maine Medical Center, Portland, ME, USA.
Dialectical Behavior Therapy (DBT) is based on a transactional model of the
etiology of borderline personality disorder (BPD). It assumes that the
associated emotional dysregulation is not simply biological or family induced
but the result of a dynamic interaction between the biology and characteristics
of an individual with the individual's social environment. This paper discusses
the theoretical issues and empirical research relating to a synthesis of family
therapy and DBT with adolescents. A review of the literature identifies support
for a greater understanding and inclusion of families in treatment, attention to
relational aspects of affect, and a dialectical framework for synthesizing
individual-oriented and systemic-oriented theories and practice. Some
implications for the development of a DBT family therapy model are discussed.
Publication Types:
Review

77: Soc Work Health Care. 2002;36(1):29-44.
Empirically derived guidelines for assessing the psychosocial needs of children
and adolescents with sickle cell.
Burlew AK.
Mail Location #0376, University of Cincinnati, Cincinnati, OH 45221, USA.
rkburlew@juno.com
This paper introduces an empirically derived psychosocial assessment form that
may facilitate the incorporation of the growing body of research on sickle cell
into the psychosocial assessment process. The psychosocial assessment form was
guided by two theoretical models that explain the variability in adjustment
among children and adolescents with sickle cell--the Disability-Stress-Coping
Model (Wallender, Varni, Babani, Banis, & Wilcox, 1989) and the Transactional
Stress and Coping Model (Thompson, Gustafson, George Spock, 1994). The
Psychosocial Assessment Form consists of two sections. The first section
includes primary indicators of adjustment such as internalizing disorders,
externalizing disorders, school performance, and difficulties in social
relationships. The second section lists secondary indicators of adjustment
including intrapersonal factors, stress processing factors, and social
ecological factors. The literature that guided this form is also reviewed.
78: Rev Med Chil. 2002 Oct;130(10):1101-12.
[Occupational stress and health in a sample of chilean executives]
Guic E, Bilbao MA, Bertin C.
Escuela de Psicologia de la Pontificia Universidad Catolica de Chile, Vicuna
Mackenna 4860, Santiago, Chile. eguic@puc.cl
BACKGROUND: Most individual and organizational costs related to job stress are
due to preventable health problems. To study the impact of occupational stress
in Chile, an instrument that evaluates the different variables involved in the
stress process is required. AIM: To study the effects of work stressors and
psychological variables on health among Chileans managers. To study reliability
and validity of the Spanish version of the Occupational Stress Indicator
(OSI-2). SUBJECTS AND METHODS: A translated version of the OSI-2 was applied to
a sample of 264 white-collar managers. RESULTS: A high frequency of symptoms was
reported by our sample. Back pain was the most frequently reported symptom in
managers with high levels of stress. Regression analysis showed that, together,
work stressors and psychological characteristics significantly explained
self-perceived mental (27.6%) and physical (22.9%) health variance.
Responsibilities of the executive role were the stressors most highly associated
with poor stress outcomes. The psychological variables most strongly correlated
with mental and physical health were Problem-focused Coping and the subscale
Impatience of Type A Behavior. The reliability and validity of the OSI-2,
Spanish version, were reasonably high. CONCLUSIONS: The transactional model of
work stress was confirmed in a sample of Chilean managers evaluated with the
Spanish version of the OSI-2.
Publication Types:
Validation Studies
79: J Psychiatr Ment Health Nurs. 2002 Dec;9(6):667-71.
Suspicion, resistance, tokenism and mutiny: problematic dynamics relevant to the
implementation of clinical supervision in nursing.
Cottrell S.
Mental Health Directorate, Conwy & Denbighshire NHS Trust.
In this paper I will discuss some of the more common pitfalls inherent in
attempts to introduce clinical supervision to hospital wards or community teams.
I will consider pre-existing relationships and how these may, if unexamined and
unaccounted for, result in clinical supervision becoming less than optimally
effective. Drawing upon the theory of Transactional Analysis, in particular the
concept of 'psychological distance', I consider four possible interpersonal
dynamics and examine how these may impact upon the implementation of clinical
supervision. These problematic dynamics can result in undue resistance,
suspicion, tokenism or interpersonal difficulties. Finally, I will consider ways
in which the aforementioned problems may be addressed and their effects
minimized through the use of co-operative contracting.
Publication Types:
Review
Review, Tutorial
80: Arch Surg. 2002 Dec;137(12):1419-27; discussion 1427.
The power of servant leadership to transform health care organizations for the
21st-century economy.
Schwartz RW, Tumblin TF.
Office of Clinical Operations, Veterans Affairs Medical Center, Department of
Surgery, Chandler Medical Center, University of Kentucky, 800 Rose St,
Lexington, KY 40536-0298, USA. rschw01@pop.uky.edu
Physician leadership is emerging as a vital component in transforming the
nation's health care industry. Because few physicians have been introduced to
the large body of literature on leadership and organizations, we herein provide
a concise review, as this literature relates to competitive health care
organizations and the leaders who serve them. Although the US health care
industry has transitioned to a dynamic market economy governed by a wide range
of internal and external forces, health care organizations continue to be
dominated by leaders who practice an outmoded transactional style of leadership
and by organizational hierarchies that are inherently stagnant. In contrast,
outside the health care sector, service industries have repeatedly demonstrated
that transformational, situational, and servant leadership styles are most

successful in energizing human resources within organizations. This optimization
of intellectual capital is further enhanced by transforming organizations into
adaptable learning organizations where traditional institutional hierarchies are
flattened and efforts to evoke change are typically team driven and mission
oriented.
81: Aging Ment Health. 2002 Nov;6(4):325-42.
Coping with family caregiving to persons with dementia: a critical review.
Gottlieb BH, Wolfe J.
Department of Psychology, University of Guelph, Guelph, Ontario, Canada.
bgottlie@uoguelph.ca
Seventeen empirical studies that relate the ways of coping employed by family
caregivers of persons affected by dementia to their health and morale are
critically reviewed for the purposes of determining whether there is any
consensus regarding ways of coping that serve health-protective functions, and
whether the studies' designs and measurement strategies are faithful to the
transactional theory of coping upon which they are founded. Due to the use of
cross-sectional designs, the adoption of different coping and outcome measures,
the lack of specificity and the incomparability of the target stressors, the
reliance on retrospective reports, and the use of inappropriate response
formats, among other limitations, the interpretability of the cumulative body of
empirical findings on caregiver coping is questionable. Ways of strengthening
and broadening coping research to make it more fruitful and theoretically
coherent are presented.
Publication Types:
Review
Review, Tutorial
82: Homeopathy. 2002 Oct;91(4):239-48.
Comment in:
Homeopathy. 2002 Oct;91(4):195-6.
Patient-practitioner-remedy (PPR) entanglement. Part 1: a qualitative, non-local
metaphor for homeopathy based on quantum theory.
Milgrom LR.
Department of Chemistry, Imperial College of Science, Technology and Medicine,
London, UK. l.milgrom@ic.ac.uk
A metaphor for homeopathy is developed in which the potentised medicine, the
patient, and the practitioner are seen as forming a non-local therapeutically
'entangled' triad, qualitatively described in terms of the transactional
interpretation of quantum mechanics.
Publication Types:
Review
Review, Tutorial
83: J Abnorm Child Psychol. 2002 Oct;30(5):431-46.
Process, mechanism, and explanation related to externalizing behavior in
developmental psychopathology.
Hinshaw SP.
Department of Psychology, University of California, Berkeley 94720-1650, USA.
hinshaw@socrates.berkeley.edu
Advances in conceptualization and statistical modeling, on the one hand, and
enhanced appreciation of transactional pathways, gene-environment correlations
and interactions, and moderator and mediator variables, on the other, have
heightened awareness of the need to consider factors and processes that explain
the development and maintenance of psychopathology. With a focus on attentional
problems, impulsivity, and disruptive behavior patterns, I address the kinds of
conceptual approaches most likely to lead to advances regarding explanatory
models in the field. Findings from my own research program on processes and
mechanisms reveal both promise and limitations. Progress will emanate from use
of genetically informative designs, blends of variable and person-centered
research, explicit testing of developmental processes, systematic approaches to
moderation and mediation, exploitation of "natural experiments," and the conduct
of prevention and intervention trials designed to accentuate explanation as well
as outcome. In all, breakthroughs will occur only with advances in translational
research-linking basic and applied science-and with the further development of
transactional, systemic approaches to explanation.
Publication Types:
Review
84: Can J Occup Ther. 2002 Oct;69(4):229-38.
Environmental analysis: insights from sociological and geographical
perspectives.
O'Brien P, Dyck I, Caron S, Mortenson P.
School of Rehabilitation Sciences, University of British Columbia.
patti@simplynow.com
Recent conceptual models, such as the Canadian Model of Occupational
Performance, emphasize the transactional relationships between individuals,
their occupations, and the environments in which they live. Nevertheless,
further theoretical development is necessary in order to gain a comprehensive
understanding of the nature of interconnections between the environment,
occupation, and disability. This paper draws on concepts from sociology and
geography that can broaden our understanding of the environment and the manner
in which its different dimensions may influence individuals' experiences of
disability. The paper demonstrates how theoretical ideas from these disciplines
can be used to inform our understanding of the daily lives of three different
individuals: a senior with Bipolar Affective Disorder, a man with HIV/AIDS, and
a parent of a child with a severe disability. The paper concludes with a
discussion of the implications of the analysis for occupational therapy theory
and practice.
Publication Types:
Case Reports
85: Fam Process. 2002 Fall;41(3):519-32.
Links between community violence and the family system: evidence from children's
feelings of relatedness and perceptions of parent behavior.
Lynch M, Cicchetti D.
Department of Psychology, SUNY Genesco, 1 College Circle, Genesco, NY 14454,
USA. mlynch@genesco.edu
In this study, we examined some of the ways in which broader ecological systems
may influence the organization of behavior within the family system.
Specifically, links between exposure to community violence and children's
relationships with maternal caregivers were investigated in a sample of 127
urban children between the ages of 7 and 13 years. Children were asked to
indicate whether they had been exposed to a wide variety of violent events. In
addition, their feelings of relatedness and separation anxiety, and their
perceptions of maternal behavior were assessed. It was expected that exposure to
community violence would be associated with feeling less secure with caregivers.
Consistent with predictions from ecological-transactional theory, data supported
this hypothesis. Children who reported that they had been exposed to high levels
of community violence also indicated that they felt less positive affect when
with their caregiver, were dissatisfied with how close they felt to her, felt
more separation anxiety, and reported more negative maternal behavior than
children exposed to less violence. Findings are discussed in terms of how
violence may affect the family system and the protective function of human
attachment.
86: J Child Psychol Psychiatry. 2002 Sep;43(6):713-25.
Nighttime sleep-wake patterns and self-soothing from birth to one year of age: a
longitudinal intervention study.
Burnham MM, Goodlin-Jones BL, Gaylor EE, Anders TF.
Department of Psychiatry, UC Davis Medical Center, Sacromento, CA 95817, USA.
BACKGROUND: The objectives of this study were to: (1) describe the longitudinal
development of sleep-wake patterns of solitary-sleeping infants from 1 to 12
months of age, (2) identify effects on sleep patterns and on self-soothing
behaviors of introducing a novel sleep aid, and (3) identify predictive factors
of self-soothing at 12 months using a transactional model as a guide. METHODS:
Eighty infants' nighttime sleep-wake patterns and associated variables were

studied at 5 times across the first year of life using videosomnography and
questionnaires. RESULTS: Sleep-wake state developmental changes, as reported in
investigations of infant sleep, were replicated, although a great deal of
individual variability in the development of all sleep-related variables was
noted. No major effects on sleep or on self-soothing behavior were evident from
the introduction of the novel sleep aid. Three variables were identified as
significant predictors of self-soothing at 12 months: decreasing amounts of time
spent out of crib across the first year, high levels of quiet sleep at birth,
and longer parental response times to infant awakenings at 3 months.
CONCLUSIONS: These data lend preliminary support for the transactional model and
suggest that infant and parental factors interact to influence the development
of self-soothing.
Publication Types:
Clinical Trial
87: Aging Ment Health. 2002 Aug;6(3):239-47.
The process of a group intervention for caregivers of demented persons living at
home: conceptual framework, components, and characteristics.
Levesque L, Gendron C, Vezina J, Hebert R, Ducharme F, Lavoie JP, Gendron M,
Voyer L, Preville M.
Centre de recherche de l'Institut universitaire de geriatrie de Montreal,
Universite de Montreal, Province de Quebec, Canada.
levesqlo@magellan.umontreal.ca
Most earlier group interventions for caregivers of demented persons lacked a
theoretical basis to guide the intervention process and focused on providing
information and practical advice and encouraging the expression of feelings.
This article presents the process of a group intervention with emphasis on its
conceptual framework, components and characteristics. As caregivers are exposed
to numerous daily stressful demands, the intervention's conceptual framework was
derived from Lazarus and Folkman's transactional theory of stress and coping and
Folkman's Coping Effectiveness Training Program. The central aim of the
intervention was to improve the ability of caregivers to cope with the stressful
demands at the core of caring for a demented person, rather than to focus on
information and the task-oriented aspects of caring. The two components of the
intervention deal with the cognitive appraisal of stressors and coping
strategies, with a view to determining which strategies are most appropriate on
the basis of the changeability of stressors. Three coping strategies were
proposed: problem solving (problem-focused coping to deal with changeable
stressors), reframing (emotion-focused coping to manage the emotional response
to unchangeable stressors), and seeking social support (problem- or
emotion-focused coping). The most salient characteristics of this group
intervention were its intensity (15 meetings) and its focus on the caregivers'
daily reality, which provided concrete reference points for the discussion of
conceptual notions.
88: Int J Audiol. 2002 Jul;41(5):308-20.

Behavioural awareness, interaction and counselling education in audiological
rehabilitation: development of methods and application in a pilot study.
Borg E, Danermar B, Borg B.
Ahlsen Research Institute, Orebro University Hospital, Sweden.
anita.dandenell@orebroll.se
In conventional audiological rehabilitation, the hearing therapist interacts
with the hearing-impaired person and with significant others. In order to
strengthen the personality and self-confidence of the hearing-impaired
individual, a different strategy was designed and implemented whereby the
pedagogic interaction was directed only towards the hearing-impaired individual,
who in turn worked as a tutor/aid/counsellor to the communication partner. On
the basis of an interactive communication model, new methods for rehabilitation
of subjects with moderate hearing impairment were developed and evaluated in a
pilot study on 13 men with noise-induced hearing loss. A course programme was
developed with three main active components: (1) increased insight and
knowledge; (2) education as counsellors with the ability to focus on the
problems of the communication partner; and (3) motivation to change through
group discussion and reflexive conversation. Increased insight and knowledge
were obtained through test and training experiences in a sound environmental
chamber, tutorials and discussions. The pedagogic training focused on helping
the hearing-impaired subjects to become able communication counsellors in
relation to their interlocutors. An act-react, offensive-defensive paradigm was
used in conjunction with transactional analysis. Results of the pilot study were
evaluated using questionnaires, interviews and a method of dialogue analysis.
The results were evaluated for the hearing-impaired and the partner and in
recordings of conversations in the home environment. There were clearly positive
cognitive and emotional effects seen in the inquiries and interviews. The
observations from the dialogue analysis indicated only small effects, with the
exception of the two individuals with the most pronounced functional impairment,
for whom dialogue was improved after the course. It was concluded that these new
methods could contribute new possibilities in rehabilitation programmes,
emphasizing the shared responsibility for communication and the unique
competence and abilities of the hearing-impaired person.
Publication Types:
Evaluation Studies
89: Nippon Rinsho. 2002 Jun;60 Suppl 6:240-5.
[Psychotherapies of sexual dysfunction--therapies of psychogenic ED by
transactional analysis]
[Article in Japanese]
Shinzato R.
Faculty of Education, University of Ryukyus.
Publication Types:
Review
Review, Tutorial
90: Prof Inferm. 2001 Apr-Jun;54(2):90-4.
[Usefulness of transactional analysis in the management of nursing staff]
[Article in Italian]
Bruno E, Tranghese A.
Ostetricia e Ginecologia Azienda Ospedaliera San Giovanni-Addolorata, Roma.
Nowadays, a ward coordinator should own not only technical knowledge but
managements skills as well. Communication is an important tool for organizing
work team. The persons are core otherwise of the structure that could be the
hardstone otherwise unuseful in case of bad managing. Transitional analysis is a
valid mean for whom to menage interpersonal relationship.
91: Psychol Bull. 2002 Jul;128(4):596-601; discussion 602-11.
Comment on:
Psychol Bull. 2002 Jul;128(4):539-79.
Punishment revisited--science, values, and the right question: comment on
Gershoff (2002).
Parke RD.
Department of Psychology, University of California, Riverside 92521, USA.
ross.parke@ucr.edu
In this comment on E. T. Gershoff (2002), the author notes the historical phases
of punishment research. Punishment as a disciplinary tactic is best viewed as a
packaged variable and therefore needs to be investigated in the context of other
socialization practices. The role of parental values in this debate about
punishment utilization and effectiveness merits more consideration. New
directions in punishment research are also noted. These include the need for a
family-systems perspective, a family-typology approach, a transactional model of
punishment, the use of innovation observation and self-report methods, and more
culturally sensitive paradigms.
Publication Types:
Comment
92: Schweiz Arch Tierheilkd. 2002 Apr;144(4):187-90.
[The transactional stress model for the animal keeper]
[Article in German]
Hassig M, Vollrath M, Thun R.

Departement fur Nutztiere, Universitat Zurich. hassig@vetgeb.unizh.ch
A health problem of an animal or a group of animals represents a potential
stress situation for the animal keeper. In this article, the transactional
stress model, which was developed in social psychology was applied on the animal
keeper and shows, how he perceives the influence of animal care. If veterinary
help is considered relevant, it may lead to an improved coping, which affects
the health of the animal keeper and the animal as well. This viewpoint leads to
a cycle, in which cause, success, coping and utility are closely linked
together.
93: J Adolesc. 2002 Feb;25(1):125-31.
Personal agency and personality in adolescence: silent voices and findings.
Meeus W, Silbereisen RK, Nurmi JE.
Department of Child and Adolescent Studies, Utrecht, The Netherlands.
W.Meeus@fss.uu.nl
We discuss the studies reported in this special issue on the basis of a
descriptive framework. We conclude that implicit assumptions-silent voices, as
we call them-concerning the transactional influence between person and
environment, and concerning the primacy of personal agency exist side by side.
We find in the studies both a variable-centred and a person-centred approach,
and show that the person-centred approach can complement the variable-centred
approach in a fruitful manner. On the other hand, both approaches seem to lead
to similar results in the studies reported in this special issue. As a rule, the
approaches lead to characterization of categories of adolescents, and moreover
they can both be seen as exemplifying transactional thinking in the psychology
of adolescence. Personal agency and personality are systematically correlated
with developmental outcomes, but there are no strong indications that personal
agency and personality are important predictors of later developmental outcomes.
Such indications are found to a greater extent as regards the influence of
parenting and the quality of the parent-adolescent relationship. Finally, there
is evidence that peers have their own specific significance in the exploration
of developmental options. Copyright 2002 The Association for Professionals in
Services for Adolescents. Published by Elsevier Science Ltd. All rights
reserved.
Transformational leadership and moral reasoning.
Turner N, Barling J, Epitropaki O, Butcher V, Milner C.
Queen's School of Business, Queen's University, Kingston, Ontario, Canada.
nick.turner@sheffield.ac.uk
Terms such as moral and ethical leadership are used widely in theory, yet little
systematic research has related a sociomoral dimension to leadership in
organizations. This study investigated whether managers' moral reasoning (n =
132) was associated with the transformational and transactional leadership
behaviors they exhibited as perceived by their subordinates (n = 407). Managers
completed the Defining Issues Test (J. R. Rest, 1990), whereas their
subordinates completed the Multifactor Leadership Questionnaire (B. M. Bass & B.
J. Avolio, 1995). Analysis of covariance indicated that managers scoring in the
highest group of the moral-reasoning distribution exhibited more
transformational leadership behaviors than leaders scoring in the lowest group.
As expected, there was no relationship between moral-reasoning group and
transactional leadership behaviors. Implications for leadership development are
discussed.
95: Kyobu Geka. 2002 May;55(5):395-400.
[Surgical angioplasty of isolated left coronary ostial stenosis]
Shimakura T, Morishita A, Miyagishima M, Kawamoto J, Umehara N.
Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital,
Fukuyama, Japan.
A 42-year-old female had suffered from chest pain for approximately 1 month, and
was admitted with unstable angina pectoris. Emergent coronary angiography showed
an isolated 75% stenosis of the left coronary ostium. Repair of ostial stenosis
by vein patch angioplasty was done by the transactional superior approach.
Postoperative catheterization revealed an expanded left coronary orifice and the
patient was discharged without any complications. We have experienced 2 other
patients of isolated left coronary ostial stenosis, who had undergone double
coronary artery bypass grafting. Long-term coronary angiography showed
regression of ostial stenosis in 1 patient, and no progression of new lesions in
either. These results suggest that direct vein patch angioplasty of the ostial
lesion is an alternative procedure for isolated left coronary ostial stenosis.
Publication Types:
Case Reports
96: Nurs Stand. 2000 May 3-9;14(33):37-41.
Using transactional analysis to understand the supervisory process.
Holyoake DD.
Priory Adolescent Recovery Centre, Woodbourne Priory Hospital, Birmingham.
Most literature on supervision praises its ability to create space for
reflection, but seldom explores the disabling effects. Using the experiences of
four nurses, this article makes use of Berne's Transactional Analysis model as a
method for illuminating patterns within supervision. The article concludes that
the confessional nature of clinical supervision reflects contemporary practice

and the implications of supervision really appear to be an undercover policing
or enforcement of cultural/management objectives.
Publication Types:
Review
Review, Tutorial
97: Encephale. 2002 Mar-Apr;28(2):123-8.
[French translation and validation of the Tension-Effort Stress Inventory (TESI,
7) emotional list]
[Article in French]
Legrand F.
Laboratoire de Psychologie appliquee, UFR STAPS, 51687 Reims cedex, France.
Since emotion became a central topic in scientific psychology, a conceptual
consensus is needed with regard to its definition. Reversal theory provides such
a widely, comprehensive theory of emotion that is currently missing from the
psychology literature. According to reversal theorists, there are 16 primary
emotions corresponding directly to one's preferred and non preferred
phenomenological experiences. These include 4 pleasant/somatic emotions
(relaxation, excitement, placidity, provocativeness), 4 unpleasant/somatic
emotions (anxiety, anger, boredom, sullenness), 4 pleasant/transactional
emotions (pride, modesty, gratitude, virtue) and 4 unpleasant/transactional
emotions (humiliation, resentment, shame and guilt). Tension-Effort Stress
Inventory (TESI, is an auto questionnaire with the 3rd section containing this
16 primary emotions list. The aim of our study deals with french translation and
factorial validation of this list. Method and procedure - Participants (n=46)
were voluntary french speaking individuals who prepared to be involved in a new
tourist attraction established in a french winter sport resort. This attraction
is made up of a 950 meters-long carrying cable tightened to an altitude of 100
meters above the ground, offering anyone whose weight exceeds 40 kg a thrilling
90 km/h rush. Of the sample of 46 individuals, 29 were male and 17 were female.
The average age was 31,4 years with a 18-59 range and 7,7 as standard deviation
value. Each subject had to complete a french version of TESI just before being
hang on the cable and just after his or her arrival on the landing zone. Results
- Pre- and post-activity descriptive statistics for each item were subjected to
Pearson correlations calculation and then, an explanatory factorial analysis was
carried out. Principal component analysis results (after varimax rotation)
exhibited 6 factors explaining a proportion of 64% of the total variance: 4 of
these 6 dimensions seemed to be similar to the ones claimed by reversal theory;
1 dimension resembled a more popular conception of emotion experience which is
bad mood ; 1 composite dimension was more ambiguous (anxiety + modesty).
Confirmatory factorial analysis (carried out from variance/covariance matrix)
proved to be conclusive in assessing the fit of the data with regard to reversal
theory classification of emotions. Thus, the eight pleasant emotions were found
to be dichotomised into four somatic and four transactional emotions with
satisfactory fit indexes [GFI (Goodness of Fit Index)=0,92, residuals=0,09]. In
addition, the eight unpleasant emotions were also split up into 4 somatic and 4
transactional groupings with comparable ratings (GFI=0,93, residuals=0,07).
Conclusion - This french version of TESI emotional list appears to be suitable

in assessing one's phenomenological emotional experiences. The equipartition
according to pleasant/unpleasant and somatic/transactional dimensions meets the
original classification postulated by reversal theorists.
Publication Types:
Validation Studies
98: Int J Palliat Nurs. 2001 Jul;7(7):323-30.
A study of family carers of people with a life-threatening illness. 2:
Implications of the needs assessment.
Scott G.
University of Sheffield, School of Nursing and Midwifery, Sheffield, UK.
This is the second of two articles that consider the findings of a Carers'
Assessment of Difficulties Index (CADI) (Nolan et al, 1998) delivered in a
palliative care context. It analyses the implications of these findings for
practitioners concerned with the delivery of palliative care to such carers and
their families. The development of support strategies and services addressing
their needs are also presented against a backdrop of transactional stress
theory. For people new to caring, recommendations for the local service include
early intervention through informational support and validation of their
emotional responses to caring; for longer-term carers they include assistance
with cognitive reappraisal of the stressfulness of caring and regular 'respite'
and socializing opportunities. These are taking place in a political climate
that finally recognizes the contribution and value of carers (Department of
Health, 1999). The research behind these carer identity and recognition
initiatives aims to apply the spirit of public recognition and practical wisdom
of palliative care expertise by responding sensitively to the specific needs of
carers of people with a life-threatening illness.
Publication Types:
Review
Review, Tutorial
99: Soins Pediatr Pueric. 2000 Nov-Dec;(197):26-9.
[The "parentified" child, a concept of contextual approach]
[Article in French]
Ajili G, Michard P.
100: Krankenpfl Soins Infirm. 2001;94(8):83.
[The "mobber": a victim himself?]
[Article in French]
Virgili-Crettaz C.
101: Krankenpfl Soins Infirm. 2000 Dec;93(12):14-5.
[Transactional analysis. Autonomy in communication]
[Article in German]
von Gunten T.
102: J Abnorm Child Psychol. 2002 Feb;30(1):77-88.
Responsiveness in interactions of mothers and sons with ADHD: relations to
maternal and child characteristics.
Johnston C, Murray C, Hinshaw SP, William EP Jr, Hoza B.
Department of Psychology, University of British Columbia, Vancouver, Canada.
cjohnston@cortex.psych
We observed mother-child interactions, at baseline, in 136 families of
7-10-year-old boys with attention-deficit/hyperactivity disorder (ADHD) who were
part of a large clinical trial, the Multimodal Treatment Study of Children with
ADHD. Independent coders rated stylistic aspects of maternal behavior and factor
analyses revealed a responsiveness factor that included overall responsiveness
and sensitivity to the child, warmth and acceptance, and appropriate control. We
examined relations between maternal responsiveness and (a) maternal depressive
symptoms and maternal childhood ADHD symptoms, and (b) boys' ADHD and conduct
problem symptoms. Controlling for all other variables, maternal responsiveness
displayed a unique negative association with mother-reported child conduct
problems, but not with child ADHD symptoms, and also was negatively related to
maternal depressive symptoms. We discuss the unique association between
mother-reported child conduct problems and parenting, and note the utility of
studying parenting style in families of children with ADHD. We describe the
results within the framework of a transactional model.
103: Scand J Psychol. 2002 Feb;43(1):41-7.
Prenatal drug exposure and the conceptualization of long-term effects.
Moe V, Slinning K.
Institute of Psychology, University of Oslo, Norway. vibeke.moe@psykologi.uio.no
This paper discusses several factors affecting the development of children
prenatally exposed to drugs. In the "first generation" of research in this field
a main factor model of disease formed the basis for a belief in the feasibility
of detecting the direct pharmacological or teratogenic effects of drug exposure
on long-term child development. However, the clustering of confounding variables

has constituted a major problem in identifying these effects. In the last few
years a "second generation" of research in this field has emerged, and
investigators have moved beyond simple main-effect models. The importance of
controlling for confounding variables has been underscored. However, prenatal
substance exposure is still often studied within a teratology model where the
main goal is the search for unique effects of a specific drug or substance.
Based on this review it is suggested that an appropriate model for understanding
the development of drug-exposed children cannot be based on a main-effect
perspective. Rather, such a model must evolve from a contextual perspective, and
it is suggested that a transactional model, where both potential risk factors
and protective factors are considered, should replace the traditional teratology
model in this field.
104: Intensive Crit Care Nurs. 2001 Aug;17(4):228-36.
Dissonant imperatives in nursing: a conceptualization of stress in intensive
care in Sweden.
Cronqvist A, Theorell T, Burns T, Lutzen K.
Department of Nursing, Karolinska Institutet, Stockholm, Sweden.
agneta.cronqvist@omv.ki.se
The aim of this study was to explore nurses' experiences of stress within the
context of intensive care. The theoretical perspective for the study builds on a
cognitive-phenomenological-transactional theory of stress and coping and the
theory of cognitive dissonance. Respondents were 36 registered nurses recruited
from 10 intensive care units (general, neonatal and thoracic units). Their
experience as nurses ranged from one to 32 years. These intensive care units had
similar structural characteristics, namely a high working pace, advanced
technology, constrained finances, frequent reorganizations, a shortage of
registered nurses and all were filled to overcapacity. Data were collected in
open-ended interviews that were audio-taped and transcribed. A content analysis
identified four contradictory themes: (1) controlled by the work
situation--needing to be in control; (2) constrained by prioritization--wanting
to do more; (3) lacking the authority to act--knowing that something should be
done; and (4) professional distance--interpersonal involvement. These four
themes were synthesized at a higher level of abstraction into a main theme:
stress induced by dissonant imperatives, which conceptualizes nursing stress in
the intensive care unit. In conclusion, dissonant imperatives might lead to
stress in intensive care nursing.
105: J Behav Med. 2002 Feb;25(1):17-31.
Relation of diabetic patients' health-related control appraisals and
physician-patient interpersonal impacts to patients' metabolic control and
satisfaction with treatment.
Auerbach SM, Clore JN, Kiesler DJ, Orr T, Pegg PO, Quick BG, Wagner C.
Department of Psychology, Virginia Commonwealth University, Box 842018,
Richmond, Virginia 23284, USA.

Desire for healthcare control, health locus of control, perceived control over
diabetes, satisfaction with diabetes treatment, and general personality traits
were assessed in 54 Type 1 and Type 2 diabetic patients of the same male
endocrinologist during a regularly scheduled office visit. At the end of the
consultation, both patients and the physician completed a measure describing the
interpersonal impacts produced in each by the other's control and affiliation
behaviors. Patient success at diabetes control was assessed via glycosylated
hemoglobin A1C (HA1C) level on the day of the visit and variability in HA1C
levels across several visits. Patients' satisfaction with treatment was
unrelated to diabetes control measures. Patients' desire for behavioral
involvement in their own healthcare and NEO Agreeableness scores were positively
associated with diabetes control. Better diabetes control also resulted when the
physician perceived patients to be more controlling and less submissive, and
when there was more reciprocity in patient and physician's perceptions of the
other's controlling interpersonal behavior. Findings support the conclusion that
both a patient's self-reported desire for involvement in his or her healthcare
and the transactional fit of patient-physician interpersonal behaviors are
potentially important contributors to better diabetes outcomes.
106: Psychol Rep. 2001 Dec;89(3):663-6.
Leaders' bases of social power and anticipation of targets' resistance as
predictors of transactional and transformational leadership.
Barbuto JE Jr, Fritz SM, Matikin GS.
University of Nebraska-Lincoln, USA.
This paper examines the value of power and resistance for predicting
transactional and transformational leadership. A sample of 232 leader-follower
dyads was used to examine these relationships using Hinkin and Schriesheim's
1989 measure of power, Barbuto's 2000 measure of resistance, and Bass' 1985
measure of transformational leadership. Analysis yielded a significant negative
relationship between leaders' Reward Power and their use of Individualized
Consideration.
107: Spinal Cord. 2002 Jan;40(1):23-9.
Linkages between coping and psychological outcome in the spinal cord lesioned:
development of SCL-related measures.
Elfstrom ML, Ryden A, Kreuter M, Persson LO, Sullivan M.
Health Care Research Unit, Goteborg University, Sweden.
STUDY DESIGN: Cross-sectional. OBJECTIVES: To investigate relationships between
coping and mental well-being with clinical relevance to spinal cord lesion
(SCL). SETTING: The Gothenburg Spinal Injuries Unit in Sweden. METHODS: The
study sample comprised 274 persons. From in-depth interviews, literature
reviews, and the transactional theory of stress and coping, items reflecting
coping and psychological outcome, respectively were generated. Principal

components factor analysis, multi-trait analysis, and structural equation
modelling were used. RESULTS: The coping scale comprised three factors:
Acceptance (i.e. revaluation of life values); Fighting spirit (i.e. efforts to
behave independently); Social reliance (i.e. a tendency towards dependent
behaviour). The outcome scale included the factors: Helplessness (i.e. feeling
perplexed, out of control and low self-esteem); Intrusion (i.e. bitterness and
brooding); Personal growth (i.e. positive outcomes of life crisis). Acceptance
showed a positive relation to Personal growth and was inversely related to both
Helplessness and Intrusion. Fighting spirit had a weak negative association to
Helplessness and a weak positive association to Personal growth. Social reliance
was positively related to Helplessness and Intrusion. Only Social reliance
showed any association to neurological status. Those lesioned 1-4 years reported
more Helplessness, Intrusion, Social reliance, and less Acceptance than those
lesioned >or=5 years. CONCLUSION: Coping is related to psychological outcome in
SCL. Our situational coping measure may be a candidate to assess intervention
effects.
108: Eur Child Adolesc Psychiatry. 2001;10 Suppl 1:I19-25.
The role of non-specific factors in treatment outcome of psychotherapy studies.
Chatoor I, Krupnick J.
Children's National Medical Center, Washington, DC 20010, USA.
Non-specific factors refer to dimensions that are shared by most psychotherapies
and include the therapeutic alliance, the therapist's competence and adherence
to the treatment protocols whereas specific factors refer to the specific
techniques and interventions that characterize particular psychotherapies.
Review of the literature on non-specific treatment factors reveals that the
therapeutic alliance and therapist competence may vary among patients and
therapists, and that the therapeutic alliance also varies among treatment
modalities. All three non-specific treatment factors, therapeutic alliance,
therapist competence and adherence to the specific treatment modality,
contribute significantly to treatment outcome and may account for more of the
variance in outcome than specific treatment approach. Consequently, these
factors need to be considered in the design of psychotherapy studies. In this
paper we use the treatment study of infantile anorexia as an example of how to
integrate these non-specific factors in the study design and the data analysis
of treatment outcome in a psychotherapy study.
109: J Clin Psychol. 2002 Feb;58(2):195-205.
Comment on:
J Clin Psychol. 2002 Feb;58(2):139-44.
An interpersonal communication perspective on resistance in psychotherapy.
Van Denburg TF, Kiesler DJ.
Department of Psychology, Transylvania University, Lexington, KY 40508-1797,

USA. TVANDENBURG@TRANSY.EDU
This article discusses resistance in psychotherapy using the contemporary
interpersonal communication model of psychotherapy. This perspective defines
resistance as moments during sessions when the patient and therapist are
interacting with one another in such a way that the patient is kept from
becoming aware of any covert experiences or transactional patterns that are
conflictual and anxiety provoking. The ways in which resistance may be
conceptualized and worked with are discussed and applied to three patient
vignettes, with an emphasis on working with resistances as they are manifested
in the patient-therapist relationship. Some of the potential reactions of the
therapist to resistance are discussed, including some relatively beneficial and
some problematic instances. Copyright 2002 John Wiley & Sons, Inc.
Publication Types:
Case Reports
Comment
110: Health Educ Res. 2001 Dec;16(6):671-92.
Consumer health information seeking on the Internet: the state of the art.
Cline RJ, Haynes KM.
Department of Health Science Education, University of Florida, Gainesville
32611, USA.
Increasingly, consumers engage in health information seeking via the Internet.
Taking a communication perspective, this review argues why public health
professionals should be concerned about the topic, considers potential benefits,
synthesizes quality concerns, identifies criteria for evaluating online health
information and critiques the literature. More than 70 000 websites disseminate
health information; in excess of 50 million people seek health information
online, with likely consequences for the health care system. The Internet offers
widespread access to health information, and the advantages of interactivity,
information tailoring and anonymity. However, access is inequitable and use is
hindered further by navigational challenges due to numerous design features
(e.g. disorganization, technical language and lack of permanence). Increasingly,
critics question the quality of online health information; limited research
indicates that much is inaccurate. Meager information-evaluation skills add to
consumers' vulnerability, and reinforce the need for quality standards and
widespread criteria for evaluating health information. Extant literature can be
characterized as speculative, comprised of basic 'how to' presentations, with
little empirical research. Future research needs to address the Internet as part
of the larger health communication system and take advantage of incorporating
extant communication concepts. Not only should research focus on the 'net-gap'
and information quality, it also should address the inherently communicative and
transactional quality of Internet use. Both interpersonal and mass communication
concepts open avenues for investigation and understanding the influence of the
Internet on health beliefs and behaviors, health care, medical outcomes, and the
health care system.
Publication Types:
Review
111: J Fam Psychol. 2001 Dec;15(4):627-45.
Transmission and transaction: predicting adolescents' internalization of
parental religious values.
Flor DL, Knapp NF.
Institute for Behavioral Research, University of Georgia, USA.
theflors@bellsouth.net
Data in this study supported a model of internalization that included both
transmission and transactional variables. Two sets of hierarchical linear
regression models were conducted on data collected from the fathers, mothers,
and adolescents (10 to 12 years old) in 171 intact Caucasian families. One set
predicted adolescent religious behavior; the other predicted the importance of
religion to child. Transmission variables (parental religious behavior and
parental desire for child to be religious) predicted the most variance in all
models. Dyadic discussions of faith (transactional) predicted significant
variance in all models. Child gender had a direct effect only on adolescent
religious behavior. A significant 3-way interaction occurred between child
gender, parental desire for child to be religious, and dyadic discussions when
predicting importance of religion to child, with child and parent gender dyads
interacting in a complex manner.
112: Z Kinder Jugendpsychiatr Psychother. 2001 Nov;29(4):297-311.
[Antisocial behavior in adolescence: risk factors and developmental types]
[Article in German]
Laucht M.
Klinik fur Psychiatrie und Psychotherapie des Kindes- und Jugendalters,
Zentralinstituts fur Seelische Gesundheit in Mannheim.
laucht@as200.zi-mannheim.de
Both the intensity and prevalence of violence and delinquency among children and
adolescents have continued to rise during the past fifteen years. Efforts to
counteract this development may benefit from recent evidence from developmental
psychopathology and neurobiology. A model proposed by Moffitt describes two
developmental pathways into antisocial problem behavior: one path characterized
by an early onset and a stable course of symptoms ("life-course persistent") and
the other by an episodic ("adolescence-limited") occurrence of anti-social
behavior. While in the latter the specific developmental tasks and life
circumstances of adolescence play a major role in the pathogenesis, persistent
antisocial behavior is perceived to be a result of a transactional process
between child and environment. Apart from psychosocial factors, biological
predispositions (genetic susceptibility) and psychological dispositions
(temperament and personality characteristics) are of primary interest. The
recent progress in neurobiological and personality research promises significant

insights into the underlying pathogenetic mechanisms. Integrating these
approaches may help in targeting prevention and early intervention programs to
high-risk groups and may thus contribute to improving their effectiveness.
Publication Types:
Review
Review, Tutorial
113: J Pers Soc Psychol. 2001 Dec;81(6):1190-204.
Personality-Relationship transaction in young adulthood.
Neyer FJ, Asendorpf JB.
Institut fur Psychologie, Humboldt-Universitat zu Berlin, Germany.
neyer@rz.hu-berlin.de
Personality and social relationships were assessed twice across a 4-year period
in a general population sample of 489 German young adults. Two kinds of
personality-relationship transaction were observed. First, mean-level change in
personality toward maturity (e.g., increase in Conscientiousness and decrease in
Neuroticism) was moderated by the transition to partnership but was independent
of other developmental transitions. Second, individual differences in
personality traits predicted social relationships much better than vice versa.
Specifically, once initial correlations were controlled for, Extraversion,
Shyness, Neuroticism, self-esteem, and Agreeableness predicted change in various
qualities of relationships (especially with friends and colleagues), whereas
only quality of relationships with preschool children predicted later
Extraversion and Neuroticism. Consequences for the transactional view of
personality in young adulthood are discussed.
114: Psychol Bull. 2001 Nov;127(6):773-96.
Development of gender differences in depression: an elaborated cognitive
vulnerability-transactional stress theory.
Hankin BL, Abramson LY.
Department of Psychology, University of Illinois at Chicago, 60607, USA.
hankinb@uic.edu
Descriptive epidemiological studies are reviewed, showing that the female
preponderance in depression begins to emerge around age 13. A developmentally
sensitive, elaborated cognitive vulnerability-transactional stress model of
depression is proposed to explain the "big fact" of the emergence of the gender
difference in depression. The elaborated causal chain posits that negative
events contribute to initial elevations of general negative affect. Generic
cognitive vulnerability factors then moderate the likelihood that the initial
negative affect will progress to full-blown depression. Increases in depression
can lead transactionally to more self-generated dependent negative life events
and thus begin the causal chain again. Evidence is reviewed providing
preliminary support for the model as an explanation for the development of the
gender difference in depression during adolescence.
Publication Types:
Review
Review, Tutorial
115: Attach Hum Dev. 2001 Sep;3(2):222-37.
Age at placement, adoption experience and adult adopted people's contact with
their adoptive and birth mothers: an attachment perspective.
Howe D.
University of East Anglia, Norwich, UK. d.howe@uea.ac.uk
Adoption holds particular interest for attachment researchers. Although children
adopted as babies experience almost continuous care by their adoptive parents,
older placed children experience at least one major change of caregiver when
they join their adoptive family. Moreover, in the majority of cases, older
placed children have generally suffered a pre-adoption history of abuse, neglect
and/or rejection. It is now being recognized that older placed children's
attachment histories and internal working models (IWMs) established in
relationship with their initial carers remain active in relationship with their
new carers. Transactional models have helped both researchers and practitioners
to understand the dynamics of parent-child relationships in cases where insecure
children with histories of neglect, abuse and rejection find themselves in new
caregiving environments. The present study examines the childhood experiences of
adult adopted people and their current levels of contact with their adoptive
mothers, and in cases where people had searched for and found a birth relative,
current levels of contact with their birth mother. Although no information was
collected on the adopted adult's pre-placement history, age at placement was
used as a proxy measure to examine whether older placed children reported
different adoption experiences and what their current levels of contact were
with their adoptive and birth mothers. The findings show that age at placement
was associated with adopted people's reported experiences of being adopted and
current rates of contact with their adoptive and birth mothers, with those
placed at older ages most likely to report that they (1) did not feel they
belonged in their adoptive families while growing up, (2) did not feel loved by
their adoptive mother, (3) were least likely to remain in high-frequency contact
with their adoptive mother, and (4) were least likely to remain in
high-frequency contact with their birth mother. An attachment perspective is
used to interpret the findings. Children adopted at older ages appear more
likely to have experienced an insecure attachment relationship with their
adoptive mother.
116: Wien Med Wochenschr. 2001;151(15-17):364-74.
[Further development of established psychotherapies: "What you have inherited
from your fathers..." (Goethe)]
[Article in German]
Franzke E.
Psychoterapie-enheten, Psykiatriska Klinikerna, Vaxjo, Schweden.
In a somehow playful creative "living-learning-process" a rich and
differentiated "material" of more or less useful forms of communication will
appear. After that, possibilities of a better, up to optimal and individual
patterns of communication will be operated. Thereby, the following items will
have a central position: 1. personality-/character-structural factors, 2.
correlated individual tendencies and basic forms of anxieties, and 3. early
considered availability of special Ego-functions.
Publication Types:
Review
Review, Tutorial
117: Scand J Psychol. 2001 Sep;42(4):335-47.
Personality and stress.
Vollrath M.
Department of Psychology, University of Zurich, Switzerland.
vollrath@sozpsy.unizh.ch
Recent years have witnessed an upsurge of interest in how personality affects
the stress process. This paper reports on a broad spectrum of findings on the
relationships between personality and stress, taking transactional stress theory
as the point of departure. A first part outlines the different approaches stress
research has taken within personality psychology as opposed to research based on
transactional stress theory and discusses the debate between these two
paradigms. The second part gives an overview of empirical findings, with a focus
on the Big Five personality factors, in order to demonstrate that personality
affects the stress process in every aspect. The discussion suggests that we
address unresolved problems of transactional stress research in the framework of
interactionist personality psychology. Special attention ought to be given to
developing a better understanding of situational characteristics,
stress-producing mechanisms, and the functions of situational choices and coping
strategies for personality.
Publication Types:
Review
Review, Tutorial
118: J Adv Nurs. 2001 Aug;35(4):533-42.
Leadership, organizational stress, and emotional exhaustion among hospital
nursing staff.
Stordeur S, D'hoore W, Vandenberghe C.
Department of Public Health, Centre des Sciences Hospitalieres, Universite

catholique de Louvain, 30, Clos Chapelle-aux-Champs, 1200 Brussels, Belgium.
stordeur@hosp.ucl.ac.be
STUDY'S RATIONALE AND OBJECTIVES: We examined the effect of work stressors and
head nurses' transactional and transformational leadership on the levels of
emotional exhaustion experienced among their staff. METHODOLOGICAL DESIGN AND
RESEARCH METHODS: A questionnaire was sent to all nurses of a university
hospital. Usable returns were received from 625 nurses, giving a response rate
of 39.2%. Data were treated using correlational analyses and multiple
regression. The latter modelled stressors and leadership as predictors of
nurses' reported emotional exhaustion. MEASURES: Work stressors were assessed
using the Nursing Stress Scale (NSS) which comprises 34 items divided into three
subscales (referring to stress from the physical, psychological, and social
environment), and the role ambiguity (three items) and conflict (three items)
scales. Leadership was measured with the Multifactor Leadership Questionnaire.
RESULTS: In regression analyses, work stressors as a whole were found to explain
22% of the variance in emotional exhaustion whereas leadership dimensions
explained 9% of the variance in that outcome measure. Stress emanating from the
physical and social environment, role ambiguity, and active
management-by-exception leadership were significantly associated with increased
levels of emotional exhaustion. Transformational and contingent reward
leadership did not influence emotional exhaustion. LIMITATIONS: A limitation of
this study is that it considered only the emotional exhaustion dimension of
burnout. Also, as data were cross-sectional in nature, conclusions regarding the
direction of causality among variables cannot be drawn. CONCLUSIONS: This study
provided, for the first time, a test of the influence of leadership on burnout
among nurses, taking into account the role of work stressors. Future research is
needed to examine if the effects reported herein can be replicated using the two
other dimensions of burnout (depersonalization and reduced personal
accomplishment).
Major depression and the stress system: a life span perspective.
Meyer SE, Chrousos GP, Gold PW.
Clinical Neuroendocrinology Branch, National Institute of Mental Health,
Bethesda, MD 20892-1284, USA. meyer104@gold.tc.umn.edu
From a transactional developmental perspective, the authors review findings from
studies of animals and humans regarding a proposed relation between stress
system abnormalities and major depression. The stress system has evolved to
promote successful adaptation across the life span, but disruptions in its
functioning may increase the risk of pathological outcomes. Emphasis is placed
on the role of prenatal and early postnatal experience in contributing to
individual differences in postnatal stress reactivity, which may interact with
cognitive and psychosocial vulnerabilities to increase susceptibility to later
onset of depression. Findings regarding cognitive, psychosocial, and medical
sequelae of depression are also reviewed, with a focus on the possible mediating
role of the stress system. The authors highlight the importance of
multidisciplinary, longitudinal studies in attempting to gain a deeper
understanding of the complex developmental processes involved in the onset and
course of depression.
Publication Types:
Review
Review, Tutorial
120: J Abnorm Child Psychol. 2001 Aug;29(4):317-29.
Dynamic analyses of mother-child interactions in functional and dysfunctional
dyads: a synergetic approach.
Dumas JE, Lemay P, Dauwalder JP.
Department of Psychological Sciences, Purdue University, West Lafayette, Indiana
47907, USA.
Describes the application of a new analytical approach (derived from
synergetics, a complex dynamic systems theory) to home observational data of
mother-child interactions in average dyads and dyads with children referred for
disruptive behavior problems at home and school (n = 11 in each group). Results
show that (1) the two groups differed in their daily interactions in predictable
ways, and (2) the most frequent patterns of interactions observed in the two
groups brought them back repeatedly to behave in similar ways toward each other.
The findings are in keeping with a body of literature on mother-child
interactions. However, they add to it by providing multivariate. graphical
representations of these interactions and by offering a conceptual framework
within which to move from an observational to an inferential level of analysis.
At that level, the transactional processes that are characteristic of functional
and dysfunctional relationships may become apparent.
121: Psychol Rep. 2001 Jun;88(3 Pt 1):832-4.
Determinants of coping: some alternative explanations and measurement issues.
Dewe P.
Department of Organizational Psychology, Birkbeck College, University of London,
Malet Street, London WC 1E 7HX, England. p.dewe@bbk.ac.uk
The determinants of coping may be better understood if we considered the
different constructs--stressors, strain, and coping within a transactional
framework: a framework wherein stress is viewed as resulting from the
transaction between the individual and the environment. Adopting such an
approach may also require researchers to consider how stressful encounters are
appraised--the meanings given to events, how coping strategies are classified,
and how they are used in the coping process, whether linear additive coping
scores really tell us anything about how individuals actually cope and whether
it is now time to consider alternative methodologies if we are to better
understand the complexities of the stress process.
122: J Consult Clin Psychol. 2001 Jun;69(3):481-8.

Appraisals of controllability and coping in caregivers and HIV+ men: testing the
goodness-of-fit hypothesis.
Park CL, Folkman S, Bostrom A.
Department of Psychology, University of Connecticut, Storrs 06269, USA.
clpark@uconnvm.uconn.edu
The authors examined goodness of fit between controllability appraisals and
coping in 82 HIV+ and 162 HIV-gay men experiencing the chronic stress of
caregiving and 61 HIV+ gay men who were not caregiving. Multiple assessments of
each individual over a 2-year period allowed replication of prior
cross-sectional research examining goodness of fit, as well as the creation of
intraindividual goodness-of-fit scores that were then used to examine
within-person fluctuations in goodness of fit over time and goodness of fit as
an individual difference variable related to adjustment. Results indicate that
the importance of goodness of fit varies for different kinds of coping: The
concept was supported for problem-focused coping and, to a lesser extent, for
emotion-focused coping but not for meaning-focused coping. Within-subject
variation in goodness of fit was related to within-subject variation in
depressed mood, but between-subjects variation (individual differences) in fit
was not associated with depressed mood, suggesting that goodness of fit is
better understood as a transactional variable than as a personality or "coping
style" variable.
123: Pacing Clin Electrophysiol. 2001 Jul;24(7):1113-7.
Young at heart: understanding the unique psychosocial adjustment of young
implantable cardioverter defibrillator recipients.
Sears SF Jr, Burns JL, Handberg E, Sotile WM, Conti JB.
Department of Clinical and Health Psychology, University of Florida,
Gainesville, Florida, USA. ssears@hp.ufl.edu
This article reviews the data related to psychosocial adjustment of young ICD
recipients, postulates theories to explain potential adjustment difficulties to
ICD therapy experienced by younger recipients, and suggests clinical management
techniques for addressing the unique psychosocial concerns of young ICD
recipients. Studies of young ICD recipients suggest that a wide range of
psychosocial adjustment issues are prominent in the post-ICD implantation period
and that the issues may be different from older ICD recipients. The
disability-stress-coping model and the transactional-stress-coping model are
postulated as explanations for the unique adjustment concerns of children and
adolescents with ICDs. Social comparison theory is also applied to the concerns
of young adults with ICDs such that they often lack same age peers to compare
experiences with cardiac difficulties. Brief, clinic-based interventions by
health care providers, like a screening and referral heuristic and an "ICD
Buddy" system, are suggested to increase effective coping and decrease social
isolation for young ICD recipients.
Publication Types:
Review
Review, Tutorial
124: J Healthc Inf Manag. 2001 Summer;15(2):119-31.
Toward best practice: leveraging the electronic patient record as a clinical
data warehouse.
Ledbetter CS, Morgan MW.
Department of Medicine, University of Toronto.
Automating clinical and administrative processes via an electronic patient
record (EPR) gives clinicians the point-of-care tools they need to deliver
better patient care. However, to improve clinical practice as a whole and then
evaluate it, healthcare must go beyond basic automation and convert EPR data
into aggregated, multidimensional information. Unfortunately, few EPR systems
have the established, powerful analytical clinical data warehouses (CDWs)
required for this conversion. This article describes how an organization can
support best practice by leveraging a CDW that is fully integrated into its EPR
and clinical decision support (CDS) system. The article (1) discusses the
requirements for comprehensive CDS, including on-line analytical processing
(OLAP) of data at both transactional and aggregate levels, (2) suggests that the
transactional data acquired by an OLTP EPR system must be remodeled to support
retrospective, population-based, aggregate analysis of those data, and (3)
concludes that this aggregate analysis is best provided by a separate CDW
system.
125: J Healthc Inf Manag. 2001 Summer;15(2):107-17.
Life cycle of a data warehousing project in healthcare.
Verma R, Harper J.
University of California-Davis, USA.
Hill Physicians Medical Group (and its medical management firm, PriMed
Management) early on recognized the need for a data warehouse. Management
demanded that data from many sources be integrated, cleansed, and formatted. As
a first step, an operational data store (ODS) was built and populated with data
from the main transactional system; encounter data were added. The ODS has
served its purpose well and has whetted management's appetite for more
information and faster, more reliable access, all in one location. PriMed hired
Annams Systems Consulting (Annams) for this effort. A team was formed, made up
of consultants from Annams and members of PriMed's information services (IS)
team. The "classical" approach is being taken: enhancing the ODS, which is
largely normalized in structure, and integrating data from various sources,
along with enforcing business rules. The team is designing and implementing data
marts and a "star schema" style of data modeling--a useful tool for management
to evaluate results before investing further.
126: J Med Philos. 2001 Jun;26(3):285-98.

Acculturating human experimentation: an empirical survey in France.
Amiel P, Mathieu S, Fagot-Largeault A.
Institut Novexis, Paris, France. amiel@novexis.com
Preliminary results of an empirical study of human experimentation practices are
presented and contrasted with those of a survey conducted a hundred years ago
when clinical research, although tolerated, was culturally deviant. Now that
biomedical research is both authorized and controlled, its actors (sponsors,
committees, investigators, subjects) come out with heterogeneous rationalities,
and they appear to be engaged in a transactional process of negotiating their
rationales with one another. In the European context "protective" of subjects,
surprisingly the subjects we interviewed (and especially patient-subjects) were
creative and revealed an aptitude for integrating experimental medicine into
common culture.
Publication Types:
Historical Article
127: J Pastoral Care. 2001 Summer;55(2):147-57.
Using a modification of the classic Drama Triangle to enhance pastoral care.
Hasty C.
Department of Pastoral Care and Education, Carolinas Medical Center, Charlotte,
NC 28232-2861, USA.
Describes the Drama Triangle of Victim-Persecutor-Rescuer conceptual model and
suggests helpful ways to use it in order to understand and intervene in the
difficult situations often encountered by pastors, pastoral counselors, and
chaplains. Attempts to join this conceptual model to a theological understanding
of persons to deepen self-examination, ground pastoral identity, and enhance
pastoral competence.
128: Biol Psychiatry. 2001 Jun 15;49(12):1101-10.
Prevention of childhood depression: recent findings and future prospects.
Beardslee WR, Gladstone TR.
Judge Baker Children's Center, Children's Hospital, Boston, MA 02115, USA.
Traditionally, research on childhood mood disorders has focused on clinical
trials and longitudinal course and outcome studies, rather than on prevention.
Recently, however, advances in the design, methodology, and evaluation of
prevention approaches and progress in understanding what factors predispose
children to depression have made possible the development of theoretically
driven, empirically justified approaches to the prevention of depression in

youngsters who are at high risk, either because of elevated symptom levels or
parental mood disorder. In this review, we outline recent empirical findings on
risk factors for depression in nonreferred samples of youngsters and also in
children of depressed parents. Additionally, we review three trials of
preventive interventions for childhood depression that yield promising initial
findings. We emphasize the need to understand both risks for depression and
factors that protect youngsters at risk from succumbing to depression in guiding
the development of prevention programs. We also argue that consideration of
prevention of depression requires addressing broader social adversity influences
that lead to poor mental health outcomes in children, even beyond the effects of
parental mood disorder. We conclude with an emphasis on the importance of a
developmental-transactional perspective that highlights opportunities for
intervention at different points across the lifespan.
Publication Types:
Review
Review, Tutorial
129: J Nurs Educ. 2001 May;40(5):203-9.
Academic leadership style predictors for nursing faculty job satisfaction in
Taiwan.
Shieh HL, Mills ME, Waltz CF.
School of Nursing, Chung Shan Medical and Dental College, Taichung, Taiwan.
The purpose of this study was to examine the influence of nursing deans' and
nursing directors' transformational and transactional leadership styles on
nursing faculty job satisfaction in baccalaureate and associate degree nursing
programs in Taiwan. The study provides a mechanism by which nursing deans or
nursing directors can obtain feedback from nursing faculty about leadership
styles. Such feedback can then serve as the basis for further development of
academic nursing leadership potential in Taiwan. The theory of transformational
versus transactional leadership style guided this study. A cross-sectional
mailed survey design was conducted. A convenience sample of 233 nursing faculty
participated in this study. Idealized influence, intellectual stimulation, and
contingent reward leadership styles significantly and positively predicted job
satisfaction. However, active management-by-exception significantly and
negatively predicted job satisfaction. Nursing leaders should implement
effective leadership styles. Study implications for nursing education
administration, limitations, and recommendations for future studies were
discussed.
130: Int J Lang Commun Disord. 2001;36 Suppl:429-34.
The Listening Skills Test--a new instrument to assess children's pragmatic
ability.
Lloyd P, Peers I, Foster C.
Department of Psychology, University of Manchester, Oxford Road, Manchester M13

9PL. lloydp@fs4.psy.man.ac.uk
Research has established that the development of autonomous (as opposed to
collaborative) communication skills, using referential communication speaker and
listener tasks, develops only slowly during the primary school years. Such a
finding has implications for the classroom which puts a premium on independent
language processing. Although the importance of oral language is recognised in
the National Curriculum, there has been little attempt to assess the ability
formally. The Listening Skills Test is a standardised pragmatic instrument
focusing on the 3 1/2-7 years age group. The test is in four parts and assesses
the ability to make judgements about the efficacy of verbal messages or
instructions. Tasks include relating messages to arrays of pictorial items,
making judgements about statements that refer to one complex picture, marking
routes on a street plan in response to an extended set of instructions, and the
ability to evaluate purely verbal utterances. The overall aim of the test is to
assess children's ability to make sense on their own of verbal information in a
decontextualised situation thought to represent the nature of much transactional
communication in the classroom. Suggestions for remediation that have arisen
from research conducted by the authors are also discussed.
131: Sangyo Eiseigaku Zasshi. 2001 Mar;43(2):27-31.
[Listener education]
Mishima N, Kubota S.
Listener education has usually been conducted as primary prevention in
occupational medicine. We report on the present state of listener education in
which the training focuses on active listening (AL). AL means the way of
listening to a person in the person-centered attitude (PCA) that is based on
Rogers' three conditions, i.e. empathy, unconditional positive regard, and
congruence. Although the need of this kind of training has been widely
described, there is a paucity of academic literature on this subject. This
review deals with listener education by dividing it into two types; one is
listener education in a narrow sense that consistently depends on the three
conditions, and the other is listener education in a broad sense that combines
other methods that have different orientations from Rogers' theory. As an
example of the former, Ikemi et al. reported the importance of the PCA, and
studies conducted by Kubota et al., Mishima et al., and Miyagi dealt with the
actual training. As an example of the later, Morisaki and Hamaguchi et al.
illustrated their training including other methods such as transactional
analysis in their studies. Finally, we point out not only that future research
needs to focus on the assessment of listener education, but also that AL needs
to be understood from the standpoint of developing workers' competency.
132: J Fam Psychol. 2001 Mar;15(1):82-94.
Linking parenting processes and self-regulation to psychological functioning and
alcohol use during early adolescence.
Brody GH, Ge X.
Department of Child and Family Development, Dawson Hall, University of Georgia,
Athens, Georgia 30602, USA. gbrody@arches.uga.edu
A longitudinal transactional model was tested linking parenting and youth
self-regulation to youths' psychological functioning and alcohol-use behavior.
Participants included one hundred twenty 12-year-olds, their mothers, and their
fathers from whom three waves of data were collected at 1-year intervals.
Teachers provided assessments of self-regulation, and parenting was assessed
from multiple perspectives, including youth reports, parent reports, and
observer ratings. Youths reported their psychological functioning and
alcohol-use behavior. The data supported the model. Parenting and youth
self-regulation were stable across time, and self-regulation was linked with
changes in harsh-conflicted parenting from Wave 1 to Wave 2. Parenting at Wave 2
was associated with youth self-regulation. Youth self-regulation at Wave 2
mediated the paths from parenting practices at Wave 2 to youth psychological
functioning and alcohol use at Wave 3.
133: J Psychosom Obstet Gynaecol. 2001 Mar;22(1):41-7.
Parents' coping in the neonatal intensive care unit: a theoretical framework.
Lau R, Morse CA.
Division of Neonatal Services, Royal Women's Hospital, and Victoria University,
Australia. laur@cryptic.rch.unimelb.edu.au
The conceptual framework that has been widely used to study the coping
strategies of parents of preterm infants in neonatal intensive care units (NICU)
has been the transactional model of stress and coping proposed by Lazarus and
colleagues. This model supports the cognitive system as the key factor in stress
transactions. The cognitive system produces an interpretation of events that
leads to making sense of numerous sensations and perceptions from both external
and social sources as well as from the internal physiological environment. The
individual cognitive system appraises stimuli in two ways: primary appraisal and
secondary appraisal. Another factor that may influence the individual's coping
effort is gender difference. Mothers and fathers of preterm infants have been
found to use different coping strategies to deal with the preterm birth. Other
factors such as personality traits and the perceived and actual availability of
social support may also influence the parents' coping effort. Implications for
clinical practice by the NICU interdisciplinary team are considered.
134: Int Nurs Rev. 2001 Mar;48(1):38-46.
The renaissance of clinical leadership.
Cook MJ.
Faculty of Health, St Martin's College, Lancaster, UK. m.cook@ucsm.ac.uk
The purpose of this work was to explore clinical nursing leadership. The
research was based on a critical examination of the leadership themes derived
from the nursing literature of the United Kingdom, the United States of America
and Australia, between 1992 and 1997. The work was also influenced by the
findings from semistructured interviews undertaken with five clinical leaders in
nursing from the United Kingdom, and study tours to both the United States of
America and Australia. The findings support a proposed leadership model as a
basis for further exploration and as a framework for contemplating clinical
leadership and leadership preparation. A model is presented that identifies
factors which influence leadership styles, such as external environment,
internal environment, experience and understanding. Four leadership styles are
outlined: transactional, transformational, connective and renaissance. These
leadership styles are linked to nursing care approaches. A second model provides
a basis for considering power and its impact in the workplace. Based on these
findings, the contents of a leadership preparation course are outlined.
Publication Types:
Review
Review, Tutorial
135: Dev Psychol. 2001 Mar;37(2):174-86.
Maternal intrusive support in the academic context: transactional socialization
processes.
Pomerantz EM, Eaton MM.
Department of Psychology, University of Illinois at Urbana-Champaign, USA.
pomerntz@uiuc.edu
Although transactional models of socialization have received support, there has
been little investigation of the processes involved. The goal of this research
was to move in this direction in the context of the socialization of
achievement. Mothers and their elementary school children (N = 166) took part in
an 18-month longitudinal study including a 2-week daily checklist. The results
suggested that children's low achievement elicits intrusive support from mothers
through 2 mechanisms. Mothers worried over their children's performance, and
this was associated with heightened intrusive support. Children's low
achievement manifested itself in uncertainty, which was linked to heightened
intrusive support. The achievement of children whose mothers frequently used
intrusive support improved over time but did not exceed that of children whose
mothers infrequently used intrusive support. Day-to-day analyses suggested that
although intrusive support promotes success, it also fosters failure for
low-achieving children.
136: Clin Child Fam Psychol Rev. 1999 Sep;2(3):129-48.
Toward a transactional conceptualization of oppositional defiant disorder:
implications for assessment and treatment.
Greene RW, Doyle AE.
Massachusetts General Hospital/Harvard Medical School, Boston 02114, USA.

The conceptualization and treatment of oppositional defiant disorder (ODD) has
been characterized by surprising homogeneity. In this paper evidence is
presented to underscore the heterogeneity within ODD, including research
demonstrating (a) the distinction between reactive and proactive forms of
aggression; (b) the importance of affective modulation and self-regulation, and
associated cognitive skills, in the development of the skill of compliance; and
(c) high levels of comorbidity between ODD and other disorders. The disparate
pathways that give rise to oppositional behavior suggest that different children
with ODD may require different forms of intervention. The necessity of a
transactional conceptualization, of achieving a comprehensive understanding of
the factors underlying the difficulties of individual children with ODD, and of
matching intervention ingredients to the specific needs of different children
and families is discussed.
Publication Types:
Review
Review, Tutorial
137: Adolescence. 2000 Winter;35(140):717-30.
"You have to have somebody watching your back, and if thats God, then thats
mighty big": the church's role in the resilience of inner-city youth.
Cook KV.
Department of Psychology, Gordon College, Wenham, Massachusetts 01984, USA.
cook@gordon.edu
This study was designed to explore Freeman's (1986) finding that the institution
that made the greatest contribution to male African-American youths'
socioeconomic success was the church. Thirty-two African-American,
Haitian-American, and Latino male and female teenagers--16 drawn from inner-city
Protestant churches and 16 comparison teenagers from the same communities-were
interviewed. The interviews revealed that churched teenagers were less stressed
and less likely to have psychological problems than were teenagers in the
comparison group. They also appeared more likely to be living with both
biological parents, less likely to have a family member on welfare, and more
likely to have a job when compared with the other teenagers. They described the
church as being central to their lives and as having multiple functions, many of
which have been identified in the resilience literature as contributing to
positive developmental outcomes. Results are interpreted in light of the
transactional model, and recommendations are made, such as expanding the role of
the church within these ethnic communities.
138: Dev Psychopathol. 2000 Autumn;12(4):555-98.
Stigma and mental disorder: conceptions of illness, public attitudes, personal
disclosure, and social policy.
Hinshaw SP, Cicchetti D.
Department of Psychology, University of California, Berkeley 94720-1650, USA.

The end of the last millennium witnessed an unprecedented degree of public
awareness regarding mental disorder as well as motivation for policy change.
Like Sartorius, we contend that the continued stigmatization of mental illness
may well be the central issue facing the field, as nearly all attendant issues
(e.g., standards of care, funding for basic and applied research efforts)
emanate from professional, societal, and personal attitudes towards persons with
aberrant behavior. We discuss empirical and narrative evidence for
stigmatization as well as historical trends regarding conceptualizations of
mental illness, including the field's increasing focus on genetic and
neurobiological causes and determinants of mental disorder. We next define
stigma explicitly, noting both the multiple levels (community, societal,
familial, individual) through which stigma operates to dehumanize and
delegitimize individuals with mental disorders and the impact of stigma across
development. Key developmental psychopathology principles are salient in this
regard. We express concern over the recent oversimplification of mental illness
as "brain disorder," supporting instead transactional models which account for
the dynamic interplay of genes, neurobiology, environment, and self across
development and which are consistent with both compassion and societal
responsibility. Finally, we consider educational and policy-related initiatives
regarding the destigmatization of mental disorder. We conclude that attitudes
and policy regarding mental disorder reflect, in microcosmic form, two crucial
issues for the next century and millennium: (a) tolerance for diversity (vs.
pressure for conformity) and (b) intentional direction of our species'
evolution, given fast-breaking genetic advances.
Publication Types:
Review
Review, Tutorial
139: J Manag Med. 2000;14(5-6):291-309.
Effective leadership within hospice and specialist palliative care units.
Barker L.
Yorkshire Hospice Peer Review Audit Project, NYCRIS, Cookridge Hospital, Leeds,
UK.
In this study the Repertory Grid interview technique was used to investigate
constructs of leadership held by a group of male and female senior managers from
within hospice and Specialist Palliative Care Units (SPCUs) in the UK. The
themes that emerged were compared with those from existing research models of
leadership. RESULTS: Men and women in these roles describe different constructs
of effective leadership. The women's constructs that emerged were predominantly
transformational, whilst the men's were predominantly transactional. Themes were
also identified in this study, which differed from previous studied, i.e. those
of political and environment awareness and the valuing of others' views
regardless of their status. These themes do not feature highly in other
research, and may be in response to the environment within which hospice and
specialist palliative care functions.

140: J Soc Psychol. 2000 Dec;140(6):751-73.
Coping style following acute stress in competitive sport.
Anshel MH, Williams LR, Williams SM.
Psychology Department, University of Wollongong, New South Wales, Australia.
The purpose of this study was to ascertain coping styles among competitive
athletes in response to various acute stressors. Specifically, the authors used
a 134-item survey to measure approach and avoidance coping styles, with
task-focused and emotion-focused coping tendencies nested hierarchically as
subdimensions under each. Australian and U.S. college-aged participants
indicated the extent to which they used approach, avoidance, task-focused, and
emotion-focused coping strategies (a 4-factor model) in response to selected
acute stressors experienced during sport competition. The authors computed
confirmatory factor analysis to test the theoretically driven model. The
criterion loading of .30 and above for each of the factors reduced the survey to
65 items. Findings indicated stronger links between the 2 approach constructs of
task- and emotion-focused coping than between the 2 avoidance constructs of
those subdimensions. The goodness-of-fit indices for the 4-factor model were
0.58 and 0.57 for Australian and U.S. samples, respectively, and .71 overall.
Concomitant low correlations between the 2 approach (0.18) and the 2 avoidance
dimensions (0.43) reflected relatively high residuals between stressors. In
general, psychometric analyses suggest that coping style may be more prevalent
in some situations than others, lending partial support for the transactional
model of coping.
141: Stud Health Technol Inform. 2000;77:1069-73.
Cryptographic framework for document-objects resulting from multiparty
collaborative transactions.
Goh A.
USM Computer Sciences, 11800 Penang, Malaysia.
Multiparty transactional frameworks--i.e. Electronic Data Interchange (EDI) or
Health Level (HL) 7--often result in composite documents which can be accurately
modelled using hyperlinked document-objects. The structural complexity arising
from multiauthor involvement and transaction-specific sequencing would be poorly
handled by conventional digital signature schemes based on a single evaluation
of a one-way hash function and asymmetric cryptography. In this paper we outline
the generation of structure-specific authentication hash-trees for the the
authentication of transactional document-objects, followed by asymmetric
signature generation on the hash-tree value. Server-side multi-client signature
verification would probably constitute the single most compute-intensive task,
hence the motivation for our usage of the Rabin signature protocol which results
in significantly reduced verification workloads compared to the more commonly
applied Rivest-Shamir-Adleman (RSA) protocol. Data privacy is handled via
symmetric encryption of message traffic using session-specific keys obtained
through key-negotiation mechanisms based on discrete-logarithm cryptography.
Individual client-to-server channels can be secured using a double key-pair

variation of Diffie-Hellman (DH) key negotiation, usage of which also enables
bidirectional node authentication. The reciprocal server-to-client multicast
channel is secured through Burmester-Desmedt (BD) key-negotiation which enjoys
significant advantages over the usual multiparty extensions to the DH protocol.
The implementation of hash-tree signatures and bi/multidirectional key
negotiation results in a comprehensive cryptographic framework for multiparty
document-objects satisfying both authentication and data privacy requirements.
142: Aust N Z J Psychiatry. 2000 Feb;34(1):92-7.
Child sexual abuse II: treatment.
Nurcombe B, Wooding S, Marrington P, Bickman L, Roberts G.
Child and Adolescent Psychiatry, University of Queensland, Mental Health Centre,
Royal Brisbane Hospital, Herston, Australia. bnurcombe@psychiatry.uq.edu.au
OBJECTIVE: To evaluate the scientific literature concerning the treatment of
child sexual abuse. METHOD: A critical review of the scientific literature.
RESULTS: There are only nine published research studies in which subjects were
randomly assigned to an index treatment or treatments and a comparison treatment
or no-treatment control group. In seven of the studies, the index treatment
exceeded the control or comparison group in regard to treatment outcome; in two
studies it did not. The successful treatments involved group therapy, combined
individual and group play therapy and cognitive behaviour therapy. CONCLUSIONS:
Treatment should be based on an explicit conceptual model of the psychopathology
of sexual abuse. The University of Queensland Sexual Abuse Treatment Project,
which is based on a transactional model, is described.
Publication Types:
Review
Review, Tutorial
143: Aust N Z J Psychiatry. 2000 Feb;34(1):85-91.
Child sexual abuse I: psychopathology.
Nurcombe B.
Child & Adolescent Psychiatry, The University of Queensland, Mental Health
Centre, Royal Brisbane Hospital, Herston, Australia.
bnurcombe@psychiatry.uq.edu.au
OBJECTIVE: To review scientific literature concerning the prevalence, childhood
outcome and adult outcome of child sexual abuse, and the hypothetical models
that have been postulated to explain its psychopathology. METHOD: Selective
critical review of literature. RESULTS: Estimates of prevalence of sexual abuse
suggest that a significant number of children of both sexes are affected.
Research into the psychopathology of sexual abuse is hindered by methodological
problems. However, sexual abuse has been associated with a number of psychiatric
disorders and maladaptive lifestyles in childhood and adulthood. Several
theoretical models of the psychopathology of child sexual abuse are examined and
compared. CONCLUSIONS: A transactional model is the most comprehensive and
encompassing.
Publication Types:
Review
Review, Tutorial
144: Health Mark Q. 2000;18(1-2):71-86.
A ten year update on the marketing life cycle for hospital information
technologies.
Sobol MG, Woods JA.
Edwin L. Cox School of Business, Southern Methodist University, Dallas, TX
75275-0333, USA. msobol@mail.cox.sm.edu
This is a 1999 update of an original article based on 1989-90 data published in
the Journal of Hospital Marketing. The adoption of hospital information
technologies shows that most of these technologies were no longer in the
innovator or early adopter stages. Infrastructure building technologies such as
clinical information links, PC networking with the mainframe, MD links between
doctors and hospital and E-mail showed the highest percentage of increase. Bar
coding for inventory (transactional) also made great increases. Opinions on
barriers to the adoption of hospital information technology are ranked and are
studied by age of respondent, public vs. private hospitals, and job function.
145: Nurs Stand. 1999 Nov 10-16;14(8):37-40.
Self-awareness: improving nurse-client interactions.
Rowe J.
Royal Hallamshire Hospital, Sheffield.
Communication is a key skill of modern nursing practice, yet often it is an area
in which nurses fail. Self-awareness exercises can help us to improve our
communication skills and enhance healthcare delivery.
146: Nurs Stand. 1999 Oct 20-26;14(5):25.
Just a minute.
McInnes B.
Five-factor model of personality and transformational leadership.

Judge TA, Bono JE.
Department of Management and Organizations, Henry B. Tippie College of Business,
University of Iowa, Iowa City 52242, USA. tim-judge@uiowa.edu
This study linked traits from the 5-factor model of personality (the Big 5) to
transformational leadership behavior. Neuroticism, Extraversion, Openness to
Experience, and Agreeableness were hypothesized to predict transformational
leadership. Results based on 14 samples of leaders from over 200 organizations
revealed that Extraversion and Agreeableness positively predicted
transformational leadership; Openness to Experience was positively correlated
with transformational leadership, but its effect disappeared once the influence
of the other traits was controlled. Neuroticism and Conscientiousness were
unrelated to transformational leadership. Results further indicated that
specific facets of the Big 5 traits predicted transformational leadership less
well than the general constructs. Finally, transformational leadership behavior
predicted a number of outcomes reflecting leader effectiveness, controlling for
the effect of transactional leadership.
148: J Nurs Manag. 2000 Mar;8(2):83-7.
A nursing theory for nursing leadership.
Laurent CL.
Family Medicine Department, Naval Hospital, Camp Pendelton, California, USA.
For many years nursing practice has found its foundations in nursing theory. A
review of theorists such as D. E. Orem, C. Roy, B. Neumen, V. Henderson, M. E.
Rogers and others reveals a focus on the management of patient care, not
leadership. This has provided most nurses with a solid foundation in
'management', but little in terms of 'leadership.' In more recent years,
theories such as the Deming Management Method, Managers as Developer Model,
Shared Governance and Transactional Leadership have been introduced, none of
which are nursing theories. This article discusses the conceptualized
differences between management and leadership theory arguing that there is a
difference between 'leadership and management'. A leadership theory is proposed
utilizing Ida J. Orlando's model for nursing. This theory provides a nursing
foundation for nursing leaders to utilize both in the management of patient care
and in leadership.
Integrating competence and psychopathology: pathways toward a comprehensive
science of adaptation in development.
Masten AS, Curtis WJ.
University of Minnesota, Minneapolis 55455, USA.
This paper examines the conceptual and empirical connections between competence
and psychopathology, two historically rich traditions for the study of
adaptation in development, and what might be gained from their integration.
Historical roots of these two traditions are reviewed, then overlaps in their
definition are considered, with a focus on the ways in which judgments about
competence enter into the nosology of mental disorders. DSM-IV is analyzed from
the perspective of competence, and the debate about "harmful dysfunction" in
defining mental disorder is discussed in relation to competence. Different
models explaining the empirical associations of competence and psychopathology
are delineated, and illustrative empirical evidence is provided. Potential
explanations include confounded concepts and methods, symptoms undermining the
effectiveness of adaptation in the environment, failures in age-salient
developmental tasks leading to emotional and behavioral problems, transactional
influences, shared vulnerability or risk factors producing both kinds of
difficulties, and more complex models. The potential benefits of integrating
competence and psychopathology as two major approaches to adaptation are
discussed in regard to theory, classification of mental disorder, research, and
intervention.
Publication Types:
Review
Review, Tutorial
150: Br J Med Psychol. 2000 Sep;73 ( Pt 3):355-69.
Hypochondriacal concerns, somatosensory amplification, and primary and secondary
cognitive appraisals.
Ferguson E, Swairbrick R, Clare S, Robinson E, Bignell CJ, Anderson C.
School of Psychology, University of Nottingham, UK. ef@psyc.nott.ac.uk
This paper uses data from four studies (N = 150, 150, 154 and 79) to examine the
associations between hypochondriacal concerns (HCs) and stress appraisals
(primary and secondary). A search activity account of HCs suggests that
increased levels of HCs should be associated with positive appraisals of a
stressful situation (i.e., increased levels of perceived challenge and perceived
control). However, the results indicated that in terms of primary appraisals,
increased perceptions of threat and not challenge were consistently associated
with increased levels of HCs. Further, the results indicated that the
association between threat and HCs is mediated by somatosensory amplification.
Consistent with the search activity account it is shown that increased levels of
perceived control (secondary appraisals) are associated with increased levels of
HCs. The association for perceived control remains once variance due to
somatosensory amplification is partialled and generalizes to a sample of
patients with a sexually transmitted infection. The results are interpreted in
relation to the transactional model of the stress process.
151: Med Hypotheses. 2000 Sep;55(3):266-76.
Corrected and republished from:
Med Hypotheses. 2000 Jan;54(1):7-17.
Transactional conflict between psychobiology and culture in the etiology of

postpartum depression.
Hayes MJ, Roberts S, Davare A.
Psychology Department, University of Maine, Orono, Maine, USA.
MHayes@Maine.Maine.Edu
In vulnerable individuals, postpartum depression may be triggered by the
disruption of neuropsychological processes during pregnancy and parturition. It
is proposed that in Western societies pre- and postnatal psychological and
instrumental needs are poorly met and this crisis may interact with
neurophysiological factors in compromising maternal psychological functioning.
The influence of developmental factors and psychological and physical stressors
are discussed in relation to women's neuropsychological health during the
peripartal transition. It is hypothesized that the environmental milieu may
support, neglect or derail the mother's psychobiological transition from
pregnancy to effective postnatal parenting and resumption of family and work
roles.
Publication Types:
Corrected and Republished Article
Review
152: J Soc Psychol. 2000 Aug;140(4):434-50.
Personal and situational variables that describe coping with acute stress in
competitive sport.
Anshel MH, Wells B.
Department of Psychology, University of Wollongong, Australia.
psychup@nts-online.net
The authors examined the degree to which competitive basketball players in
Australia were consistent in their cognitive appraisals and coping strategies in
response to 4 types of stressful situations that they had experienced during
previous basketball games as functions of perceived stress intensity. The
authors predicted that both approach and avoidance coping strategies would be
dependent on the type of stressful event, in accord with the transactional
model. The results supported that prediction: Approach strategies were more
prevalent than avoidance strategies following 3 of the 4 events. Cognitive
appraisals and perceived stress intensity also strongly influenced the
participants' use of coping strategies, accounting for 34% of the variance.
153: West J Nurs Res. 2000 Aug;22(5):623-41.
Job uncertainty and health status for nurses during restructuring of health care
in Alberta.
Maurier WL, Northcott HC.
Department of Sociology, University of Alberta, Edmonton.

The Alberta health care system experienced dramatic changes after provincial
funding cuts to health care from 1993 to 1996. As a result, stressors for nurses
increased. The question of whether job uncertainty, working conditions,
cognitive appraisal, and coping strategies influence the health of registered
nurses in a context of health care restructuring was examined. Lazarus and
Folkman's Transactional Model of Stress was used as the conceptual framework. A
total of 271 registered nurses employed in a large, urban, acute-care teaching
hospital responded to a self-administered survey questionnaire. Using multiple
regression analysis, depression and self-reported physical health were analyzed.
The data suggest that the threat of being placed on recall, having a coworker
bumped or laid off, and perceived job security were adversely related to
physical health. High primary appraisal of threat was associated with high
levels of depression and poor physical health. In addition, the findings suggest
that various coping strategies had both buffering and exacerbating effects on
physical health and depression.
154: J Soc Psychol. 2000 Jun;140(3):317-27.
The dimensionality of coping among Chinese health care workers.
Scherer RF, Hwang CE, Yan W, Li J.
College of Business and Administration, Wright State University, Dayton, Ohio,
USA. rscherer@wright.edu
The transactional model defines coping as a process that changes on the basis of
the context of an environmental encounter. An instrument used to investigate
coping in diverse person-environment interactions is the Ways of Coping
Questionnaire (WOC; S. Folkman & R. S. Lazarus, 1988). Although evidence exists
to support the basic underlying structure of the WOC in Western societies, no
research has been conducted on the instrument's dimensionality in non-Western
societies. The authors identified 14 factors for the WOC administered to a
sample of health care workers in Beijing, China. The 14 factors identified in
the present study were similar to the 8 factors identified in the original
validation study (S. Folkman, R. S. Lazarus, C. Dunkel-Schetter, A. DeLongis, &
R. J. Gruen, 1986), but they were more content specific.
155: Adv Child Dev Behav. 1999;27:181-220.
Temperament and attachment: one construct or two?
Mangelsdorf SC, Frosch CA.
Department of Psychology, University of Illinois at Urbana-Champaign 61820, USA.
In this chapter we described the constructs of temperament and attachment and
have discussed similarities and differences between the two. We addressed the
issue of whether temperament contributes to overall attachment security or to
the specific type of attachment that children display. We conclude that although
temperament may influence the type of secure and insecure attachment

relationship children form with their parent, temperament alone will not
determine if a child is classified as securely or insecurely attached. We
presented evidence suggesting that certain dimensions of temperament,
specifically negative emotionality, may be associated with infants' behavior
during the Strange Situation, such as proneness-to-distress during separations.
However, we noted that these temperament dimensions do not predict overall
security of attachment. It is likely that although no single temperament
characteristic, such as proneness-to-distress, in and of itself determines
overall attachment security, it is possible that a constellation of temperament
characteristics may be more strongly related to attachment security. The
examination of constellations of temperament characteristics may be particularly
useful for furthering our understanding of individual differences within
attachment classifications. Such an approach may elucidate the reasons why
infants are classified into one subgroup of secure, insecure-avoidant, or
insecure-resistant attachment versus another subgroup. Furthermore, we suggest
that the collection of findings regarding temperament and attachment not only
underscores the importance of a transactional approach to early social-emotional
development, but emphasizes that temperament and attachment can make unique and
interactive contributions to children's social-emotional functioning. That is,
the goodness-of-fit between infant and parent characteristics may best predict
security of attachment. Although child characteristics clearly contribute to the
development of the parent-child relationship, we believe that the effects of
infant temperament on infant-caregiver attachment may well be indirect, and may
be moderated by such variables as maternal personality and social support. Thus,
taken together, a growing literature clearly indicates that although temperament
and attachment security are interrelated, they are by no means interchangeable
constructs. To return to our guiding question, "Temperament and attachment: One
construct or two?" We reply, "two."
Publication Types:
Review
Review, Tutorial
156: Dimens Crit Care Nurs. 2000 Jan-Feb;19(1):46-54.
The transformational leadership of critical care nurse-managers.
Ohman KA.
Department of Nursing, College of St. Benedict/St. John's University in St.
Joseph, Minn., USA.
This study of transformational leadership found critical care nurse-managers to
be highly transformational, using inspiration, motivation, and vision to empower
staff, rather than intervening only when problems arise. Significant positive
relationships were found between transformational leadership and previous
leadership experience. The findings have implications for the recruitment,
selection, and development of nursing leaders.
157: Dev Psychopathol. 2000 Spring;12(2):215-34.
Toward an interpersonal life-stress model of depression: the developmental

context of stress generation.
Rudolph KD, Hammen C, Burge D, Lindberg N, Herzberg D, Daley SE.
Department of Psychology, University of Illinois, Urbana-Champaign, Champaign
61820, USA. krudolph@uiuc.edu
The validity of a developmentally based life-stress model of depression was
evaluated in 88 clinic-referred youngsters. The model focused on (a) the role of
child-environment transactions, (b) the specificity of stress-psychopathology
relations, and (c) the consideration of both episodic and chronic stress.
Semistructured diagnostic and life-stress interviews were administered to
youngsters and their parents. As predicted, in the total sample child depression
was associated with interpersonal episodic and chronic stress, whereas
externalizing disorder was associated with noninterpersonal episodic and chronic
stress. However, the pattern of results differed somewhat in boys and girls.
Youngsters with comorbid depression and externalizing disorder tended to
experience the highest stress levels. Support was obtained for a
stress-generation model of depression, wherein children precipitate stressful
events and circumstances. In fact, stress that was in part dependent on
children's contribution distinguished best among diagnostic groups, whereas
independent stress had little discriminative power. Results suggest that
life-stress research may benefit from the application of transactional models of
developmental psychopathology, which consider how children participate in the
construction of stressful environments.
158: Psychiatr Serv. 2000 Jun;51(6):781-5.
Mental health team leadership and consumers satisfaction and quality of life.
Corrigan PW, Lickey SE, Campion J, Rashid F.
Center for Psychiatric Rehabilitation, University of Chicago, Tinley Park, IL
60477, USA.
OBJECTIVE: The purpose of this study was to determine the association between
leadership styles of leaders of mental health treatment teams and consumers'
ratings of satisfaction with the program and their quality of life. METHODS: A
multifactor model has distinguished three factors relevant to leadership of
mental health teams: transformational leadership, in which a leader's primary
goal is to lead the team to evolving better programs; transactional leadership,
in which the leader strives to maintain effective programs through feedback and
reinforcement; and laissez-faire leadership, an ineffective, hands-off
leadership style. Research has shown transformational leadership to be
positively associated with measures of the team's functioning, but the effects
of leadership style on consumers is not well known. A total of 143 leaders and
473 subordinates from 31 clinical teams rated the leadership style of the team
leader. In addition, 184 consumers served by these teams rated their
satisfaction with the treatment program and their quality of life. RESULTS:
Consumers' satisfaction and quality of life were inversely associated with
laissez-faire approaches to leadership and positively associated with both
transformational and transactional leadership. Moreover, leaders' and
subordinates' ratings of team leadership accounted for independent variance in
satisfaction ratings-up to 40 percent of the total variance. CONCLUSIONS:

Leadership seems to be an important variable for understanding a team's impact
on its consumers.
159: J Nurs Adm. 2000 May;30(5):241-50.
Nurse executive transformational leadership found in participative
organizations.
Dunham-Taylor J.
College of Nursing, East Tennessee State University, Johnson City, USA.
dunhamta@etsu.edu
OBJECTIVE: The study examined a national sample of 396 randomly selected
hospital nurse executives to explore transformational leadership, stage of
power, and organizational climate. BACKGROUND: Results from a few nurse
executive studies have found nurse executives were transformational leaders. As
executives were more transformational, they achieved better staff satisfaction
and higher work group effectiveness. This study integrates Bass'
transformational leadership model with Hagberg's power stage theory and Likert's
organizational climate theory. METHODS: Nurse executives (396) and staff
reporting to them (1,115) rated the nurse executives' leadership style, staff
extra effort, staff satisfaction, and work group effectiveness using Bass and
Avolio's Multifactor Leadership Questionnaire. Executives' bosses (360) rated
executive work group effectiveness. Executives completed Hagberg's Personal
Power Profile and ranked their organizational climate using Likert's Profile of
Organizational Characteristics. RESULTS: Nurse executives used transformational
leadership fairly often; achieved fairly satisfied staff levels; were very
effective according to bosses; were most likely at stage 3 (power by
achievement) or stage 4 (power by reflection); and rated their hospital as a
Likert System 3 Consultative Organization. Staff satisfaction and work group
effectiveness decreased as nurse executives were more transactional. Higher
transformational scores tended to occur with higher educational degrees and
within more participative organizations. CONCLUSIONS: Transformational qualities
can be enhanced by further education, by achieving higher power stages, and by
being within more participative organizations.
160: Med Hypotheses. 2000 Jan;54(1):7-17.
Corrected and republished in:
Med Hypotheses. 2000 Sep;55(3):266-76.
Transactional conflict between psychobiology and culture in the etiology of
postpartum depression.
Hayes MJ, Roberts S, Davare A.
Psychology Department, University of Maine, Orono 04469, USA.
MHayes@Maine.Maine.Edu
In vulnerable individuals, postpartum depression may be triggered by the
disruption of neuropsychological processes during pregnancy and parturition. It

is proposed that in Western societies pre- and postnatal psychological and
instrumental needs are poorly met and this crisis may interact with
neurophysiological factors in compromising maternal psychological functioning.
The influence of developmental factors and psychological and physical stressors
are discussed in relation to women's neuropsychological health during the
peripartal transition. It is hypothesized that the environmental milieu may
support, neglect or derail the mother's psychobiological transition from
pregnancy to effective postnatal parenting and resumption of family and work
roles.
Publication Types:
Review
161: J Adv Nurs. 2000 Mar;31(3):681-8.
Erratum in:
J Adv Nurs 2000 Apr;31(4):989.
Nursing stress: the effects of coping strategies and job satisfaction in a
sample of Australian nurses.
Healy CM, McKay MF.
Health Psychology, Swinburne University, Melbourne, Victoria, Australia.
chealy@swin.edu.au
Nursing stress: the effects of coping strategies and job satisfaction in a
sample of Australian nurses The study reported in this paper examined
relationships between nursing work-related stressors and coping strategies, and
their impact upon nurses' levels of job satisfaction and mood disturbance. It
was proposed that higher levels of perceived work stress and use of avoidance
coping would increase mood disturbance, while problem-focused coping would be
associated with less mood disturbance. The study also aimed to explore the
possible 'buffering effects' of using humour in coping with stress, and the
effect of job satisfaction on the stress-mood relationship. The sample consisted
of 129 qualified Australian nurses who volunteered to complete standardized
questionnaires, including the Nursing Stress Scale, Ways of Coping
Questionnaire, the Coping Humour Scale, Job Satisfaction Scale of the Nurse
Stress Index, and the shortened version of the Profile of Mood States. Results
revealed a significant positive relationship between nursing stress and mood
disturbance, and a significant negative relationship between nursing stress and
job satisfaction. The use of avoidance coping and the perception of work
overload were found to be significant predictors of mood disturbance. No
evidence was found to indicate that the use of humour had a moderating effect on
the stress-mood relationship but there was support for the influence of job
satisfaction upon this relationship. These results provided some support for a
transactional model of stress since situational factors were found to influence
the nurses' coping and perceptions of stress.
162: Can J Nurs Res. 1999 Sep;31(2):41-52.
Peer sexual harassment: a barrier to the health of adolescent females?

Dahinten VS.
University of British Columbia, Vancouver.
Despite increasing societal concern about sexual harassment in the workplace and
in academia, to date sexual harassment has been neglected by nurses as a health
issue among adolescents. Sexual harassment includes a wide range of unwelcome
sexually oriented and gender-offensive behaviours that contribute to a hostile
environment. Although the research is limited and lacking in rigour, early
findings, along with evidence abstracted from the workplace-harassment and
stress and coping literature, suggest that peer sexual harassment may adversely
affect young women's mental and physical health, health-related behaviours, and
future relationships. The author makes recommendations for further
sexual-harassment research, specific to the adolescent population, based on a
conceptual framework derived from the transactional stress and coping
literature.
Publication Types:
Review
Review, Tutorial
163: Am J Ment Retard. 2000 Jan;105(1):32-46.
Models of child-family interactions for children with developmental delays:
child-driven or transactional?
Keogh BK, Garnier HE, Bernheimer LP, Gallimore R.
Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine
90095-1759, USA.
Child-driven and transactional models of child-family interactions were tested
with 80 children who had developmental delays and their families. Children's
cognitive competence, personal-social competence, behavior and communication
"hassle," and family accommodations to the children were assessed at child ages
3, 7, and 11. Accommodations were summarized as internal (within the family) and
external (use of outside resources) intensity and types. Results indicate that
the longitudinal relationships between children's cognitive competence,
personal-social competence, behavior and communication hassle, and family
accommodations are best explained by a child-driven model. Implications for
early intervention and for the need to consider both child and family outcomes
are discussed.
164: Fam Process. 1999 Winter;38(4):463-76.
Family interaction styles of children with depressive disorders,
schizophrenia-spectrum disorders, and normal controls.
Hamilton EB, Asarnow JR, Tompson MC.
Department of Psychiatry and Biobehavioral Sciences, UCLA, USA.

Family interaction processes during a problem-solving task were examined in
children with depressive disorders, children with schizophrenia-spectrum
disorders, and a normal control group of community children screened for the
absence of psychiatric disorder. Major findings were: a) children with
depressive disorders were more likely than children with schizophrenia-spectrum
disorders and children with no psychiatric disorder to direct guilt-inducing
comments toward their parents; and b) parents of children with
schizophrenia-spectrum disorders were more likely to direct harsh critical
comments toward the child than were parents of depressed children or parents of
normal controls. In addition, children's and mothers' use of benign criticism
was linked, while children's harsh criticism was associated with intrusion from
the father, and children's self-denigrating comments were related to specific
paternal criticism. Implications of these results for understanding
transactional processes associated with childhood-onset depressive and
schizophrenia-spectrum disorders are discussed.
165: Nurs Res. 2000 Jan-Feb;49(1):37-43.
Leadership styles across hierarchical levels in nursing departments.
Stordeur S, Vandenberghe C, D'hoore W.
Department of Public Health at the Universite catholique de Louvain, Brussels,
Belgium.
BACKGROUND: Some researchers have reported on the cascading effect of
transformational leadership across hierarchical levels. One study examined this
effect in nursing, but it was limited to a single hospital. OBJECTIVES: To
examine the cascading effect of leadership styles across hierarchical levels in
a sample of nursing departments and to investigate the effect of hierarchical
level on the relationships between leadership styles and various work outcomes.
METHODS: Based on a sample of eight hospitals, the cascading effect was tested
using correlation analysis. The main sources of variation among leadership
scores were determined with analyses of variance (ANOVA), and the interaction
effect of hierarchical level and leadership styles on criterion variables was
tested with moderated regression analysis. RESULTS: No support was found for a
cascading effect of leadership across hierarchical levels. Rather, the variation
of leadership scores was explained primarily by the organizational context.
Transformational leadership had a stronger impact on criterion variables than
transactional leadership. Interaction effects between leadership styles and
hierarchical level were observed only for perceived unit effectiveness.
CONCLUSIONS: The hospital's structure and culture are major determinants of
leadership styles.
Publication Types:
Multicenter Study
166: J Clin Child Psychol. 1999 Dec;28(4):553-7.
Comment in:
J Clin Child Psychol. 1999 Dec;28(4):558-62.

Links among theory, research, and practice: cornerstones of clinical scientific
progress.
Jensen PS.
Department of Child Psychiatry, NYSPI, NY 10032, USA.
Discusses how explicit links among clinical theory, research, and practice are
necessary if a clinical discipline is to survive in the managed care marketplace
of today. Robust links among theory, research, and practice enable the
elaboration of a systematic body of clinical knowledge that is practical in its
deployment, effective in its methods, and compelling in its rationale. Moreover,
theoretical advances are increasingly necessary, in that they allow scientists
to categorize and prioritize the growing amount of empirically derived
information, determine how pieces of multilevel data fit together, identify
knowledge gaps, and set priorities for future studies. As shown by some of the
articles in this special section, evolving theories of behavior have several
characteristics in common; namely that they are developmental, transactional,
contextual, adaptational, multilevel, and multidetermined. Concerns may be
raised, however, as to whether current research methods are fully adequate to
test these newer, more complex, multilevel theories or the clinical phenomena
they seek to characterize. To address these difficulties, as well as to increase
the pace of scientific advances that may result from propitious links among
theory, research, and practice, I offer several recommendations to clinical
psychology in general and to clinical child psychological research in
particular.
167: J Clin Child Psychol. 1999 Dec;28(4):467-75.
Closing the gaps: developmental psychopathology as a training model for clinical
child psychology.
van Eys PP, Dodge KA.
Department of Psychology and Human Development, Vanderbilt University,
Nashville, TN 37203, USA.
Espouses developmental psychopathology as a framework for training our future
leaders due to its emphasis on an ecological, transactional lifespan
perspective, as well as interdisciplinary bridging and policy focus. This
perspective, used as a framework for questioning and thinking about the complex
interplay of psychological and social phenomena, provides a method for closing
the gaps in training future psychologists as it allows for the development of
niche expertise under an umbrella of the broader, ecological perspective. In an
increasingly complex world of shrinking mental health dollars and growing
severity of mental health problems for families and youth, clinical
psychologists are needed more than ever to solve social problems. The current
training paradigms in clinical child psychology programs need redirection and
clarification for future psychologists to contribute meaningfully to science,
practice, and policy. This article provides background in the history and
influence of the developmental psychopathology perspective, as well as future
implications for doctoral training programs in clinical psychology.

168: J Adv Nurs. 1999 Dec;30(6):1321-31.
An embedded decisional model of stress and coping: implications for exploring
treatment decision making by women with breast cancer.
Balneaves LG, Long B.
School of Nursing, University of British Columbia, Vancouver, BC, V6T 2B5,
Canada.
Treatment decision making by women with breast cancer has been recognized to be
an inherently stressful process. However, past decisional theory and research
has failed to fully elucidate the personal, transactional, and relational nature
of choice behaviour. The purpose of this paper is to explore an embedded
decisional model of stress and coping that locates key assumptions of Janis &
Mann's (1977) conflict-theory model of decision making within Lazarus &
Folkman's (1984) transactional framework. Through combining decisional and
stress and coping theories, a model is developed that addresses the theoretical
limitations of the conflict-theory model and provides greater specificity within
decision-making research. The paper examines the complexity of treatment
decision making within the context of the constructs of causal antecedents,
primary appraisal, secondary appraisal, coping, and adaptational outcomes.
Examples specific to women with breast cancer are provided to illustrate the
potential application of the embedded model. The implications of this inclusive
and comprehensive decisional theory for future knowledge development and
research in the area of treatment decision making are also discussed.
Publication Types:
Review
Review, Tutorial
169: J Adolesc. 1999 Dec;22(6):819-33.
Relational support and person characteristics in adolescence.
van Aken MA, van Lieshout CF, Scholte RH, Branje SJ.
Rutten Institute for Research in Psychology, Section of Developmental
Psychology, University of Nijmegen, The Netherlands. vanaken@psych.kun.nl
In this paper, an heuristic model of the personality characteristics of
adolescents and the supportive dimensions of interactions, relationships and
groups is presented. The model takes the concept of developmental tasks as its
starting point and it is assumed that developmental tasks can be characterized
in terms of four modalities: intentions, behaviour, cognitions and affect. The
same four modalities can also be used to characterize dimensions of personality
and aspects of interactional and relational support. The results of several
empirical studies are presented to illustrate the model. Together, these studies
present a transactional picture of the personality of adolescents and their
relationships in which personality and relationships influence each other and
jointly determine psychosocial functioning. Copyright 1999 The Association for
Professionals in Services for Adolescents.

Publication Types:
Review
Review, Tutorial
170: J Adv Nurs. 1999 Oct;30(4):882-92.
An embedded decisional model of stress and coping: implications for exploring
treatment decision making by women with breast cancer.
Balneaves LG, Long B.
Doctoral Student, School of Nursing, University of British Columbia, Vancouver,
Canada.
Treatment decision making by women with breast cancer has been recognized to be
an inherently stressful process. However, past decisional theory and research
has failed to fully elucidate the personal, transactional and relational nature
of choice behaviour. The purpose of this paper is to explore an embedded
decisional model of stress and coping that locates key assumptions of Janis and
Mann's conflict-theory model (CTM) of decision making within Lazarus and
Folkman's transactional framework. Through combining decisional and stress and
coping theories, a model is developed that addresses the theoretical limitations
of the CTM and provides greater specificity within decision-making research. The
paper examines the complexity of treatment decision making within the context of
the constructs of causal antecedents, primary appraisal, secondary appraisal,
coping and adaptational outcomes. Examples specific to women with breast cancer
are provided to illustrate the potential application of the embedded model. The
implications of this inclusive and comprehensive decisional theory for future
knowledge development and research in the area of treatment decision making are
also discussed.
Publication Types:
Review
Review, Tutorial
171: J Am Acad Psychiatry Law. 1999;27(3):462-70.
Memory as power: who is to decide?
Beahrs JO.
Oregon Health Sciences University, Portland, USA.
The transactional aspects of human memory remain enigmatic: memory disputes
carry intense affective charge; memory's effects vary with how content is framed
or slanted by one's perspective; memory is vulnerable to suggestive influence;
and these processes are seen at all levels of social scale from simple dyads to
whole societies. These observations suggest that memory serves important
functions in mediating interpersonal relationships. As hypotheses for further
study, I propose that (1) memory mediates interpersonal power dynamics; (2)
social legitimization countermands memory's truth value when the two conflict;
(3) suggestibility protects otherwise disadvantaged individuals by rendering
them more adaptable to dominant others' belief systems; and (4) mutual
suggestion ties together all levels of scale within a given society. All of
these hypotheses are discussed within a context of recent controversies
surrounding hypnotically refreshed eyewitness testimony and adult delayed
traumatic recall, which are worked out at the intersection of mental health and
legal practice with a pivotal role given to the expert witness. The presumption
of innocence dominates current trends in these areas. Cases that appear to
violate this presumption, such as Pennsylvania v. Crawford (718 A.2d (Pa.
1998)), affirm another fundamental principle of democracy: that the ultimate
issue of witness credibility is to be decided not by an expert, but by the
citizenry itself-as represented in the jury.
172: J Am Coll Health. 1999 Sep;48(2):75-83.
The Hassles Assessment Scale for Students in College: measuring the frequency
and unpleasantness of and dwelling on stressful events.
Sarafino EP, Ewing M.
College of New Jersey, Ewing.
Development of the Hassles Assessment Scale for Students in College, a new scale
to measure students' stress, is described. In the scale, students rate each of
54 hassles for its frequency and unpleasantness in the past month and indicate
the degree to which they dwelt or ruminated on it. Very high levels of internal
consistency for the frequency, unpleasantness, and dwelling measures were found.
Correlational analyses demonstrated the scale's criterion validity (scores were
negatively correlated with the number of hours respondents reported engaging in
physical exercise) and congruent validity (scores were positively correlated
with scores on the Inventory of College Students' Recent Life Experience, an
established scale for assessing student hassles). Exploratory factor analyses
suggested the possibility that many items on the scale are independent, with
each contributing some specific variance to the total variance of the item pool
that is not shared with other items.
173: Rev Mal Respir. 1999 Jun;16(3):353-9.
[Coping strategies utilized by asthma patients]
[Article in French]
Cousson-Gelie F, Taytard A.
Laboratoire de Psychologie, Equipe Psychologie de la Sante, UFR des Sciences de
l'Homme, Universite de Bordeaux II.
In the Lazarus' transactional model of stress, each individual when facing a
stressful situation, set up specific adjustement strategies called coping,
including a meaningful pattern of cognitive, behavioral, emotional and somatic
responses. Coping strategies used by asthmatic patient are relatively unknown.
The objective of this study was to assess the usual coping strategies. We
administered the WCC (a shortened version of Lazarus and Folkman's
questionnaire) to 116 asthmatic patients and 880 healthy adults French subjects
(males and females). A principal component analysis, followed by varimax
rotations yielded three factors accounting for about 68.2% of the total
variance. They were interpreted as Problem-focused, Emotion-focused and
Social-support seeking types of coping. These two first dimensions of coping
were closed to those generally described in the literature. Asthmatic patients
used more emotion-focused strategy than the control group. These results and
their theoretical and practical implications are discussed.
174: Community Ment Health J. 1999 Aug;35(4):301-12.
Transformational and transactional leadership skills for mental health teams.
Corrigan PW, Garman AN.
University of Chicago Center for Psychiatric Rehabilitation, Tinley Park, IL
60477, USA. pcorriga@mcis.bsd.uchicago.edu
Many treatments for persons with severe mental illness are provided by mental
health teams. Team members work better when led by effective leaders. Research
conducted by organizational psychologists, and validated on mental health teams,
have identified a variety of skills that are useful for these leaders. Bass
(1990, 1997) identified two sets of especially important skills related to
transformational and transactional leadership. Leaders using transformational
skills help team members to view their work from more elevated perspectives and
develop innovative ways to deal with work-related problems. Skills related to
transformational leadership promote inspiration, intellectual stimulation,
individual consideration, participative decision making, and elective
delegation. Mental health and rehabilitation teams must not only develop
creative and innovative programs, they must maintain them over time as a series
of leader-team member transactions. Transactional leadership skills include
goal-setting, feedback, and reinforcement strategies which help team members
maintain effective programs.
175: Nurs Forum. 1999 Jan-Mar;34(1):5-11.
Compliance: a concept analysis.
Evangelista LS.
University of California, Los Angeles, School of Nursing, USA. levangel@ucla.edu
Compliance has a myriad of definitions. Understanding it as a phenomenon is
complicated by the different perspectives of different disciplines. Nurses need
to define compliance in a manner that best fits the philosophy of the nursing
discipline. This article makes a distinction between the ordinary use and the
scientific use of the term compliance. Nurses are challenged to embrace an
interactive, transactional process in order to form a partnership with clients,
which allows for client choice and control in decision making about carrying out
the prescribed behavior.
Publication Types:
Review
Review, Tutorial
176: Am J Community Psychol. 1999 Apr;27(2):211-37.
The risk and protective functions of perceived family and peer microsystems
among urban adolescents in poverty.
Seidman E, Chesir-Teran D, Friedman JL, Yoshikawa H, Allen L, Roberts A, Aber
JL.
Psychology Department, New York University, New York 10003, USA.
seidman@psych.nyu.edu
Utilized a pattern-based approach to discover the different constellations of
perceived social transactions separately for family and peer systems and
explored the risk and protective functions of these microsystem profiles for
both depression and antisocial behavior among a sample of ethnically and
racially diverse urban adolescents living in poverty. Measures of perceived
social support, involvement and hassles with family and peers, as well as
perceived social acceptance and peers' values were entered into two sets of
iterative cluster analyses to identify distinct profiles of family and peer
transactions. From each of the perceived family and peer transactional analyses,
six replicated profiles emerged. Several of the profiles were consistent with
expectations from prior literature such as Enmeshing families and Rejecting peer
networks, while others were novel and intriguing such as Entangling peers.
Family profiles were consistent in their risk and protective associations for
both depression and antisocial behavior, while the peer profiles varied in their
effects for each developmental outcome. For example, the Rejecting peer profile
placed adolescents at increased risk for depression but protected them from
antisocial behavior. Implications for future research and preventive
intervention are discussed.
177: Dev Psychol. 1999 May;35(3):868-79.
After-school activities and the development of low-income urban children: a
longitudinal study.
Posner JK, Vandell DL.
Department of Educational Psychology, University of Wisconsin-Madison, 53706,
USA.
After-school activities of 194 African American and White children from
low-income households were studied from 3rd to 5th grade to determine relations
with (a) child, family, and contextual variables and (b) children's adjustment
over time. Girls were more likely to engage in academic activities and
socializing, whereas boys were more likely to play coached sports. Children who
attended after-school programs spent more time on academic and extracurricular
activities, whereas children in informal care settings spent more time watching
TV and hanging out. Evidence of transactional relations between after-school

activities and child adjustment was found. Time spent in activities between 3rd
and 5th grades was related to children's adjustment in 5th grade. In addition,
child adjustment measured in 3rd grade was associated with time in different
activities in 5th grade.
178: Child Dev. 1999 May-Jun;70(3):722-41.
Predicting mothers' beliefs about preschool-aged children's social behavior:
evidence for maternal attitudes moderating child effects.
Hastings PD, Rubin KH.
National Institute of Mental Health, Section on Developmental Psychopathology,
National Institutes of Health, Bethesda, MD 20892, USA. Paul_D_Hastings@nih.gov
Maternal beliefs about children's social behavior may be important contributors
to socialization and development, but little is known about how such beliefs
form. Transactional models suggest that children's characteristics may influence
parents. At 2 years of age, the shy and aggressive behaviors of 65 toddlers (28
females) were observed during interactions with an unfamiliar peer; as well,
mothers described the extent to which they advocated protective and
authoritarian childrearing attitudes. These variables were used to predict
mothers emotions, attributions, parenting goals, and socialization strategies in
response to vignettes depicting aggressive and withdrawn child behaviors 2 years
later. Most child effects were moderated by maternal attitudes or gender
effects. Authoritarian mothers of aggressive toddlers were most likely to report
high control and anger, to blame their children for aggression, and to focus on
obtaining compliance rather than teaching skills to their children. Protective
mothers reported that they would use warmth and involvement to comfort withdrawn
children, especially their daughters.
179: Child Dev. 1999 May-Jun;70(3):660-77.
Age and gender as determinants of stress exposure, generation, and reactions in
youngsters: a transactional perspective.
Rudolph KD, Hammen C.
University of Illinois, Department of Psychology, Champaign 61820, USA.
krudolph@uiuc.edu
The present study used a contextual and transactional approach to examine age
and gender differences in the experience and consequences of life stress in
clinic-referred preadolescents and adolescents. Eighty-eight youngsters and
their parents completed the Child Episodic Life Stress Interview, a detailed
semistructured interview assessing the occurrence of stressful events in
multiple life domains. Interviews were coded using a contextual threat rating
method to determine event stressfulness and dependence. Youngsters also
completed the Children's Depression Inventory and the Revised Child Manifest
Anxiety Scale to assess self-reported symptoms of depression and anxiety.
Consistent with predictions, age- and gender-related patterns of life stress
varied across the type and context of stressors. Most notably, adolescent girls
experienced the highest levels of interpersonal stress, especially stress and
conflict that they generated within parent-child and peer relationships.
Preadolescent girls experienced the highest levels of independent stress and
conflict in the family context. Adolescent boys experienced the highest levels
of noninterpersonal stress associated with self-generated events. Girls
demonstrated particular vulnerability to depressive responses to dependent
stress. The results build on and extend previous theory and research on age and
gender differences in close relationships and stress, and illustrate the value
of more refined conceptual models and more sophisticated methodologies in child
life stress research.
180: Int J Aging Hum Dev. 1999;48(1):1-15.
Place therapies for older adults: conceptual and interventive approaches.
Scheidt RJ, Norris-Baker C.
Lifespan Human Development Unit, School of Family Studies and Human Services,
Kansas State University, Manhattan 66502, USA. scheidt@humec.ksu.edu
The study of place transitions-moves between places as well as changes occurring
in environments of elders who age in place-is a relatively new, diverse research
area of high relevance for adult developmentalists and gerontologists. This
article explores the usefulness of a tractable model of environmental stress and
proposes three potential "place therapies" that may minimize the negative
impacts of place transitions upon older adults. Specifically, a transactional
model of environmental stress linked to behavior setting theory is proposed for
understanding both positive and negative outcomes associated with different
kinds of place transitions. Three distinct "place therapies" are considered as
interventions that may hold promise for preventing, ameliorating, and enriching
the diverse impacts of place transitions on older adults and their environmental
milieu.
181: Genet Soc Gen Psychol Monogr. 1999 May;125(2):109-56.
Parent-child mediated learning interactions as determinants of cognitive
modifiability: recent research and future directions.
Tzuriel D.
School of Education, Bar-Ilan University, Israel. tzuried@mail.biu.ac.il
The main objectives of this article are to describe the effects of mediated
learning experience (MLE) strategies in mother-child interactions on the child's
cognitive modifiability, the effects of distal factors (e.g., socioeconomic
status, mother's intelligence, child's personality) on MLE interactions, and the
effects of situational variables on MLE processes. Methodological aspects of
measurement of MLE interactions and of cognitive modifiability, using a dynamic
assessment approach, are discussed. Studies with infants showed that the quality
of mother-infant MLE interactions predict later cognitive functioning and that
MLE patterns and children's cognitive performance change as a result of
intervention programs. Studies with preschool and school-aged children showed

that MLE interactions predict cognitive modifiability and that distal factors
predict MLE interactions but not the child's cognitive modifiability. The
child's cognitive modifiability was predicted by MLE interactions in a
structured but not in a free-play situation. Mediation for transcendence (e.g.,
teaching rules and generalizations) appeared to be the strongest predictor of
children's cognitive modifiability. Discussion of future research includes the
consideration of a holistic transactional approach, which refers to MLE
processes, personality, and motivational-affective factors, the cultural context
of mediation, perception of the whole family as a mediational unit, and the
"mediational normative scripts."
182: J Adv Nurs. 1999 May;29(5):1246-55.
A framework for the study of coping, illness behaviour and outcomes.
Shaw C.
Department of Epidemiology and Public Health, University of Leicester, 22-28
Princess Road West, Leicester LE1 6TP, England. cs32@le.ac.uk
This paper presents a theoretical framework for the study of coping, illness
attribution, health behaviour and outcomes. It is based upon models developed
within health psychology and aims to provide a theoretical basis for nurse
researchers to utilize psychosocial variables. It is an interactionist model
which views outcomes as dependent upon both situation and person variables. The
situation is viewed as the health threat or illness symptoms as well as the
psychosocial context within which the person is operating. This context includes
socio-economic factors, social support, social norms, and external factors such
as the mass media. The experience of health threat is dependent upon individual
appraisal, and the framework incorporates Folkman and Lazarus' transactional
model of stress, as well as Leventhal's illness representation model. Behaviour
and the perception of threat are also dependent upon outcome expectancies and
the appraisal of one's own coping resources, and so the concepts of locus of
control and self-efficacy are also incorporated. This framework allows one to
identify determinants of behaviour and outcome, and will aid nurses in
identifying areas for psycho-social intervention.
183: J Stud Alcohol Suppl. 1999 Mar;13:45-51.
Parent-child relationships, child temperament profiles and children's alcohol
use norms.
Brody GH, Flor DL, Hollett-Wright N, McCoy JK, Donovan J.
Department of Child and Family Development, University of Georgia, Athens 30602,
USA.
OBJECTIVE: The purpose of this study was to examine the contributions of child
temperament, parents' alcohol use norms for their children and parent-child
relationship quality to children's alcohol use norms. METHOD: Observational and
self-report data on these variables were gathered from mothers, fathers and
target children during home visits to a purposive random sample of 171 intact
white families with a 10- to 12-year-old child, 85 with girls and 86 with boys.
RESULTS: Liberality in children's norms was associated with active,
sensation-seeking temperament, liberality in parents' norms and poor
parent-child relationship quality. Positive parent-child, particularly
father-child, relationships were associated with less liberal child norms even
when parents' norms were liberal and children's temperaments were active and
sensation oriented. CONCLUSIONS: Positive parent-child relationships have a
conventionalizing effect on children's alcohol use norms that moderates the
effects of temperament and parental norms. The development of alcohol use norms
is best described by transactional models.
184: Can J Psychiatry. 1999 Apr;44(3):227-34.
Complementary development of prevention and mental health promotion programs for
Canadian children based on contemporary scientific paradigms.
Breton JJ.
Research Department, Riviere-des-Prairies Hospital, Montreal, QC.
jean-jacques_breton@hrdp.qc.ca
Confusion regarding definitions and standards of prevention and promotion
programs is pervasive, as revealed by a review of such programs in Canada. This
paper examines how a discussion of scientific paradigms can help clarify models
of prevention and mental health promotion and proposes the complementary
development of prevention and promotion programs. A paradigm shift in science
contributed to the emergence of the transactional model, advocating multiple
causes and dynamic transactions between the individual and the environment.
Consequently, the view of prevention applying over a linear continuum and of
single stressful events causing mental disorders may no longer be appropriate.
It is the author's belief that the new science of chaos theory, which addresses
processes involved in the development of systems, can be applied to child
development and thus to the heart of prevention and promotion programs. Critical
moments followed by transitions or near-chaotic behaviours lead to stable states
better adapted to the environment. Prevention programs would focus on the
critical moments and target groups at risk to reduce risk factors. Promotion
programs would focus on stable states and target the general population to
develop age-appropriate life skills. The concept of sensitive dependence on
initial conditions and certain empirical studies suggest that the programs would
have the greatest impact at the beginning of life. It is hoped that this effort
to organize knowledge about conceptual models of prevention and mental health
promotion programs will foster the development of these programs to meet the
urgent needs of Canadian children.
Publication Types:
Review
185: Dev Psychopathol. 1999 Winter;11(1):1-13.
Implications of attachment theory for developmental psychopathology.
Sroufe LA, Carlson EA, Levy AK, Egeland B.

Institute of Child Development, University of Minnesota, Minneapolis 55455, USA.
Bowlby's attachment theory is a theory of psychopathology as well as a theory of
normal development. It contains clear and specific propositions regarding the
role of early experience in developmental psychopathology, the importance of
ongoing context, and the nature of the developmental process underlying
pathology. In particular, Bowlby argued that adaptation is always the joint
product of developmental history and current circumstances (never either alone).
Early experience does not cause later pathology in a linear way; yet, it has
special significance due to the complex, systemic, transactional nature of
development. Prior history is part of current context, playing a role in
selection, engagement, and interpretation of subsequent experience and in the
use of available environmental supports. Finally, except in very extreme cases,
early anxious attachment is not viewed as psychopathology itself or as a direct
cause of psychopathology but as an initiator of pathways probabilistically
associated with later pathology.
Publication Types:
Review
Review, Tutorial
186: Psychol Rep. 1999 Feb;84(1):157-66.
Suicide among German federal and state police officers.
Schmidtke A, Fricke S, Lester D.
Universitat Wurzburg, Germany. clips.psychiatry@rzbox.uniwurzburg.de
Most American studies report higher police officer suicide rates in comparison
to age-matched populations. In the Federal Republic of Germany police
organizations are comprised of Federal Customs, 16 state police, and 2 federal
police organizations. A survey carried out in 1997 yielded higher suicide rates
for police officers also in Germany in comparison to rates of the comparable age
group (25 per 100,000 vs 20 per 100,000). The most commonly used suicide method
was firearms (66-71%). Hypotheses often attribute this high suicidality among
police officers to higher work stress than in other professions. Other
hypotheses implicate individual variables such as psychiatric illnesses,
alcoholism, and interpersonal and marital problems. A transactional model might
explain these different views.
187: Twin Res. 1998 Dec;1(4):216-23.
Nature vs nurture: are leaders born or made? A behavior genetic investigation of
leadership style.
Johnson AM, Vernon PA, McCarthy JM, Molson M, Harris JA, Jang KL.
Department of Psychology, University of Western Ontario, London, Canada.
ajohnson@julian.uwo.ca
With the recent resurgence in popularity of trait theories of leadership, it is

timely to consider the genetic determination of the multiple factors comprising
the leadership construct. Individual differences in personality traits have been
found to be moderately to highly heritable, and so it follows that if there are
reliable personality trait differences between leaders and non-leaders, then
there may be a heritable component to these individual differences. Despite this
connection between leadership and personality traits, however, there are no
studies of the genetic basis of leadership using modern behavior genetic
methodology. The present study proposes to address the lack of research in this
area by examining the heritability of leadership style, as measured by
self-report psychometric inventories. The Multifactor Leadership Questionnaire
(MLQ), the Leadership Ability Evaluation, and the Adjective Checklist were
completed by 247 adult twin pairs (183 monozygotic and 64 same-sex dizygotic).
Results indicated that most of the leadership dimensions examined in this study
are heritable, as are two higher level factors (resembling transactional and
transformational leadership) derived from an obliquely rotated principal
components factors analysis of the MLQ. Univariate analyses suggested that 48%
of the variance in transactional leadership may be explained by additive
heritability, and 59% of the variance in transformational leadership may be
explained by non-additive (dominance) heritability. Multivariate analyses
indicated that most of the variables studied shared substantial genetic
covariance, suggesting a large overlap in the underlying genes responsible for
the leadership dimensions.
Publication Types:
Twin Study
188: Annu Rev Psychol. 1999;50:509-35.
Influences on infant speech processing: toward a new synthesis.
Werker JF, Tees RC.
Department of Psychology, University of British Columbia, Vancouver, Canada.
Jwerker@cortex.psych.ubc.ca
To comprehend and produce language, we must be able to recognize the sound
patterns of our language and the rules for how these sounds "map on" to meaning.
Human infants are born with a remarkable array of perceptual sensitivities that
allow them to detect the basic properties that are common to the world's
languages. During the first year of life, these sensitivities undergo
modification reflecting an exquisite tuning to just that phonological
information that is needed to map sound to meaning in the native language. We
review this transition from language-general to language-specific perceptual
sensitivity that occurs during the first year of life and consider whether the
changes propel the child into word learning. To account for the broad-based
initial sensitivities and subsequent reorganizations, we offer an integrated
transactional framework based on the notion of a specialized perceptual-motor
system that has evolved to serve human speech, but which functions in concert
with other developing abilities. In so doing, we highlight the links between
infant speech perception, babbling, and word learning.
Publication Types:
Review
189: J Nurse Midwifery. 1999 Jan-Feb;44(1):57-64.
Creating off-campus/distance learning courses for midwifery education. A brief
introduction.
Carr KC.
Midwifery education is undergoing a curriculum revolution that is reflective of
current trends in other fields. Distance learning programs have developed in
response to these changes. This article provides an overview of a
student-centered transactional educational model, discusses the role of faculty
as midwife-teachers, and reviews the factors influencing technology decisions
for distance education. Curricular structure is discussed and ideas for learning
activities are presented to assist faculty considering the development of
off-campus, distance learning courses.
Publication Types:
Review
Review, Tutorial
190: Ann Behav Med. 1998 Spring;20(2):118-34.
The comparison of individuals with recurrent tension-type headache and
headache-free controls in physiological response, appraisal, and coping with
stressors: a review of the literature.
Wittrock DA, Myers TC.
Department of Psychology, North Dakota State University, Fargo 58105, USA.
It is widely accepted that stress plays an important role in the experience of
tension-type headache. This article reviews the literature in which individuals
with recurrent tension-type headache are compared to headache-free controls in
the experience and appraisal of stress, psychophysiological response to stress,
and coping with stress. A modified and extended version of the transactional
model of stress as it might apply to tension-type headache is used to organize
the relevant literature. In summary, there is evidence to suggest that
individuals with recurrent tension-type headache experience more stressful
events and are more sensitive and have a lower threshold to pain. There are some
suggestions that headache sufferers may use different coping strategies for
stress and pain. There is little evidence of differences in physiological
responses to stressful events. The shortcomings of this body of literature are
addressed and directions for future research are identified.
Publication Types:
Review
Review, Tutorial
191: Child Care Health Dev. 1999 Jan;25(1):55-79.

Using a model of transactional developmental regulation to evaluate the
effectiveness of an early intervention programme for pre-school children with
motor impairments.
Woolfson LH.
Department of Educational Studies, University of Strathclyde, Glasgow, UK.
This study investigates how early intervention programme benefits may operate
beyond the traditional parameters of child developmental progress by exploring
family outcomes too. Sameroff and Fiese's (1990) model of transactional
developmental regulation is applied to provide a conceptual framework for the
evaluation of an interdisciplinary intervention programme for pre-school
children with motor impairments. Qualitative and quantitative methods were
combined by using standardized assessment of child progress and interviews.
Fifteen children, 11 mothers and five staff participated in the study.
Triangulation of data was carried out to obtain evidence of remediation (child
progress), re-education (parent learning) and redefinition (changes in parental
perceptions and expectations of their child's difficulties that allowed parents
to apply usual, rather than special, caregiving practices) as described in
Sameroff and Fiese's model. Findings point to the effectiveness of the programme
as indicated by evidence of child developmental progress, parental re-education
and redefinition. The study suggests that redefinition may be at least as
important a programme outcome as remediation or re-education, challenging
established notions of the goals of pre-school programmes for disabled children.
Implications of a broader-based, family-focused approach are discussed.
192: Suicide Life Threat Behav. 1998 Winter;28(4):328-37.
Suicide across the life span: pathways to prevention.
King CA.
Department of Psychiatry, University of Michigan Medical School, Ann Arbor
48109-0390, USA. kingca@umich.edu
As reflected in a recent series of highly visible suicide awareness and
prevention activities, the call for a comprehensive suicide prevention strategy
has never been stronger, nor more unified. Using the framework provided by the
transactional model of human development, the author illustrates the central
implications that a developmental perspective has for suicide prevention,
emphasizing the need to consider multiple pathways to prevention, to place
renewed emphasis on prevention strategies that have their impact earlier in the
life course and earlier in the course of mental disorder, and to collaborate
with prevention specialists and advocates in related fields.
Publication Types:
Review
Review, Tutorial
193: Harefuah. 1998 Sep;135(5-6):193-7, 254.

[Feeding disorders in infancy: feeding interaction concept in diagnosis and
treatment]
[Article in Hebrew]
Keren M, Tyano S.
Community-based Mental Health Baby Clinic, Gehah Hospital.
In infancy clinical manifestations of psychological distress are mainly somatic.
Feeding disorders are one of the most common and nonspecific manifestations of
different kinds of disturbed parent-child relationships. These disturbances may
have their origins in the baby's constitution and physical status, in the
parent's personality structure, or both, as has been conceptualized in the
transactional model of normal and abnormal development. Among the daily
interactions a baby has with parents, feeding has special inherent impact on the
early parent-child relationship because of its psychological meanings.
Therefore, feeding disorders, with or without failure to thrive, often reflect
various disorders of infancy, still not well recognized in the medical
community, such as regulatory disorders, attachment disorders, depression of
infancy, disorders of separation-individuation, and post-traumatic eating
disorder. 3 clinical cases are brought to increase awareness of psychological
distress in the infant, and of feeding disorders as 1 of its manifestations.
Each illustrates a different kind of feeding disorder in terms of etiology and
pathogenesis. Through these cases we emphasize the need for a
multi-disciplinary, integrative approach in diagnosis and treatment. Our
conceptual background is based both on the transactional model of development
(infant and parental factors impact on each other) in a very dynamic paradigm,
and on psychodynamic premises. Intrapsychic conflicts and past representations
impact heavily on the parenting characteristics. We emphasize the psychological
significance of disturbed feeding interactions, with or without failure to
thrive.
Publication Types:
Case Reports
194: Crit Care Nurs Clin North Am. 1998 Sep;10(3):315-26.
Management of psychiatric symptoms in medically ill patients in the homecare
setting.
Gonzalez EW, Walker D, Krupnick S.
Allegheny University of the Health Sciences, Philadelphia, USA.
Nurses with critical care knowledge and experience increasingly provide
technologically advanced care to patients at home who often present comorbid
psychiatric symptoms. Failure to accurately recognize and provide appropriate
intervention can be devastating for patients because these symptoms can
exacerbate the medical condition and may lead to mortality. The Biopsychosocial
Model and the Transactional Model of Stress were presented as guides for nursing
practice. Practice is directed at 1) understanding the patient's perception of
events, 2) involving the caregiver(s) in the patient's recovery, and 3)

enhancing the individual's adaptive coping efforts and resources. The article
attempts to guide nurses in making decisions on when to consult and collaborate
with an APPN to achieve desired patient outcomes.
Publication Types:
Review
Review, Tutorial
195: Psychother Psychosom Med Psychol. 1998 Sep-Oct;48(9-10):321-37.
[Coping--status of knowledge in the 90's]
[Article in German]
Heim E.
After a brief historical introduction the literature that has appeared on coping
since the middle eighties is reviewed. Theoretically Lazarus' concept of
transactional coping has been developed with focus on emotions. Antonovsky's
salutogenesis is considered to be innovative. Methodology is discussed in view
of instruments, observers time and perspective and need for qualitative
evaluation. Clinically it must be concluded from the many cross-sectional
comparisons that diseases with comparable demands call for similar coping. Only
in long-term studies can stage-dependent differences of efficacy be detected.
Active, tackling coping based on social and emotional resources and
problem-analysis is significantly superior to passive coping with social
withdrawal, ruminating, resignation and self-accusation. More recently interest
in coping is extended to families and caretakers of patients. It is concluded
that more corresponding with stress-research is needed, methodology should be
adjusted and in view of important intervention strategies evaluation of efficacy
is necessary.
Publication Types:
Review
Review, Tutorial
196: Z Gerontol Geriatr. 1998 Aug;31(4):250-6.
[Every day life experiences of healthy and mobility impaired elderly patients]
[Article in German]
Oswald F.
Abt f. Soziale und Okologische Gerontologie, Deutsches Zentrum fur
Alternsforschung, Universitat Heidelberg (DZFA). oswald@dzfa.uni-heidelberg.de
Studies on the everyday life of the elderly often deal with visible behavior. In
this study, the subjective experience of the everyday living environment was
investigated, paying special consideration to the role of mobility impairment.
Two approaches, one oriented toward the subject's experience of the home
environment, another oriented toward the environmental specifics of the

individual's favorite place, were employed. Is the experience of living at home
different for individuals with various levels of competence? Which aspects are
perceived to be the most important? 84 men and women aged 62-92 years (M = 77
years) participated in the study. 42 persons were generally healthy; the other
42 subjects suffered from severe mobility impairment. The experience of the
everyday environment was assessed in semistructured interviews at home. A
content analysis of the data gathered using the person-oriented approach
resulted in five experiential categories. Differences between healthy and
mobility impaired adults were found in the experience of cognitive,
biographical, and spatial dimensions of the living environment. Similarities
were found in the experience of emotional, social, and behavioral dimensions of
one's home. Competence loss played an important role in how the subjects
experienced living at home, yet even the mobility impaired experienced their
home as an environment which could be shaped. The environment-oriented approach
showed that the favorite place of mobility impaired persons was characterized by
higher spatial density. Finally, an examination of four home environment
profiles using cluster analysis illustrated the connection between both personand environment-oriented approaches and offered insights into a transactional
perspective of person and environment. Even though the subjective experience of
one's home environment is not easily quantifiable in terms of maintaining
everyday competence, it nonetheless imparts meaning to the elderly person's
daily life.
197: Pain. 1998 Jul;77(1):33-9.
Pain coping strategies predict perceived control over pain.
Haythornthwaite JA, Menefee LA, Heinberg LJ, Clark MR.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University,
Baltimore, MD 21287-7218, USA.
Perceptions of control over pain and specific pain coping strategies are
associated with a number of positive outcomes in patients with chronic pain
conditions. Transactional models of stress have emphasized coping as a process
that is both determined by, and influences appraisals of control. While
perceptions of control and coping efforts are associated with better adjustment,
little is known about the specific coping strategies that contribute to
perceptions that pain is controllable. One hundred and ninety-five (65% female)
individuals with chronic pain conditions admitted to an inpatient unit completed
the Multidimensional Pain Inventory, the Survey of Pain Attitudes and the Coping
Strategies Questionnaire. Stepwise multiple regression analyses were used to
predict perceived pain control from measures of pain severity and coping. After
controlling for pain severity and education, coping self-statements and
reinterpreting pain sensations predicted greater perceptions of control over
pain, whereas ignoring pain sensations predicted lower perceptions of control
over pain. The coping strategies did not interact with pain severity in
predicting perceptions of control. Coping flexibility, or the number of pain
coping strategies reported at a high frequency, also predicted perceptions of
control over pain and did not interact with pain severity. The present findings
suggest that, regardless of pain severity, the use of specific cognitive pain
coping strategies may increase perceptions of control over pain. Since the
existing coping literature largely identifies maladaptive pain coping
strategies, it is especially critical to establish which pain coping strategies

are adaptive. Specific cognitive strategies, particularly coping self
statements, are important components for cognitive-behavioral interventions for
chronic pain management. Future research will need to determine whether other
adaptive cognitive strategies such as reinterpreting pain sensations can be
increased with cognitive interventions, since this strategy is infrequently
used.
198: Gerontologist. 1998 Aug;38(4):422-33.
Everyday competence in later life: current status and future directions.
Diehl M.
Department of Psychology, University of Colorado at Colorado Springs 80933-7150,
USA. mdiehl@mail.uccs.edu
This article reviews the literature on the antecedents and outcomes of everyday
competence in later life and discusses future directions. It is argued that
there is a fairly solid knowledge base with regard to the antecedents and
outcomes but not in terms of the components and mechanisms of older adults'
everyday competence. Five key issues are identified and discussed in terms of a
future research agenda. For each key issue, directions for future research are
outlined and a transactional approach is advocated. It is emphasized that older
adults should be viewed as proactive individuals who are motivated to minimize
the losses and maximize the gains associated with the aging process.
Publication Types:
Review
Review, Tutorial
199: J Pediatr Psychol. 1998 Aug;23(4):219-28.
Psychological adaptation and adjustment of mothers of children with congenital
heart disease: stress, coping, and family functioning.
Davis CC, Brown RT, Bakeman R, Campbell R.
Georgia State University, USA.
OBJECTIVE: Investigate support for the transactional stress and coping model for
mothers of children with congenital heart defects, in accounting for the
variance in maternal adjustment. METHODS: Participants were 52 mothers of
children recruited from a university medical center. Measures included illness
variables, cognitive processes (i.e., appraisals of stress, expectations,
methods of coping, family functioning, and maternal psychological adjustment).
RESULTS: Maternal adjustment was associated with high levels of daily stress and
palliative coping techniques and was not significantly associated with severity
of the cardiac defect. Together, the variables of the model accounted for
approximately 38% of the variance in maternal adjustment. CONCLUSIONS: The
findings are in accord with previous research among other chronically ill
populations in suggesting an association between stress, coping, and maternal
adjustment. Within the limitations of the study, the data were interpreted to
support the utility of theoretical models in identifying areas in need of
intervention across chronic illness groups.
200: J Dev Behav Pediatr. 1998 Aug;19(4):283-5.
Pygmalion in the cradle: observer bias against cocaine-exposed infants.
Woods NS, Eyler FD, Conlon M, Behnke M, Wobie K.
Department of Psychology, Austin Peay State University, Clarksville, Tennessee
37044, USA.
This study examined whether the widely disseminated negative image of the
"cocaine baby" would lead adults to perceive a videotaped unexposed infant more
negatively simply because they had been told the infant was prenatally
cocaine-exposed. Two hundred and forty-nine students from three state
universities used a seven-point Likert scale to rate either an African-American
or a white female infant on 20 bipolar adjective-pairs. As predicted,
participants who observed a labeled infant rated her more negatively than did
those for whom the infant had not been labeled as cocaine-exposed. The
potentially negative consequences of this documented bias toward cocaine-exposed
infants should both alert and concern professionals and researchers. If adults
view the behavior of a nonexposed infant more negatively merely because they
believe that the infant has been exposed, then parents (biological and
adoptive), professionals, and researchers may view and respond to the behavior
of infants who are cocaine-exposed more negatively. Transactional models of
development suggest a potential for self-fulfilling prophecy.
201: Behav Brain Res. 1998 Jul;94(1):11-24.
Clinical foundations of hyperactivity research.
Taylor E.
MRC Child Psychiatry Unit, Institute of Psychiatry, London, UK.
Clinical research into the psychopathology of attention deficit/hyperactivity
disorder (AD/HD) has established reliable measures of the defining behavioural
problems: inattentiveness, overactivity, and impulsiveness. Experimental
measures have defined them with increasing accuracy, but research is still
needed before it is clear what processes need to be explained at the level of
brain dysfunction. Understanding the associations of AD/HD, and the way they
change over time, requires the approach of developmental psychopathology. This
paper outlines some key concepts. The possible heterogeneity of AD/HD is
stressed, with substantial differences being associated with the predominant
type of symptom, the situations in which it is expressed, and the types of
co-existing problems. Developmental influences on course need not be the same as
initiating causes and a transactional model is outlined. Cultural and familial
factors modulate the course of this biologically initiated disorder. Genetic
influences appear to be strong and a combination of behavioural and molecular
genetics with longitudinal study offers hope of advances in nosology.
Publication Types:
Review
Review, Tutorial
202: Schweiz Rundsch Med Prax. 1998 Jul 8;87(27-28):893-6.
[The dynamics of the dialogue situation]
[Article in German]
von Uslar D.
203: Int J Eat Disord. 1998 Sep;24(2):157-66.
Stress, coping, and crisis support in eating disorders.
Troop NA, Holbrey A, Treasure JL.
Psychiatry Department, Institute of Psychiatry, London, United Kingdom.
OBJECTIVE: Recent research has supported the role of stress in the development
and maintenance of eating disorders. However, coping and crisis support,
important aspects of this stress process, have received little systematic
attention. The cognitive-transactional approach to coping emphasizes the
importance of the relationship between the individual and the particular
problematic situation and yet most studies investigating coping in eating
disorders have failed to measure situation-specific coping. METHOD: The present
study used semistructured interviews to measure coping and crisis support in
response to severe events and/or marked difficulties in 12 women with anorexia
nervosa (AN), 21 women with bulimia nervosa (BN), and 21 women without an eating
disorder (non-ED). RESULTS: Women with eating disorders were more likely to use
cognitive avoidance or cognitive rumination and were less likely to downplay
their problems. In addition, BN subjects were more likely to blame themselves
and were less likely to receive crisis support from a core-tie. Overall, women
with eating disorders were less likely to be masterful in response to crises
than women without eating disorders. DISCUSSION: It is concluded that women with
eating disorders are less effective in their coping than women without eating
disorders.
204: J Occup Health Psychol. 1998 Jul;3(3):227-42.
The structure of work-related stress and coping among oncology nurses in
high-stress medical settings: a transactional analysis.
Florio GA, Donnelly JP, Zevon MA.
Department of Psychology, Roswell Park Cancer Institute, Buffalo, New York
14263, USA.
A transactional approach was used to examine stress and coping among 59 oncology
nurses. Nine work stress clusters were identified: Physician-Related Stress,
Organizational Factors, Observing Suffering, Ethical Concerns, Death and Dying,
Carryover Stress, Negative Self-Thoughts, Inadequate Resources, and Coworker
Stress, with the first 3 rated as most frequent and most intense. Ten coping
clusters were also identified: Coworker Support, Positive Reappraisal,
Developing a Growth Perspective, Positive Involvement in Treatment, Affective
Regulation, Balancing Work Stress, Negative Coping, Apathy, Withdrawal, and
Catharsis, with the first 3 rated as most frequently used and most effective.
The relationships among the clusters, as well as the theoretical and clinical
implications of these results, were discussed.
205: Hosp J. 1998;13(3):35-48.
Transformational leadership and the hospice R.N. case manager: a new critical
pathway.
Lafferty CL.
INOVA VNA Community Hospice, Arlington, VA, USA.
This article asserts that in light of changing conditions in the healthcare
environment, transformational leadership is the most appropriate leadership
style for the hospice registered nurse case manager. The author defines
transformational leadership and, tracing from early leadership theories,
demonstrates how the transformational-transactional leadership paradigm emerged
from preceding leadership theories. The components of transformational
leadership--transformational behavior and transformational characteristics--are
linked to hospice theory and hospice-specific nursing practices. The expanding
role of the hospice R.N. case manager is addressed in light of transformational
leadership and culture building. Specific actions are proposed in the arenas of
research, education, and community, corporate, and legislative involvement.
Publication Types:
Review
Review, Tutorial
206: Health Serv Manage Res. 1998 Aug;11(3):182-91.
Management of health system reform: a view of changes within New Zealand.
Ritchie D.
Faculty of Health Studies, School of Nursing and Health Administration, Charles
Sturt University, NSW, Australia.
This paper reports on the context and process of health system reform in New
Zealand. The study is based on interviews conducted with 31 managers from three
Crown Health Enterprises (publicly funded hospital-based health care
organizations). A number of countries with publicly funded health services
(e.g., UK, Australia and New Zealand) have sought to shift from the traditional
'passive' health management style (using transactional management skills to
balance historically-based expenditure budgets) to 'active' transformational

leadership styles that reflect a stronger 'private sector' orientation
(requiring active management of resources--including a return on 'capital'
investment, identification of costs and returns on 'product lines', 'marketing'
a 'product mix', reducing non-core activities and overhead costs, and a closer
relationship with 'shareholders', suppliers and customers/clients). Evidence of
activities and processes associated with transformational leadership are
identified. Success of the New Zealand health reforms will be determined by the
approach the new managers adopt to improve their organization's performance.
Transformational leadership has been frequently linked to the successful
implementation of significant organizational change in other settings (Kurz et
al., 1988; Dunphy and Stace, 1990) but it is too early to assess whether this is
applicable in a health care context.
207: Dev Psychopathol. 1998 Spring;10(2):235-57.
An ecological-transactional analysis of children and contexts: the longitudinal
interplay among child maltreatment, community violence, and children's
symptomatology.
Lynch M, Cicchetti D.
Mt. Hope Family Center, University of Rochester, USA.
Cicchetti and Lynch have conceptualized ecological contexts as consisting of
nested levels with varying degrees of proximity to the individual. These levels
of the environment interact and transact with each other over time in shaping
individual development and adaptation. With a sample of maltreated (n = 188) and
nonmaltreated (n = 134) children between the ages of 7 and 12 years, this
investigation employed a 1-year longitudinal design to conduct an
ecological-transactional analysis of the mutual relationships among community
violence, child maltreatment, and children's functioning over time. Indicators
of children's functioning were externalizing and internalizing behavior problems
and self-rated traumatic stress reactions, depressive symptomatology, and
self-esteem. Either full or partial support was obtained for the study's primary
hypotheses. Rates of maltreatment, particularly physical abuse, were related to
levels of child-reported violence in the community. In addition, child
maltreatment and exposure to community violence were related to different
aspects of children's functioning. Specific effects were observed for neglect
and sexual abuse and for witnessing and being victimized by violence in the
community. Finally, there was evidence that children and their contexts mutually
influence each other over time. Results were discussed within the framework of
an ecological-transactional model of development.
208: J Subst Abuse Treat. 1998 May-Jun;15(3):177-82.
Case presentation of a substance-abusing borderline patient. Illustrating use of
the immediate transactional experience.
Stanger R.
Department of Psychiatry, North Shore University Hospital-NYU School of
Medicine, Manhasset 11030, USA.

This paper presents a severely disturbed self-mutilating person with a chronic
substance abuse history. It demonstrates how use of the immediate transactional
experience is an analytic model, facilitated treatment. The authentic use of the
therapist's self is endorsed as mutative in facilitating personality change in
the patient. Fellow professionals are encouraged to respond to this paper in the
service of fruitful analytic dialogue, in the service of promoting more
effective treatment of this difficult population in equally difficult times.
Publication Types:
Case Reports
209: Scand J Psychol. 1998 Mar;39(1):15-24.
Neuroticism, coping and change in MCMI-II clinical syndromes: test of a mediator
model.
Vollrath M, Torgersen S, Alnaes R.
Department of Social Psychology, University of Zurich, Switzerland.
The aim of the study was to examine prospectively whether coping mediated the
relation between Neuroticism and change in different clinical mental syndromes.
Assessments were conducted with 154 former psychiatric outpatients six and seven
years after their initial contact with an outpatient clinic. Dispositional
coping mediated the relation between Neuroticism and change in four of the nine
clinical scales of the Millon Clinical Multiaxial Inventory (MCMI-II) (Millon,
1987). High Neuroticism led to coping strategies of disengagement and the
venting of emotions and to a lack of problem-focused coping, which in turn
translated into a relative increase on the MCMI-II scales. The mediator model of
coping was found to apply to the MCMI-II scales 'somatoform disorder',
'dysthymia', 'alcohol dependence' and 'thought disorder'. Results are discussed
under the perspective of an integration of the positions of the transactional
theory of stress and personality psychology.
210: Psychol Bull. 1998 May;123(3):234-7.
Comment on:
Psychol Bull. 1998 May;123(3):224-30.
Psychol Bull. 1998 May;123(3):231-3.
Infant abuse and neglect in monkeys--a discussion of definitions, epidemiology,
etiology, and implications for child maltreatment: reply to Cicchetti (1998) and
Mason (1998)
Carroll KA, Maestripieri D.
Department of Psychology, Berry College, Georgia.
In response to D. Cicchetti's (1998) and W. A. Mason's (1998) commentaries, this
article scrutinizes infant maltreatment in monkeys and its public health
implications. Studies of infant abuse and neglect in monkeys have used

operational definitions based on (a) adult behavior or (b) adult behavior and
infant outcome (depending on data available for analysis). Direct comparisons
between the incidence of maltreatment in monkey and human populations can be
only tentative as a result of differences in operational definitions of
maltreatment. A simplified version of the ecological-transactional model of
maltreatment can be used in research with nonhuman primates, and different
species can be used to model different aspects of the human phenomenon. Although
abuse and neglect take different forms in animals and humans, research with
animal models can make an important contribution to elucidating the adaptive
function, if any, of child maltreatment and the proximate mechanisms underlying
its occurrence.
Publication Types:
Comment
211: Behav Med. 1998 Spring;24(1):5-16.
Coping and appraisal of daily stressors predict heart rate and blood pressure
levels in young women.
Fontana A, McLaughlin M.
Department of Psychology, Colgate University in Hamilton, New York, USA.
AFontana@Center.Colgate.edu
An anger-provocation paradigm was used to assess the effects of coping processes
and appraisal of daily stressors on stress reactivity in 33 normotensive
undergraduate women. Participants performed a mental arithmetic and an
interpersonal conflict task during the pre- and postmenstrual phases of their
menstrual cycles. Increased use of the emotion-focused coping processes of
tension reduction and positive reappraisal was correlated with lower levels of
baseline heart rate, whereas distancing was associated with higher levels of
systolic blood pressure reactivity during the conflict task. Perceiving daily
stressors as more stressful was associated with higher baseline diastolic blood
pressure levels. The authors concluded that the transactional model of stress is
useful for generating hypotheses about factors that predict heart rate and blood
pressure levels in women.
Publication Types:
Clinical Trial
212: Arch Psychiatr Nurs. 1998 Apr;12(2):81-9.
Addiction recovery for low-income pregnant and parenting women: a process of
becoming.
Nardi D.
Indiana University Northwest School of Nursing, Gary 46408, USA.
A naturalistic field study of low-income women (N = 17) in an intensive
outpatient addiction recovery program addressed the question: What is the nature
of addiction recovery for pregnant and parenting-women in an addiction treatment
program? Grounded theory methodology was used to determine the nature of the
interpersonal and social processes that define addiction recovery for women in
this study. Over 2 years, audiotaped semi-structured interviews, document
reviews of medical records, treatment progress and group therapy notes, and
participant observation notes were collected and analyzed. The constant
comparison method of analysis involved an ongoing process of theoretical
sampling, memoing, and open and then axial coding to identify, group, link, and
reduce the categories produced. A developmental model of addiction recovery in
pregnant and parenting women emerged that consisted of the dimensions of
becoming drug and alcohol free, a partner in a relationship, a person, and a
parent. These four dimensions parallel and transform each other, yielding
different outcomes but similar patterns over time. This model of addiction
recovery provides a beginning framework for understanding the transactional
nature of addiction recovery for low-income women who are adapting to a drug and
alcohol-free lifestyle and the task and role of parenting a newborn.
213: J Abnorm Child Psychol. 1998 Feb;26(1):71-82.
Child and adolescent psychotherapy research: developmental issues.
Eyberg SM, Schuhmann EM, Rey J.
University of Florida, Gainsville 32610, USA. seyberg@hp.ufl.edu
Describes developmental issues that pose current challenges to the design of
treatment outcome investigation with children and adolescents. Normal childhood
development and the development of childhood disorders are discussed using the
transactional model of development. Challenges in diagnostic decision making,
the selection of the most appropriate treatment regimen, and the measurement
methods are highlighted. Recognition of the need to study child treatments
through long-term follow-up periods underscores the need for resolution of these
developmental issues.
Publication Types:
Review
Review, Tutorial
214: Hokkaido Igaku Zasshi. 1998 Jan;73(1):29-33.
[Informed consent in psychosomatic medicine]
Satohisa E.
Hoyuukai Sapporo Clinic of Obstetric and Gynaecology, Sapporo, Japan.
Obtaining informed consent perfectly is very difficult from the view of
psychosomatic medicine. Medical education regarding informed consent is
generally of a low level. However as it is important to defend patients' human
rights, we must educate them as to the precise meaning of both "informed" and
"consent". In this report I have tried to demonstrate that both the education of
medical students and their social consciousness are very important. I examined
students' opinions regarding the care of a sudden case of hysterectomy (Porro's
emergent operation). The following students were involved: 1st year medical
students (N = 73), 4th year (N = 85) and 6th year (N = 119), and 3rd year
nursing students (N = 42) and midwife students (N = 27). I examined their
answers by transactional analysis. The answers of the 1st year medical students
reflecting the view of the child ego state were significantly greater than those
of the other students (P < 0.01). But following my lecture the answers of the
same 1st year students altered to reflect the view of the adult ego more (P <
0.05). We opened "the key center of psychosomatic women's health in Japan" in
our clinic two years ago. Since then we have talked every month to people in
general about various women's diseases, and also discussed various problems of
the doctor-patient relationships during these talks. I feel that public
awareness concerning informed consent has increased gradually recently in Japan.
215: Can J Nurs Res. 1997 Fall;29(3):79-91.
[Study of the relation between transformational leadership of the head nurse and
supplementary efforts of nursing personnel]
[Article in French]
Ouimet G, Tourigny L.
The present study proposes to show that the ethos of the Head Nursing staff is
related to the practice of transformational leadership, and to additional
efforts displayed by the treatment staff. Using a sampling of 57 nurses, it was
established that transformational leadership presented a positive influence on
additional efforts which were superior to that produced by transactional
leadership. Contrary to transactional leadership, transformational leadership
was shown to exert a positive effect on the ethos of the leader who in turn, had
a positive influence on the extra care supplied by the nursing staff.
216: J Pediatr Psychol. 1997 Dec;22(6):811-25.
Adherence behavior among adolescents with type I insulin-dependent diabetes
mellitus: the role of cognitive appraisal processes.
Murphy LM, Thompson RJ Jr, Morris MA.
Department of Psychology, Otterbein College, Westerville, Ohio 43081, USA.
Guided by a transactional stress and coping model, this study examined the
contribution of cognitive appraisal processes to diabetes adherence behavior
among adolescents 12 to 18 years old (n = 40). Multiple hierarchical regression
analyses indicated that esteem related to physical appearance accounted for a
significant 16% of the variance in checking one's blood sugar. Perceived control
when ill and attributional style for negative events each accounted for
significant increments of variance as well (10 and 6%, respectively), yielding a
total of 32% of the variance explained by appraisal processes. Results suggest
that adolescents who (a) have a negative perception of their bodies, (b)
perceive little internal control over health when ill, and (c) have an external
attributional style for negative events were at greatest risk for poor
compliance as indicated by less frequent checking of blood sugar.
217: Am Psychol. 1998 Feb;53(2):167-84.
What matters? What does not? Five perspectives on the association between
marital transitions and children's adjustment.
Hetherington EM, Bridges M, Insabella GM.
Department of Psychology, University of Virginia, Charlottesville 22903-2477,
USA. emh2f@virginia.edu
This article presents an analysis of 5 views of factors that contribute to the
adjustment of children in divorced families or stepfamilies. These perspectives
are those that emphasize (a) individual vulnerability and risk; (b) family
composition; (c) stress, including socioeconomic disadvantage; (d) parental
distress; and (e) disrupted family process. It is concluded that all of these
factors contribute to children's adjustment in divorced and remarried families
and that a transactional model examining multiple trajectories of interacting
risk and protective factors is the most fruitful in predicting the well-being of
children.
Publication Types:
Review
Review, Tutorial
218: Child Care Health Dev. 1998 Jan;24(1):21-30.
Children's and adolescents' perception of their asthma bronchiale.
Noeker M, Petermann F.
Centre for Paediatrics, University of Bonn, Germany.
The present study examines the perception of asthma bronchiale in a large sample
of 382 children and adolescents (mean age = 12.5 years) across three different
treatment settings (outpatient, short-term rehabilitation, residential
treatment) by using a revised child version of the 'Asthma Problem Behavior
Checklist.' A PCA reveals two factors (eigenvalues: 26.3; 4.2; 0.9 ..) with a
complementary structure: 'appraisal of asthma-related distress' (explained
variance: 48.5%) and 'appraisal of resources in coping with asthma-related
distress' (explained variance: 20.9%). Implications for clinical psychological
assessment of young patients with asthma and the congruence with the LAZARUS
transactional conceptualization of stress and coping are discussed.
219: Psychooncology. 1997 Dec;6(4):267-78.
Stress, social support and negative affectivity in children with newly diagnosed
cancer: a prospective transactional analysis.
Varni JW, Katz E.
Department of Psychiatry, University of California, San Diego, School of
Medicine, USA.
Conceptually-driven investigations on the potentially modifiable predictors of
individual differences among children with newly-diagnosed cancer may facilitate
the identification of pediatric cancer patients at risk for maladjustment during
the profound adversity associated with this life-threatening disease and
aversive biomedical treatment. Within a risk and resistance theoretical
framework, perceived stress and social support were investigated concurrently
and prospectively within an exploratory design as predictors of negative
affectivity (anxiety and depressive symptoms composite construct) in
newly-diagnosed pediatric cancer patients at Time 1 (within one month after
diagnosis), Time 2 (6 months postdiagnosis), and Time 3 (9 months
postdiagnosis). Hierarchical multiple regression analysis findings indicate that
perceived stress and social support have direct and independent effects on
negative affectivity principally at the 9-month time interval. These findings
are discussed in terms of the cognitive-behavioral treatment implications for
enhancing child adjustment during the transition from the initial cancer
diagnosis and aversive biomedical treatment to subsequent school and social
reintegration.
220: Wien Klin Wochenschr. 1997 Oct 17;109(19):781-91.
[Physician speechlessness in physician-patient communication. Discourse analytic
studies]
[Article in German]
Wodak R, Lalouschek J.
Institut fur Sprachwissenschaft, Angewandte Sprachwissenschaft, Universitat
Wien, Osterreich.
Publication Types:
Case Reports
221: J Consult Clin Psychol. 1997 Dec;65(6):959-69.
Content analysis of archival data.
Lee F, Peterson C.
Department of Psychology, University of Michigan, Ann Arbor 48109-1109, USA.
fionalee@umich.edu
Content analysis can be a particularly suitable method for measuring cognitive
variables from archived texts. Although content analysis has been underused by
clinical psychologists, there are many benefits to this strategy. Longitudinal

studies can be conducted retrospectively, the range of possible research
participants can be expanded to include individuals otherwise unavailable (e.g.,
the famous or the dead), existing data sets can be used and reused to answer new
questions, and studies across cultures and across levels of analysis (individual
vs. group) can be facilitated. To illustrate the use and usefulness of content
analysis to measure cognitive variables, the authors focus on the examples of
causal attributions and integrative complexity, describing past research and
sketching future applications to clinical research and practice.
Publication Types:
Review
Review, Tutorial
222: J Nurs Manag. 1997 Sep;5(5):279-87.
A measure of organizational effectiveness in nursing management in relation to
transactional and transformational leadership: a study in a Swedish county
hospital.
Prenkert F, Ehnfors M.
Department of Business Administration, Computer Science, Economics and
Statistics, University of Orebro, Sweden.
This paper presents an empirical study of the influences of transactional (TA)
and transformational (TF) leadership on organizational effectiveness (OE),
measured as the degree of goal attainment and the quality of nursing care (NQ).
The study subjects were all head-nurses and assistant head-nurses at a
medium-sized hospital in Sweden (n = 23). The methods used were questionnaires
and interviews. The multi-leadership questionnaire earlier developed by Bass was
modified and named the Leadership Nursing-Effectiveness Questionnaire (LNEQ),
comprising 84 items using Likert-type scales. The study showed low mean scores
on OE (2.19) and TA (1.05) but high mean scores on NQ (3.17) and TF (3.84). The
results suggest that the degree of TA and TF leadership had a low and
insignificant connection with OE in this hospital organization. The study did
not support the statement that organizational units exposed to a higher degree
of TA and TF leadership at the same time show a high degree of OE, as has been
shown in studies in other cultural contexts and organizations.
223: Dimens Crit Care Nurs. 1997 Nov-Dec;16(6):292-300.
Application of a transactional model of stress and coping with critically ill
patients.
Byers JF, Smyth KA.
College of Nursing, University of Florida, USA.
Critically ill patients are exposed to many physiologic and environmental
stressors, which can result in deleterious physiological and psychological
effects. Stress and coping within Lazarus and Folkman's transactional model is
used as a basis for describing patient responses in critical care. The authors
propose specific strategies to reduce stress and maximize coping in the
critically ill patient.
Publication Types:
Case Reports
Preventive intervention as means of clarifying direction of effects in
socialization: anxious-withdrawn preschoolers case.
LaFreniere PJ, Capuano F.
Department of Psychology, University of Maine, Orono 00469, USA.
Peterlaf@Maine.Maine.Edu
An indicated preventive intervention research program integrating attachment,
attributional, and behaviorist perspectives was conducted to test the hypothesis
that parent-child relationship disturbances directly effect the child's
adjustment to the preschool. Anxious-withdrawn preschool children and their
mothers were divided equally into treatment and control groups, and assessed on
maternal self-report of parenting stress, behavioral ratings of mother-child
interaction, and teacher ratings of the children in the preschool classroom.
Results showed significant changes in the treatment of group: mothers in the
treatment group moderated their level of control to a more appropriate, less
intrusive level, while children in the treatment group showed an increase in
cooperation and enthusiasm during a problem solving task with mother.
Teacher-rated social competence and anxious-withdrawn behavior indicated
improvement, although only the former was significant. The demonstration of
effects of this home intervention for the mother on the child's behavior in the
preschool confirm the transactional model underlying this study and demonstrate
the utility of a parent-child interaction training component for the prevention
of behavioral-emotional problems in young children.
225: J Nerv Ment Dis. 1997 Sep;185(9):533-41.
Do attention deficit hyperactivity disorder and major depression share familial
risk factors?
Faraone SV, Biederman J.
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114,
USA.
Comorbidity between ADHD and major depression has been reported from both
epidemiologic and clinical studies of both children and adults. Our goal was to
assess the validity of the association by reviewing family studies of the two
disorders. We examined this issue from a genetic epidemiologic perspective by
searching the literature for family studies of ADHD children that had assessed
depression in relatives and family studies of depressed children that had
assessed ADHD in relatives. Family studies of ADHD, family studies of
depression, and one population-based family study strongly support the assertion
of a familial link between ADHD and depression. ADHD families with antisocial
disorders show the greatest risk for depression. However, in the absence of
antisocial disorders, ADHD also imparts a familial risk for depression. ADHD and
major depression probably share familial risk factors, and the difference
between depressed and nondepressed ADHD patients can be attributed to
environmental factors. Depression in an ADHD child should not be routinely
dismissed as demoralization secondary to ADHD, and depression in mothers of ADHD
children should not always be attributed to the stress of living with an ADHD
child. The converse statements are equally valid: ADHD in depressed children may
not be secondary to depression, and ADHD in the children of depressed mothers
may not be a transactional response to the mother's depression.
Publication Types:
Review
Review, Tutorial
226: Clin Auton Res. 1997 Aug;7(4):191-7.
A novel psychophysiological treatment for vasovagal syncope.
Khurana RK, Lynch JJ, Craig FW.
Division of Neurology, Union Memorial Hospital, Baltimore, Maryland 21218, USA.
The objective of this study was to evaluate the efficacy of transactional
psychophysiological therapy (TPT) in a patient with recurrent vasovagal syncope
(VVS) and to quantify the capacity of human dialogue to effect significant and
consistent measurable therapeutic cardiovascular (CV) changes. A 31-year-old
nurse with recurrent VVS and a reproducibly abnormal tilt-table test was
refractory to pharmacological and conventional psychiatric treatments. She was
treated with TPT. Her CV responses during psychotherapy were incorporated into
the dialogue as an important source of communicative information, and she was
taught psychophysiological techniques to correct exaggerated CV responses. These
responses, during 16 weekly and 12 subsequent monthly sessions, were analysed
using a one-way multiple analysis of variance. As TPT progressed, the magnitude
and lability of CV responses as well as frequency of VVS were reduced. She has
been relatively asymptomatic for 14 years posttherapy. In conclusion, (1) TPT
may be an effective primary/adjunctive treatment for patients with VVS; (2) TPT
may reduce syncopal episodes, perhaps by normalizing limbic input to the
brainstem baroreflex system.
Publication Types:
Case Reports
227: Soc Sci Med. 1997 Sep;45(6):957-66.
AIDS-related knowledge, attitudes and behaviour among South African street
youth: reflections on power, sexuality and the autonomous self.
Swart-Kruger J, Richter LM.
Dept of Anthropology and Archaeology, University of South Africa, Pretoria,

South Africa.
Street children in South Africa are, in the main, between the ages of 11 and 17
years. Rape, prostitution, sexual bartering and exchange, casual sex and
romantic sexual relationships all occur in the experiences of young people who
live and work on inner-city streets. In this study, the AIDS-related knowledge,
attitudes and behaviour of 141 street youth, living in seven large cities in
South Africa, were elicited in focus group discussions. At the time of the
study, 79 boys (56%) were living in shelters run by nongovernmental and welfare
organisations, while 62 boys (44%) were sleeping "rough". The results, both
qualitative and quantitative, indicated that the AIDS knowledge of South African
street children was comparable to levels reported for groups of "hard-to-reach"
youth in other parts of the world. Fear of HIV infection did not appear in a
list of day-to-day priorities constructed by the children, a list dominated by
survival concerns with food, money and clothes. However, more than half of the
boys conceded that they engaged in sex for money, goods or protection, several
boys indicated that they had been raped, and most reported being sexually active
with "girlfriends", who themselves frequently engaged in transactional sex. The
findings are interpreted in terms of the relationships between power dynamics
surrounding race and age, and how they affect self-initiated controls over
sexuality and sexual protection.
228: Issues Ment Health Nurs. 1997 Jul-Aug;18(4):331-50.
Coping style, health beliefs, and breast self-examination.
Barron CR, Houfek JF, Foxall MJ.
University of Nebraska Medical Center, College of Nursing, Omaha 68198-5330,
USA.
The purpose of this study was to determine the role of coping style in women's
practice of breast self-examination (BSE). The framework was adapted from the
Cognitive Transactional Model of Stress and Coping and the Health Belief Model.
The convenience sample consisted of 269 women recruited from an employee list of
a medical center and a membership list of a professional nurses' group. Survey
booklets were distributed via interdepartmental or U.S. mail and contained
measures of trait anxiety and defensiveness and questions related to health
beliefs, BSE practice, and demographics. The sample was categorized by coping
style (i.e., repressive, true high anxious, defensive high anxious, or true low
anxious), and data were analyzed via MANOVAs, ANOVAs, and hierarchical
regression. Results indicated that coping style predicted BSE practice (i.e.,
proficiency, frequency) and health beliefs of barriers, confidence, seriousness,
and susceptibility. The findings provide nurses with information for developing
interventions to foster BSE.
229: J Am Acad Child Adolesc Psychiatry. 1997 Jun;36(6):799-808.
Adolescent physical abuse and suicide attempts.
Kaplan SJ, Pelcovitz D, Salzinger S, Mandel F, Weiner M.
Department of Psychiatry, North Shore University Hospital-NYU School of

Medicine, Manhasset 11030, USA.
OBJECTIVE: The rate of suicide attempts and the exposure to risk factors for
suicide in an unselected sample of confirmed cases of physically abused
adolescents recruited directly from the New York State Central Register for
Nassau and Suffolk Counties was compared with those of a community sample of
nonabused adolescents. METHOD: Semistructured and structured diagnostic
interviews were used in the assessment of psychopathology of adolescents and
their parents RESULTS: The proportion of adolescents attempting suicide did not
differ for the two groups. However, the abused adolescents showed significantly
greater exposure to risk factors for adolescent suicide, including family
disintegration, and diagnoses of depression, disruptive behavior disorders, and
substance abuse and dependence. Comparisons of the 8 physically abused
adolescents who attempted suicide with the 91 who did not attempt suicide showed
that the following factors were associated with significantly greater risk for
suicide attempts: adolescents' perceptions of their families as lacking
cohesiveness and maternal support, higher adolescent "hostility" ideation
scores, adolescent diagnoses of disruptive disorders and conduct disorders,
adolescent substance abuse/dependence, and exposure to a suicide attempt by a
family member or a friend. CONCLUSION: A transactional model of abuse, family
and personal stressors, and the development of adolescent vulnerability leading
to psychopathology is offered to explain the results.
230: J Nurs Adm. 1997 May;27(5):27-34.
The relation between leadership style and empowerment on job satisfaction of
nurses.
Morrison RS, Jones L, Fuller B.
Capstone College of Nursing, University of Alabama, Tuscaloosa, USA.
OBJECTIVE: The authors explore the relation between leadership style and
empowerment and its effect on job satisfaction among the nursing staff of a
regional medical center. BACKGROUND: Several empirical studies on
transformational leadership-found that transformational leadership behaviors
were positively related to work team success and leadership effectiveness.
Transformational leadership processes have also been suggested to enhance
followers' work-oriented values and shape the self-efficacies of followers.
Employee empowerment may be influenced by the perception that the organization
cares about its employees' well-being and that their work is valued. Empowering
nurses may increase job satisfaction and improve patient care. Leadership style
and empowerment influence job satisfaction among workers. METHODS: All nursing
department staff were invited to complete a self-report questionnaire with no
identifying information. Leadership style was measured using Bass's Multifactor
Leadership Questionnaire, empowerment was measured with items from Spreitzer's
Psychological Empowerment instrument, and job satisfaction was measured by Warr,
Cook, and Wall's job satisfaction questionnaire. RESULTS: Both transformational
and transactional leadership were positively related to job satisfaction, as was
empowerment. Differences in the contributions of empowerment and leadership
style in predicting job satisfaction for licensed and unlicensed workers was
evident. CONCLUSION: Designing interventions that allow for the relative
influence of leadership style as well as empowerment on varying classifications

of nursing personnel may be a more effective strategy and have a greater effect
on staff attitudes and behaviors.
231: J Behav Med. 1997 Apr;20(2):163-76.
Hostility, social support, and ambulatory cardiovascular activity.
Benotsch EG, Christensen AJ, McKelvey L.
Department of Psychology, University of Iowa, Iowa City 52242, USA.
The present study compared ambulatory blood pressure in male and female subjects
preselected for high and low hostility levels and investigated interpersonal
daily stress as a possible mediational mechanism. Ambulatory blood pressure and
heart rate were measured in 48 male and female students previously classified as
high or low on the Cook-Medley Hostility (Ho) Scale. Subjects wore an ambulatory
monitor for a working day and also completed measures of perceived social
support, daily interpersonal stress, and health behavior information. Results
indicated that subjects scoring high on the Ho scale had higher mean levels of
ambulatory systolic blood pressure than low Ho subjects, even when controlling
for traditional risk factors, such as cigarette smoking. High Ho subjects also
reported greater daily interpersonal stress and less social support than low Ho
subjects. Perceived interpersonal stress partially accounted for the
relationship between hostility and blood pressure. Subjects high in hostility
showed greater mean ambulatory systolic blood pressure levels. Consistent with
the transactional model of hostility and health, the relationship between
hostility and blood pressure appears to be partially accounted for by the daily
experience of interpersonal stress.
232: J Pediatr Psychol. 1997 Apr;22(2):229-44.
Transactional patterns of child, mother, and father adjustment in
insulin-dependent diabetes mellitus: a prospective study.
Chaney JM, Mullins LL, Frank RG, Peterson L, Mace LD, Kashani JH, Goldstein DL.
Department of Psychology, Oklahoma State University, Stillwater 74078, USA.
Utilized both interview and self-report methods to examine transactional
patterns of child, mother, and father adjustment in a sample of children and
adolescents with insulin-dependent diabetes mellitus (IDDM). Overall, levels of
child and parental adjustment were relatively stable over the 1-year study
period. Regression analyses revealed that increases in fathers', but not
mothers', distress over time contributed significant incremental variance to
poorer subsequent children's adjustment, after controlling for demographic (age,
gender, and SES) and disease parameters (illness duration and metabolic
control). Decline in fathers' adjustment was a significant predictor of better
mothers' adjustment at follow-up; child adjustment was not significantly
associated with mothers' adjustment. Variations in both children's and mothers'
adjustment made significant, independent contributions to predicting subsequent
fathers' adjustment. Findings illustrate the transactional nature of
relationships that exist in families of children with IDDM and underscore the
importance of family systems or biobehavioral family treatment approaches in the
clinical management of children with chronic illnesses.
Family context in pediatric psychology from a transactional perspective: family
rituals and stories as examples.
Fiese BH.
Department of Psychology, Syracuse University, New York 13244-2340, USA.
Reviewed the transactional model as applied to the family context of pediatric
psychology. A three-part sequence of child behavior, parent behavior, and family
interpretation was used to describe developmental adaptation and transitions. It
was proposed that families are regulated by practices that are proximal to the
child's experience and representations that are more distal to the child's
experience. Family practices are examined through family routines and rituals.
Family representations are examined through family stories. Case examples of low
birth weight premature infants and an adolescent referred for repeated
hospitalizations due to diabetic ketoacidosis were presented to illustrate the
model. Guidelines for the practicing pediatric psychologist are presented to
assess family organization through family rituals and family meaning-making in
the telling of family stories.
Publication Types:
Case Reports
234: J Psychosoc Nurs Ment Health Serv. 1997 Mar;35(3):31-3.
Comment in:
J Psychosoc Nurs Ment Health Serv. 1997 May;35(5):11.
The 'no suicide contract': helpful or harmful?
Egan MP, Rivera SG, Robillard RR, Hanson A.
Massachusetts Department of Mental Health, Boston, USA.
1. Contracting for Safety (CFS) has become an integral part of nursing practice
but never has been subjected to scientific scrutiny. 2. Clinical reasons for
avoiding the use of contracting with some patient populations exist, including
that some patients may construe CFS as a failure of empathy by the caregiver. 3.
CFS can, in some instances, be helpful in establishing a therapeutic
relationship or aiding in assessment, but never should be the sole basis for
determining a patient's lethality.
235: Arch Psychiatr Nurs. 1997 Feb;11(1):46-51.
Assertion training therapy in psychiatric milieus.

Aschen SR.
Indiana University Medical Center, Indianapolis, USA.
The current investigation involved an attempt to develop a clinical procedure to
decrease anxiety and increase responsiveness (assertion) of psychiatric
inpatients of both sexes in mixed diagnostic categories and to evaluate the
effectiveness of the procedure. Using a Solomon Four-Group Design, patients,
matched on age, sex, and diagnosis, were assigned to one of the following
conditions: (1) pretest, treatment, posttest; (2) pretest, no treatment,
posttest; (3) treatment, posttest; or (4) no treatment, posttest. The
Gambrill-Richey Assertive Inventory was used to assess patient Degree of
Discomfort and Response Probability with and without assertion training therapy.
Results indicated that (1) patients receiving assertion training therapy were
less anxious and more responsive after treatment than before, (2) patients
receiving assertion training therapy were less anxious and more responsive than
were matched control subjects, (3) control subjects who received no assertion
training therapy and who were pretested showed moderate significant gains on the
posttest measure, (4) patients reported a greater reduction of anxiety than they
did an increase in responsiveness, and (5) pretesting did not significantly
influence posttest scores.
Publication Types:
Clinical Trial
Controlled Clinical Trial
236: Br J Nurs. 1997 Jan 9-22;6(1):44-50.
Strategies for reducing stress and burnout in nursing.
Farrington A.
Department of Nursing and Midwifery, De Montfort University, Leicester.
Three models of stress-the stimulus model, the response model and the
cognitive-phenomenological-transactional (CPT) model-have been described in
detail elsewhere (Farrington, 1995), and the notion of accepting occupational
stress as an industrial disease has been suggested (Nursing Times, 1995). This
article focuses on the nursing experience of stress and describes strategies for
reducing stress and burnout on a personal and organizational level. It concludes
by presenting a small-scale research study which examined the nature and impact
of events perceived by postregistration nurses to cause personal psychological
distress. The findings of the research show that certain stimuli are
consistently perceived as being psychologically traumatizing in the daily
working life of the student nurse. Nursing clearly remains an emotionally
demanding occupation and more work is needed to examine the way in which events
and microstressors are cognitively processed by nurses.
237: Br J Psychiatry. 1997 Jan;170:58-61.
Relatives' expressed emotion and non-verbal signs of subclinical psychopathology

in schizophrenic patients.
Woo SM, Goldstein MJ, Nuechterlein KH.
Department of Psychology, University of California, Los Angeles 90024, USA.
BACKGROUND: Previous research has generally found that variations in relatives'
affective attitudes (expressed emotion; EE) towards a schizophrenic family
member could not be accounted for by differences in the severity or form of the
patient's symptomatology. These findings have been based on clinicians' ratings
of psychopathology in patients. METHOD: To approach the question from a
different perspective, videotaped interactions between a patient and family
members, obtained four to five weeks after hospital discharge, were coded for
subclinical signs of psychopathology expressed by the patient. The Behavioral
Subclinical Rating Scale (BSRS) was developed to compare subclinical levels of
non-verbal and paralinguistic symptoms expressed by patients from both high- and
low-EE families. RESULTS: Highly significant differences were found in the BSRS
data. Patients from high-EE families showed more hostile and unusual behaviour
with relatives than those from low-EE homes, who, in contrast, showed more
anxious behaviour. CONCLUSION: These data suggest that a complex transactional
model is necessary to understand how family attitudes evolve during the course
of a relatives' schizophrenic disorder.
238: Annu Rev Psychol. 1997;48:243-67.
Families as systems.
Cox MJ, Paley B.
Frank Porter Graham Child Development Center, University of North Carolina at
Chapel Hill 27599-8180, USA.
In this chapter, we discuss theoretical and conceptual models that use an
organismic or systems metaphor for understanding families. We suggest that such
theories are important for stimulating new research and organizing existing
data, and that advances in these theories over the past few decades have
expanded the potential for understanding child development, as well as adult
adaptation and the development of close relationships. These paradigms follow
from models that view development as resulting from the transactional regulatory
processes of dynamic systems. Such models are helpful for considering multiple
influences on development and adaptation and have implications for the design of
effective interventions. We focus on the specifics of systems theories as
applied to families, and the research generated by or consistent with these
views. Our review is not exhaustive; rather, we intend to give a sense of the
direction of this work and its importance for the understanding of development
and adaptation.
Publication Types:
Review
Review, Tutorial
239: J Pers. 1996 Dec;64(4):959-91.

The mismeasure of coping by checklist.
Coyne JC, Gottlieb BH.
University of Michigan Medical Center, Department of Family Practice, Ann Arbor
48109-0708, USA.
Hundreds of studies have now used standardized checklists to assess respondents'
self-reports of coping with naturally occurring stress. This article presents a
critical review of the conceptual and methodological issues involved in the use
of these checklists. As they are currently employed, conventional checklists
render an incomplete and distorted portrait of coping. Specifically, these
checklists are grounded in too narrow a conception of coping; the application
and interpretation of checklists in the typical study are not faithful to a
transactional model of stress and coping; statistical controls cannot eliminate
the effects of key person and situation variables on coping; and no consistent
interpretation can be assigned to coping scale scores. Researchers are
encouraged to consider a broader range of methods for assessing coping,
including semistructured interviews, customized checklists tailored to their
specific hypotheses and objectives, daily diaries, and traditional trait
measures.
Publication Types:
Review
Review, Tutorial
240: J Pers. 1996 Dec;64(4):711-35.
Personality and coping: three generations of research.
Suls J, David JP, Harvey JH.
Department of Psychology, University of Iowa, Iowa City 52242, USA.
This article introduces the Journal of Personality's special issue on coping and
personality. It first presents a historical overview of the psychological study
of how people cope with stress and identifies three generations of theory and
research: (a) the psychoanalysts and the ego development school, which tended to
equate personality and coping strategies; (b) the transactional approach, which
appeared in the 1960s and emphasized situational and cognitive influences on
coping while downplaying the role of individual differences; and (c) the most
recent, "third generation," whose work is represented in this special issue and
focuses on the role of personality in coping while maintaining strong
operational distinctions among coping, personality, appraisal, and adaptational
outcomes. This introduction concludes with a discussion of unresolved conceptual
and methodological issues and a brief orientation to the third-generation
articles that follow in this special issue.
Publication Types:
Review
Review, Tutorial

241: Health Care Superv. 1996 Dec;15(2):27-34.
Leadership in the formation of new health care environments.
Kent T, Johnson JA, Graber DR.
Department of Health Administration and Policy, Medical University of South
Carolina, Charleston, USA.
The capacity for managers to be effective leaders is clearly being challenged by
rapid changes in the health care environment. In this climate, transformational
leadership is considered superior to hierarchy-dependent, transactional
leadership. This approach may also be very effective in motivating staff and
fostering organizational transformation. The article describes six processes
that are critical for those who seek to be dynamic leaders: visioning,
communicating for meaning, creating possibilities, developing stakeholders,
building spirit and will, and sustaining focus.
242: J Am Acad Child Adolesc Psychiatry. 1996 Nov;35(11):1532-41.
Risk and protective factors affecting the adjustment of siblings of children
with chronic disabilities.
Fisman S, Wolf L, Ellison D, Gillis B, Freeman T, Szatmari P.
Division of Child and Adolescent Psychiastry, Children's Hospital of Western
Ontario, London, Canada.
OBJECTIVE: To examine the adjustment of nondisabled siblings of handicapped
children. METHOD: In a 3-year longitudinal study, 46 siblings of children with
pervasive developmental disorder (PDD), 45 siblings of children with Down
syndrome, and 46 siblings of developmentally normal children (serving as
controls) were examined at time 1 using the sibling, primary caretaker, and
teacher as informants. Both direct and indirect variables related to sibling
adjustment were considered. RESULTS: Significantly more difficulties were found
in the siblings of children with PDD compared with the other two groups.
Different correlates of adjustment were present in the siblings of the disabled
compared with nondisabled children, and mediating factors differed in parent and
teacher reports of internalizing difficulties in siblings of children with PDD.
Marital satisfaction, lack of parental depression, a cohesive family, and a
warm, nonconflictual sibling relationship were protective for normal control and
Down syndrome siblings but not for PDD siblings. CONCLUSION: Findings underline
the risks for the siblings of children with PDD and suggest the importance of a
transactional mechanism rather than identification of single risk or protective
factors in predicting sibling adjustment. Subsequent data analysis in this
longitudinal study will assist in defining these mechanisms and allow for
improved intervention strategies.
243: Psychoanal Rev. 1996 Oct;83(5):643-56.
The Wolf Man's analysis--an interactional perspective.

Dorpat TL.
Seattle Institute for Psychoanalysis, USA.
244: Am J Psychoanal. 1996 Sep;56(3):253-68.
Direct interpretation of dreams: neuropsychology.
van den Daele L.
Psychology Doctorate Program, California Institute of Integral Studies, San
Francisco 94109, USA.
Although the role and importance of the interpretation of dreams has been
de-emphasized in clinical discussions for the past several decades, new models
of dream physiology suggest the central role and importance of dreams in the
regulation of behavior. According to a body of current research, dreams
potentiate new pathways of problem solving. A review of the neurophysiological
literature pertinent to direct interpretation suggests dreams are sustained by
midbrain anatomical networks with feed-back and feed-forward links to the
cortex. The anatomical networks are termed the endogenous-intraorganismic
system, the exogenous-transactional system, and the relational system that
correspond to subjective, objective, and relational dreams in direct
interpretation. Just as ordinary thought is the province of the dominant or left
hemisphere, dreams are the province of the nondominant or right hemisphere.
During REM states new pathways of problem solving are laid down by the
nondominant hemisphere. In the awake state, thought and behavior about content
that relates to dream material follow these pathways. The new neuropsychology of
dreams reaffirms the central role of dreams in the organization of affect,
emotion, intention, and general adaptation.
Publication Types:
Review
Review, Tutorial
245: JAMA. 1996 Aug 14;276(6):496-502.
Comment in:
JAMA. 1996 Dec 11;276(22):1801-2; author reply 1802.
JAMA. 1996 Dec 11;276(22):1801; author reply 1802.
JAMA. 1996 Dec 11;276(22):1802; author reply 1802.
Breaking bad news. A review of the literature.
Ptacek JT, Eberhardt TL.
Department of Psychology, Bucknell University, Lewisburg, PA, USA.
OBJECTIVE: To review the literature on breaking bad news while highlighting its
limitations and describing a theoretical model from which the bad news process
can be understood and studied. DATA SOURCES: Sources were obtained through the
MEDLINE database, using "bad news" as the primary descriptor and limiting the
sources to English-language articles published since 1985. STUDY SELECTION AND
EXTRACTION: All articles dealing specifically with bad news were examined. These
works included letters, opinions, reviews, and empirical studies.
Recommendations from these articles were examined, sorted into discrete
categories, and summarized. DATA SYNTHESIS: The 13 most consistently mentioned
recommendations (eg, delivering the news at the patient's pace, conveying some
hope, and giving the news with empathy) were examined. CONCLUSION: Although much
has been written on the topic of breaking bad news, the literature is in need of
empirical work. Research should begin with the simple question of whether how
the news is conveyed accounts for variance in adjustment before moving to more
specific questions about which aspects of conveying bad news are most
beneficial. It is suggested that the bad news process can be understood from the
transactional approach to stress and coping.
Publication Types:
Review
246: Integr Physiol Behav Sci. 1996 Jul-Sep;31(3):210-8.
A transactional analysis of biobehavioral systems.
Germana J.
Dept. of Psychology, Virginia Polytechnic Institute, Blacksburg 24061-0436, USA.
The system of behavior [B] consists of those transactional interrelationships
between organism [O] and environment [E] that govern their commerce. The
biological significance of such [O]-[E] interrelationships, their truing through
learning, as well as those systems involved in the subordinate and superordinate
regulation of behavior, are clear when life, itself, is seen as an emergent
property of the [O]-[E] complex. In addition, a systems view of these
hierarchically organized complexities suggests that they adaptively
self-stabilize and self-organize, over time, as they participate in [L], the
organism-environment complex. Such a transactional analysis of biobehavioral
systems resonates well with the most basic axioms of Pavlov's paradigm.
Publication Types:
Review
Review, Tutorial
247: J Soc Psychol. 1996 Jun;136(3):311-23.
Coping styles among adolescent competitive athletes.
Anshel M.
Psychology Department, University of Wollongong, New South Wales, Australia.
The use of approach and avoidance coping styles and task-focused and
emotion-focused coping strategies in competitive sport was explored. Four
hundred twenty-one adolescent males from New South Wales, Australia, who were
currently competing in team sports indicated their usual responses to each of 8
acute stressors commonly experienced in sport, using a 128-item inventory. The
reliability coefficient (Cronbach's alpha) for each stressor ranged from .81 to
.92. Twenty-six of the original 128 items on the inventory were retained, on the
basis of factor analysis. Correlations between stressors indicated that coping
styles were a function of type of stressor, providing support for the
transactional model. Goodness of fit was high (.87). The present results
partially support the construct of coping style among adolescent-aged sports
competitors.
248: Pflege. 1996 Jun;9(2):120-6.
[Humanistic care--a vital dialog with myself as a nurse]
[Article in German]
Lobchuk MM.
The author documents the use of "humanistic care" as described by Paterson &
Zderad (1988) and presents two case studies. Humanistic care is a transactional
process, the carer entering into a relationship with the person for whom he/she
cares. At the same time the carer embarks on a conscious dialogue with him/her
self. To be "present" means being conscious of ones own thoughts, feelings,
impressions and reactions. During a course of graduate study in Canada, the
author enrolled in a "self-directed learning programme". She set herself the
task of self-analysis. She conducted interviews with two patients suffering from
cancer and with their relatives. She hoped that she would be able to reexamine,
in this new situation, feelings and emotions which she had repressed earlier in
her hospital nursing experience. The goal of the learning experience was to
develop personal "authenticity" by becoming aware of existential experiences
(her own and others').
249: Nurs Stand. 1996 May 22;10(35):39-42.
Transactional analysis: how to improve communication skills.
Bailey J, Baillie L.
Transactional analysis (TA) can be a useful framework for promoting effective
communication. This article outlines the theoretical constructs of TA and
suggests a strategy for teaching the model to diploma student nurses. The
authors argue that an understanding of TA will allow nurses to analyse and
adjust their skills to communicate more effectively.
250: Clin Lab Manage Rev. 1996 Mar-Apr;10(2):169-75.
Comparison of four methods (L/S ratio, TDx FLM, lamellar bodies, PG) for fetal
lung maturity using meta-analysis.
Petersen JR, Smith E, Okorodudu AO, Bissell MG.

University of Texas Medical Branch, Galveston, TX, USA.
Multiple factors in the past encouraged physicians to order laboratory tests
excessively and perhaps even abusively. The shift in the financing of health
care to managed care and capitation will create an environment where physicians
will be more receptive to laboratory efforts to influence their test ordering
behavior toward cost-effectiveness. Various strategies to modify physicians'
test-ordering behavior have met with only mixed success due to lack of data to
support the desired result: reducing laboratory tests that are not specifically
indicated for a particular patient. The current dynamics in the health care
industry in general and in the clinical laboratory in particular place
increasing value on information about the overall process of health-care
delivery. This information can be derived from data from what were formerly
considered discrete, transactional events, i.e., specific publications.
Combining data from articles dealing with the same subject (meta-analysis) is
increasingly being used to assess the value of the overall process of delivery
(the outcome). Although considered inverted question markarm chair inverted
question mark research, meta-analysis is an important tool in evaluating the
worth of a method in patient care. We chose to evaluate, given the current
literature, which laboratory test--lecithin/ sphingomyelin ratio,
surfactant/albumin ratio, lamellar bodies, or phosphatidylglycerol--is the best
and most cost effective method to screen for fetal lung maturity. We identified
all pertinent literature from 1966 to the present using a search of Medline.
251: Br J Psychol. 1996 Feb;87 ( Pt 1):3-29.
Models of job-related stress and personal achievement among consultant doctors.
Deary IJ, Blenkin H, Agius RM, Endler NS, Zealley H, Wood R.
Department of Psychology, University of Edinburgh, UK.
The antecedents and outcomes of feelings of job-related stress and personal
achievement were studied in a large sample of consultant doctors working in
Scotland. In a sample of 333 doctors it was found that a tendency to use
emotion-oriented coping strategies and negative appraisals of organizational
changes in the practice of medicine mediated the effect of the personality
dimension of Neuroticism on reported job stress. Job stress levels predicted the
degree of 'burnout' experienced by doctors, i.e. their tendencies to be
emotionally exhausted by their work and to dehumanize patients. Higher clinical
workloads were related to higher levels of stress but also to higher feelings of
personal achievement. A substantial proportion of the variance in many of the
variables in the stress model was accounted for by a general tendency to
experience negative emotions, closely related to Neuroticism; this general
factor appeared to be similar to the recently formulated concepts of 'negative
affectivity' and 'somatopsychic distress'. The personality factors of
Extraversion and Conscientiousness both contributed to positive feelings of
personal achievement (N = 344); the effect of Extraversion was direct, whereas
the effect of Conscientiousness was mediated by a tendency to use task-oriented
coping strategies. Models of the processes of stress and personal achievement
were tested for acceptability using the EQS Structural Equations Program. The
implications of the models for transactional theories of stress are discussed.

252: Int J Nurs Stud. 1996 Feb;33(1):29-36.
The development of Taiwanese Elderly Stressor Inventory.
Lin LC, Snyder M, Egan EC.
Institute of Clinical Nursing, National Yang-Ming University, Taipei, Taiwan,
ROC.
The purpose of this study was to develop a stressor inventory for use with a
population of elderly Taiwanese people that allows the respondent to rate the
degree of stressfulness of each stressor experienced, based on a transactional
stress model. Thirty-three subjects identified stressors experienced from age 65
onwards. Seventy-three stressors were identified and listed in the instrument.
Inter-rater agreement on the content was > or = 0.90. The psychometric
properties of the instrument was established among 351 elderly Taiwanese
subjects. In determining the stability of stressfulness, the generalizability
coefficient for the relative decisions was 0.90 and generalizability coefficient
for the absolute decision was 0.90. As to stability of stressor frequency, the
generalizability coefficients for both the relative and absolute decisions was
0.72. Construct validity of the instrument was provided by a correlation of 0.59
with state-anxiety, of 0.56 with negative affect, and -0.28 with positive
affect. Further refinement of the toll is in progress.
253: Sch Inq Nurs Pract. 1996 Winter;10(4):329-45; discussion 347-50.
A transactional perspective on critical thinking.
Gendrop SC, Eisenhauer LA.
College of Nursing, University of Massachusetts, Boston 02125, USA.
The quality of thinking has received much attention within the last decade. The
scientific inquiry models introduced by Dewey, Dressel and Mayhew, and
Watson-Glaser have been expanded to incorporate such aspects as reflection,
development, attitude, skill, and knowledge domain. Dichotomies between critical
and creative thinking have been eased. While this scholarship on thinking has
been impressive, current pedagogy remains focused on scientific inquiry and on
received knowledge. In nursing the learning paradigm has been similarly focused
for the past 3 decades on a scientific inquiry model and received knowledge. The
major cognitive approach to education and practice has been the nursing process,
a linear problem-solving paradigm equivalent to the scientific method. This
linear approach does not fully account for how nurses think and make judgments
in clinical practice. The Transactional Model of Critical Thinking presented in
this paper addresses the complexity of critical thinking in nursing. The model
provides an educative and novel vision of thinking based on a transactional view
of the individual, personal attributes, and the environment. Components and
elements of the model are described and suggestions made for teaching-learning
and for evaluation of critical thinking in nursing.
254: Annu Rev Psychol. 1996;47:485-512.

Environmental psychology 1989-1994.
Sundstrom E, Bell PA, Busby PL, Asmus C.
Department of Psychology, University of Tennessee, Knoxville 37916, USA.
A review of research and theory on transactions between people and physical
environments emphasizes new contributions to theory and empirical research
published in major journals of environmental psychology, 1989-1994. Theories
focused on arousal, load, stress, privacy-regulation, behavior settings, and
transactional analysis; new theory increasingly incorporated situational and
contextual variables. Empirical research emphasized field settings over the
laboratory and employed increasingly diverse methods, populations, and cultures.
Environmental design studies integrated scientific and applied goals through
post-occupancy evaluation. New findings concerned features of residences, work
places, hospitals, schools, prisons, and larger community environments. New
studies also addressed environmental stressors (e.g., temperature, noise);
effects of attitudes and behaviors on conservation, crime, pollution, and
hazards; and issues for neighborhoods, public places, and natural environments.
Directions for the future include integrated theory to guide research, more
design experiments, and development of conventions for case studies.
Publication Types:
Review
Review, Tutorial
255: Br J Nurs. 1995 Nov 9-22;4(20):1190-2, 1209-13.
Nursing and health education: victim blaming.
Caraher M.
Health education may contribute to creating victims. In this article, the
concept of victim blaming, and how the victim role is created, is explored using
transactional analysis. Specifically, the Drama Triangle is used as a tool for
analysis rather than a model for practice.
256: Psychol Bull. 1995 Nov;118(3):328-57.
Determinants and consequences of children's coping in the medical setting:
conceptualization, review, and critique.
Rudolph KD, Dennig MD, Weisz JR.
Department of Psychology, University of California, Los Angeles, USA.
The recent burgeoning of theory and research on how children cope with painful
medical stressors warrants close scrutiny. The authors examine the prominent
typologies of coping and the research on child adjustment and outcomes
stimulated by those typologies. They focus on what researchers know and need to
know about moderators (characteristics of the child and the environment that
influence coping and outcome) and mediators (mechanisms linking stress, coping,
and adjustment). It is argued that important advances can be achieved through
efforts to (a) conceptualize and study pain and coping within a
multidisciplinary framework; (b) clearly distinguish among coping responses,
goals, and outcomes; and (c) replace simplistic conceptualizations with
transactional and goodness-of-fit models.
Publication Types:
Review
Review, Tutorial
257: Can J Nurs Adm. 1995 Sep-Oct;8(3):8-21.
How a better understanding of transformational leadership can help improve your
practice as a nurse administrator.
Skelton-Green JM.
Nursing administrators of today find themselves practising in an environment of
permanent whitewater--an environment of chaotic change. Not only is the
environment changing, so too are our employees: their needs, motives and
priorities are vastly different than those we knew 20 years ago. The challenges
of permanent whitewater cannot be overcome without effective leadership.
Theorists agree that most North American organizations are currently overmanaged
and underled. Certainly the leadership record of Canadian health care
institutions has not been impressive. This paper will examine a selected set of
concepts which the author believes are essential for nursing administrators who
wish to provide real leadership to their departments and organizations:
transformational (as compared to transactional) leadership; feminine (as
compared to masculine) leadership; and empowerment. The literature review draws
out both theory and practical applications.
Publication Types:
Review
Review, Tutorial
258: Rev Enferm. 1995 Sep;18(205):52-5.
[Psychological motivators "COMPLACE". Effects on the selection on the selection
of nursing]
Cea Ugarte JI, Marcal Lopez JA.
259: Nurs Manage. 1995 Sep;26(9):64JJ-64LL, 64NN.
Transformational leadership and job satisfaction.
Medley F, Larochelle DR.

University of Florida, Gainesville, USA.
The relationship of head nurse leadership style to staff nurse job satisfaction
was investigated using the leadership paradigm of transformational and
transactional leadership. The Multifactor Leadership Questionnaire and the Index
of Work Satisfaction were completed by 122 staff nurses employed throughout
acute care community hospitals in many patient care areas. Correlations showed a
significant positive relationship between those head nurses exhibiting a
transformational leadership style and the job satisfaction of their staff
nurses.
260: J Stud Alcohol. 1995 Sep;56(5):580-8.
College students' decisions to intervene in alcohol-related situations.
Thomas RW, Seibold DR.
Department of Speech Communication & Dramatic Arts, Central Michigan University,
Mt. Pleasant 48859, USA.
OBJECTIVE: In reviewing research on college students' intervention practices in
alcohol-related situations, Seibold and Thomas recently advanced a transactional
influence reconceptualization of intervention episodes. This study sought to
explicate the factors contributing to college students' decision to intervene or
not to intervene in alcohol-related situations. METHOD: In order to empirically
explore this area, 489 students from three U.S. universities were surveyed about
factors affecting their decisions to intervene or not in two types of
alcohol-related situations: a drunk-driving situation and an alcohol abuse
situation. RESULTS: Students' intervention decisions were motivated primarily by
concerns for the target and for potential consequences if they did not
intervene. In contrast, decisions not to intervene were motivated primarily by
an absence of a strong relationship with the target, their own condition at the
time, and the potential impact of the intervention attempt on their image.
Gender differences moderated many of these findings, however. CONCLUSIONS:
Results are discussed in terms of approaching the study of alcohol interventions
from a transactional influence perspective.
261: J Am Acad Child Adolesc Psychiatry. 1995 Aug;34(8):1060-6.
Child physical abuse and aggression: preliminary findings on the role of
internalizing problems.
Scerbo AS, Kolko DJ.
Department of Psychology, Eastern Washington University, Cheney 99004-2431, USA.
OBJECTIVE: To test the prediction that the interaction of physical abuse and
internalizing problems will heighten levels of aggressive behavior in a group of
disruptive children. METHOD: Fifty-two clinic-referred disruptive children (aged
7 through 15 years) were assessed in terms of history of physical abuse,

internalizing behavior problems (rated by parents), and aggressive behavior
(rated by parents, teachers, and clinic staff). RESULTS: Physically abused
children with co-occurring high levels of internalizing problems (based on a
median split) exhibited significantly higher levels of aggression as rated by
parents (p < .000) and teachers (p < .020) and a trend toward heightened
aggression as rated by staff (p < .08). The patterns were similar across the
three independent informants and remained regardless of age, gender, or race.
CONCLUSIONS: Physical abuse was related to heightened levels of aggression only
in those children who also had emotional difficulties. Results lend some support
to a transactional model of the development of aggression, suggesting that
problems arise out of interactions between child factors (such as internalizing
problems) and adverse family experiences (such as physical abuse).
262: Nurs Res. 1995 Jul-Aug;44(4):214-9.
Development and testing of the barriers to cessation scale.
Macnee CL, Talsma A.
East Tennessee State University, Johnson City, USA.
The purpose of this research was to develop and test a measure of barriers to
smoking cessation. Barriers, reconceptualized within the Transactional Model of
Stress (Lazarus, 1966), reflect specific stressors associated with smoking
cessation. The measure consists of a 19-item scale, which has been tested in
three studies. Cronbach's alpha coefficients ranged from .81 to .87. Construct
validity was demonstrated by correlations between barriers scores and scores on
the Daily Hassles Scale (DeLongis, Folkman, & Lazarus, 1988). Predictive
validity was demonstrated by findings that barriers scores significantly
contributed to classification of abstainers versus relapsers 8 weeks after
smoking cessation group participants quit smoking.
263: J Nurs Adm. 1995 Jun;25(6):68-70.
Identifying the best in nurse executive leadership: Part 1, Questionnaire
results.
Dunham-Taylor J, Klafehn K.
College of Nursing, University of Akron, Ohio, USA.
Further analysis of a previously reported transformational leadership study
indicated that the study's 81 excellent nurse executives can be further
delineated into four groups based on the difference between the scores of nurse
executives and staff for transformational and transactional leadership. Part 1
reports questionnaire results, indicating that staff identify two groups as more
highly transformational. Part 2 will identify further characteristics of these
groups based on interview data results.
264: Public Health Nurs. 1995 Jun;12(3):171-80.

Preterm infant follow-up project: a multi-site field experiment of hospital and
home intervention programs for mothers and preterm infants.
Kang R, Barnard K, Hammond M, Oshio S, Spencer C, Thibodeaux B, Williams J.
University of Washington School of Nursing SM-24, Department of Community Health
Care Systems, Seattle 98195, USA.
This study was designed as a multi-site field experiment to test the efficacy of
hospital and home visit interventions to improve interaction between mothers and
preterm infants. Hospital intervention consisted of State Modulation (SM)
treatment, which focused on teaching mothers to read the behavioral cues and
modulate the states of consciousness of preterm infants during feedings. Home
visit intervention was a field-tested program, Nursing Systems for Effective
Parenting-Preterm (NSTEP-P), implemented during the first five months after the
infant's hospital discharge. A hospital program on car seats (CS) and standard
public health nursing home visits (PHN) served as comparison treatments. The
sample consisted of 327 mothers and their preterm infants who were less than 36
weeks of gestational age at hospital discharge. Mothers were randomly assigned
to intervention groups on the basis of their education. High education (HE) was
> or = 13 years of education, while low education (LE) was < or = 12 years of
education. HE mothers were only assigned to hospital programs, while LE mothers
were assigned to combinations of hospital and home visit programs. Evaluations
were conducted at 40 weeks conceptual age (expected date of birth), at 46 weeks
conceptual age (1.5-months-corrected age), and 60 weeks conceptual age
(5-months-corrected age). Comparisons were made within each educational group.
For HE groups, SM infants gave significantly more clear cues during observations
of feeding interactions at 1.5-months-corrected age and teaching interactions at
5-months-corrected age than infants in the CS group. During the teaching
interaction, well-educated SM mothers provided significantly more
social-emotional and cognitive stimulation than CS mothers. For LE groups,
infants in the SM group combined with either PHN or NSTEP-P exhibited
significantly more responsive behavior during feeding observations than those
infants in the CS/PHN group at 1.5-months-corrected age. LE mothers in the
SM/NSTEP-P group demonstrated more sensitivity and more stimulation during
teaching interactions at 5-months-corrected age than mothers in the SM/PHN or
CS/PHN groups. Findings suggest that State Modulation treatment is effective in
influencing positive social interaction of infants regardless of the level of
maternal education. State modulation treatment combined with NSTEP-P is most
effective in improving the social interaction between preterm infants and
mothers with limited formal education. Such treatment-specific programs suggest
avenues for providing cost-effective care that complements the changing
transactional needs of mothers and preterm infants.
Publication Types:
Clinical Trial
265: J Abnorm Psychol. 1995 May;104(2):259-67.
Expressed emotion and subclinical psychopathology observable within the
transactions between schizophrenic patients and their family members.
Rosenfarb IS, Goldstein MJ, Mintz J, Nuechterlein KH.

Department of Psychology, University of California, Los Angeles, USA.
The authors examined whether young, recently discharged schizophrenic patients
from high (n = 34) and low (n = 14) expressed emotion (EE) families differ in
their level of subclinical symptomatology during a direct interaction task.
Compared with patients from low-EE homes, patients from high-EE home showed
significantly more odd and disruptive behavior with family members. High-EE
relatives were more likely than low-EE relatives to respond with criticism to
the first unusual thought verbalized by the patient; when this occurred, the
probability of a second unusual thought was augmented. Results suggest that
high-EE family members may display negative attitudes toward patients in part
because they are exposed to higher levels of unusual or disruptive behavior than
low-EE relatives. The data also support a bidirectional, transactional model of
the relationship between relatives' EE and patients psychopathology.
266: Pediatrics. 1995 Apr;95(4):516-21.
Developmental outcome as a function of the goodness of fit between the infant's
cry characteristics and the mother's perception of her infant's cry.
Lester BM, Boukydis CF, Garcia-Coll CT, Peucker M, McGrath MM, Vohr BR, Brem F,
Oh W.
Brown University School of Medicine, Providence, RI, USA.
OBJECTIVE. To determine whether the "goodness of fit" between infant cry
characteristics and the mother's perception of the cry is related to
developmental outcome at 18 months of age. DESIGN. This was a prospective,
longitudinal study from birth to 18 months performed in a blinded manner.
SETTING. The study was conducted in a maternity hospital, including normal and
special care nurseries and a laboratory for developmental follow-up. PATIENTS.
The 121 term and preterm infants and their mothers were selected to meet medical
criteria. MEASUREMENT. Acoustic analysis of 1-month infant cry and the mother's
perception of the same cry was used to divide subjects into four groups
representing matches and mismatches between infant cry characteristics and
maternal cry perception. Primary outcome measures of cognitive, language, motor,
and neurologic outcome were administered at 18 months. Caretaking environment
measures were also recorded. RESULTS. Statistically significant (P < .05)
findings showed that matched groups scored higher on measures of language and
cognitive performance than infants in the mismatch groups, with a particular
advantage for infants in the matched group in which mothers accurately perceived
the higher-pitched cries of their infants. There were no differences between the
groups in biologic or sociodemographic factors. Group differences were observed
in social support and maternal self-esteem. CONCLUSIONS. Matches and mismatches
between infant cry characteristics at 1 month and the mother's perception of the
cry are related to cognitive and language outcome at 18 months in term and
preterm infants. This relation is probably due to transactional processes in
which developmental outcome is affected by the clarity of the infants' signals
and by the ability of the mother to accurately perceive her infant's signals.
The mother's ability to read her infant's cues may be affected by factors such
as social support and self-esteem.

267: J Obstet Gynecol Neonatal Nurs. 1995 Mar-Apr;24(3):249-55.
Intercultural communication: finding common ground.
Nance TA.
Diversity has become a leading topic of discussion in virtually all sectors of
our society. This is certainly true in health care; the nursing profession has
long been dealing with issues of cultural appropriateness. This article looks at
the relationship of culture to communication. The current approach to
intercultural communication discussed in much of the nursing literature is
judged to be short-sighted. An alternative approach based on the development of
a functional cultural communication perspective is offered.
268: J Adv Nurs. 1995 Mar;21(3):528-36.
The phenomenon of stress as perceived by Project 2000 student nurses: a case
study.
Hamill C.
Southern Area College of Nursing, Portadown, County Armagh, Northern Ireland.
This case study was undertaken at a college of nursing in Northern Ireland with
its first cohort of Project 2000 student nurses. The aim was to investigate
perceived stress on the course. A qualitative approach was adopted utilizing
Cox's (1991) transactional model of stress as the guiding theoretical framework.
Data were collected through questionnaires and in-depth semi-structured
interviews and analysed using a grounded theory methodology. Findings reveal
that stress is perceived in relation to non-integration with tertiary education
and non-integration with the ward team. This stress results from a tension
between dependence and the quest for independence in the pursuit of academic
freedom and clinical competence. The dependence/independence continuum has been
identified as the core variable underpinning student-reported stress. Valuable
insights have been gained in relation to how student nurses perceive and cope
with stress associated with the introduction of the new Project 20000
curriculum, especially at this time of flux in nurse education. It is concluded
that student stress could be minimized if tutors acknowledged its presence and
reflected the course philosophy in their practice. Better liaison between the
college and clinical areas may resolve some of the ward staff's negative
attitudes and misunderstanding of the course aims. Finally, students have a need
to develop clinical skills much earlier in the course than at present, in order
to feel valued, to contribute to patient care and to integrate with the ward
team.
269: J Clin Nurs. 1995 Mar;4(2):109-15.
Impaired autonomy--the challenge of caring.
Sines D.
The aim of this paper is to present an informed argument in favour of changing
power relationships between learning disability nurses and their clients and to
do so through an examination of the influence that they have on quality of life
issues for people whose autonomy is impaired. The challenge of empowerment and
enhanced autonomy is considered to be at the 'cutting edge' of the
learning-disability agenda with its increasing focus on the provision of
supported living opportunities for clients in the community. Features related to
institutional methods of care delivery continue to exist in some services and as
a result clients may still be expected to conform to the dominant themes of
time, order, control and regimentation. The application of social and
environmental engineering techniques to the field of learning disability care is
prerequisite for the development of more positive alternatives to the
mental-handicap hospital as a focus for care provision. The main requirement for
persons whose autonomy is impaired will be the promotion of equal power sharing
between clients and carer. This process will involve a number of transactional
considerations such as advocacy, risk taking and shared action planning. The
emergence of a new paradigm for nursing practice will result in the solution for
shifting the balance of power in the emergent world of consumerism for clients
whose autonomy is impaired.
270: J Abnorm Psychol. 1995 Feb;104(1):104-13.
"Balance of power": a transactional analysis of control in mother-child dyads
involving socially competent, aggressive, and anxious children.
Dumas JE, LaFreniere PJ, Serketich WJ.
Department of Psychological Sciences, Purdue University, West Lafayette, Indiana
47907.
The authors compared mother-to-child and child-to-mother control exchanges in
dyads involving socially competent, aggressive, and anxious children (aged
2.5-6.5 years) observed in a laboratory setting. Competent children and their
mothers influenced each other positively and reciprocally, making prudent use of
control exchanges and setting firm limits to coercive attempts. Aggressive
children and their mothers were relatively positive, but children made regular
use of coercive control and mothers responded indiscriminately and failed to
oppose more extreme forms of coercion. Anxious children and their mothers were
generally aversive: mothers attempted to control their children by being
coercive and unresponsive, and children tried to manage their mothers by being
resistant and coercive. Results show that young children are active agents who
influence and are influenced by their relationship with their mother and who
behave--across contexts and with different social partners--in ways that reflect
this relationship.
Publication Types:
Clinical Trial
271: Sb Lek. 1995;96(2):131-6.
[Motivation for preventive care]

[Article in Czech]
Honzak R, Blaha K.
Oddeleni lekarske psychologie, psychoterapie a psychosomatiky 1. lekarske
fakulty Univerzity Karlovy, Praha 6 (Czech Republic).
This article outlines those psychological characteristics of preventive and
prophylactic work that qualify it as an efficient and effective skill. The
transactional analysis model is used for explaining some peculiarities of
everyday contact and communication between medical professionals and patients.
272: Medinfo. 1995;8 Pt 1:542.
The hospital information system as a source for the planning and feed-back of
specialized health care.
Liebelt P, Sleyster E, Leeferink-Smit J.
Qommit Consultancy bv, Amerongen, The Netherlands.
1. INTRODUCTION. In university hospitals, choices are made to which extend
specialized health care will be supported. It is characteristic, for this type
of care, that it takes place in a process of the continual advance of medical
technology and the growing awareness by consumers and payors. Specialized
healthcare contributes to the hospital qualifiers having a political and
strategic impact. The hospital board needs information for planning and
budgeting these new tasks. Much of the information will be based on data stored
in the Hospital Information System (HIS). Due to load limitations, instant
retrieval is not preferred. A separate executive information system, uploaded
with HIS data, features statistics, on a corporate level, with the power to
drill-down to detailed levels. However, the ability to supply information on new
types of healthcare is limited since most of these topics require a flexible
system for new dedicated cross-sections, like medical treatment from several
specialisms and functional levels. 2. DATA RETRIEVAL AND DISTRIBUTION. During
the information analysis, details were gathered on the necessary working
procedures and the administrative organization, including the data registration
in the HIS. In the next phase, all relevant data was organized in a relational
datamodel. For each topic of care, dedicated views were developed at both low
and high aggregation levels. It revealed that a matching change of the
administrative organization was required, with an emphasis on financial
registration aspects. For the selection of relevant data, a bottom-up approach
was applied, which was based on the registrations starting from the patient
administrative subsystem, through several transactional systems, ending at the
general ledger in the HIS. Data on all levels was gathered, resulting in medical
details presented in quantities, up to financial figures expressed in amounts of
money. This procedure distinguishes from the predefined top-down techniques
generally used for management and executive information systems. Data was
regularly collected from the HIS, then converted and reorganized into relational
datasets using XBase protocols. After having performed central quality controls
and privacy protection measures, the datasets were distributed electronically to
local PCs. Standard low-cost software packages enable analyses by user-friendly

selection and presentation facilities. 3. EVALUATION. The method developed for
data retrieval is flexible and easy to implement. If all basic data is
registered in the HIS, the procedure can be applied for all strategic hospital
functions that require planning and controlling during a certain time. Critical
success factors and pitfalls will be presented in the poster. Using one
consistent dataset, the information required about production and budget is
presented at several functional levels and is quantified in units familiar to
that level. The motivation for fast and accurate registration in the HIS was
improved from the moment the medical and administrative staff recognized their
own data in the feed-back on specialized health care.
273: Am J Psychother. 1995 Summer;49(3):371-84.
Psychotherapeutic discourse analysis.
Lewis B.
Dept. of Psychiatry, George Washington University, Washington, D.C. 20037, USA.
Psychotherapeutic discourse analysis is a significant, largely unexplored, tool
for psychotherapist and an ideal data sight for linguists. Increased
multidisciplinary research in this area would be particularly fruitful.
Conversations, including therapeutic conversations, are far from transparent
conduits of information from one person to another. Complicating surface
communication is "metacommunication," which takes the form of unconscious
conversational styles--culturally influenced rules, norms, and expectations of
how a conversation should proceed. If the therapist and the patient are working
with different conversational styles, then blocks in communication and
understanding are inevitable. Through discourse analysis conversational styles
can become more available to awareness for use in the service of therapeutic
goals. This paper is an example of a discourse analysis of an individual therapy
session. I attempt to bridge the gap between broad psychodynamic treatment
strategies and minute micro-conversational strategies that can be used to
enhance the therapeutic process.
274: Arch Toxicol Suppl. 1995;17:233-60.
Prenatal exposure to marihuana and tobacco during infancy, early and middle
childhood: effects and an attempt at synthesis.
Fried PA.
Department of Psychology, Carleton University, Ottawa, Ontario, Canada.
Both marihuana and cigarettes appear implicated, in a differential fashion, in
the neurobehaviour of infants and children born to women who used these
substances during pregnancy. In a low-risk upper middle class sample, marihuana
use was associated, in the newborn, with mild withdrawal symptoms and some
autonomic disruption of nervous system state regulation. However, between 6
months and 3 years of age no behavioural consequences of marihuana exposure
(once confounding factors were controlled) were noted. At four years of age,
although global tests of intelligence did not differentiate exposed from

non-marihuana exposed children, verbal ability and memory were associated with
in utero marihuana exposure. At five and six years of age these general areas
were also noted to be associated with maternal cannabis use as was sustained
attention. These areas of neurobehavior that appear affected by marihuana
exposure during fetal development are ones that are consistent with the
cognitive construct of 'executive functioning' which is thought to be a marker
of prefrontal lobe functioning. Consistent with the observations derived from
these children is that prefrontal functioning may not be apparent until
approximately four years of age and that executive functioning is disassociated
from measures of global intelligence. Exposure to cigarettes during pregnancy
appears to be associated with neurobehavioural deficits in the auditory domain.
In the newborn this is manifested by decreased responsivity to sound and altered
auditory habituation. Between the ages of one and 11 years the performance on
auditory related tasks (verbal memory, language, auditory processing) were
consistently the domains that differentiated the cigarette exposed from the non
exposed children. The possible role of the cholinergic mediated efferent
auditory system is discussed. Also associated with in utero exposure to
cigarettes were general cognitive performance and parental reports and
objectively derived measures of impulsivity. The striking degree of consistency
over the years lends strength to the interpretation that the observations in
childhood have, at least as their partial etiology, the prenatal exposure to
cigarettes. However, in interpreting the evidence presented it must be
recognized that the alterations in the child's behaviour may well affect the
parenting behaviour. This potential transactional interaction must remain an
integral part of drawing conclusions about both marihuana and cigarette's
effects.
Publication Types:
Review
Review, Tutorial
275: J Hum Hypertens. 1995 Jan;9(1):5-10.
Communication theory and the search for effective feedback.
Simonds SK.
University of Michigan, School of Public Health, Ann Arbor, USA.
If messages transmitted to the public, patients and health professionals could
be assured of being received, understood and acted on as intended by the senders
of messages, there would be little need to focus on communications and feedback.
That the physician's office, the healthcare system and the community are
littered with messages that 'never got through' attests to the problem of
ineffective communications and the absence of effective feedback. Communication
theorists, health psychologists and thoughtful health professionals,
particularly those working in community hypertension programmes, have developed
approaches that improve the probabilities of 'getting the message through'.
Theory-based communications with built-in feedback and 'feed-forward' enhance
the probabilities of success considerably. This presentation explores these
problems using the SMCR model of communication. Differences between linear
models and transactional models are discussed. On the assumption that the health
message environments of the future will be increasingly complex with highly
differentiated target audiences in a rapid paced computer and electronically

driven world, 'getting the message through' will become an even greater
challenge than in the recent past. Specific steps to change communication
approaches in this setting are proposed.
276: Suicide Life Threat Behav. 1995 Summer;25(2):241-52.
Problem solving, stress, and coping in adolescent suicide attempts.
Wilson KG, Stelzer J, Bergman JN, Kral MJ, Inayatullah M, Elliott CA.
Department of Psychology, Rehabilitation Centre, Ottawa, Ontario, Canada.
Twenty adolescents who had made suicide attempts were compared with 20
nonpsychiatric control subjects on measures of problem solving, stress, and
coping. The suicidal group did not show evidence of "rigid" thinking or of
deficits in the ability to generate solutions to standardized interpersonal
problems. However, they did report recent histories of more severe life stress
and had inaccurate appraisal of the extent to which stressful events could be
controlled. Although suicidal patients were able to generate as many adaptive
strategies as control subjects for coping with their own most severe recent
real-life stressor, they actually used fewer. They were also more likely to
identify maladaptive behaviors as ways of coping. These findings support a
transactional model of adolescent suicidal behavior, whereby inaccuracies in the
appraisal aspects of problem solving (but not in the solution-generation
aspects) in the face of high life stress lead to a reduction in the use of
adaptive efforts to cope.
277: Schweiz Med Wochenschr. 1994 Dec 27;124(51-52):2341-9.
[The child in the hospital]
[Article in German]
Merz M.
Medizinische Universitats-Kinderklinik und Poliklinik, Inselspital Bern.
Children and adolescents live in a rich emotional world of imagination and
fantasies. In the hospital they are confronted with a highly complex field of
transactions. This generates images and feelings within the child and the
adolescent which can be either healing, illness-provoking or maintaining certain
problems. If doctors, nurses and other staff-members encourage the child and his
relatives to develop favorable images, this may support the process of healing
and enhance the quality of life, in dying patients as well. The presentation
shows some of the images children have developed in the hospital and reports
constructive and destructive transactional patterns related to the hospitalized
patient.
Publication Types:
Case Reports

278: Ann Med Psychol (Paris). 1994 Dec;152(10):674-82.
[Health psychology, medical psychology, psychosomatic medicine and liaison
psychiatry]
[Article in French]
Bourgeois M.
I.P.S.O., Universite Bordeaux II.
Health psychology is a new discipline which introduces transactional conceptions
and biopsychosocial integrative models of health and disease. Its fields of
research overlap the traditional domain of psychosomatic medicine (study and
treatment of the mind--conscious or unconscious--of organic patients), and also,
partially, the domain of psychological medicine (which in France is focused on
the psychology of the practitioner and the patient-doctor relationship),
behavioral medicine and liaison psychiatry (which is the use of modern diagnosis
and treatment of psychiatry proper to medical patients). Rather than a potential
competition, one must see a challenge and an opportunity for renewal of
psychiatry in the field of medicine as well as collaborative perspectives.
Health psychology uses new stringent methodology and instruments for research
(dimensions) evolving from scientific psychology. Brief and critical analysis of
this new discipline.
Publication Types:
Review
Review, Tutorial
279: Fam Process. 1994 Dec;33(4):389-407.
Relational control patterns and expressed emotion in families of persons with
schizophrenia and bipolar disorder.
Wuerker AM.
School of Nursing, University of California-Los Angeles 90024.
The process of relational control, that is, the negotiation of "who's in
charge," was examined in 40 families of persons with schizophrenia and bipolar
disorder. Verbal interaction recorded during problem-solving tasks was coded
with the Relational Control Coding System (RCCS). Patterning of message and
response sequences was compared by diagnosis of the patient and level of
expressed emotion (EE) of the family. Results indicated that patients with
either diagnosis assert control more than their parents, that high-EE families
compete for control more than low-EE families, and that families of bipolar
patients compete for control whatever their EE status. The most dramatic
differences in control patterns were in the dual-parent, high-EE families of
persons with schizophrenia, in which the patients successfully challenged
parents for control, and parents often yielded. It was concluded that EE
reflects transactional processes in families that vary by diagnosis of the
patient.

280: Br J Clin Psychol. 1994 Nov;33 ( Pt 4):469-81.
Sequences of emotional distress expressed by clients and acknowledged by
therapists: are they associated more with some therapists than others?
Viney LL.
Department of Psychology, University of Wollongong, NSW, Australia.
When clients come to psychotherapy they are distressed, this distress usually
being expressed in the form of anxiety, hostility, depression and helplessness.
This study explored the sequences of emotional distress expressed by clients and
acknowledged by therapists, and examined their associations with other factors.
The transcripts of five therapists (two single sessions each) were
content-analysed: they used personal construct, client centered,
rational-emotive, Gestalt and transactional analysis therapy. Log-linear
analyses of appropriate contingency table cell frequencies were conducted to
test associations between identified sequences and the two variables of
therapist and timing of completion of the sequence. Therapist-client sequences
of Anxiety-Anxiety, Anxiety-Hostility and Helplessness-Hostility were found to
be associated more with the personal construct and client centred therapists
than with the rational-emotive therapist. Client-therapist sequences of
Anxiety-Anxiety, Helplessness-Anxiety and Helplessness-Helplessness were more
often found with the client centred therapist than the other therapists. For
most of these sequences timing had an effect, yet timing rarely interacted with
the therapist variable. The findings are discussed in terms of their relevance
to the theoretical positions represented, the shortcomings of the research and
the value of this methodology in studies linking therapy process with outcome.
281: Sangyo Igaku. 1994 Nov;36(6):397-405.
Quantitative assessment of stressors and stress reaction: a review.
Ezoe S, Morimoto K.
Department of Hygiene and Preventive Medicine, Osaka University School of
Medicine.
To survey methods for assessing stress and to examine the relationship of stress
to health and the factors of lifestyle, we reviewed the literature on stressors
and stress reactions. Firstly, we reviewed the representative methods for
assessing stressors. Secondly, self-report questionnaires based on a theoretical
model of occupational stressors were surveyed and factors in work stress were
listed. Then, we reviewed stress reactions including physiological,
psychological and behavioral reactions. Finally, we examined the relationship of
perceived stress measured by a single question to mental health status
determined by the General Health Questionnaire (GHQ-28), lifestyles and
personality based on the Egogram in Transactional Analysis. It is suggested that
we need to assess subjective aspects as well as using objective indices such as
data from physical examinations, to evaluate the level of stress and to promote
mental health.
Publication Types:
Review
Review, Tutorial
282: Curr Opin Pediatr. 1994 Oct;6(5):525-9.
Diagnosis, management, and implications of maternal depression for children and
pediatricians.
Green M.
Indiana University School of Medicine, Indianapolis.
The past decade has witnessed a marked increase in the quantity and quality of
research relating to maternal depression and the children of depressed mothers.
Such children are at heightened psychological risk of problems in adjustment and
depression. The outcomes in this vulnerable group are determined by many
influences in the child, the mother, and the family. There is a reciprocal
relationship between psychological problems in the child and in the mother.
Recently, the contextual and transactional aspects of maternal depression has
been emphasized in the literature. Attention has to be given not only to the
mother and her child but also to acute and chronic family stressors. In this not
uncommon life event, the pediatrician has a key role in early identification and
intervention, both preventive and therapeutic.
Publication Types:
Review
Review, Tutorial
283: Psychol Bull. 1994 Sep;116(2):340-62.
Stress, appraisal, and coping in child sexual abuse: a theoretical and empirical
review.
Spaccarelli S.
Program for Prevention Research, Arizona State University.
A review of theories to predict the mental health effects of child sexual abuse
suggests that existing models have not adequately defined stress and coping
constructs and have not specified how those variables might interact with other
environmental factors. This article outlines a transactional model that
conceptualizes sexual abuse as a stressor consisting of a series of abuse
events, abuse-related events, and disclosure-related events that each tend to
increase risk for maladaptive outcomes. The model also proposes that cognitive
appraisals and coping responses mediate the effects of these events, that
developmental and environmental factors may moderate relationships between
sexual abuse stressors and victim responses, and that victims' initial responses
may effect subsequent levels of abuse-related stress. Empirical studies relevant
to the major components of this model are reviewed, and the implications of
these findings for future research are considered.
Publication Types:
Review
Review, Tutorial
284: Percept Mot Skills. 1994 Aug;79(1 Pt 1):259-64.
Assessment of cognitive appraisal and coping linkages using two forms of
canonical correlation.
Scherer RF, Coleman JC, Drumheller PM Jr, Owen CL.
Department of Management, Wright State University, Dayton, OH 45435.
As a conceptual framework for research on stress and coping, the transactional
model of Lazarus and Folkman is process-oriented and requires methodologies that
capture the process nature of cognitive appraisal and coping across stages of a
transaction. Two forms of canonical correlation were used to analyze strength of
association measures between pairs of cognitive appraisal and coping variable
sets for 138 student subjects. Analysis indicated that, when an environmental
transaction includes more than one time period, the generalized canonical
correlation approach may offer some advantages in assessing linkage strength
over the pairwise method.
285: Can J Psychiatry. 1994 Aug;39(6):321-5.
Future of child psychiatry. I: Models and guiding principles.
Minde K.
Division of Child Psychiatry, McGill University, Montreal, Quebec.
This article reviews some concepts the author believes will guide scientific and
clinical work in child psychiatry during the next 25 years. Specifically, it is
postulated that the traditional biopsychosocial model may have to be expanded to
look at ways we can understand transactional events versus nonshared family
characteristics, the development of internal representations and risk factors
versus risk carriers.
Publication Types:
Review
Review, Tutorial
286: Arch Psychiatr Nurs. 1994 Aug;8(4):221-7.
Stress and coping in the context of psychoneuroimmunology: a holistic framework
for nursing practice and research.
McCain NL, Smith JC.
College of Nursing, Rush University, Chicago, IL.

Nurses who specialize in mental health routinely deal with stress and coping as
priority issues. Yet there has been no consensus on an overriding framework for
organizing and interpreting knowledge concerning the influences of stress on
health and well-being. In addition, stress-management interventions have often
been piecemeal. This article surveys traditional and emerging conceptualizations
of stress and stress management, with a special focus on the transactional model
and psychoneuroimmunology as complementary integrative frameworks. The authors
recommend a comprehensive approach for stress management that includes
behavioral, cognitive, and combination strategies for active coping as well as
cognitive-behavioral techniques for relaxation.
Publication Types:
Review
Review, Tutorial
287: J Pediatr Nurs. 1994 Aug;9(4):218-25.
Change in the hospital setting: adopting a team approach for nonorganic
failure-to-thrive.
MacPhee M, Mori C, Goldson E.
Children's Hospital of Denver, CO 80218.
The change process is described for the adoption of a multidisciplinary team
approach to nonorganic failure-to-thrive (NOFTT) management at a pediatric care
facility. A member of the nursing staff acted as a change agent. The need for
change was documented with medical record audits. A team was developed and a
management protocol derived from an external evaluation of successful programs
described in the literature. Preliminary outcomes of the project are reported.
Box 1 at the end of this article contains criteria for NOFTT diagnosis and an
outline of the team's protocol.
288: Psychother Psychosom Med Psychol. 1994 Aug;44(8):273-83.
[Change in self-object differentiation in an eating disordered patient during
inpatient therapy]
[Article in German]
Grabhorn R, Overbeck G, Kernhof K, Jordan J, Muller T.
Klinikum, Johann Wolfgang-Goethe Universitat Frankfurt.
This paper is intended as a contribution to qualitative-quantitative research on
the psychotherapeutic process. It reports on the course of a three-month
inpatient psychosomatic treatment of a female patient with an eating disorder
from the preferred point of view of psychoanalytically oriented individual
therapy. Given the central role of the self-object relationship in women with
eating disorders, changes that occur with regard to this aspect over the course
of the therapy are recorded and described. In addition to the clinical

perspective, the selected approach is based on a combination of methods, with an
emphasis on the analysis of linguistic content using the Gottschalk-Gleser
method, the Core Conflictual Relationship Theme method according to Luborsky and
the projective procedure of Object Relations Technique according to Phillipson.
In the course of treatment reveals changes in terms of reducing shame-anxiety
and inwardly-directed aggressiveness as well as in the patient's object
repproachement and to a more positive way of dealing with herself, all of which,
on the whole, can be considered indicative of an increasing degree of
self-object differentiation.
Publication Types:
Case Reports
289: J Speech Hear Res. 1994 Aug;37(4):841-51.
Facilitating prelinguistic communication skills in young children with
developmental delay. II: Systematic replication and extension.
Yoder PJ, Warren SF, Kim K, Gazdag GE.
John F. Kennedy Center, Vanderbilt University, Nashville, TN.
Four children with mental retardation were studied in the context of a multiple
baseline across subjects design. Staff members used a modified version of the
milieu teaching method to facilitate intentional requesting. The results
replicated the finding that a modified version of milieu teaching was effective
in facilitating the use of intentional requesting by children with developmental
delays in an intervention context (Warren, Yoder, Gazdag, Kim, & Jones, 1993).
This study also extended the Warren et al. (1993) work by (a) documenting that
increased intentional requesting generalized to sessions with the children's
mothers, (b) demonstrating that mothers who were naive to the purposes of the
study were more likely to linguistically map their children's prelinguistic
communication after the intervention than before the treatment, and (c) that
mothers and teachers who were naive to the purposes of the study linguistically
mapped the children's intentional communication more than the children's
preintentional communication. We discuss implications of these results for early
intervention, the transactional theory of development, and the importance of the
distinction between intentional versus preintentional communication.
290: Midwives Chron. 1994 Jun;107(1277):224-5.
An application of transactional analysis in midwifery practice.
Chue CM, Slater T.
Stability and change in the psychological adjustment of mothers of children and
adolescents with cystic fibrosis and sickle cell disease.
Thompson RJ Jr, Gil KM, Gustafson KE, George LK, Keith BR, Spock A, Kinney TR.
Duke University Medical Center, Durham, North Carolina 27710.
Found moderate stability in the classification of maternal adjustment in two
longitudinal studies of mothers of children and adolescents with cystic fibrosis
and sickle cell disease. In terms of the transactional stress and coping model,
stable poor maternal adjustment was associated with higher levels of appraisal
of daily stress and palliative coping and low levels of family supportiveness.
With initial levels of maternal adjustment, demographic parameters, and
follow-up interval controlled, concurrent levels of daily stress accounted for
significant portions of variance in maternal adjustment at follow-up for both
illness groups. In addition, illness severity, child psychological adjustment,
and family conflict added significant increments to maternal adjustment at
follow-up in the cystic fibrosis group. Findings are discussed in terms of a
basis for subsequent intervention studies to enhance the adjustment of mothers
of children with chronic illness.
292: Prax Kinderpsychol Kinderpsychiatr. 1994 Apr;43(4):130-7.
[New decision making therapy in foster, adoptive and institutionalized children
with failed outcome]
[Article in German]
Heinemann C.
Westfalisches Institut fur Jugendpsychiatrie und Heilpadagogik Hamm.
A specific group of children, adolescents and young adults with failure
syndromes and courses of failure is described and a report is made on the new
decision-making therapy, which has been modified for young patients. This is
described from its transaction-analytical background as well as in its practical
implementation in the in-patient department of a clinic for child and adolescent
psychiatry. Here it is not a matter of a single method of therapy but of a
therapy direction. The objective of this is to help the young person to review
its earlier decisions that were made in connection with relationships in the
sense of one's own prohibition of admission, these being the main cause for
failure, and to code to a new decision of wanting to have successful
relationships in the future. In its implementation different psychotherapeutical
processes are applied according to the individual process situation. The new
decision-making therapy can be considered to be completed when the typical
failure syndrome symptoms have disappeared and the young person begins to open
itself towards development-promoting help and to enter into relationships.
Publication Types:
Case Reports
293: Int J Eat Disord. 1994 Mar;15(2):179-85.
Qualitative analysis and eating disorders: discourse analytic research on
anorexia nervosa.
Hepworth J.
School of Psychology, University of South Australia, Adelaide.
The absence of qualitative analysis in mainstream research on eating disorders
is discussed in the following article as being a weakness in developing theory
and clinical practice. This article includes an analysis of interviews with
British health-care workers who manage anorexic patients. This analysis presents
an example of qualitative methodology in the form of discourse analysis, which
is argued to provide a systematic, yet flexible approach to research on eating
disorders. The overwhelming prevalence of anorexia nervosa in women is
specifically examined within the context of the identification of the "discourse
of femininity." The research findings are discussed in relation to the use of
discursive practices that contribute to the maintenance and reproduction of
clinical processes and their relative efficacy.
294: Pflege Aktuell. 1994 Mar;48(3):150-1.
[A profession in a dramatic triangle]
[Article in German]
Seipel P.
295: Sygeplejersken. 1994 Feb 16;94(7):10-4.
[Prevention--humor is good for the heart. Interview by Mette-Marie Davidsen.]
[Article in Danish]
Petersen LG.
Publication Types:
Interview
296: Soc Psychiatry Psychiatr Epidemiol. 1994 Feb;29(1):40-5.
A strengthening experience? Mental distress during military service. A study of
Norwegian army conscripts.
Schei E.
Institute of Community Medicine, University of Tromso, Norway.
Conscription compels 70% of male Norwegians to invest 1 year of their lives in
military training. For 19-to 20-year-old men, the military service is an
important arena of secondary socialization. In a cross-sectional study of mental
health in army conscripts using the 12-item General Health Questionnaire (GHQ),
the case prevalence was 48% (cut-off 2/3). This was remarkably high, given that
the study population had been screened for mental disease on several occasions,
and a large number of recruits with symptoms of mental disease had been excluded
before the survey began. Statistical analyses indicated that the high case
prevalence was mainly due to situational factors. Four dimensions were
identified: (1) social relations with officers, peers and family, (2) structural
factors inherent in the system of obligatory military service, (3) the
meaningfulness of daily tasks and (4) financial problems. GHQ caseness was
statistically associated with physical inactivity and consumption of junk-food,
tobacco, alcohol and cannabis. It is concluded that military service in its
present form may have undesirable consequences both for civilian society and for
military efficiency. Recruits need help to cope with the complex psychosocial
and transactional challenges of military service.
297: Am J Ment Retard. 1994 Jan;98(4):463-80.
Relations among maternal stress, cognitive development, and early intervention
in middle- and low-SES infants with developmental disabilities.
Brinker RP, Seifer R, Sameroff AJ.
University of Illinois at Chicago.
Relations between maternal stress and the development of infants with handicaps
was examined in 72 middle-SES and 72 low-SES families who attended a weekly
early intervention program. Measures of maternal stress and development of
infants were obtained 10 months apart. Regression analyses predicted 81% of
variance in later developmental level with initial Bayley MA, initial Mental
Development Index (MDI), SES, initial stress, early intervention participation,
and SES x Initial Stress x Attendance interaction. Subsequent maternal stress
was predicted (42% variance explained) by initial stress, attendance, initial
MDI, number of intervention agencies and MDI x SES x Attendance. Results were
interpreted in terms of a transactional model.
298: J Nurs Educ. 1994 Jan;33(1):21-8.
Description of a stressful encounter: appraisal, threat, and challenge.
Burns KR, Egan EC.
University of Minnesota School of Nursing, Minneapolis 55455-0342.
The purpose of this study was to examine a potentially stressful event for
students, the midterm examination, using the Lazarus transactional stress model.
At two time periods during an academic term, 50 students responded to
questionnaires focused on the midterm examination and its outcome. Responses
were used to identify changes in appraisals, personal stakes, perceptions of
threat and challenge; to determine these variables' relations to each other and
to the examination grade; and to determine the best predictors of threat,
challenge, and grade. Results indicated that threat and challenge perceptions
were the only variables that changed as the situation evolved; they were
negatively correlated. The best predictor of threat and challenge was control,
while the only variable that correlated with grade was harm.
299: Psychoanal Rev. 1994 Summer;81(2):279-300.
What brings about change in psychoanalytic treatment?
Chessick RD.
The development of two general points of view regarding what brings about change
in psychoanalytic treatment is traced in this article. One set of conceptions
emphasizes interpretation, especially of the transference, and historical or
narrative reconstruction. The other set emphasizes the experiential and
transactional aspects of a new and better human relationship. Various current
versions of this difference in emphasis are discussed. Future investigation is
needed to distinguish the role of correction of expectations generated out of
actual infantile experiences through the new relationship to the analyst, from
the role of interpretation of early fantasy activity and reconstruction of how
this was generated and congealed in the patient's childhood. The danger of
avoiding the analysis of core infantile fantasy activity and its effect on the
patient's current perception, thinking, and behavior, by a premature termination
of the treatment when the relationships of the patient seem to be more
successful, mature, and realistic, is stressed. One must be careful not to
utilize self psychology or object relations theory beyond foundational repair in
psychoanalytic therapy without considering the consequences. One must ask
oneself always if one is utilizing such theories and practices and the
interpretations based on them defensively, in a collusion to avoid facing the
patient's core unique childhood oedipal and preoedipal fantasy activity and the
reverberations of it in the analyst's core fantasy activity. Continuing
self-analysis is required in each and every treatment process, which is why the
analyst also learns and matures from every case. The openness of the analyst
permits insight through interpretation, meliorative noninterpretive aspects of
the new object relationship or experience, regression due to the analyst's
reliability which gives the opportunity to undo developmental arrests through
the analysis of core fantasies, a symbolic holding environment, and the
collaborative creation of a narrative, all of which are known to have
therapeutic effects and work together to produce change in psychoanalytic
treatment.
300: Z Klin Psychol Psychopathol Psychother. 1994;42(2):89-117.
[Coping-oriented therapy in schizophrenia]
[Article in German]
Wiedl KH.
Fachbereich Psychologie, Universitat Osnabruck.
After a discussion of general problems concerning the development of new and
innovative methods of psychotherapy, an approach based on the transactional
perspective of coping and aiming at therapeutic interventions on schizophrenic
persons' coping with their disease and related problems is presented. The
development of this approach makes use of specific empirical data provided by

coping research, a theoretical analysis of basic assumptions of the
transactional approach including related theoretical elaborations and
differentiations, and of empirical knowledge concerning specific impairments of
schizophrenic persons, which may have an impact on their participation in this
kind of therapy. Also, implications of the approach for the selection of
specific methods of intervention and for the organization of the whole setting
are discussed. After illustrating the approach by describing a program for
groups of patients, which so far has clinically proved to be useful, some ideas
concerning the strategy of evaluation are presented. These refer to the process
of therapeutic intervention and to aspects of general and differential
effectivity.
Publication Types:
Review
Review, Tutorial
301: Acta Psychiatr Scand Suppl. 1994;384:60-6.
Intrafamilial relationships and the course of schizophrenia.
Goldstein MJ, Rosenfarb I, Woo S, Nuechterlein K.
Department of Psychology, University of California, Los Angeles 90024-1563.
This paper describes efforts to explicate the significance of schizophrenic
patients' sub-clinical psychopathology (SCP) to affective attitudes expressed by
relatives about these patients. Using data from two 10-minute interactions
between patients and close relatives (usually parents), verbal and non-verbal
behaviors were scored for signs of SCP by the patient. Scores reflective of more
overt signs of SCP were highly related to relatives' expressed emotion status
and their affective style when interacting with the patient, suggesting that a
complex transactional model best explains the connection between high EE status
of a relative and the risk for patient relapse.
302: Am J Orthopsychiatry. 1994 Jan;64(1):9-19.
Prenatal cocaine exposure and childhood psychopathology: a developmental
analysis.
Scherling D.
A rising number of children exposed to cocaine in utero are substantially
vulnerable to mortality and morbidity expressed in a variety of physical,
cognitive, emotional, motor, and social problems. Research on developmental
outcomes in such children is reviewed and the interaction of prenatal and
postnatal environmental factors, with a focus on the parent-child-environment
transactional system, is discussed. Related societal and treatment issues are
highlighted.
Publication Types:
Review
Review, Tutorial
303: Biofeedback Self Regul. 1993 Dec;18(4):255-80.
An incremental model to isolate specific effects of behavioral treatments in
essential hypertension.
Goebel M, Viol GW, Orebaugh C.
Psychology Service, VA Hines Hospital, Illinois 60141.
To prove clinical effectiveness of behavioral treatments in essential
hypertension, an incremental repeated measures design was combined with findings
that positive expectancies (placebo factors) potentiate specific effects. If
positive expectancy effects were maximized in a Baseline Control Phase (6-26
weeks of BP stabilization), specific effects might be isolated as well as
potentiated in a Learning Phase (2a, 6 weeks, twice/week; 2b, 6 weeks,
once/week--fading). Follow-up Phase 3 was six weeks, once/week; six months,
once/month; and at 12 months. To equalize groups across seasons over 12 years of
regular clinical work, 117 volunteer outpatient veterans with borderline to
moderate essential hypertension (130-170/90-110) were assigned in order of entry
(10-20 each year) to one of four Treatments: R, simple relaxation; REMG, R + EMG
biofeedback; BP, BP biofeedback only; RBP, R + BP; or to an inert Control Group
(TA, reading about transactional analysis without skills training). The four
Treatment groups showed modest but consistent BP decreases during Phase 2 (p
range from .0001 to .01). Control Phase placebo effects matched those in the
Control Group (no BP decrease after Baseline). With a two-way mixed ANOVA
design, Learning Phase 2 isolated specific effects of behavioral treatments,
while the Control Phase 1 with liberal placebo factors potentiated specific
effects during regular clinical work.
304: Br J Med Psychol. 1993 Dec;66 ( Pt 4):341-52.
Religiosity as a predictor of well-being and moderator of the psychological
impact of unemployment.
Shams M, Jackson PR.
MRC/ESRC Social and Applied Psychology Unit, University of Sheffield, UK.
This paper examines the relationship between employment status and psychological
well-being for a sample of British Asians; and explores the role of religiosity
both as a direct predictor of well-being and as a moderator of the impact of
unemployment. Two samples of male employed (N = 69) and unemployed (N = 71)
British Asians were interviewed, selected to be equivalent in age and a number
of demographic variables. Findings showed poorer psychological well-being for
the unemployed group, and especially for those of middle age; thus replicating
findings for white groups. Furthermore, the hypothesis of religiosity as
buffering the impact of unemployment was confirmed. Results are interpreted in
terms of transactional models of stress, and the benefits of religious belief
and practice for unemployed people of Asian background are discussed.

305: Child Dev. 1993 Dec;64(6):1732-54.
Mother-child relationships as sources of support or stress: a comparison of
competent, average, aggressive, and anxious dyads.
Dumas JE, LaFreniere PJ.
Department of Psychological Sciences, Purdue University, West Lafayette, IN
47907.
We tested the proposition that mother-child relationships can be sources of
support or stress, by comparing patterns of mother-child interactions in a
problem-solving task that children completed with their own and with an
unfamiliar mother. 4 groups of preschoolers (n = 30 in each group)--identified
on the basis of teacher ratings as socially competent, average, aggressive, or
anxious--participated. Mothers of competent and average children were highly
positive and reciprocal toward their own and unfamiliar children. Mothers of
aggressive and anxious children were only positive and reciprocal toward
unfamiliar children but generally indiscriminate (aggressive group) or aversive
and negatively reciprocal (anxious group) toward their own. Children in all 4
groups tended to be reciprocal toward their own mothers, but only competent and
average children were reciprocal toward unfamiliar mothers also. Aggressive and
anxious children generally responded to unfamiliar mothers by ignoring or
actively rejecting their overtures. Results (1) indicate that the relationship
with the primary caregiver may serve as a major source of support or stress in
the preschool years; (2) focus attention on the dynamic organization of
interactions rather than on the presence or frequency of particular behaviors,
indicating that a dynamic of reciprocity enables children and mothers to adapt
positively to the ever changing demands of new social situations; (3) point to
the need to develop new means of assessing relationships to better understand
how they influence development; and (4) highlight the importance of
incorporating transactional models in the diagnosis and treatment of childhood
dysfunctions rather than accounting for them solely in terms of limited skills
in parents or children.
306: J Am Acad Child Adolesc Psychiatry. 1993 Nov;32(6):1207-16.
Precursors of hyperactivity and aggression.
Sanson A, Smart D, Prior M, Oberklaid F.
Psychology Department, University of Melbourne, Parkville, Australia.
OBJECTIVE: This study investigated the early characteristics of children who at
8 years old were hyperactive, aggressive, or both, to clarify the etiology of
these disorders. METHOD: Prospective data from infancy to 8 years on children
who were hyperactive (N = 65), aggressive (N = 57), or both (N = 60) at 8 years
were compared with those on a normal comparison group (N = 70). Variables
included ratings of temperament, behavior, school performance, and socioeconomic
and life stress indices. RESULTS: The two aggressive groups, particularly the
hyperactive-aggressive group, were more difficult in temperament and behavior
from infancy and had less optimal environments. In contrast, the "pure"
hyperactive group showed more problems than did the comparison group only from 3
to 4 years on. All three clinical groups had poorer academic performance than
did the controls. CONCLUSIONS: The findings are consistent with a transactional
model of development in which aggression (with or without hyperactivity) emerges
when difficultness in infancy interacts with a stressed environment.
Hyperactivity, when unassociated with aggression, may emerge later from poor
self-regulation when faced with societal, especially school, demands. The
pattern of group differences found suggest that risk indicators for specific
patterns of later maladjustment may be identifiable for early intervention.
307: Nurse Pract. 1993 Nov;18(11):50-3.
Examining the common stressors and coping methods of rural adolescents.
Puskar KR, Lamb JM, Bartolovic M.
University of Pittsburgh School of Nursing, Pennsylvania.
The major objective of this study was to explore and examine common stressors
and coping strategies of rural adolescents. Coping was defined as a cognitive
and transactional process between a person and the person's environment. A
survey of 222 normal adolescents attending a rural southwestern Pennsylvania
high school reported experiencing stressful events related to school, family,
friendship, health, and transportation. The coping strategy reported as being
the most commonly used was optimistic. However, the coping strategy reported to
be most effective in dealing with stressful events was supportant. The results
of this study contribute to the limited information on adolescent coping in
rural areas. This study should help health care providers further their
understanding of this vulnerable population. Clinicians can enhance the
effective coping and overall health of the rural adolescent by screening for and
discussing coping strategies.
308: J Pediatr Psychol. 1993 Oct;18(5):549-59.
Psychological adjustment of mothers of children and adolescents with sickle cell
disease: the role of stress, coping methods, and family functioning.
Thompson RJ Jr, Gil KM, Burbach DJ, Keith BR, Kinney TR.
Assessed the psychological adjustment of 78 mothers of children and adolescents
(7-17 years of age) with sickle cell disease. Support was provided for a
transactional stress and coping model in delineating the processes associated
with maternal adjustment. In particular, poor maternal adjustment was associated
with use of palliative coping methods and high levels of stress related to daily
hassles. Variables of the model accounted for 55% of the variance in maternal
psychological distress.
309: J Abnorm Child Psychol. 1993 Oct;21(5):493-518.
Developmental theories of parental contributors to antisocial behavior.

Shaw DS, Bell RQ.
Department of Psychology, University of Pittsburgh, Pennsylvania 15260.
In view of the increased interest in a developmental approach to
psychopathology, and mounting evidence of the importance of parent-child
interactions in the etiology of early antisocial behavior, the following
questions were posed for this review. What theories of parent-child
relationships and family management techniques are available? How developmental
are they, how specific and transactional are they relative to parent and child
behaviors involved? And how well do they cover the period in which antisocial
behavior develops? Six theories have some developmental features but the
attachment theories (by L. A. Sroufe, B. Egeland, and M. T. Greenberg) and two
social learning theories (by G. R. Patterson and J. Martin) are most clearly
developmental. They postulate reciprocal interactions of parent and child, and
transformations in the form of normative changes in the child or changes in
family processes. The social learning theories of Patterson and Martin are most
specific, microanalytic in fact, as to the interaction processes involved, and
the attachment theories at least specify kinds of behavior involved and also do
not rely on traits or types of influence as their units of analysis.
Conceptualization is most weak and overly general between late infancy and the
preschool years. This gap makes it difficult to link attachment and social
learning theories, both of which have driven a large number of studies. A
bridging theory is offered to link the two sets of theories in the critical
period involved.
Publication Types:
Review
Review, Tutorial
310: Issues Ment Health Nurs. 1993 Oct-Dec;14(4):323-36.
Parent influences on children's self-esteem in economically disadvantaged
families.
Killeen MR.
The purpose of this study was to test hypotheses from a transactional model of
the self, related to parental influences on children's self-concepts and
self-esteem, within economically disadvantaged families. Thirty-nine school-age
children completed self-report instruments that assessed multiple dimensions of
self-perceptions, perception of parental support, importance of specific
domains, and family conflict. Parents completed similar ratings of their
children's specific competencies and their importance, childrearing practices,
and family conflict. The results supported a model in which parents (a)
influence self-concepts by providing children with information on how well they
perform in specific domains and which domains are important; and (b) influence
self-esteem by their affective behavior. Children and parents clearly agreed on
the children's competence in school, social acceptance, and behavior but not in
athletics or physical appearance. Family members did not consistently agree in
their importance ratings. Global self-worth was predicted by children's
perceptions of parental support and perceived competence in domains that were

important to the parents.
311: J Dev Behav Pediatr. 1993 Aug;14(4):242-9.
Cognitive development of preterm low birth weight children at 5 to 8 years old.
Lee H, Barratt MS.
Waisman Center, University of Wisconsin-Madison 53705.
Prematurity and low birth weight have been considered to be important risk
factors for cognitive development during early childhood; however, it has been
suggested that the developmental delays disappear with age. Eighty-one preterm
(< 38 weeks) low birth weight (< 2500 g) children between 5 and 8 years old from
the Children of the National Longitudinal Survey of Youth were compared with
individually matched full-term normal birth weight children to investigate the
catch-up delays in cognitive functioning including language and mathematics
skills. Preterm children showed a significant delay in cognitive functioning
only until 6 years old. Regression analyses showed that environmental factors
accounted for more variation in cognitive development than did perinatal
factors. In support of a transactional model, preterm children exhibited a
self-righting tendency during their early childhood so that eventually
environmental influences overshadowed biological influences.
312: Percept Mot Skills. 1993 Jun;76(3 Pt 2):1267-73.
Challenge and type A scorers: implications of situational consistency and
control.
Doster JA, Guynes JL.
University of North Texas.
A transactional approach to Type A behavior was examined using a
computer-editing task. 39 men and 47 women were assigned to treatment conditions
involving either a fast, inconsistent, or slow computer-system response time.
High scores on Type A and Competitiveness measures of the Jenkins Activity
Survey were associated with users' briefer response times during fast and slow
conditions. High scores on Competitiveness were associated with increased (postminus pretask) state-anxiety scores during the fast condition and with decreased
state-anxiety scores during the slow condition. Type A behavior scores were
uncorrelated to subjects' response times or emotional reactivity during the
inconsistent condition. Implications of situational predictability and control
for Type A behavior pattern were discussed.
Role of child and maternal processes in the psychological adjustment of children
with sickle cell disease.
Thompson RJ Jr, Gil KM, Burbach DJ, Keith BR, Kinney TR.
In this study, 64% of children aged 7-12 years with sickle cell disease were
found to have a parent-reported behavior problem, and 50% met the criteria for a
Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) diagnosis based
on a structural clinical interview of the child. Internalizing types of behavior
problems and diagnoses were the most frequent. Support was provided for a
transactional stress and coping model in delineating the processes associated
with child adjustment. In particular, maternal anxiety accounted for 16%-33% of
the variance in mother-reported internalizing and externalizing behavior
problems, respectively, and child pain-coping strategies accounted for 21% of
the variance in child-reported adjustment problems.
314: Pediatrics. 1993 May;91(5 Pt 2):1056-62.
Culture, ethnicity, and bicultural competence: implications for children with
chronic illness and disability.
Brookins GK.
University of Minnesota, Minneapolis.
315: J Consult Clin Psychol. 1993 Apr;61(2):354-9.
Stress exposure and stress generation in children of depressed mothers.
Adrian C, Hammen C.
Department of Psychiatry and Biobehavioral Sciences, University of California,
Los Angeles 90024.
Two hypotheses were tested: (a) One mechanism contributing to the high rate of
disorder in children of women with affective disorders is elevated exposure to
stressful events and conditions and (b) the children of depressed women,
particularly women with unipolar depression, contribute to event occurrence
because of increased interpersonal conflict. Life stress interview assessments
were made at 6-month intervals for 3 years on 53 children of unipolar, bipolar,
medically ill, and normal women. Both hypotheses were confirmed. Transactional
models of risk and further studies of the interpersonal functioning of children
at risk for depression are needed.
316: Br J Med Psychol. 1993 Mar;66 ( Pt 1):15-31.
Transactional escalation in rigidity and intensity of interpersonal behaviour
under stress.
Van Denburg TF, Kiesler DJ.
Department of Psychology, University of Kentucky, Lexington 40506-0044.

The present study provides empirical support for a new interpersonal concept of
transactional escalation. This proposition hypothesizes that an individual's
typical pattern of interpersonal behaviour will become more extreme and rigid
under stressful interpersonal conditions. Thirty Caucasian females participated
in brief interviews that had two stages: low-stress and high-stress conditions.
The half of the subjects who were assigned to a high-stress interview condition
were predicted to show an escalation of their typical friendly-submissive
patterns during the second half of the interview. Findings revealed that
escalation was evidenced by an increase in the extremeness and rigidity of their
interpersonal behaviour. Implications for interpersonal theory, and for
diagnostic and psychotherapy endeavours are discussed and directions for future
research are provided.
Publication Types:
Clinical Trial
317: Psychiatr Clin North Am. 1993 Mar;16(1):11-20.
Recent advances in addictive disorders. Prevention. Current research and trends.
Kumpfer KL, Hopkins R.
Department of Health Education, University of Utah, Salt Lake City.
The AOD prevention programs of the 1990s should be resiliency-focused and
include interventions of sufficient dosage and strength. Although some child
behavioral technology exists to tackle successfully changes in resiliency,
additional prevention strategies need to be developed and studied. In some way,
the prevention field is hampered by the lack of sufficient research in the child
and adolescent psychiatry and psychology fields, that includes transactional
research in parenting and child rearing for high-risk youth. We simply do not
know enough to determine how parents and other adults can best foster resilience
in children. Questions that arise include how much to protect children from
environmental stressors and how much to push them to confront new life stressors
in the form of challenges to develop new skills or talents. There are no simple
answers to these questions, but a number of useful guidelines could help parents
and teachers to increase resilience in youth. Some of the guidelines currently
being stressed include developing in youth an increased sense of responsibility
for their own success, helping them to identify their talents, motivating them
to dedicate their lives to helping society rather than feeling their only
purpose in life is to be consumers, providing realistic appraisals and feedback
for youth rather than graciously building up their self-esteem, stressing
multicultural competence in an ever-shrinking world, encouraging and valuing
education and skills training, increasing cooperative solutions to problems
rather than competitive or aggressive solutions, and increasing a sense of
responsibility for others and caring for others. Clearly, these are important
objectives for creating the type of citizens that can make American strong in
the twentieth century.
Publication Types:
Review
Review, Tutorial
318: Psychiatry. 1993 Feb;56(1):96-118.
Toward an ecological/transactional model of community violence and child
maltreatment: consequences for children's development.
Cicchetti D, Lynch M.
Mt. Hope Family Center, Department of Psychology, University of Rochester, NY
14608.
In recent decades it has become increasingly apparent that violence affects a
significant proportion of families in the United States (Bureau of Justice
Statistics 1983). Violence, in fact, is becoming a defining characteristic of
American society. A recent comparison of the rates of homicide among 21
developed nations indicates that the United States has the highest homicide rate
in the world, and its rate is more than four times higher than the next highest
rate (Fingerhut and Kleinman 1990). What is even more alarming is the high
incidence of violent death and injury for children and adolescents in the United
States. Acts of violence are the cause of death for over 2000 children between
the ages of 0 and 19 years each year, and more than 1.5 million children and
adolescents are abused by their adult caretakers each year (Christoffel 1990).
Publication Types:
Review
Review, Tutorial
319: J Neurosci Nurs. 1993 Feb;25(1):9-13.
Revised epilepsy stressor inventory.
Snyder M.
School of Nursing, University of Minnesota, Minneapolis 55455.
The relationship between high levels of stress and the occurrence of seizures
has been postulated, and findings from studies are beginning to substantiate
this hypothesis. Identifying stressors experienced by each person will help
health care workers in developing plans of care. In the original epilepsy
stressor inventory (ESI) persons selected stressors they had experienced that
were associated with epilepsy. To facilitate congruency of the ESI with the
Lazarus Transactional Stress Model, revisions were made that allow the person to
rate the degree of stressfulness the stressor causes. An alpha of .93 was found
indicating high internal consistency of the revised epilepsy stressor inventory
(ESI-R). A test-retest reliability of .76 was found. Because the ESI-R is short
(22 items) and easy to administer, it can be readily used in practice settings.
320: J Psychol. 1993 Jan;127(1):5-15.
Detection of deception: a transactional analysis perspective.

Elaad E.
Israel National Police Headquarters, Jerusalem.
I have attempted to integrate two divergent fields in applied psychology, the
psychophysiological detection of deception (polygraph testing) and the
transactional analysis theory. Transactional analysis theory provides a useful
framework for understanding the examiner-examinee interaction in the pretest
interview of the widely used but highly controversial control-question polygraph
test. This research is relevant to the ongoing debate about the plausibility of
the rationale underlying this technique.
321: Behav Med. 1993 Winter;18(4):173-80.
Medical students' differential use of coping strategies as a function of
stressor type, year of training, and gender.
Stern M, Norman S, Komm C.
Department of Counseling Psychology, State University of New York, Albany.
The cognitive-transactional model of stress was used to study the process by
which medical students cope with stress. The study examined the coping responses
employed by male and female first- and fourth-year medical students as a
function of those situations they appraised as most stressful. Multivariate
analyses of variance (MANOVAs) revealed that preferred coping strategies varied
by stressor type and year of training. In dealing with medical-school-related
stressors, first-year students used self-blame and problem-solving styles of
coping more than did fourth-year students. When dealing with interpersonal
stressors, however, fourth-year students tended to use confrontive coping more
than did first-year students. Surprisingly, whether the student was a man or a
woman had no impact on coping responses. The findings underscored the importance
of the moderating impact of the appraisal process on the coping strategies
employed to manage stressful situations. Implications for medical education, as
well as for future research on coping with stress, are discussed.
322: Image J Nurs Sch. 1993 Winter;25(4):285-90.
Effect of nurse-client transaction on female adolescents' oral contraceptive
adherence.
Hanna KM.
Wichita State University, Kansas.
An experimental study was conducted to test the effect of a nurse-client
transactional intervention (King, 1981) on 51 female adolescents' oral
contraceptive adherence. Subjects were randomly assigned to a control or an
experimental group. Both groups experienced the clinics' contraceptive teaching.
Subjects in the experimental group experienced the transactional intervention.

Contraceptive perceptions were measured immediately post-intervention and at the
three-month follow-up. Oral contraceptive adherence was measured at the
three-month follow-up. Female adolescents who experienced the transactional
intervention had greater levels of oral contraceptive adherence than those who
had not (F = 4.15, p < .05).
PIP: A doctoral student examined the influence of a 10-15 minute nurse-client
transaction intervention during the initial clinic visit of 51 female
adolescents on oral contraceptive (OC) compliance. She compared the compliance
scores of the study group with those of the control group. Both groups received
OC information through written materials and videos during the initial clinic
visit. The nurse-client transaction intervention involved personalized
discussions regarding maturity, responsibility, and decision-making.
Specifically, both the nurse and client identified perceived OC benefits and
barriers and perceived OC barriers as potential interference to OC adherence,
confirmed the adolescent's goal of preventing pregnancy by using OCs, and
developed an OC adherence regimen to manage perceived OC barriers. At baseline,
both groups had high scores for perceived interpersonal contraceptive benefits
and contraceptive benefits of responsibility and low scores for perceived
contraceptive barriers. The 3-month follow-up score for contraceptive adherence
was higher than the mean for both groups, suggesting a high level of OC
compliance. At 3 months, the controls and subjects were no different in terms of
contraceptive benefits of responsibility, interpersonal contraceptive benefits,
and contraceptive barriers. In fact, the scores for contraceptive benefits of
responsibility and interpersonal contraceptive benefits for both groups indicate
a high level of perceived contraceptive benefits. The intervention group had a
significantly higher score for contraceptive adherence than did the control
group (10.24 vs. 8.95; F ratio = 4.151; p = 0.049).
Publication Types:
Clinical Trial
323: J Pediatr Psychol. 1992 Dec;17(6):741-55.
Psychological adjustment of children with cystic fibrosis: the role of child
cognitive processes and maternal adjustment.
Thompson RJ Jr, Gustafson KE, Hamlett KW, Spock A.
Division of Medical Psychology, Duke University Medical Center, Durham, North
Carolina 27710.
Found 60% of children 7-12 years old with cystic fibrosis to have a
parent-reported behavior problem and 62% met the criteria for a DSM-III
diagnosis based on a structured clinical interview with the child. Mixed
internal and external behavior problem patterns and diagnoses of anxiety and
oppositional disorder were most frequent. Support was provided for the
hypothesized psycho-social/mediational roles of child perception of self-worth
and maternal anxiety in child adjustment. Together, the variables of the
transactional stress and coping model accounted for 39 and 43% of the variance
in mother-reported internalizing and externalizing behavior problems and for 68%
of the variance in child-reported problems.

324: J Holist Nurs. 1992 Dec;10(4):294-305.
Presence: discovering the artistry in relating.
Hines DR.
Through the substantive practice experience of relating to patients, the author
has identified provisional attributes associated with presence. Concept analysis
was used to systematically illustrate the uses of presence identified by other
authors and disciplines. A model case with the attributes of presence as
described by the author is presented. The provisional attributes proposed by the
author are (a) time with another (T), (b) unconditional positive regard (UPR),
(c) transactional speaking with, being with, doing with (TR), (d) encounter that
is valued (EV), (e) connectedness (essence linking) (C), and (f) sustaining
memory (SM). The definition of presence as a nursing intervention is included.
Publication Types:
Case Reports
325: Pediatrics. 1992 Nov;90(5 Pt 2):808-15.
Behavioral consequences of illness: childhood asthma as a model.
Creer TL, Stein RE, Rappaport L, Lewis C.
Department of Psychology, Ohio University, Athens.
Several areas of research on childhood asthma are discussed within a
transactional model of asthma. The model emphasizes the multidirectional
influences that affect the severity of asthma and associated behavioral
disability. The initial focus is on how the clinical presentation and morbidity
of asthma are affected both by somatic predisposition and by interactions with
multiple internal and external elements. Specific elements include emotional
factors, neuroimmunology, temperament, and medication side effects. Second, the
impact of asthma on the child, his or her family, and segments of the community
are described, as are consequences of the disorder on quality of life. Third,
there is a synopsis of preventative interventions for reducing the medical and
behavioral impact of childhood asthma. The motif is that the interaction of
medical and behavioral procedures can improve the management of asthma while
consequences of the disorder are mollified. Finally, as examples of a
transactional model of asthma, self-management programs for teaching children to
become partners with their physicians in establishing and maintaining control
over the disorder are described. A representative of self-management--the ACT
(Asthma Care Training) program--is described, along with the impact such
programs have on children, their families, and institutions. The conclusion
emphasizes that asthma is a complicated and unpredictable disorder that puzzles
physicians, behavioral scientists, and patients. Although new treatments may be
over the horizon, controlling childhood asthma and its consequences currently
rests on the cooperation and increased interaction of medical and behavioral
scientists.
Publication Types:
Review
Review, Tutorial
326: Nippon Rinsho. 1992 Nov;50(11):2758-63.
[Psychosomatic treatment of irritable bowel syndrome]
Sasaki D, Sutoh T, Abe T.
Health Administration Center, Hirosaki Univ.
Irritable bowel syndrome (IBS) may be defined as a psychosomatic disease. Most
primary care physicians do not want to undertake psychosomatic treatment, but
may find it necessary in refractory patients. Brief psychosomatic treatments,
providing patients with betterways to cope with stress, reduce the symptoms. The
literature on the psychosomatic treatment for IBS is summarized. Supportive
therapy and autogenic training that produce relaxation response appear to be
effective. Other special psychological therapies that require specialized
training, such as hypnosis, biofeedback, cognitive therapy, transactional
analysis may be used for IBS but adequately controlled trials are lacking. It is
certain that psychosomatic treatment take part in the management of IBS.
Additional studies are needed to verify the effectiveness of these treatment for
IBS.
Publication Types:
Review
327: Nippon Koshu Eisei Zasshi. 1992 Nov;39(11):839-47.
[Study on the relationship between toddler temperament and development (second
report)--the relationship between toddler temperament and developmental delay]
Asahara K, Murashima S, Ida S.
School of Allied Medical Sciences, Shinshu University.
The purpose of this study is to clarify the relationship between toddler
temperament and developmental delay, and to examine whether the result could be
adapted to the health practice of mother and child. As the conceptual framework,
we used A. J. Sameroff's transactional model. Questionnaires concerning toddler
temperament, rearing environment and toddler development were sent to mothers
whose children were scheduled to receive 1 year and 6 months child health
examinations, and collected 306 responses. We assessed the developmental status
of 41 children among the 306 by means of the Japanese edition of the Denver
Developmental Screening Test. All 306 children were classified into either the
developmental delayed group (30) or the normal group (275). The data analyses
were conducted both quantitatively and qualitatively with the following results.
Compared with normal children, developmentally delayed children showed these

characteristics: (1) The temperamental category scores of adaptability and
persistence were higher, indicating low adaptability and persistence. The
prevalence of difficult child, slow to warm up (STWU) child and intermediate
high child was relatively higher, with STWU child the highest. (2) The score for
the rearing environment was lower. (3) There were cases where disagreement
between a child's temperament and the mother's rearing behavior had an influence
on the child's development. As a conclusion, these results indicate that a
child's temperament must be considered developmental and child-rearing
counseling in child health examinations.
328: Br J Psychiatry Suppl. 1992 Oct;(18):88-96.
Paths to relapse: possible transactional processes connecting patient illness
onset, expressed emotion, and psychotic relapse.
Nuechterlein KH, Snyder KS, Mintz J.
Department of Psychiatry and Biobehavioral Sciences, University of California,
Los Angeles 90024-6968.
Assessment of coping with schizophrenia. Stressors, appraisals, and coping
behaviour.
Wiedl KH.
University of Osnabruck, Germany.
Onset and course of schizophrenic disorders. Dynamic interactions between
relevant factors. 3rd International Symposium on Transactional Processes in the
Development and Course of Schizophrenic Disorders. Bern, October 1990.
[No authors listed]
Publication Types:
Congresses
Overall
331: Nippon Koshu Eisei Zasshi. 1992 Sep;39(9):696-706.
[Study on the relationship between toddler temperament and development (first
report)--the correlation among toddler temperament, maternal perception and
rearing environment]
Asahara K, Murashima S, Iida S.
School of Allied Medical Sciences, Shinshu University.
The purpose of this study is to clarify how a child's temperament and maternal
perception influences the rearing environment. As the conceptual framework, we
used A.J. Sameroff's transactional model and Miyake's conceptual model of mother
and child. The following process was hypothesized: toddler temperament
influences maternal perception, which in turn influences rearing environment
under which children are developing. Questionnaires concerning toddler
temperament, maternal perception and rearing environment were sent to mothers
whose children were scheduled to receive 1 year and 6 months child health
examinations, and results from 306 mothers and children who answered the
questionnaires were analyzed. The results were as follows: (1) Child temperament
showed a tendency to accord with maternal perception of how easy it is to handle
him/her. (2) Maternal perception was related to rearing environment. (3)
Temperamental characteristics were related to rearing environment. (4) While the
influence of child temperament and maternal perception on the rearing
environment was not shown to be strong, the hypothesized process of this study
was supported to a certain degree. From these results, it appears that it is
important to pay attention to a child's temperament as a contributing factor in
the health practice of mother and child.
332: Health Soc Work. 1992 Aug;17(3):207-13.
Implications for expressed emotion therapy within a family therapeutic context.
Fox P.
Adolescent Day Treatment Program, Tualatin Valley Mental Health Center, Tigard,
OR 97223.
Expressed emotion instruments measure variant levels of criticism, blaming, and
anger within families of mentally ill people. Some theorists believe that high
levels of expressed emotion predispose schizophrenic patients for relapse.
However, recent trends in family therapy indicate that high expressed emotion
may naturally result from caring for an ill family member. Families may
therefore often feel unfairly blamed by practitioners for causing mental
illness. The author examines the usefulness of integrating expressed emotion
measures into family therapy from three theoretical perspectives: the
transactional perspective, the coping and adaptation perspective, and the
systems perspective. Each of these perspectives provides a framework for
incorporating expressed emotion measures into the broader context of research on
and treatment of schizophrenia. The author postulates that appropriate controls
designed to reduce pent-up emotion in families must accompany expressed emotion
interventions in family therapy. Appropriate controls might include exercise,
meditation, spiritual focus, or membership in a support group.
Publication Types:
Review
Review, Tutorial

333: J Consult Clin Psychol. 1992 Aug;60(4):595-604.
Type A behavior pattern: new perspectives on theory, assessment, and
intervention.
Thoresen CE, Powell LH.
School of Education, Stanford University, California 94305-3096.
Research on the Type A behavior pattern (TA) has been plagued by inadequate
theory, insensitive assessment, and insufficient interventions. These problems
(e.g., using global dichotomous ratings of TA) have contributed to several
failures of TA to predict cardiovascular outcomes prompting concern for new
approaches. Conceptual models are discussed, such as a transactional model of
TA, social cognitive theories (e.g., self-evaluative processes), and associative
network theory (e.g., how emotions distort information). The view of hostility
as the only pathogenic feature of TA is questioned. The ethnographic gap in TA
research is described, and detailed descriptive and experimental case studies
are recommended. Profile measures that assess all dimensions of TA are urged
along with contextually sensitive multimodal assessments. Unlike results of some
correlational studies, controlled TA interventions, although few, have
consistently yielded positive results. Study of TA within an expanded conceptual
perspective is encouraged, especially controlled experiments and interventions.
Publication Types:
Review
Review, Tutorial
334: Psychother Psychosom Med Psychol. 1992 Aug;42(8):285-92.
[Developmental structures in children with perinatal risk factors]
[Article in German]
Pauli-Pott U.
Abteilung Medizinische Psychologie, Universitat Giessen.
This longitudinal study focuses on the improvement of understanding the
development of infants with perinatal complications. 38 infants with perinatal
complications requiring intensive care for at least two weeks and their parents
were examined shortly after birth and up to the age of 3 years. A number of
biological and psychosocial data were collected. By means of cluster analysis
based on data collected from children and families during the first three month
three groups were obtained. After three years, children differed significantly
in many developmental areas according to this grouping. A second cluster
analysis based on three years follow-up data yielded four clusters which were
characteristically related to the original ones. The results are discussed using
a transactional perspective.
335: Int J Group Psychother. 1992 Jul;42(3):319-34.

Redecision therapy.
Gladfelter J.
Fielding Institute, Santa Barbara, CA.
Redecision therapy has grown out of an amalgam of transactional analysis and
Gestalt therapy along with extensive clinical experience. This approach as
developed by the Gouldings presents a model that differs from group-focused
therapy in a number of ways. The treatment is centered on the individual. The
therapist takes an active role in the treatment and works within the contract
for change of each individual. Many of the traditional concepts of group therapy
like transference, cohesion, resistance, and group process are not used. The
theory of transactional analysis serves as a conceptual core along with terms
developed to describe the processes used in redecision therapy. Impasses,
contact, cons, games, early decisions, anchoring, injunctions, and scripts are
part of the lexicon of this treatment.
Publication Types:
Case Reports
Stress, coping, and psychological adjustment of adults with sickle cell disease.
Thompson RJ Jr, Gil KM, Abrams MR, Phillips G.
A transactional model of psychological adjustment to chronic illness was
examined with 109 African-American adults with sickle cell disease (SCD). Good
psychological adjustment was associated with lower levels of perceived daily
stress and stress regarding SCD illness tasks, higher efficacy expectations,
less use of palliative coping methods, less use of negative thinking/passive
adherence pain-coping strategies, and family functioning characterized by high
levels of support and low levels of conflict and control. Overall the underlying
stress and coping conceptual model accounted for 44-50% of the variance in
psychological adjustment.
337: Soc Sci Med. 1992 Jun;34(11):1203-16.
Methodological issues and research strategies in the study of coping with
cancer.
Somerfield M, Curbow B.
Johns Hopkins University, Baltimore, MD 21205.
We explore methodological issues and research strategies and applications in the
study of coping with cancer. The major points are addressed within the context
of the transactional, or process, model of stress and coping offered by Lazarus

and Folkman. Three features of this model are discussed: (a) a focus on what
individuals are actually doing and thinking in stressful transactions as opposed
to what they usually do or would do; (b) an emphasis on assessing coping
behavior in relation to a specific context and; (c) attention to the dynamic
nature of coping behavior. We outline each of these three features and discuss
its implications for research on coping with cancer; particular attention is
given to specific measurement strategies and substantive research questions. We
also consider the utility of research on coping with cancer for the design and
implementation of coping interventions for individuals with cancer.
Publication Types:
Review
338: J Abnorm Child Psychol. 1992 Jun;20(3):327-50.
Development of conduct problems and peer rejection in preschool children: a
social systems analysis.
Olson SL.
Department of Psychology, University of Michigan, Ann Arbor 48109.
The development of impulsive-aggressive problem behavior and peer rejection was
examined in sixty 4- to 5-year-old boys from low-income family backgrounds.
Children's sociometric status and behavioral adjustment were assessed
longitudinally at the beginning and end of the preschool year, and related to
measures of peer interaction at three different points in time. Boys identified
as socially rejected and aggressive in the beginning of the year were highly
likely to be identified as such at the end of the year. Early in the preschool
year, these children contributed to their own rejection by initiating socially
aversive exchanges with peers. Although peers clearly perceived these problems,
they did not reciprocate with counteraggression at first. However, as time
passed, peers began to actively victimize these children, and most of the
aggression on the part of victims became reactive in nature. Thus, the current
findings strongly support a transactional model of the development of early peer
rejection and conduct problems.
339: Child Dev. 1992 Jun;63(3):542-57.
A prospective study of life stress, social support, and adaptation in early
adolescence.
DuBois DL, Felner RD, Brand S, Adan AM, Evans EG.
Department of Psychology, University of Illinois, Champaign 61820.
This study employed a 2-year longitudinal design to examine the relation of
stressful life events and social supports to psychological distress and school
performance among 166 early adolescents (mean age = 13.5 years). A prospective
approach was utilized to control for initial levels of adjustment when examining
the relation of Time 1 stress and support variables to Time 2 psychological
distress and school performance. Both stress and support variables made
significant contributions to the prediction of subsequent psychological
distress. Stresses, but not supports, made a significant contribution to the
prediction of subsequent school performance. Evidence for reciprocal and
interactive linkages was also found, including effects of psychological distress
and school performance on subsequent stresses and supports, and greater adaptive
impact of school-based supportive resources under conditions of heightened risk
outside of school. Implications for ecological and transactional models of
development relating to the targeting and efficacy of preventive efforts are
discussed.
340: Br J Addict. 1992 Jun;87(6):832-3; discussion 833-5.
Davidson's dilemma.
Orford J.
Department of Psychology, University of Exeter.
341: Acta Psiquiatr Psicol Am Lat. 1992 Jun;38(2):119-22.
[Gender role and anorexia nervosa]
Behar R.
Depto. Psiquiatria, Universidad de Valparaiso, Chile.
The gender role is defined; its physiognomy, adopted by women since the
occurrence of the Industrial Revolution, and the intricate status that
characterizes the present feminine role are described. Finally, a psychosocial
approach of anorexia nervosa is made. This disorder is considered as a paradigm
of the present ambiguity of the femininity concept likely to become a
transactional phenomenon between sexual identities.
342: Am J Clin Hypn. 1992 Apr;34(4):245-54.
Fairy tales as a trance experience: possible therapeutic uses.
Stevens-Guille ME, Boersma FJ.
University of Alberta, Edmonton, Canada.
The psychological literature contains little documentation of the therapeutic
use of fairy tales. We suggest that fairy tales are uniquely suitable for
hypnotherapy and for helping clients reframe existential issues. We propose that
the structure of fairy tales allows the meaning of the story to be applied
personally and that they also stimulate unconscious search. We examine the way
in which hypnosis is achieved when fairy tales are read to children, as well as
possible therapeutic uses of this learning set in therapy with both children and
adults. We conclude by suggesting that fairy tales need to be given serious
consideration as an alternative therapeutic trance procedure.
Publication Types:
Review
Review, Tutorial
343: Fam Process. 1992 Mar;31(1):3-18.
Illness, family theory, and family therapy: I. Conceptual issues.
Wynne LC, Shields CG, Sirkin MI.
University of Rochester School of Medicine, Department of Psychiatry, NY.
This article examines and clarifies controversies about the concept of illness
in the field of family therapy. We contend that illness, as traditionally
understood in all cultures, is a relational, transactional concept that is
highly congruent with core principles of present-day family theories. Family
therapists need not buy into a biotechnical, reductionistic reframing of illness
as disease. Rather, it is more appropriate to conceptualize and work with
illness as a narrative placed in a biopsychosocial context. Such a narrative
includes how shared responsibility for coping and for finding solutions can take
place, without becoming involved in disputes about causal models.
Publication Types:
Review
Review, Tutorial
344: Z Psychosom Med Psychoanal. 1992;38(2):101-14.
[New approaches to revision of the psychoanalytic theory of development. II. The
J. D. Lichtenberg concept and principles of a new psychoanalytic theory of
development]
[Article in German]
Schussler G, Bertl-Schussler A.
Abteilung fur Psychosomatik und Psychotherapie, Universitat Gottingen.
Both D.N. Stern and J.D. Lichtenberg have outlined new models of a
psychoanalytic theory of development taking into account the results of
empirical infant research. The theory of Lichtenberg is described, whereas part
I centered about the model of Stern. Both theories are discussed and central
principles of development are specified: activity, social adaption, the
influence of genetic factors, the importance of affect and a transactional model
of development.

[Dimensions of coping with chronic pain--a replication study]
[Article in German]
Geissner E.
Medizinisch-psychosomatische, Klinik Roseneck, Prien am Chiemsee.
Clinical-psychological research on pain conceptualizes pain as a transactional
process. There, important components are pain-experience, pain control (coping
with pain) and subjectively felt pain-related stress. The intent of one
preceding study (Geissner, 1991) was to describe, analyze, and validate
behavioral and cognitive aspects of pain control and emotional and behavioral
aspects of pain-related subjective stress. The purpose of the present study is
to replicate the factors of pain-processing, gained by exploratory
data-analyses. 162 patients with headache, back pain and joint pain answered the
revised version of the set of questionnaires used in the former study. Analyses
are done by means of confirmatory factor analysis (LISREL 7 by Joreskog &
Sorbom) and with admission of steps to optimize a solution found. 3 Dimensions
of more behavioral aspects of pain control are identified: Mental distraction,
relaxation and counteractivities. Also, 3 dimensions of cognitive aspects of
pain control are found: Cognitive restructuring, planning skills to deal with
the pain, and self-assurance of ones own skills. The dimensions of subjectively
felt pain-related stress are (1) helplessness/depression, (2) anxiety, and (3)
anger. All dimensions prove to be factorially homogenous and structurally
distinct. In regard to the solution found in the preceding study, differences
are small. Therefore, it can be said, that the results gained formerly are
replicable. Findings from correlational and regression-analytic studies further
support the validity of the dimensions of pain-processing.
346: Psychiatr Med. 1992;10(1):25-39.
Hypnotic transactions, and the evolution of psychological structure.
Beahrs JO.
Oregon Health Sciences University.
This article integrates study of hypnotic transactions with data on their
primate antecedents, toward clarifying the question of differential
responsibility. It concludes that psychological structures are recently evolved
transactional processes that masquerade as explanatory entities, but obey rules
of intentionality: a hypothesis with clinical and forensic implications.
Publication Types:
Review
Review, Tutorial
A dynamic vulnerability perspective on stress and schizophrenia.

Nicholson IR, Neufeld RW.
University of Western Ontario, London, Canada.
Previous vulnerability models of schizophrenia, while strong, have serious
limitations. To deal with the main areas of concern, a multifactor transactional
conceptual framework of stress and schizophrenia, which builds on earlier models
and incorporates recent research findings, is proposed. Research implications
deriving from this framework are discussed.
Publication Types:
Review
Review, Tutorial
348: Scand J Rehabil Med Suppl. 1992;26:132-41.
Traumatic brain injury crisis intervention and family therapy--management and
outcome. Brain Injury Treatment and Research Group.
Soderstrom S, Fogelsjoo A, Fugl-Meyer KS, Stenson S.
Department of Physical Medicine, University of Umea, Sweden.
This article presents a model for crisis intervention and family therapy after
traumatic brain injury. Our program, firmly rooted in object-relations theory
and transactional analysis, included patients and family members (significant
others) living within 100 miles from the University Hospital of Umea. The
effects of the interventions were gauged at one and two years after the trauma
are presented in terms of agreement/disagreement between the patient and the
significant other concerning inter- and intrapersonal relationships as well as
through a short case presentation. As a conclusion of our study a point is made
to expand the scope of intervention to include also other segments of the social
network of the patient.
Publication Types:
Case Reports
349: J Health Soc Behav. 1991 Dec;32(4):408-23.
Mental health, social relations, and social selection: a longitudinal analysis.
Johnson TP.
Survey Research Laboratory, University of Illinois, Chicago 60607.
A wide body of literature documents the effect of social networks and social
supports on mental health. Fewer studies, however, have examined the reciprocal
effect of mental health on social relationships. This problem is examined using
data from a national panel survey of adults aged 20-64. For the sample as a
whole, support was found for a social selection process, since psychological
distress predicted decreases in primary, but not secondary, social

relationships. The extent of primary relationships also were found to be
associated with subsequent distress, providing evidence that the relationship
between mental health and social environment may be transactional. When examined
separately by gender, males but not females were found to be vulnerable to the
process of social selection, supporting the hypothesis that the expression of
distress is less role-appropriate for men and therefore more likely to invite
social sanctions. Social causation effects also were observed only among males.
350: J Pediatr Psychol. 1991 Oct;16(5):629-42.
The children's eating behavior inventory: reliability and validity results.
Archer LA, Rosenbaum PL, Streiner DL.
Department of Psychology, Chedoke-McMaster Hospitals, Hamilton, Ontario, Canada.
Eating and mealtime problems are common in childhood. They occur across a broad
age span, in normally developing children and in a wide variety of developmental
and medical disorders. There is no currently available standard instrument by
which to assess these problems. The Children's Eating Behavior Inventory (CEBI)
was developed according to a conceptual framework based upon a
transactional/systemic understanding of parent-child relationships. It was
completed by 206 mothers of nonclinic children and 110 mothers of clinic
children. Results of test-retest and internal reliability testing indicate that
the CEBI meets criteria for instrument reliability. Construct validity is
demonstrated by the significant difference between the clinic and nonclinic
groups in the mean total eating problem score and in the mean number of items
perceived to be a problem.
351: J Nurs Educ. 1991 Oct;30(8):341-6.
Multidimensional stress management in nursing education.
Russler MF.
Department of Nursing, California State University, Fresno 93740-0025.
This study investigated the effectiveness of multidimensional stress management
training for beginning baccalaureate nursing students (N = 57). An experimental
pretest-posttest placebo group, control group design was used. Two pretest and
three posttest measurements of the dependent variables of state anxiety (SA),
reported emotions, and coping methods were completed. The program incorporated
cognitive, physiological, and behavioral approaches. Second, this study examined
the relationship of self-esteem, recent life experiences, and trait anxiety (TA)
to encountered stressors. A repeated measures analysis of variance demonstrated
no significant differences between treatment groups across time. However,
written workshop evaluations demonstrated a strongly positive response by the
experimental group. Significant within-subjects change was demonstrated for all
57 subjects over the semester on the dependent variables of SA, Threat emotions,
and Challenge emotions reinforcing Lazarus' transactional model. A correlation
matrix revealed that individuals with low self-esteem appraised the environment
in a negative manner as did those subjects with high state and TA.
Recommendations include further revision of the multidimensional stress
management approach and continued use of the transactional theoretical
framework.
352: J Pers. 1991 Sep;59(3):507-38.
Predicting the everyday life events of older adults.
Zautra AJ, Finch JF, Reich JW, Guarnaccia CA.
Department of Psychology, Arizona State University, Tempe 85287-1104.
Predicting the everyday life events of people is a relatively unexplored topic,
although several major theoretical approaches deal with related issues. The
dispositional approach would assign a causal role to personality, while the
situational approach would locate causation in the person's environment.
Variations on these two extreme themes invoke an interactionist interpretation.
Beyond this, a genuinely transactional approach focuses on the enduring
person-environment relationship established as people deal with major and
everyday life events. This study investigated a wide range of predictors of
daily positive, negative, and ill-health events over time in a sample of 206
older adults. Results showed that personality variables played only a minor role
in predicting daily events, although an interaction between extraversion and
social network size was significant. Background demographic variables and the
major stressors of recent conjugal bereavement and physical disability played a
role in daily event occurrences. Overall, the strongest degree of predictability
of events came from the events themselves: The high degree of event stability
over time indicated the value of a genuinely transactional model in
understanding the occurrence of everyday events.
353: J Pers. 1991 Sep;59(3):453-72.
Personal strivings, daily life events, and psychological and physical
well-being.
Emmons RA.
Department of Psychology, University of California, Davis 95616.
Interactional models of life events and personality posit domains of
vulnerability within which individuals are most likely to be affected by
negative life events. A variation of this model was tested in a study of the
separate as well as interactive effects of daily life events and personal
strivings on psychological and physical well-being. Subjects listed 15 of their
personal strivings,which were later categorized as reflecting either
achievement, affiliation, intimacy, or power. For 21 consecutive days, subjects
recorded up to eight events that most influenced their moods each day, and
completed mood and physical symptom checklists. Power strivings were negatively
correlated with well-being. Affiliation strivings were correlated with positive
affect. No significant between-subject interactions occurred between strivings
and events. However, within-subject analyses revealed several significant
effects. Achievement-oriented individuals tended to be affected by good

achievement events; similarly, the moods of affiliation- and intimacy-oriented
individuals were affected by interpersonal events. Results are interpreted
within a transactional framework, and implications for research on personality,
life events, and well-being are discussed.
354: Br J Med Psychol. 1991 Sep;64 ( Pt 3):237-51; discussion 253-61.
Comment on:
Br J Med Psychol. 1988 Jun;61 ( Pt 2):111-23.
The concept of dependence as developed by Birtchnell: a critical evaluation.
Cadbury S.
District Psychology Service, Branksome Clinic, Parkstone, Poole, UK.
Birtchnell (1988) appeals for an accurate definition of dependence. Such
accuracy would help with measurement, prevention and treatment of depression. He
describes dependence as a developmental deficiency. In so doing, he presupposes
a psychodynamic trait-based, and gender-related development model, but does not
acknowledge its influence on his thinking. Birtchnell's analysis has three types
of problem. The reasoning may be questioned because of faulty inferential leaps,
undue reliance on the concept of 'maturity', the use of a tautology, ('The
dependent person is...dependent'), internal contradictions, and a questionable
analogy between children's and adults' behaviour. Secondly, he appears to
suggest that there is empirical evidence to support his theoretical approach,
but he does not provide explicit evidence. He draws conclusions about causal
links and neglects alternative interpretations, especially the transactional
interpersonal element in social relationships. Finally, the analysis is
potentially weakened by what may be described as an androcentric bias and relies
upon a 'medical model' of psychological disorder, which fails to consider the
impact of social influences on the expression of emotion. The author argues that
it is at present premature and inappropriate to define dependence, but appeals
for methods of research which would be more helpful in understanding it.
Publication Types:
Comment
Review
Review, Tutorial
355: Nurse Educ. 1991 Sep-Oct;16(5):35-6.
Stressful and satisfying experiences of adult RN/BSN learners.
Wang AM.
Publication Types:
News
356: Prax Kinderpsychol Kinderpsychiatr. 1991 Jul-Aug;40(6):227-31.

[Voice dialogue--dialogue of voices]
[Article in German]
Wille A.
Voice Dialogue is an integration of different therapeutic methods
(Gestalttherapy, Psychodrama, Psychology of C.G. Jung, Transactional Analysis,
Psychosynthesis). It is a therapeutic method, which allows in a rather
humoristic way, without provoking lots of resistance, to contact the
subpersonalities of a client. This will objectify and bring into awareness the
different subpersonalities, as well as the disowned parts of the personality.
Therefore we will have the chance to deal with these parts in a creative way
without the Ego interfering critically. So a new balance can be found between
the different subpersonalities and the Ego. Voice Dialogue can be applied very
well in single, partner or family therapy and has worked successfully with
grown-ups and especially with youngsters.
357: Community Dent Oral Epidemiol. 1991 Apr;19(2):68-71.
Communication about dental health in Norwegian adults.
Rise J, Sogaard AJ.
Research Center for Health Promotion, University of Bergen, Norway.
The present study describes the amount and distribution of communication on
dental health issues in Norwegian adults. The empirical data stem from a
representative sample of Norwegians aged 15 and above, and were collected by
means of personal interviews by the poll organization Norges Markedsdata in
1983. Edentulous subjects were excluded, and the study group finally comprised
1225 subjects. The dependent variable - dental communication - was a dichotomy
based upon whether or not the respondents had communicated with friends about
dental health during the last 6 months. The following independent variables were
used: age, sex, marital status, education, use of dental services, number of
teeth, knowledge of prevention, information about dental health from dentists
and media, use of dental floss and toothpicks. The empirical analysis was
performed using contingency table analysis and Multiple Classification Analysis
(MCA). Separate analyses were performed for men and women. Significantly more
women (27.6%) than men (14.5%) reported dental communication. In addition, the
model provided a better fit to the data on women compared to men in terms of R2
(12.5% and 8.9%). These observations can to some extent be accounted for by the
existing sex-role pattern. The only predictor which showed a consistent direct
effect across sex was whether the respondents had received information about
dental health from media. This means that reference to the interpersonal context
of mass communication perhaps best describes the complex transactional interplay
of media and interpersonal sources in dental health matters.
358: Nurs Diagn. 1991 Apr-Jun;2(2):72-8.
Clinical nurses' characterizations of patient coping problems.

Becket N.
The author reports the findings from a qualitative study of diagnostic data
obtained and interpreted by hospital nurses on the coping of adult patients and
their families. Clinical data taken from taped interviews were transcribed and
analyzed using grounded theory and analytic induction techniques. The data were
then compared with diagnoses accepted for testing by NANDA. The phenomena
described by the research did not match the NANDA constructs for individual and
family coping problems. Nurses' assessments of coping response, however, fit
within transactional theory. The use of the term "ineffective" to qualify coping
was generally avoided. Ineffective coping, suggesting an outcome or product of
coping, was not often considered applicable to the coping responses nurses found
appropriate at specific times in specific situations.
359: Schizophr Bull. 1991;17(3):525-38.
Coping with symptoms related to schizophrenia.
Wiedl KH, Schottner B.
Dept. of Psychology, Osnabruck, Germany.
This article describes a method developed to assess coping with schizophrenia by
inpatients and outpatients. The approach is based on a transactional theory of
coping. Symptoms related to the disease, subjective appraisals given by the 40
patients, and coping behavior are assessed using a list of disease-related
strains, rating scales, and a semi-structured interview. Results of this study
indicate that the patients' appraisals of the effects of their efforts to cope
may not be realistic, leading to a low degree of satisfaction. Coping, described
as "problem-centered" versus "nonproblem-centered" and as behavioral, cognitive,
or emotional, seemed to be related to the patients' clinical status.
Nonproblem-centered strategies predominated in the highly strained groups, along
with a tendency to more emotional and less cognitive coping.
360: Psychiatr Enfant. 1991;34(1):171-275.
[Interactions of the infant with its partners: evaluation of preventive and
therapeutic approaches]
[Article in French]
Lamour M, Lebovici S.
Unite des Petits, Fondation de Rothschild, Paris.
Interactions between the infant and its partners are defined and described on
three levels: behavior, affect, fantasy, with a special focus on the functioning
of the infant. The dynamics of the parent/infant relationships are analyzed
along transactional theories: the infant and its partners influence each other
in a constant process of developing and changing. Together with acknowledging
the baby's active role in the relation, we seek better understanding of how the
infant shapes up throughout transactions. Different assessment methods of the
interactions are analyzed both within a clinical framework and a research
framework, and examples of assessment format are given. The transactional
perspective in clinical practice with the infant introduces a new model for
understanding the pathogenesis of relational disturbances. It appears necessary
to conceptualize a specific nosology of interactive pathology, beyond the
reference to parental or infant pathology; we thus propose a classification of
interactive disturbances by integrating the three levels (behavior, affect,
fantasy). The aim of this investigation of interactions, based on an attempt to
synthetize anglo-saxon and european research in the field, is to outline a new
perspective in clinical concepts and practice which is not solely focused on the
description of behaviors in infant interactions with its partners. This
viewpoint, resolutely psychopathological in its orientation, implies an empathic
approach which leads to important therapeutic changes and legitimizes early
preventive interventions.
Publication Types:
Review
Review, Tutorial
361: J Soc Occup Med. 1991 Winter;41(4):151-6.
The cardiovascular perfusionist as a model for the successful technologist in
high stress situations.
Friday PJ, Mook WJ.
Shadyside Hospital, Pittsburgh.
This study investigates the psychological profiles of highly stressed medical
technologists. One hundred and four individuals representing a cross-section of
the United States who function as operators of heart-lung machines during open
heart surgery (perfusionists) were studied using both internal and external
models based on the works of Eric Berne and Karen Horney. Daily exposure to life
and death responsibilities combined with the constant pressures of maintaining
current technical skills can make the profession selected for this study
representative of high technology professions that require a great deal of
coping. Results of this study indicate that there is a balanced psychological
profile in successful technologists functioning in long-term, high-stressed
occupations. Female perfusionists appear to be more aggressive and critical than
their male counterparts. This is seen as an attempt by female perfusionists to
compensate for what has historically been a male dominanted, highly technical
and high-stressed occupation. Generalizations for candidate selections to high
stressed occupations could be made as well as projections of foundations for
possible progressive disillusionment (burn out).
362: J Health Soc Policy. 1991;2(3):23-38.
Females' use of alcoholic beverages: a study in context.
Lesch WC, Celuch KG.
Illinois State University, Normal 61761.

The literature on female uses of alcoholic beverages is sparse. This paper
advocates studying consumption contextually, and by using secondary data,
presents initial findings which support the utility of the approach.
363: Nurs Res. 1990 Nov-Dec;39(6):360-4.
Mediators of daily stress and perceived health status in adolescent girls.
De Maio-Esteves M.
College of Nursing, Rutgers, NJ.
A causal model based on the transactional cognitive theory of psychological
stress and coping was tested in a middle adolescent female population to
determine the effects of daily stress, introspectiveness, and coping efforts on
perceived health status. Daily stress was hypothesized to affect perceived
health status both directly and through the mediating variables of
introspectiveness and coping efforts. A sample of 159 female adolescents
completed the Hassles Scale, the Ways of Coping Checklist-Revised, the
Introspectiveness Scale for Adolescents and the General Health Rating Index. The
causal model was tested using the LISREL VI program. Findings indicated that the
model fit the data, indicating a plausible representation of the relationships
among the variables identified (x2 = 15.76, df = 12, p less than .203). Daily
stress was significantly negatively related to perceived health status through
the mediating variables of introspection and problem-focused coping but not
emotion-focused coping. Introspectiveness had a significant direct effect on
perceived health status. Problem-focused coping was found to have a direct
positive effect on perceived health status.
364: Cancer Nurs. 1990 Aug;13(4):221-8.
Measurement of stress in clinical nursing.
Benoliel JQ, McCorkle R, Georgiadou F, Denton T, Spitzer A.
Community Health Care Systems Department, University of Washington, Seattle.
The Nurse Stress Checklist was developed to measure stress in clinical nursing
as a multidimensional construct. The instrument was formulated within a
transactional model of stress. The items were derived from five domains thought
to contribute to nurse stress in clinical settings and were organized into a
questionnaire. Holmes Schedule of Recent Events was included as a validity
measure. The instrument was tested on 104 staff nurses working in three
institutions in an urban community. Exploratory factor analysis was applied to
the 74 items presented to subjects in Likert-type format. Five factors were
derived and subjected to psychometric evaluation. Internal consistency
reliability for the five factors was good, ranging from 0.80 to 0.91. Means and
measures of dispersion supported the potential of the five subscales to
discriminate among respondents on the attributes being measured.
Intercorrelations of the factors provided evidence of the distinctiveness of the

five components of stress, although factor loadings showed some overlap between
Personal Reactions and Work Concerns and Work Concerns and Work Completion
Concerns. Validity of the factors also was supported by correlations with
Holmes' Schedule of Recent Events. Content validity was supported by comparison
of these results with findings of other investigators. Limitations of the
results are discussed, and recommendations for future work on the instrument are
offered.
365: Rev Enferm. 1990 Jul-Aug;13(143-4):16-22.
[What is transactional analysis?]
Marcal Lopez JA, Zuazo Barandika F.
366: Behav Modif. 1990 Jul;14(3):230-54.
Etiological models of child maltreatment. A behavioral perspective.
Ammerman RT.
Department of Research and Clinical Psychology, Western Pennsylvania School for
Blind Children, Pittsburgh 15213-1499.
Child abuse and neglect are complex phenomena that require a multidisciplinary
perspective. This article describes current etiological formulations of child
maltreatment. Three models (ecological, transactional, and transitional) are
described that delineate the multiple pathways leading to abuse and neglect.
These approaches emphasize the interaction of causative factors in bringing
about maltreatment and the importance of high- and low-risk characteristics that
differentially influence the development of maltreatment. Behavioral
explanations of child maltreatment are also discussed. Particularly relevant
here are observational learning, anger control, and coercive family processes.
Finally, the implications of our understanding of etiology to assessment,
treatment, and prevention are outlined and considered.
Publication Types:
Review
Review, Tutorial
367: J Dent Assoc S Afr. 1990 Jul;45(7):313-7.
Role of information systems in public health services.
Hartshorne JE, Carstens IL.
Department of Community Dentistry, University of Stellenbosch, Tygerberg 7505.
The purpose of this review is to establish a conceptual framework on the role of

information systems in public health care. Information is indispensable for
effective management and development of health services and therefore considered
as an important operational asset or resource. A Health Information System is
mainly required to support management and operations at four levels: namely
transactional and functional; operational control; management planning and
control; and strategic planning. To provide the necessary information needs of
users at these levels of management in the health care system, a structured
information system coupled with appropriate information technology is required.
Adequate and relevant information is needed regarding population
characteristics, resources available and expended, output and outcome of health
care activities. Additionally information needs to be reliable, accurate,
timely, easily accessible and presented in a compact and meaningful form. With a
well-planned health information system health authorities would be in a position
to provide a quality, cost-effective and efficient health service for as many
people as need it, optimal utilisation of resources and to maintain and improve
the community's health status.
Interrelating research processes of process research.
Shoham-Salomon V.
Department of Psychology, University of Arizona, Tucson 85721.
Given the contextual boundedness of process variables, 3 assumptions implicit in
present process research are questioned: Process variables (a) have fixed
meanings, (b) discretely contribute to outcomes, and (c) have a decontextualized
net worth, evaluated by their correlations with outcomes. From a systemic
perspective, a conceptual framework is suggested that integrates both
theory-driven and discovery-oriented strategies into a cyclical, ecologically
oriented model. Experiments, observations of change events, and detailed
descriptions partake in this cyclical model, informing and enriching each other.
The core of this integration is a transactional conception that sees change
processes as mutually defining rather than interacting with each other, thus
leading to holistic examinations of changes of pattern in addition to patterns
of change. The transactional core serves as the point of departure and home base
for both theory-driven and discovery-oriented research strategies.
Publication Types:
Review
Review, Tutorial
369: J Adv Nurs. 1990 May;15(5):544-55.
Stress is in the eye of the beholder: reconceptualizing the measurement of carer
burden.
Nolan MR, Grant G, Ellis NC.
Centre for Social Policy Research and Development, University College of North
Wales, Bangor.
The development of community care policy and the inadequacies of professional
responses to the needs of informal carers were described in an earlier paper. A
qualitative analysis of carers' replies to a questionnaire survey demonstrated
that the most potent stressors, contrary to what has previously been assumed,
were linked more to subjective perceptions of events or circumstances than to
the objective features of the events and circumstances themselves. This paper
presents a quantitative analysis of data from the same survey which confirm the
impressions gained from the analysis of the qualitative data. These findings
prompt a reconceptualization of carer burden within a transactional model of
stress, which is then considered as a basis for understanding how carers adapt
to stress in their lives. Practice implications are assessed.
370: J Nurs Adm. 1990 Apr;20(4):28-34.
Transformational leadership and the nurse executive.
Dunham J, Klafehn KA.
College of Nursing, University of Akron, Ohio.
Effective nurse executive leadership is paramount in today's health care
environment. Such leadership includes the qualities of a transformational leader
and, to a lesser extent, a transactional leader. A study conducted among
excellent nurse executives and members of their immediate staff showed that all
executives were predominantly transformational leaders but also possessed
transactional leadership skills.
371: Clin Perinatol. 1990 Mar;17(1):31-45.
The Mother-Infant Transaction Program. The content and implications of an
intervention for the mothers of low-birthweight infants.
Rauh VA, Nurcombe B, Achenbach T, Howell C.
School of Public Health, Columbia University, New York, New York.
A brief, economic neonatal intervention based on the transactional model of
development and influenced predominantly by the conceptual design of the
Neonatal Behavioral Assessment Scale was implemented in an intensive care
nursery with the mothers of a group of low-birthweight infants. The development
of the intervention group was compared with that of a similar group of
low-birthweight infants who did not receive the intervention and contrasted with
that of a group of normal-birthweight infants. The intervention had a
significant effect on maternal adjustment and perception of the infant at 6
months. No significant effect on infant cognitive development was apparent until
36 months (that is, 31 months after the intervention had ceased). The
intervention effect was even more significant at 48 months. It appeared that the
two low-birthweight groups had progressively diverged after 12 months, the
intervention group rising until it approximated the normal-birthweight group in
cognitive development, whereas the low-birthweight control group deteriorated.
The economical nature of the MITP, its unique (although delayed) benefits, and
the apparent durability of the intervention effect, suggest that this
intervention program has important theoretical and practical implications and
potentially far-reaching applications.
372: Am J Psychother. 1990 Jan;44(1):116-28.
Towards breaking the cycle of intergenerational abuse.
Leifer M, Smith S.
La Rabida Children's Hospital and Research Center, Chicago, IL 60649.
A quantitative single case study of an adolescent mother with a history of being
abused as a child is presented. It illustrates the diagnostic and treatment
issues during an intervention designed to break the cycle of intergenerational
abuse. Drawing upon an ecological, transactional model of development, the case
study utilized a multimethod, longitudinal approach to assess the mother's
history and current psychosocial functioning, the infant's developmental
competence and attachment status, patterns of mother-infant interaction and
components of the family's social ecology. Measures were administered during a
baseline period and systematically repeated throughout the one-year period of
intervention. The treatment involved two weekly therapy sessions; one, an
individual session for the mother and the other, a session in which mother and
infant were seen together. The findings at the one-year evaluation showed
improved maternal psychosocial functioning, the infant's shift from an insecure
to a secure attachment classification and improved patterns of mother-infant
interactions. The implications of this therapeutic approach and the use of
single-case methodology are discussed.
Publication Types:
Case Reports
373: Perspect Psychiatr Care. 1990;26(2):14-20.
The abused woman and her family of origin.
Leach CL.
The abuse of women in significant heterosexual relationships is an important
societal problem in the United States. Structural family therapy offers a useful
perspective to nurse therapists working with abused women who have left the
abusive relationship to rejoin their families of origin. Common errors are
avoided if the abused woman and her family are diagnosed within the system's
context of structural family therapy. Dysfunctional transactional patterns that
originated in the abused woman's childhood or adolescent years can be challenged
at their source.
Publication Types:
Case Reports
374: J Psychosoc Nurs Ment Health Serv. 1989 Dec;27(12):26-9.

Helping or hurting? Interacting in the psychiatric milieu.
Emrich K.
St. Joseph Mercy Hospital, Pontiac, Michigan.
375: Semin Perinatol. 1989 Dec;13(6):506-12.
Early intervention for vulnerable infants and their families: an emerging
agenda.
Kruskal MO, Thomasgard MC, Shonkoff JP.
Department of Pediatrics, University of Massachusetts Medical Center, Worcester
01655.
Early childhood development is a complex dynamic process that begins at birth
and unfolds in a transactional manner as infants interact with their
environment. Children are highly adaptive organisms with powerful homeostatic
mechanisms; consequently, most high-risk infants do well. Environmental factors
are powerful mediators in this process, and a supportive and responsive
environment may alleviate many early developmental insults, while a deficient
environment can exacerbate developmental weaknesses. Available data suggest that
appropriately designed early intervention services can be effective in
facilitating both child and family adaptation for a variety of target groups.
However, many important questions remain unanswered. For example, although
interventions have been shown to improve cognitive function, effects in other
important areas such as social and emotional functioning and family coping have
not been well studied. Information about the impact of family variables is also
incomplete as is our knowledge about which services work best for which children
and families. Finally, the influence of protective factors in the child and in
the environment requires further exploration. The perinatologist can make
several critical contributions to the comprehensive care of high risk infants
beyond their medical management. He or she can play a pivotal role in
identifying those neonates who need early intervention on the basis of their
biologic vulnerability, their environmental risk factors, or both.
Perinatologists are also in the best position to facilitate early entry into an
appropriate service system and can be important collaborators in providing
comprehensive services and long-term follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
Publication Types:
Review
Review, Tutorial
376: Behav Modif. 1989 Oct;13(4):431-46.
New evidence for the effectiveness of stress management training in groups.
Tallant S, Rose SD, Tolman RM.
This study evaluates the effectiveness of a stress management treatment based

upon transactional stress and group treatment theory. Treatment components
included teaching the cognitive-behavioral skills of relaxation, cognitive
restructuring, and assertiveness within a structured small-group setting.
Thirty-two symptomatic volunteers were assigned to either a treatment group or a
wait-list condition. Treatment consisted of eight, two-hour weekly group
sessions. On all dependent measures of stress, the treatment subjects evidenced
significant pre- to posttest reductions. Furthermore, on three of the four
measures, the treatment subjects evidenced significant pre- to posttest
reductions in stress compared to the wait-list subjects.
377: Nurs Stand. 1989 Sep 2;3(49):36-7.
Counselling as liberation.
Burnard P.
Publication Types:
Case Reports
378: Arch Gen Psychiatry. 1989 Sep;46(9):859-60.
Comment on:
Arch Gen Psychiatry. 1988 Oct;45(10):948-52.
Social zeitgebers, biological rhythms, and transactional analysis.
Patterson CW.
Publication Types:
Comment
Letter
379: Am J Orthopsychiatry. 1989 Jul;59(3):346-54.
Anorexia nervosa reconceptualized from a psychosocial transactional perspective.
Marcus D, Wiener M.
Department of Psychology, Clark University, Worcester, Mass.
Anorexia nervosa is conceptualized as a number of very different instrumental
actions that occur within particular family contexts. Six psychosocial
transactional patterns--negativistic, attention centering, distracting,
childlike, attractive, and self-punishing--are identified. This psychosocial
transactional perspective is proposed as an alternative to approaches that focus
on the "psychopathology" of young female anorexics.
Publication Types:
Review
Review, Tutorial
380: Fam Process. 1989 Jun;28(2):169-81.
Is expressed emotion an index of a transactional process? II. Patient's coping
style.
Strachan AM, Feingold D, Goldstein MJ, Miklowitz DJ, Nuechterlein KH.
UCLA Department of Psychology 90024-1563.
This article examines the extent to which expressed emotion (EE) indexes not
only relatives' behavior toward schizophrenic patients but also patients'
behavior toward their relatives. The coping styles (CS) of schizophrenic
patients were assessed during interactions with their parents and were compared
with parental EE attitudes assessed during an acute hospitalization and during
the aftercare period. It was found that parental EE attitudes measured during
the inpatient period strongly predicted patients' outpatient transactional
behavior: patients interacting with low-EE relatives showed significantly fewer
critical and more autonomous statements than patients interacting with high-EE
relatives. Further, the dominant patient coping style (autonomous, neutral,
externalizing, or internalizing) was strongly related to the relatives'
interactional affective style (AS) and to their pattern of EE attitudes. Patient
coping style was not related to clinical attributes of these patients
themselves. This article and its preceding companion (17) together suggest that
EE indexes a transactional process so that the quality of both parents' and
patients' transactional behaviors may predict subsequent patient functioning.
381: J Pediatr Psychol. 1989 Jun;14(2):293-314.
Family context in pediatric psychology: a transactional perspective.
Fiese BH, Sameroff AJ.
The degree to which the family is seen as a significant contributor to child
health conditions impacts directly on the successful functioning of the
pediatric psychologist. A transactional model of family functioning is proposed
for pediatric psychology. Development is considered to be the result of a
three-part process that starts with child behavior that triggers family
interpretation that produces a parental response. Family interpretation is
presented as part of a regulatory system that includes family paradigms, family
stories, and family rituals. Corresponding to the proposed three-part regulation
model, three forms of intervention are discussed: remediation, redefinition, and
reeducation. Clinical decision making based on this model is outlined with
examples given from different treatment approaches. Implications for the
treatment of families in pediatric psychology are discussed.
Publication Types:
Review
Review, Tutorial

382: Fam Process. 1989 Jun;28(2):153-67.
Is expressed emotion an index of a transactional process? I. Parents' affective
style.
Miklowitz DJ, Goldstein MJ, Doane JA, Nuechterlein KH, Strachan AM, Snyder KS,
Magana-Amato A.
Department of Psychology, University of Colorado, Boulder 80309-0345.
The degree to which expressed emotion (EE) attitudes in key relatives reflect
ongoing transactional processes in families is a topic of controversy. The
associations between EE attitudes, as measured during an acute hospitalization
(using the Camberwell Family Interview) and during the aftercare period (using
5-minute speech samples), and interactional behavior in parents of recent-onset
schizophrenics (this article) and in patients themselves (second article), were
investigated. In the first study, EE attitudes manifested by parents during the
aftercare period were stronger correlates of their interactional behaviors
during the aftercare period than were EE attitudes measured during the inpatient
period, despite the frequent correspondence between the two EE measures. The
pattern of attitudes shown between the inpatient and outpatient periods also
predicted transactional styles in parents during the outpatient period, findings
not accounted for by clinical attributes of patients. When high-EE attitudes
persist during the aftercare period and are reflected in transactional
behaviors, the risk for subsequent patient relapse may be enhanced.
383: Holist Nurs Pract. 1989 May;3(3):47-55.
Spirituality: an essential dimension in the treatment of hypertension.
Thomas SA.
In this time of "burnout" and high turnover in nursing, we must attend to our
own needs for healing. Integration of a spiritual dimension in our lives and
work are central to our health. A balanced life allows nurses to give more, not
less, to their practice. Spirituality enlarges the purpose and meaning of our
lives and work. Nursing practice entails care, comfort, and healing. These
nursing actions flow naturally from a peaceful center.
Publication Types:
Case Reports
384: Int J Addict. 1989 Apr;24(4):303-14.
Program evaluation research in ongoing alcoholism treatment: a summary of the
Tuscaloosa VA project.
Alfano AM, Thurstin AH.
Veterans Administration Medical Center, St. Cloud, Minnesota 56303.
Early in 1980 a Veterans Administration Medical Center initiated a comprehensive

program evaluation project of its Alcohol Treatment Unit. The project has
resulted in numerous publications detailing the major findings; however, many
outcomes of interest have not been reported, and no report is extant which
summarizes the outcome of the program evaluation. In this paper, many results
are reported for the first time, and previously published results are briefly
described. Additionally, the problems encountered in program evaluation are
discussed, as are the implications of the results of the project.
385: Am Psychol. 1989 Feb;44(2):336-40.
The future of schooling.
Linney JA, Seidman E.
Distinction is drawn between research on learning processes among children in
schools and the impact of schooling on students' academic and socioemotional
development. Schooling and the learning environment are considered within an
ecological/transactional framework. The research on school effectiveness and
teacher effects is summarized. Interventions directed at the social regularities
of the schooling environment are proposed as strategies to improve the learning
environment of the school and optimize student outcomes.
Publication Types:
Review
Review, Tutorial
386: J Theor Biol. 1989 Jan 9;136(1):13-9.
On the quantum physical theory of subjective antedating.
Wolf FA.
This paper explores the question of mental events causing neural events through
the actions of the quantum physical probability field. After showing how quantum
mechanical descriptions pertain to the influence that mental events have upon
neural events, the question of Libet's "delay-and-antedating" observation is
examined in the light of quantum mechanical description, specifically in the
action of the probability field. The probability field is the product of two
quantum wave functions. According to the transactional interpretation (TI) of
quantum physics these wave functions can be pictured as offer and echo
waves--the offer wave passing from an initial event to a future event and the
echo wave passing from the future event back in time towards the initial event.
I propose that two events so correlated are experienced as one and the same
event; that is, any two quantum physically correlated events separated in time
or space will constitute a single experience--an event in "consciousness." Using
the TI then suggests a quantum physical resolution of the "delay-and-antedating"
hypothesis/paradox put forward by Libet, B., Wright, E. W., Feinstein, B., &
Pearl, D. K. (Brain, 1979, 102, 193). It also offers a first step towards the
development of a quantum physical theory of subjective antedating based on the
transactional interpretation of quantum mechanics.

387: Issues Ment Health Nurs. 1989;10(1):89-97.
The role of the therapist's critical parent.
Haber LC.
The need for nurse therapists to be aware of their own feelings, beliefs, and
attitudes is all-important if treatment is to be effective. In this paper, the
author uses the concept of the therapist's Critical Parent (from Berne's 1961
Transactional Analysis model) to explore countertransference reactions. Clinical
examples from the author's professional experience are employed to demonstrate
the interplay of ego states between therapist and client and how understanding
of the effect of the therapist's Critical parent can enhance his or her ability
to intervene effectively.
388: J Am Acad Child Adolesc Psychiatry. 1989 Jan;28(1):38-41.
Transactional risk model for short and intermediate term psychiatric inpatient
treatment of children.
Woolston JL.
The transactional model provides a novel guide for the psychiatric hospital
treatment of children by improving the attunement between the child and his or
her important interpersonal environment. Since children's development is highly
context dependent, generalization of the gains made in the hospital will largely
depend upon how well the child's parents and school can internalize the hospital
experience. One method to implement this transactional model is to bring the
child's parents and school into the hospital to join the child's treatment team.
389: Matern Child Nurs J. 1989 Spring;18(1):1-29.
Postpartum depression: a clinical view.
Landy S, Montgomery J, Walsh S.
Recent studies identify a much higher incidence of postpartum depression than
had previously been acknowledged and show that a mother's depression may have a
highly deleterious effect on the early development of her infant. Although a
variety of theories exist concerning the etiology of postpartum depression, many
writers now accept a transactional model of causality. This article suggests
that for many women early depriving or abusive experiences are necessary but not
sufficient conditions to explain the development of severe postpartum
depression. Four different types of postpartum depression are presented with
widely differing prognoses and needs for treatment. It is suggested that a wide
range of treatment modalities may be needed with the more serious depressions
and that such services are lacking in most communities.
Publication Types:
Case Reports
Review
Review, Tutorial
390: Soc Sci Med. 1989;29(4):555-61.
Family response in head injury: denial ... or hope for the future?
Ridley B.
University of California, San Francisco 94143.
Denial is often seen as a major obstacle to successful adaptation in the family
of the head-injured. In fact, it is typically inadequately understood in the
rehabilitation setting. The term is frequently used in a simplistic way, with
the social and cultural factors behind the denial, particularly the stigma of
head injury, not examined or confronted. There is very little hard data on what
constitutes successful family adaptation over the long term. Professionals have
a tendency to focus exclusively on the patient's deficits and the family's
difficulties, ignoring the positive ways in which people cope. This article
suggests that there is a need for a paradigm shift, based on the transactional
theory of stress and coping, in which denial is seen as a positive response in
some situations. Instead of becoming locked into trying to dispel what is
usually called denial and adopting an adversary stance to the family, it may be
more beneficial for rehabilitation staff to work together with family members to
understand why head injury is so difficult to deal with, develop positive models
for living with the sequelae, and encourage hope for the future.
Publication Types:
Review
Review, Tutorial
391: Nurs Pract. 1989;3(1):7-8.
Nursing practice. Stress and attitudes towards the work environment.
Thomas M.
This paper discusses a survey carried out within four wards in an elderly
services' unit. There were two main aims of the study. One was an attempt to
determine the degree of burn-out present in the wards, and the second was to
ascertain the nursing staff's perceived areas of stress within their work
environment. Clarke (1) relies heavily on the transactional view of stress,
while Selye (2), suggests that coping with stress involves the individual in
direct action in changing the demands put upon him or her. This direct action is
aided by information on how to cope with stressors and, therefore, knowledge of
stress symptoms are required. She suggests that giving information changes an
uncertain situation into one of certainty, and at the very least, will change an
individual's view of a new event from something frightening into a more familiar
experience.
392: Duodecim. 1989;105(22):1867-71.

[The patient's psychiatric encounters]
[Article in Finnish]
Aalberg V.
393: Psychother Psychosom. 1989;52(4):214-9.
Communication of emotional meaning, alexithymia, and somatoform disorders: a
proposal for a diagnostic axis.
Lolas F.
Department of Psychiatry, Faculty of Medicine, University of Chile, Santiago.
In this paper, a plea is made for establishing the dimension communication of
emotional meaning as a descriptive axis in biopsychosocial diagnosis. Studies on
alexithymia and somatic illness suggest that this dimension possesses not only
diagnostic implications but also prognostic and therapeutic ones. A
transactional viewpoint considering the definitions and expectations of
patients, professionals and society would convert multiaxial into
multidimensional diagnosis adapted to a given culture. Somatoform disorders are
taken as illustration of the usefulness of the proposed dimension for further
research and theorizing.
394: Pediatr Clin North Am. 1988 Dec;35(6):1187-206.
Failure to thrive.
Frank DA, Zeisel SH.
Boston University School of Medicine, Massachusetts.
Malnutrition is the primary biologic insult in most cases of failure to thrive.
A transactional model of infant development provides a framework for
understanding the psychosocial context in which such malnutrition occurs. Each
child who fails to thrive should receive a multidisciplinary evaluation to
address the diagnostic and therapeutic implications of nutritional, medical,
psychosocial, and developmental factors contributing to growth failure.
Publication Types:
Review
Review, Tutorial
395: CMAJ. 1988 Aug 15;139(4):293-5.
Prevention of psychosocial problems in children with chronic illness.
Rosenbaum PL.
Department of Pediatrics, Chedoke-McMaster Hospitals, Hamilton, Ont.
Children with chronic illness and disability are at considerably increased risk
of psychosocial problems, such as neurosis, attention deficit and poor
adjustment to school. Health care professionals, especially primary care
physicians, can do a great deal to prevent such problems in these children and
their families. The approach outlined here is based on an understanding of the
transactional model of development, in which the child interacts with--and to
some extent creates--the social environment, and on a "noncategorical" concept
in which common elements in chronic illness are recognized and emphasized. The
physician's role is to inform the family of the child's condition as soon as
possible, to offer hope, encouragement and guidance, to watch the child's
development, to maintain a shared view of the child and family, and, if
possible, to ensure continuity of care.
Publication Types:
Review
Review, Tutorial
396: Neurotoxicol Teratol. 1988 Jul-Aug;10(4):305-13.
12- and 24-month neurobehavioural follow-up of children prenatally exposed to
marihuana, cigarettes and alcohol.
Fried PA, Watkinson B.
Department of Psychology, Carleton University, Ottawa, Ontario.
The motor, mental, and language development plus the home environment was
examined in 217 twelve-month and 153 twenty-four-month-old children for whom
prenatal exposure to marijuana, alcohol and cigarettes was previously
ascertained. With this low-risk sample multiple regression analysis was used to
assess the association between outcome measures and prenatal drug exposure while
adjusting for potential confounding factors. Prenatal exposure to marijuana was
uniquely positively associated with a series of items evaluating the child's
attitudes and interests that reflect a cognitive factor. Moderate levels of
alcohol were significantly associated with lower mental scores at 24 months of
age. Prenatal maternal cigarette smoking was significantly associated with lower
mental scores at 12 months of age and altered responses on auditory items at 12
and 24 months. However, at 24 months, the strong relationship of postnatal
environmental factors with cognitive outcomes and with prenatal maternal smoking
resulted in loss of significant, unique predictive power for maternal smoking.
Based on the present work and supplemented by previously reported data
pertaining to maternal attitudes during pregnancy and neonatal behaviour, a
transactional interpretation is presented.
397: J Adolesc. 1988 Jun;11(2):139-53.
Cultural and cognitive considerations in the prevention of American Indian
adolescent suicide.
LaFromboise TD, Bigfoot DS.
School of Education, Stanford University, California 94305.
A description of cultural considerations associated with American Indian
adolescent coping is presented within a transactional,
cognitive-phenomenological framework. Select cultural values and cultural
beliefs of American Indians associated with death are discussed in terms of
person variables and situational demand characteristics that interplay in the
transactional coping process. Three situational demand characteristics
(ambiguity of identity, frequency of loss, and pervasiveness of hardships) are
then presented to illustrate the reciprocal relationship between environmental
contingencies and American Indian individual and community efforts at coping.
The dynamic interdependence between person and environmental variables is
emphasized and considered essential for inclusion in the design of interventions
to prevent suicide. Existing intervention efforts with American Indian
adolescent suicide attempters are reviewed and a school-wide cognitive
behavioural approach based on the transactional model of coping with suicide is
described. It is suggested that on-going cognitive restructuring, social skills
training, and peer counselling training activities be culturally adapted and
integrated into relevant areas of the school curricula in order that coping be
enhanced and suicide ameliorated.
398: Child Dev. 1988 Jun;59(3):554-70.
Longitudinal predictors of developmental status and social interaction in
premature and full-term infants at age two.
Greenberg MT, Crnic KA.
Department of Psychology, University of Washington, Seattle 98195.
This investigation involved the longitudinal assessment of 30 mother-preterm and
40 mother-full-term dyads from birth to 2 years of age. Measures of maternal
attitudes, maternal perception of the infant, and parental functioning were
obtained at 1 and 8 months of infant age. Mother-infant interactions were
observed at 4, 8, 12, and 24 months. Infant cognitive, motor, and language
development was assessed at 4, 12, and 24 months. Results indicated that by age
2 years, no group differences were apparent on any child development,
mother-child interaction, or maternal attitudinal measures; the lone exception
was that preterms were significantly poorer in motor skills. This similarity in
functioning at age 2 years was in marked contrast to earlier findings of major
group differences at 12 months. Correlational and regression analyses indicated
that the developmental and social interaction outcomes were predicted by
different factors in the two groups; moreover, whereas 40%-60% of the variance
in preterm infants' social and cognitive outcomes could be accounted for, only
15%-30% was accounted for in the full-term group. These results are discussed in
terms of compensatory mechanisms that may characterize the parenting of
high-risk infants, and of the applicability of transactional models of
development.
399: Child Dev. 1988 Jun;59(3):544-53.

Minimizing adverse effects of low birthweight: four-year results of an early
intervention program.
Rauh VA, Achenbach TM, Nurcombe B, Howell CT, Teti DM.
Center for Population and Family Health, Columbia University, School of Public
Health, New York, NY 10032.
The outcome of an early intervention program for low-birthweight (LBW) infants
was examined in this study. The intervention consisted of 11 sessions, beginning
during the final week of hospitalization and extending into the home over a
3-month period. The program aimed to facilitate maternal adjustment to the care
of a LBW infant, and, indirectly, to enhance the child's development. Neonates
weighing less than 2,200 grams and under 37 weeks gestational age were randomly
assigned to experimental or control conditions. A full-term, normal birthweight
(NBW) group served as a second control. 6-month analyses of dyads who completed
all assessments over a 4-year period (N's = 25 LBW experimental, 29 LBW control,
and 28 NBW infant-mother dyads) showed that the experimental group mothers
reported significantly greater self-confidence and satisfaction with mothering,
as well as more favorable perception of infant temperament than LBW control
group mothers. A progressive divergence between the LBW experimental and LBW
control children on cognitive scores culminated in significant group differences
on the McCarthy GCI at ages 36 and 48 months, when the LBW experimental group
caught up to the NBW group. Possible explanations for the observed delay in the
emergence of intervention effects on cognitive development and the mediating
role of favorable mother-infant transactional patterns are discussed in light of
recent evidence from the literature.
PIP: The outcome of an early intervention program for low-birthweight (LBW)
infants was examined in this study. The intervention consisted of 11 sessions,
beginning during the final week of hospitalization and extending into the home
over a 3-month period. The program aimed to facilitate maternal adjustment to
the care of a LBW infant, and indirectly, to enhance the child's development.
Neonates weighing less than 2,200 grams and under 37 weeks gestational age were
randomly assigned to experimental or control analysis of dyads who completed all
assessments over a 4-year period (N's = 25 LBW experimental, 29 LBW control, and
28 NBW infant-mother dyads) showed that the experimental group mothers reported
significantly greater self-confidence and satisfaction with mothering, as well
as more favorable perception of infant temperament than LBW control group
mothers. A progressive divergence between the LBW experimental and LBW control
children on cognitive scores culminated in significant group differences on the
McCarthy GCI at ages 36 and 48 months, when the LBW experimental group caught up
to the NBW group. Possible explanations for the observed delay in the emergence
of intervention effects on cognitive development and the mediating role of
favorable mother-infant transactional patterns are discussed in light of recent
evidence from the literature. These findings support a transactional model for
facilitating mother-infant interactions. A logical next step would be to
replicate the intervention program on a different sample of infants considered
to be at biological risk. The studies were conducted at Medical Center Hospital
in Vermont.
Publication Types:
Clinical Trial

400: Soc Sci Med. 1988;26(3):279-91.
Stress research: its present status and issues for future developments.
Vingerhoets AJ, Marcelissen FH.
Department of Medical Psychology, Free University Amsterdam, The Hague, The
Netherlands.
In this article the contribution of nine approaches to stress research is
discussed. These approaches are: (1) the biological approach; (2) the (classic)
psychosomatic approach; (3) the life event approach; (4) interactionistic or
transactional approaches; (5) life style and behavior; (6) group differences;
(7) sociocultural (macro-)factors; (8) work and organizational psychology; and
(9) intervention and prevention. It is concluded that, more and more, exchanges
take place between different approaches and that the willingness to collaborate
increases. Not only do we observe collaboration between different disciplines,
there also are examples of an integration of laboratory research and field
research. In addition, interest of animal workers for human research and vice
versa seems to increase. Although it is realized that stress research has its
own inherent characteristic problems (e.g. ethics), the authors feel that the
future still can bring important progress.
Publication Types:
Review
Review, Tutorial
Rapprochement in the psychic development of the toddler: a transactional
perspective.
Horner TM.
Department of Psychiatry, University of Michigan, Ann Arbor.
The concept of rapprochement, central to separation-individuation theory, is
examined and reinterpreted from a transactional perspective. A range of
naturally occurring confrontations and conflicts between toddlers and their
caregivers is addressed to advance the idea that rapprochement is a continuing
rather than phase-specific process of early development.
Publication Types:
Review
Review, Tutorial
402: Psychiatr Q. 1988 Fall;59(3):165-81.
Parens patriae considerations in the commitment process.

Bursztajn H, Gutheil TG, Hamm RM, Brodsky A, Mills MJ.
Program in Psychiatry and the Law, Massachusetts Mental Health Center, Boston
02115.
Seventy-one commitment-seeking decisions made by 36 clinicians in a state-funded
mental health center were studied to determine the extent to which clinicians
attend to legally mandated "dangerousness" criteria in seeking commitment. A
previous finding that clinicians rely largely on the dangerousness criteria was
replicated. In addition, clinicians were found to be sensitive to clinical
indicators of the patient's need for treatment, a question which is central to
the parens patriae approach to involuntary hospitalization. Further, patients
who were judged to be more seriously ill or more dangerous were more likely to
retract their requests for discharge. This finding suggests that the patient's
request for release and the psychiatrist's petition for commitment together
constitute an interactive, transactional process in which the clinician's and
the patient's views of the patient's need for hospitalization influence each
other.
[Psychotherapeutic processes--regarding the difficulty in explaining
psychotherapeutic changes]
[Article in German]
Bastine R.
Psychologisches Institut, Universitat Heidelberg.
Until now, there is no sufficient answer to the question how psychotherapy
works. It is argued that progress will come from three areas. First, the
understanding what the term "therapeutic process" means has to be improved. It
will be useful to start from the three central phenomena of psychotherapy: (a)
client changes within the therapeutic situation and his/her life context, (b)
therapeutic procedures including personal characteristics of therapists, (c) the
context of the institution of psychotherapy. Second, there is a need to define
more carefully elements of the therapeutic process, e.g. there is an inflational
(mis-) use of the term "therapeutic relationship". Referring to a model by
LINSENHOFF, BASTINE & KOMMER (1982), two components of psychotherapy process
(problem conceptualization and therapeutic relationship) were critically
examined. Third, two different ways to analyse psychotherapeutic change were
evaluated: In Type A-studies, therapeutic processes were characterized by stable
features as interactional factors (e.g. age, gender, education of the
participants; therapeutic maxims). In contrast, Type B-studies rely on a
transactional view of the therapeutic process as a sequence of heterogeneous
segments (therapeutic episodes; therapeutic strategies).
Publication Types:
Review
Review, Tutorial

404: New Dir Child Dev. 1988 Spring;(39):123-45.
Stage-salient issues: a transactional model of intervention.
Cicchetti D, Toth SL, Bush MA, Gillespie JF.
405: Am J Orthopsychiatry. 1987 Oct;57(4):548-60.
Measuring children's coping.
Wertlieb D, Weigel C, Feldstein M.
Eliot-Pearson Department of Child Study, Tufts University, Medford, Mass.
Using a transactional model of stress and coping, a measure of children's coping
is offered and applied in a semi-structured interview in which specific coping
styles are assessed. Data from 176 school-age children yielded findings on age
and gender differences along with other preliminary suggestions of the validity
of the instrument.
406: J Pediatr Psychol. 1987 Sep;12(3):343-62.
Transactional relationships between perceived family style, risk status, and
mother-child interactions in two-year-olds.
Crnic KA, Greenberg MT.
407: Sygeplejersken. 1987 Aug 19;87(34):22-5.
[Children's health. 33. Family therapy with children as valuable and active
participants]
[Article in Danish]
Neubauer I.
Publication Types:
Case Reports
408: Ups J Med Sci Suppl. 1987;44:204-7.
Mother-child transactions in families with normal and handicapped children.
Kaiser AP, Blair G.
George Peabody College of Vanderbilt University, Department of Special
Education, Nashville, Tennessee.

This paper describes two aspects of mother-child interaction: children's
contribution to early conversations and mother's tactics for eliciting verbal
responses. Normal and handicapped children matched for linguistic complexity
(mean length of utterance) differed in both qualitative and quantitative aspects
of their verbal interactions with their mothers. Normal children talked more,
responded correctly more often, and made more attempts to control the
conversation than mentally retarded children. Clear differences in mother choice
of tactics for eliciting child verbalizations also were evident between the two
groups. Overall, mothers of handicapped children modeled responses more and
frequently asked fewer and less complex questions. The differences in mother
behavior appeared to be a function of the child's specific skills, and not of
the child's general classification as normal or mentally retarded; patterns of
mother linguistic adjustment were identical in the two groups. These findings
are discussed in terms of a general model of transactional linguistic teaching
in dyads with mentally retarded children.
409: Am J Pediatr Hematol Oncol. 1987 Spring;9(1):73-83.
Psychosocial issues in childhood cancer. An ecological framework for research.
Michael BE, Copeland DR.
A number of psychosocial issues are evolving as childhood cancer becomes a
chronic rather than a fatal condition. These include issues associated with
extended hospitalization and social isolation, as well as long-term adjustment
to survival that may involve recurrence of disease. Primary emphasis in current
research and intervention is placed on how children and their families adapt to
long-term survival. This article reviews the scope and limitations of previous
research in this area, which focuses on the individual with little reference to
the family, school, or social networks or to the interactions occurring among
these arenas. An ecological model is suggested as the most useful perspective
for enhancing our understanding of the impact of childhood cancer on the child,
family, and community. Much of what is already known about how cancer and its
treatment affect children and families is consistent with the propositions of an
ecological model. The transactional, reciprocal, and interdependent nature of
coping behaviors within a family system is perhaps the most obvious indicant of
the need for multiple perspectives for understanding how families respond to the
pressures of a chronic, but possibly life-threatening, illness. An ecological
approach is timely, therefore, in that there is a need for psychological
research and intervention directed beyond the immediate context of treatment to
extended levels of social interaction and social systems.
Publication Types:
Review
410: Ky Nurse. 1986 Nov-Dec;34(6):9-16.
Rational-emotive therapy--transactional analysis: similarities and differences
of two approaches to group therapy.
Staton M.
411: J Child Psychol Psychiatry. 1986 Nov;27(6):719-59.
Thirty years of child psychology: a selective review.
Clarke AM, Clarke AD.
A selective review of the literature in child psychology over the last 30 years
reveals substantial changes in methodology, in analysis and the interpretation
of findings. Evidence on the multifactorial nature of development is drawn from
genetic/environmental research, longitudinal studies and a consideration of
potential long-term effects of early experience, including planned intervention.
It is increasingly recognized that individuals play some part in causing their
own development, via ongoing transactional processes. Eight themes form the
basis for discussion, including the belated emergence of Piaget's theory and the
changing outlook for the mentally retarded. In addition, the explosion of
research upon infancy and the growing influence of behavioural psychology are
noted.
Publication Types:
Historical Article
Review
412: Psychiatry Res. 1986 Aug;18(4):365-77.
Information processing and communication deviance in schizophrenic patients and
their mothers.
Wagener DK, Hogarty GE, Goldstein MJ, Asarnow RF, Browne A.
Tests of attention/information processing, the continuous performance test (CPT)
and the span of apprehension task (SAT), were given to 25 schizophrenic patients
and their mothers. Measures of communication deviance also were obtained from
the mothers. Comparison of these assessments in the mothers revealed different
transactional profiles for good attenders and poor attenders on the CPT and on
the SAT. The relationships between generations (patient and mother) differ from
the within-individual relationships. CPT performance by the patient is not
significantly correlated with scores from the mother. However, SAT performance
by the patient could be related to SAT performance by the mother and specific
communication deviance factor scores.
413: Health Educ. 1986 Aug-Sep;17(4):37.
Transactional analysis applied to family living.
Mackey RT.
414: Vojnosanit Pregl. 1986 Jul-Aug;43(4):282-6.

[The life scenario of suicidal patients]
[Article in Serbian]
Nada P.
415: Am J Community Psychol. 1986 Jun;14(3):241-57.
A prospective study of life events, social support, and psychological
symptomatology during the transition from high school to college.
Compas BE, Wagner BM, Slavin LA, Vannatta K.
Life events, perceived social support, and psychological symptoms were studied
prospectively among older adolescents during the transition from high school to
college. These variables were reciprocally related to one another in patterns
which changed over a period of 6 months. The findings are supportive of a
transactional model of stress that emphasizes reciprocal, rather than linear,
paths of influence. Further, the study highlights the importance of studying
stress and social support during life transitions that may constitute periods of
greater vulnerability to life events.
416: Kurinikaru Sutadi. 1986 May;7(5):555-8.
[Nursing approach using transactional analysis to a schizophrenic patient
lacking a sense of cleanliness]
Komiriya Y.
Publication Types:
Case Reports
417: Radioisotopes. 1986 Mar;35(3):115-21.
[Estimation of 99mTc-dimercaptosuccinic acid renal uptake using single photon
emission computed tomography]
Ohishi Y, Machida T, Kido A, Tashiro K, Wada T, Torii S, Yoshigoe F, Yamada H,
Chiba K, Toyama H.
Renal function was assessed by measurement of 99mTc-dimercaptosuccinic acid
(DMSA) uptake by the kidney based on the transsectional tomographic image
obtained by single photon emission computed tomography (SPECT). The renal uptake
was expressed as percentage of the total radioactivity detected in the kidney,
the volume of which was measured by convolution method, against the amount
dosed. Absorption was corrected by GE-STAR method using cut off level of 42%. In
order to determine normal range, measurement was made for 40 kidneys of each of
10 male and female volunteers confirmed of having normal kidneys both
morphologically and functionally. The average volume of the kidney was 220.4 ml
for the right and 239.3 ml for the left for males, and 205.9 ml and 236.5 ml,
respectively for females. The renal uptake of radioactivity (at 2 h after
injection), was 26.8% for the right and 27.6% for the left for males, with
corresponding figures for females being 26.4% and 27.9%, respectively.
Distribution range of renal volume and renal uptake was obtained by bivariate
analysis with 90% and 95% probability. From these results, our method of renal
function determination based on renal uptake of 99mTc-DMSA obtained from renal
transactional tomogram by SPECT is considered to be accurate and potentially
useful for clinical purpose.
418: J Stud Alcohol. 1986 Jan;47(1):34-40.
Resilient offspring of alcoholics: a longitudinal study from birth to age 18.
Werner EE.
This study focuses on child characteristics and on the qualities of the
caregiving environment that differentiated between offspring of alcoholics who
did and those who did not develop serious coping problems by age 18. The 49
subjects (22 male) are members of a multiracial cohort of 698 children born in
1955 on the island of Kauai, Hawaii, who were followed at ages 1, 2, 10 and 18.
In this group, males and the offspring of alcoholic mothers had higher rates of
psychosocial problems in childhood and adolescence than females and the
offspring of alcoholic fathers. Children of alcoholics who developed no serious
coping problems by age 18 differed from those who did in characteristics of
temperament, communication skills, self-concept and locus of control. They had
also experienced fewer stressful life events disrupting their family unit in the
first two years of life. Results of the study support a transactional model of
human development and demonstrate bidirectionality of child-caregiver effects.
419: Adolescence. 1986 Winter;21(84):785-96.
Late adolescents' identity formation: individuation from the family of origin.
Anderson SA, Fleming WM.
This study explored the relationships between late adolescents' self-reported
ego identity and individuation from their family of origin. Individuation was
defined as adolescents' subjective perceptions of how psychologically enmeshed
they were in the transactional processes of fusion and triangulation within
their family of origin. The results indicated a significant relationship between
adolescents' perceived involvement in their family's patterns of fusion and
triangulation and the total score, and three of the five subscale scores, from
the identity measure. The implications of the findings and directions for future
research are discussed.
420: Int J Aging Hum Dev. 1986;23(1):27-45.

Contextual age as a life-position index.
Rubin AM, Rubin RB.
A contextual age construct was developed and examined as a transactional,
life-position index of aging. The eighteen-item contextual age index included
six interrelated dimensions: physical health, interpersonal interaction,
mobility, life satisfaction, social activity, and economic security. In addition
to the development of the index, associations among contextual age and
sociodemographic characteristics were examined for a sample of 640 persons.
Chronological age was correlated negatively with mobility and physical health,
and positively with economic security, life satisfaction, and interpersonal
interaction. Mobility, economic security, life satisfaction, physical health,
and interpersonal interaction discriminated between chronological age groups.
Interpersonal interaction, economic security, physical health, and social
activity were predictors of life satisfaction. The contextual age construct
raises questions concerning several negative myths about aging. The findings
reflect the weak validity of chronological age as a unidimensional indicator of
life-position and well-being.
Publication Types:
Review
421: Kangogaku Zasshi. 1985 Aug;49(8):911-6.
[Bedside nursing. Recognition of one-sided nursing actions. Re-evaluation of
nursing scenes using transactional analysis]
Takasago A, Fujimaki E.
422: Kango Tenbo. 1985 Jul;10(8):789-94.
[Improving problems in patient education by means of TA]
Tsutsui S, Hashi A, Omori T.
423: Fam Process. 1985 Jun;24(2):213-24.
Alternative strategies for creating "relational" family data.
Fisher L, Kokes RF, Ransom DC, Phillips SL, Rudd P.
A major problem facing family clinicians and researchers is creating data that
will reflect the family as a unit. To address this problem, we present a

framework for family assessment based on three measurement strategies:
individual family member assessment, relational family assessment, and
transactional family assessment. Within this context, we present several
categories of methods for combining individual family member data into
"relational" scores that reflect the couple or family as a unit. The problems
and benefits of each method are presented, and it is suggested that the choice
of method is dependent upon the content of the assessment, the theory underlying
the content, and the statistical properties of the individual family member
scores.
424: Kango Kyoiku. 1985 Jun;26(6):355-9.
[Characteristics and development of communication at the ego state in
transactional analysis: understanding of patients and nursing in clinical case
studies]
Sato Y.
425: J Nurs Educ. 1985 Jun;24(6):252-5.
Individualizing patient care.
Strickland B, Arnn J, Mitchell JN.
Patients are people as well as potential problems. Increasing our awareness of
patients' lifestyle preferences, as well as developing more productive ways to
interact with them, can promote growth along with recovery. The very least it
can do is to facilitate working with patients and reduce the negative impact of
stress of conflict in a very demanding profession.
Publication Types:
Case Reports
426: Sygeplejersken. 1985 May 22;85(21):10-3.
[Psychotherapy. Psychological game disclosed by transactional analysis]
[Article in Danish]
Barre K.
427: Nurs Success Today. 1985 Apr;2(4):8-14.
Confront coworkers with the truth! Use effective methods.
Hurst JB, Keenan M.

428: CAL. 1985 Mar;48(9):1, 3-4, 6.
Try using transactional analysis for better communication.
Stephens DW.
429: Nurs Life. 1985 Mar-Apr;5(2):49-51.
Nose-to-nose conflict: here's how to find the middle ground.
White TA.
430: Radiol Technol. 1985 Jan-Feb;56(3):154-8.
Stress in clinical learning: a transactional approach.
Dowd SB.
After relevant literature regarding stress and clinical learning is reviewed, a
model designed to reduce stress experienced by students in the clinical learning
setting is presented. The application of the model is discussed, using a
specific clinical example.
431: Curationis. 1984 Dec;7(4):13-8, 29.
[Psychiatric nursing abilities in other nursing dimensions]
[Article in Afrikaans]
Poggenpoel M.
432: Aust Paediatr J. 1984 Nov;20(4):271-5.
Children with school problems--an expanding role for the paediatrician.
Oberklaid F.
Children with school problems comprise a significant part of the new paediatric
morbidity. There is confusion in terminology and it is suggested that instead of
attempting to make a diagnosis of doubtful validity and limited clinical
utility, paediatricians focus instead on generating an accurate description of
the strengths and weaknesses of these children. When placed in the context of a
transactional model of aetiology and function, such an individual difference,
nondiagnostic, nonlabelling approach facilitates the development of appropriate
intervention strategies, as well as creating a suitable framework for

interdisciplinary communication. It is suggested that such a broad based
approach to the assessment and management of children with school problems
allows the paediatrician to play an important role in enabling these children to
fulfil their potential.
433: J Nurs Educ. 1984 Oct;23(8):353-5.
A comprehensive interpersonal skills program for nurses.
Anderson M, Gerrard B.
434: Nurs Mirror. 1984 Sep 12;159(9):21-4.
What makes us tick?
Quinn D.
435: Nurs Life. 1984 Sep-Oct;4(5):62-4.
What's really bothering your patient? 5 ways to find out.
Henrich AP.
436: Focus Crit Care. 1984 Jun;11(3):11-6.
Transactional analysis: a better patient approach.
Hill RL, Simon B.
Publication Types:
Case Reports
437: Krankenpfl Soins Infirm. 1984 Apr;77(4):61-2.
[What is done to assist students in managing patient's aggression? What positive
things can be done with aggression?]
[Article in French]
Poletti R.
Publication Types:
Case Reports
438: Monogr Soc Res Child Dev. 1984;49(1):1-79.

"Difficult" children as elicitors and targets of adult communication patterns:
an attributional-behavioral transactional analysis.
Bugental DB, Shennum WA.
A transactional model of adult-child interaction was proposed and tested. In
determining the effects that caregivers and children have on each other, it was
maintained that adult attributions act as important moderators in the
interaction process. Specifically, it was predicted that adult beliefs about the
causes of caregiving outcomes act as selective filters or sensitizers to child
behavior--determining the nature and amount of adult reaction to different child
behaviors. It was further predicted that adult attributions act in a
self-fulfilling fashion, that is, the communication patterns that follow from
caregiver beliefs act to elicit child behavior patterns that maintain those
beliefs. In a synthetic family strategy, elementary-school-aged boys were paired
with unrelated mothers (N = 96) for videotaped interactions. Children were
either trained or preselected on two orthogonal dimensions: responsiveness and
assertiveness. Mothers were premeasured on their self-perceived power as
caregivers (S+) and the social power they attributed to children (C+).
Videotapes were analyzed separately for adult facial expression and posture,
voice intonation, and verbal communication. Each of these behavioral dimensions
was measured on the dimensions of affect, assertion, and "maternal quality"
(e.g., baby-talk). We expected low self-perceived power to sensitize the adult
to variations in child responsiveness and high child-attributed power to
sensitize the adult to variations in child assertiveness. Two transactional
sequences were obtained (the same patterns were obtained for acted and
dispositional enactments of child behavior): 1. Low S+ mothers (in comparison
with high S+ mothers) were selectively reactive to child unresponsiveness. These
adults reacted to unresponsive children with a communication pattern
characterized by a "maternal" quality, negative affect, and positive affect that
was unassertively inflected. Unresponsive children, in turn, reacted to low S+
mothers with continued unresponsiveness. 2. High C+ mothers (in contrast to low
C+ mothers) were selectively reactive to child unassertiveness. These adults
reacted to shy children with a "maternal," strong, and affectively positive
communication style. Unassertive children, in turn, reacted to high C+ mothers
with increased assertiveness. High S+ and low C+ mothers demonstrated no
significant alterations in their behavior as a function of child behavior. This
nonreactivity had positive consequences for child unresponsiveness (reduced) and
negative consequences for child unassertiveness (maintained).(ABSTRACT TRUNCATED
AT 400 WORDS)
439: Community Ment Health J. 1984 Summer;20(2):135-45.
Leaderstyle and community involvement.
O'Neal GS.
Mental health executives are faced with implementing policy mandates that
require the participation of a variety of constituency representatives in a
community mental health system. This study examines the extent of community
involvement in community mental health centers and utilization of a
transactional leadership orientation as the foundation for compliance with

community involvement demands.
Current therapies and the ancient East.
MacHovec FJ.
Current therapies, their theories and techniques ebb and flow in popularity, but
there is a residue of basic principles and practices which remain. Much of this
useful residue has been present in ancient Eastern religions and philosophies.
This article compares the content of several current theories of individual,
group, and family therapies to seed ideas in ancient Taoist, Zen, Confucian,
yoga, and Buddhist source materials. Gestalt, existential, psychoanalytic,
transactional analysis, cognitive-behavioral and family therapy concepts are
traced to these ancient precursors. Illustrative examples are presented such as
satori (flash of insight), koans (insight riddles), parables, yanas (exercises),
rituals, and written teachings. The article concludes with the Four Noble Truths
and the 8-fold path of Buddhism, given 2500 years ago but very timely to
contemporary problems of life adjustment and a useful guide to counseling and
therapy.
441: Schweiz Arch Neurol Neurochir Psychiatr. 1984;135(1):41-71.
[Schizophrenia and systems therapy]
[Article in German]
Guntern G.
The notion of Systems Therapy subsumes two different although closely
interrelated issues. On the one hand Systems Therapy implies a systemic
Eco-Anthropology based upon Systems Science, i.e., a Systems Theory of man in
and with his environment. On the other hand Systems Therapy is a theory and a
practice of the therapeutic transformation of human systems, based upon a
systemic Eco-Anthropology. Three basic concepts of Systems Therapy are presented
here: the concept of the organism as a system, the concept of the eco-system,
and the concept of the transactional field with its basic organization and its
corresponding transactional patterns. These concepts are illustrated by many
examples taken from case histories of schizophrenic patients and systems. The
status quo of the scientific epistemic process in the field of schizophrenia is
evaluated from the perspective of Systems Therapy in 1983. With rare exceptions
English notions are not translated into German in order to avoid terminological
errors and lack of precision.
442: Neuropsychobiology. 1984;11(3):195-202.
Neuropsychological effects of lead in children: interactions with social
background variables.
Winneke G, Kraemer U.
Following a short and selective summary of findings from psychological studies
on lead-induced cognitive dysfunction in man, our own studies in lead-exposed
children are briefly described in more detail. These studies, run in the cities
of Duisburg and Stolberg, were based on tooth lead levels as the principal
indicator of long-term cumulative lead exposure. From a comprehensive sample of
neuropsychological outcome measures, only few significant findings emerged,
namely lead-related deficits of visual-motor integration and of reaction
performance, but not of general intelligence. Without exception, the observed
lead effects were small compared to those of social background. An interesting
interaction was found between lead exposure and social background for
visual-motor integration and for reaction performance: for both these measures,
but not for intelligence, the degree of association between performance deficit
and lead exposure was more pronounced in socially disadvantaged children than in
those from a more middle-class background. This finding was tentatively
discussed within a transactional model of development. The common practice of
simply controlling the effects of confounding social factors by analysis of
covariance or related techniques appears doubtful in this context.
443: Am J Phys Med. 1983 Dec;62(6):271-86.
Structural treatment approach for families in crisis. A challenge to
rehabilitation.
Wiley SD.
Disability is viewed as a crisis occurring within the context of the family. Its
impact on family structure can be understood through the study of transactional
patterns and communication of the family system. Crisis is defined as a
challenge to the system for which the usual transactional patterns are
ineffective. The crisis of disability provides the family system with an
opportunity to modify its structure, developing new and more effective patterns
of interaction. The opportunity for family development may be realized through a
structural family treatment approach. The origins of this conceptualization are
reviewed. Clinical material is used to exemplify aspects of family assessment
and treatment.
444: Kangogaku Zasshi. 1983 Dec;47(12):1393-404.
[Reevaluation of the improvement of health education for diabetics by the
analysis of each interactive scene]
Usuki K, Fukushima M, Hatayama I, Iwasaki T, Matsuda M.
445: J Nurs Educ. 1983 Nov;22(9):367-71.
A framework for conceptualizing stress in clinical learning.

Strauss SS, Hutton EB.
Nursing faculty are becoming increasingly concerned about the amount of stress
experienced by nursing students. They will find little to guide them in the
nursing literature on coping strategies utilized by nursing students or
facilitating more effective coping strategies that are used by nursing students
in dealing with stress and their efforts in student's behalf to facilitate more
effective coping. Using the Transactional Model to conceptualize nursing
students' stress experiences should enable nursing educators to: Appreciate the
complexity of students' responses to stress. Identify patterns of students'
coping strategies. Develop a better understanding of the importance of timing of
intervention to facilitate optimal adaptation to stressful situations. Identify
areas which need to be addressed in future research. Further study by nursing
educators of nursing students' responses to stress is important because there is
a great need to identify patterns of coping and appropriate interventions in
order to facilitate effective adaptation in education programs and ultimately
the work environment.
446: J Adolesc. 1983 Sep;6(3):229-46.
Approaching the incestuous and sexually abusive family.
Will D.
This paper reviews family transactional theories of incest and sexual abuse. Two
main types of family are described: the chaotic family and the "endogamous"
incestuous family. Some general features of incestuous and sexually abusive
families are then discussed, after which some basic principles of clinical work
with such families are considered.
Publication Types:
Case Reports
447: AORN J. 1983 Sep;38(3):403-10.
Difficult physicians in the OR.
Gatch G, Harrison T.
Publication Types:
Case Reports
448: Nurs Manage. 1983 Aug;14(8):22-4.
Practical management course. Module 3: nurse/physician relationship: part I.
Some basic insights (continuing education).
Murphy EC.

449: J Clin Psychol. 1983 Jul;39(4):628-32.
Dimensions of self-actualization and posttreatment alcohol use in fully and in
partly recovered alcoholics.
Cernovsky Z.
Contacted 46 alcoholics 1 year upon discharge from a residential treatment
program based primarily on transactional analysis. Twenty-five reported to be
fully abstinent for the 1-year follow-up, and the other 21 reported that they
were not drinking heavily. Correlational analysis of the relationship of
reported alcohol use to responses on the Personal Orientation Inventory at the
1-year follow-up suggested that the abstinent persons had somewhat higher
self-esteem and were slightly freer in expression of feelings.
450: Health Educ. 1983 Jul-Aug;14(4):35-7.
Human energy education and transactional analysis.
Bennett C.
451: Nurs Life. 1983 May-Jun;3(3):25-9.
How to stay cool in a conflict and turn it into cooperation.
Guttenberg RM.
452: Child Dev. 1983 Apr;54(2):396-407.
The use and abuse of environment in behavior-genetic research.
Wachs TD.
The measurements and conceptualizations of environment by environmentally
oriented behavioral scientists and behavior geneticists are contrasted. For the
environmentalist, the measurement of environment involves direct observation are
manipulation. The environment is conceptualized as multidimensional, dynamic and
transactional in nature, as well as being mediated, in its effects, by the
individual. In contrast, in behavioral-genetic studies the environment is either
estimated but not measured or is only measured indirectly. The conceptualization
of environment used by behavior geneticists is static and global. In spite of
these differing conceptualizations and measurements, areas of common interest
are observed, centering around the question of how genotype and environment
transact to influence development. Specifically, commonalities and joint
research strategies are proposed for the areas of gene-environment
correlation/transactional model and gene-environment interaction/organismic
specificity.

453: Krankenpflege (Frankf). 1983 Feb;37(2):47-50.
[Overcoming conflict in the ward team]
[Article in German]
Schmincke I.
454: Int J Psychiatry Med. 1983-84;13(2):141-52.
A systems approach to the treatment of chronic encopresis.
Margolies R, Gilstein KW.
This article addresses two issues which have received little attention from
researchers or practitioners; encopresis as a chronic disorder, and its
treatment via a systems-based approach to therapy. Chronic encopresis is viewed
as a complex process rather than a static, symptomatic entity, with emphasis
placed on the significance of family transactional patterns in the maintenance
of the symptom. The case of a fourteen year old encopretic male is presented to
illustrate the utility of assessing family contexts relevant to symptom display.
Publication Types:
Case Reports
455: J Sex Marital Ther. 1983 Fall;9(3):233-43.
Recycling parental sexual messages.
Darling CA, Hicks MW.
The purpose of this study was to explore parent-child sexual communication by
investigating the impact of direct and indirect parental messages on the sexual
attitudes and sexual satisfaction of young adults. A survey research design was
used to obtain data from undergraduate students attending a large Southern
university. The findings indicate that both direct and indirect parental sexual
messages are negative and restrictive and have a differential impact on sexual
satisfaction and sexual attitudes. While sexual satisfaction was positive,
sexual attitudes were found to be problematic, especially among females.
Suggestions are given for approaches that family life educators and parents may
use in order to recycle previous sexual messages.
456: Vard Nord Utveckl Forsk. 1983 Spring;3(4):115-22, 135.
[Patient-nurse relationship set in a transactional analysis communication
perspective. An analysis of communication between patient and nurse in a somatic
hospital]
[Article in Norwegian]
Lonstad A.
457: Recent Dev Alcohol. 1983;1:79-103.
How environments and persons combine to influence problem drinking. Current
research issues.
Braucht GN.
In this chapter, a brief review of existing empirical research on environmental
correlates of problem drinking is presented. The review shows that environmental
factors do relate to the prevalence of drinking problems and also to the way
drinking problems are expressed. In the major section of the chapter, however,
it is shown that our present knowledge of how environmental and personal factors
combine to influence problem drinking is quite limited, perhaps because almost
all of the existing empirical research has attempted to account for problem
drinking by means of individual variables alone, environmental variables alone,
or in terms of linear combinations of individual and environmental variables. It
is shown that alternative approaches offer more promise for understanding how
individual and environmental factors combine to influence problem drinking;
these approaches are aimed at accounting for problem drinking in terms of the
mutual interdependence between persons and their environments. Within two
hypothetical sets of data, a number of conceptual and methodological issues,
problems, and features of these kinds of interactional or transactional
approaches are then illustrated. It is shown that although such approaches offer
a promise of greater understanding, they also present a set of interrelated
problems which run the gamut from measurement, statistical analysis,
experimental design, and sampling issues to paradigm issues lying close to the
realm of the philosophy of science.
Publication Types:
Review
458: Clio Med. 1983;18(1-4):101-11.
[Physician-patient relations in the light of medical and psychiatric
development]
[Article in French]
Ors Y.
The doctor-patient relationship in the light of medical and psychiatric
evolution. The doctor-patient relationship can be studied from different points
of view--social, economic, scientific, psychological. Considerable clarity has
been brought to the matter by the application of the transactional approach of
contemporary psychiatry. In the light of this approach, the relationship can be
considered dynamically and in different societies of the past as well as in our
time. This relationship, called also the doctor-patient communication, is
closely related to what has been known as "the medical art" and is influenced by
such different factors as specialization in medicine, medical education,
personality of the physician, characteristics of the society, and so on. Such a
relationship is not found, as a rule, in other scientific fields with man as
their subject matter, and appears to be an almost exclusive characteristic of
the medical profession. This evidently arises from the fact that medical
practice has always been directed to concrete human situations.
459: Child Health Care. 1982 Winter;10(3):83-6.
Effects of hospitalization on young children: implications of two theories.
Hodapp RM.
In this article the effects of hospitalization on the young child are analyzed
from the perspective of two theoretical models of development. The first model,
the critical periods model, asserts that there is an hypothesized critical
period for the development of certain skills and competencies. In this model
early experiences are crucial to the skills which either cannot develop or
develop with much difficulty after the critical period has passed. The second
model is a transactional model of development which asserts that, although early
experiences are important, each interaction of the child and the environment
makes a difference in development and only through continuous assessment of
these transactions can we determine how the child changes and evolves. Data from
studies of the effects of hospitalization on children are used to illustrate the
utility of these models in the study and management of children who are
hospitalized.
460: Psychiatr Clin North Am. 1982 Dec;5(3):529-42.
An integrative approach to marital therapy: transactional analysis.
Magran BA.
Publication Types:
Case Reports
[Application of transactional analysis. 19. Examples of application (3)]
Shirai S.
462: Soins Psychiatr. 1982 Nov;(25):41-5.
[New psychosociologic and therapeutic approaches. A danger for whom?]
[Article in French]
Adam E.
463: Kangogaku Zasshi. 1982 Nov;46(11):1301-4.
[Application of transactional analysis to nursing. 18. Examples of application
2]
Shirai S.
464: Semin Perinatol. 1982 Oct;6(4):340-52.
TRANSACT--a model for integrating clinical practice and longitudinal research.
Liden CB, Nichter CA, Murphy TF.
To effectively deal with the high-risk infant and his outcome, it would appear
that clinicians and researchers must, in a sense, place themselves "at-risk."
They must recognize the limitations of a reductionistic, biomedical model when
applied to this population and its problems. They must move beyond this
traditional model to a so-called "biopsychosocial model" which acknowledges the
uncertainties of human development and its transactional character. To do so,
they must also seek to break down many traditional "boundaries" that have served
to inhibit a better understanding of the high-risk infant. These boundaries
include those between disciplines, between clinicians and researchers, between
assessment and treatment, between cost efficiency and comprehensiveness, and
those between quantitative and qualitative methodologies to name a few. This
process must not be one of all or none exclusion, where a uniform perspective is
adopted in isolation and applied to all aspects of the problem. Rather it must
be a combination and synthesis of many perspectives. In essence, the construct
used to understand and study the high-risk infant and his outcome should be
consistent with the transactional and multifactorial nature of the problem.
These tasks are formidable and threatening to undertake, particularly when they
do not always yield the type of outcomes we have been conditioned to expect:
"hard" data; narrow etiologies; and successful cures. However, failure to take
such "risks" would seem to impede a further understanding of the at-risk infant.
The T.R.A.N.S.A.C.T. model presented here is offered as a working construct
which has yet to be fully operationalized. Its perceived limitations will
reflect the background, biases and perspectives of the reader. Hopefully, it
will serve to stimulate those interested and involved in the high-risk infant
and his outcome to modify, refine or build upon their current approaches.
465: Prax Kinderpsychol Kinderpsychiatr. 1982 Oct;31(7):271-7.
[Families with drug-dependent adolescents]
[Article in German]
Stiksrud A, Margraf J.
466: J Am Diet Assoc. 1982 Oct;81(4):450-3.
Incorporating Transactional Analysis into a weight loss program.
O'Brien MH, Samonds KW, Beal VA, Hosmer DW, O'Donnell J.
467: Kangogaku Zasshi. 1982 Oct;46(10):1181-4.
[Nursing application of transactional analysis. 17. Clinical application (1)]
Shirai S.
468: Fam Process. 1982 Sep;21(3):313-20.
Transactional theories but individual assessment: a frequent discrepancy in
family research.
Fisher L.
469: Kango Kyoiku. 1982 Sep;23(9):555-61.
[Application of transactional analysis in clinical training of adult nursing for effective interpersonal relationship between nursing students and patients
in clinical training]
Saeki K, Soga H, Yasumori Y.
470: Kangogaku Zasshi. 1982 Sep;46(9):1061-4.
[Transactional analysis used in nursing. 16. Transactional analysis in terminal
care]
Shirai S.
471: Int J Addict. 1982 Aug;17(6):1091-8.

The treatment facility as coalcoholic.
Dean JC.
An institution or group has a personality which is different from the
individuals who make up the institution or group. An institution functions as a
person. It is not just the total of its members. It is a distinct entity. The
alcohol treatment facility has the capacity to interact with clients. The
relationship can lead to alcoholic "game playing" between the institution and
its clients. This can occur regardless of the administrative structure of the
facility. the notion of the "game" adopted for this paper comes from
Transactional Analysis. According to this theory, the potential game roles
include: persecutor, rescuer, victim, patsy, and connection. The roles may be
played by the institution as well as the clients. It can perpetuate the
alcoholic behavior of the clients. Examples of this process come from clinical
observation. Ultimately the potential for change of this situation rests with
the self-awareness of the administration and treatment staff as a collective
personality. The game can be ended when the players recognize the role playing
and refuse to continue to play. The staff and administration are key elements in
this recognition and refusal.
472: Kangogaku Zasshi. 1982 Aug;46(8):941-4.
[Transactional analysis in nursing. 15. Transactional analysis used in terminal
care]
Shirai S.
473: Nurs Times. 1982 Jul 14-20;78(28):1201-2.
Counselling in psychiatric nursing--2.
Minshull D.
474: Kangogaku Zasshi. 1982 Jul;46(7):821-4.
[Transactional analysis. 14. Transactional analysis in terminal care. (1)]
Shirai S.
475: Can J Public Health. 1982 Jul-Aug;73(4):267-71.
Stress coping.
Sethi AS.
476: Kangogaku Zasshi. 1982 Jun;46(6):701-4.
[Transactional analysis in nursing. 13. Decision making in changing goals in
life]
Shirai S.
477: Schweiz Rundsch Med Prax. 1982 May 4;71(18):752-7.
[New psychotherapeutic methods]
[Article in German]
Kind H.
478: Kangogaku Zasshi. 1982 May;46(5):581-4.
[Transactional analysis in nursing. 12. Analysis of the "life script"]
Shirai S.
479: Kangogaku Zasshi. 1982 Apr;46(4):461-4.
[Transactional analysis used in nursing. 11. Analysis of a human drama. 1]
Shirai S.
480: J Nerv Ment Dis. 1982 Mar;170(3):143-53.
Interpersonal aspects of blood pressure control.
Lynch JJ, Thomas SA, Paskewitz DA, Malinow KL, Long JM.
Recent observations of large, consistent increases in blood pressure during
human communication prompted a reassessment of the role of interpersonal factors
in the behavioral control of hypertension. It was noted that the conceptual
framework around which earlier behavioral studies have been carried out, as well
as in the physical methods of pressure determination themselves, have
contributed to a general lack of information about the role of interpersonal
interactions in hypertension. An awareness of the relationship between speaking
and pressure elevations has led to the development of a new conceptual approach
to understanding the etiology and treatment of hypertension. Using techniques
developed out of transactional psychophysiology, hypertensive patients have been
able to observe the importance of interpersonal communications in the regulation
of their own blood pressure. Evidence from the clinical use of such information
suggests that a new way can be developed to help patients lower their blood
pressure.
Publication Types:
Case Reports
481: Kangogaku Zasshi. 1982 Mar;46(3):341-4.
[Transactional analysis used in nursing. 10. Analysis of psychological games
(2)]
Shirai S.
482: Kangogaku Zasshi. 1982 Mar;46(3):302-7.
[Bedside nursing. Assistance in self-care of a patient with non-specific
complaints - use of transactional anaylsis]
Ashikawa E.
Publication Types:
Case Reports
483: Kangogaku Zasshi. 1982 Feb;46(2):221-4.
[Transactional analysis in nursing. 9. Analysis of psychological games (1)]
Shirai S.
484: J Sex Marital Ther. 1982 Spring;8(1):44-56.
Cognitive and social aspects of sexual dysfunction: sexual scripts in sex
therapy.
Gagnon JH, Rosen RC, Leiblum SR.

The formulation and treatment of sexual dysfunction are conceptualized within a
framework of sexual scripts. This approach places particular emphasis on the
cognitive and interpersonal dimensions of sexual interaction and provides
greater continuity in our understanding of the development of sexual conduct in
general. Clinical assessment of sexual scripts begins with a comparison of
performative and cognitive scripts, which are then elaborated in terms of key
script attributes such as complexity, rigidity, conventionality and
satisfaction. Sex therapy is viewed as a process of script modification, in
which particular attention is payed to the integration of covert and overt
aspects of the script. Two case illustrations are provided. The discussion
contrast the present use of script analysis with the way the term is used in
transactional analysis and research in artificial intelligence.
Publication Types:
Case Reports
485: Nervenarzt. 1982 Jan;53(1):18-24.
[Applicability of the transactional analysis model of personality structure in
psychiatric hospital practice (author's transl)]
[Article in German]
Winkler WT.
486: J Med Educ. 1982 Jan;57(1):68-9.
Using interaction analysis to evaluate the faculty in a human behavior course.
Bernstein RA, Irvine CA, Clarke JH, Clark AA.
487: Kangogaku Zasshi. 1982 Jan;46(1):101-4.
[Transactional analysis in nursing. 8. Desire for structuring time]
Shirai S.
Long-term effects of behavioral versus insight-oriented therapy with inpatient
alcoholics.
Olson RP, Ganley R, Devine VT, Dorsey GC Jr.
Publication Types:
Clinical Trial
489: Clin Pediatr (Phila). 1981 Dec;20(12):792-6.
Severe psychosomatic illness in children: effect on a pediatric ward's staff.
Fialkov MJ, Miller JA.
Observations of a pediatric ward's response to the repeated hospitalization of
an asthmatic child revealed a close parallel to the transactional patterns
described in families of children with psychosomatic illnesses. Characteristics
of such families include enmeshment, overprotectiveness, rigidity and resistance
to change, lack of conflict resolution, and use of the child's sick role to
relieve tension and discomfort within the family. In this article we have
attempted to demonstrate the similarity of responses between these families and
groups of hospital ward personnel. Resolution of the ward personnel's internal
conflict was followed by changes in the coping abilities of the staff, with a
successful outcome for a second child with a similar clinical condition.
Publication Types:
Case Reports
[Transactional analysis. 7. A desire for stroking (2)]
Shirai S.
491: Pediatr Clin North Am. 1981 Nov;28(4):981-9.
Audiologic aspects of learning and behavior.
Liden CB.
To effectively deal with learning and behavioral problems, physicians must
acquire a new knowledge base and interact meaningfully with professionals from a
variety of disciplines. They must be aware that audiologic factors are only one
part of a complex matrix of components contributing to learning and behavior.
Although the exact nature of these components is still being defined, their
interrelationship can be hypothesized. An individual can overcome the
uncertainties and avoid inappropriate diagnoses in this field by applying a
comprehensive, descriptive diagnostic process. With a broad understanding of the
transactional model of learning and behavior, physicians can ensure that
audiologic problems are defined and addressed appropriately. By acknowledging
this approach in the identification, assessment and management of children with
learning and behavioral dysfunction, the physician can become a powerful

advocate for these children.
492: Soins Psychiatr. 1981 Nov;(13):17-26.
[Transactions]
[Article in French]
Fornari P, Bentata H, Mercier J.
493: Kangogaku Zasshi. 1981 Nov;45(11):1301-4.
[Transactional analysis. 6. Desire for a stroking. (1)]
Shirai S.
494: Kangogaku Zasshi. 1981 Oct;45(10):1181-4.
[Transactional analysis in nursing. 5. Analysis of interactions. (2)]
Shirai S.
495: Child Dev. 1981 Sep;52(3):857-65.
Infant irritability, mother responsiveness, and social support influences on the
security of infant-mother attachment.
Crockenberg SB.
This study investigates the influence of infant irritability, maternal
responsiveness, and social support on the development of secure and anxious
infant-mother attachments at 1 year. Infant irritability was assessed during the
neonatal period using the Neonatal Behavioral Assessment Scale, maternal
responsiveness to crying was measured during observations at 3 months, and
social support was based on interviews also conducted at 3 months. Security of
attachment measures were derived from strange-situation videotapes. Results
indicate that social support is the best predictor of secure attachment, and
that it is most important for mothers with irritable babies. Maternal
unresponsiveness is associated with resistance during reunion episodes and
appears to be a mechanism through which anxious attachment develops. Some
evidence suggests that social support may mitigate the effects of unresponsive
mothering by providing the infant with a responsive substitute. Results are
discussed in terms of a transactional/contextual model of development.

496: Fam Process. 1981 Sep;20(3):331-5.
J.L. Moreno: An unrecognized pioneer of family therapy.
Compernolle T.
J.L. Moreno's fundamental and pioneering contributions to be development of
group therapy, encounter, transactional analysis, and especially psychodrama are
well known. However, most family therapists seem unacquainted with the fact that
from his earliest writings in 1923 J.L. Moreno developed an interactional view
of psychotherapy that in 1973 already resulted in formulations of a true systems
orientation and very concrete ideas about marital therapy, family therapy, and
network therapy. He probably is the first (1937!) therapist that actually
involved a husband's lover in conjoint marital therapy. His general theoretical
formulations about the pathology of interpersonal relations as well as his
practical suggestions for the therapy of the interpersonal relations seem to be
insufficiently known to workers and researchers in the field of family therapy.
Publication Types:
Biography
Historical Article
Personal Name as Subject:
Moreno JL
497: Compend Contin Educ Dent. 1981 Sep-Oct;2(5):315-8.
The application of transactional communication to preventive dentistry (part
III).
Harris JH.
498: Kangogaku Zasshi. 1981 Sep;45(9):1061-4.
[Transactional analysis in nursing. 4. Analysis of personal interactions (1)]
Shirai S.
499: Drug Alcohol Depend. 1981 Aug;8(1):61-8.
Treatment attitudes of recovered alcoholic counselors and nonalcoholic
counselors.
Skuja A.
The advent of the profession of alcoholism counseling has generated concern

about the clinical treatment attitudes of counselors who are recovered
alcoholics. The treatment attitudes of eight recovered counselors and eight
nonalcoholic counselors at a U.S. Navy alcohol treatment facility were compared
by rating the counselors' perception of client clinical characteristics,
diagnosis, and preference for treatment modality and goals. Recovered counselors
perceived: greater psychological dependence on alcohol, higher probability of
substitution of another drug for alcohol, psychologists as less helpful,
Antabuse as more helpful, abstinence as a more necessary treatment goal, and
transactional analysis as a more helpful treatment. No significant differences
remained between the attitudes of both groups of counselors after intervening
counselor characteristics (e.g., Alcoholics Anonymous activity and alcohol
training experience) were controlled. The findings may indicate reticence among
nonalcoholic counselors to challenge traditional alcoholism treatment methods
and theories.
500: Compend Contin Educ Dent. 1981 Jul-Aug;2(4):227-9.
The application of transactional communication to preventive dentistry (part
II).
Harris JH.
[Transactional analysis used in nursing. 2. Analysis of the ego state and the
egogram]
Shirai S.
502: Kangogaku Zasshi. 1981 Jun;45(6):701-4.
[Transactional analysis used in nursing. 1. Development of the theory of
transactional analysis]
Shirai S.
503: Compend Contin Educ Dent. 1981 May-Jun;2(3):188-90, 195.
The application of transactional communication to preventive dentistry (part I).
Harris JH.
504: Superv Nurse. 1981 May;12(5):18-23.

The use of transactional analysis in patient teaching.
Foster CM.
505: Child Dev. 1981 Mar;52(1):213-8.
Preventing intellectual and interactional sequelae of fetal malnutrition: a
longitudinal, transactional, and synergistic approach to development.
Zeskind PS, Ramey CT.
This report presents continuing longitudinal data of a natural experiment in
which fetally malnourished infants and their controls were randomly assigned to
2 environments differing in intellectually supportive characteristics. Whereas a
previous report of these infants from 3 to 24 months of age provided evidence
supporting the bidirectionality of effects of infant and environmental
attributes, this study shows the continuation of the detrimental effects through
36 months of age on intellectual, behavioral, and social-interactional
development in a nonsupportive caregiving environment, and the continued
amelioration of those effects in a supportive caregiving environment. Further,
analyses of maternal variables showed that the mothers of fetally malnourished
infants may have had life histories of increased risk when compared to mothers
of control infants. The results are discussed in terms of the convergence of
dynamic intergenerational, prenatal, and postnatal influences on development.
Publication Types:
Clinical Trial
506: J Sex Marital Ther. 1981 Fall;7(3):207-22.
A typology of marital interaction for sexually dysfunctional couples.
Roffe MW, Britt BC.
An empirical typology of marital interactions for couples seeking sexual
dysfunction therapy was developed based upon their self-evaluations and
interpersonal perceptions on the Taylor-Johnson Temperament Analysis (T-JTA).
T-JTA scores of 246 couples on the psychological traits of
Expressive-Responsive/Inhibited and Hostility/Tolerance were used to separate
four groups of couples defining three distinct types of marital interactions.
Groups 1 and 2 represented the Conflict-Centered relationship in which one
spouse, wives and husbands respectively, scored high on the trait Hostility.
Group 3, the Passive-Constrained relationship was characterized by husbands who
scored low on the trait Expressive-Responsive (Inhibited) and Group 4, the
Congenial-Affectionate relationship was based upon the profiles of the remaining
couples in this sample. Self-perceptions of spouses are described and the
transactional dynamics of the couple types discussed in terms of their
therapeutic implications.

507: Int J Psychiatry Med. 1981;11(3):291-302.
Family therapy in the treatment of anorexia nervosa: theory and technique.
Lagos JM.
Family systems theory views anorexia nervosa not only as a product of
dysfunctional transactional patterns within a family, but also as a crucial
stabilizing element within the family. This paper describes the dysfunctional
characteristics of anorexic families as well as the relevance of these
characteristics to the anorexic symptoms. Two approaches to the treatment of
these families, one developed by Minuchin and the other by Selvini Palazzoli,
are described and the compatability of family therapy with individual therapy is
briefly discussed.
The genesis and nature of self-esteem.
Chrzanowski G.
Self-esteem is defined as a positive image of oneself based on a fair appraisal
of one's assets and liabilities. It represents a longitudinal as well as a
transactional, cognitive phenomenon that is considered to be a key target area
for all forms of psychotherapy. The construct of self-esteem is preferred to the
model of the "conflict-free sphere" of Ego psychology since in the author's
opinion it provides a broader observational platform and a potentially more
reliable source for clinically valid data. Clinical illustrations of the
vicissitudes of self-esteem are offered. The primary purpose of this article is
to encourage the systematic exploration of self-esteem as a means of better
understanding a vital ingredient of human behavior without making it the
exclusive focus in psychotherapeutic activities.
Publication Types:
Case Reports
509: Fam Process. 1980 Dec;19(4):367-76.
Multi-level couple therapy: applying a metacommunicational framework of couple
interactions.
Bernal G, Baker J.
Excerpts from a couple therapy case are cited to illustrate the practical
significance of a multi-level framework in understanding couple interactions.
The clinical implications of the metacommunicational framework, as a metaphor
for examining and understanding relational processes, are discussed. Also, the
pragmatics of following "process" at a variety of levels when working with
punctuational differences, developing therapy strategies and goals, and
measuring the progress of couple therapy are discussed.
Publication Types:
Case Reports
510: Br J Psychiatry. 1980 Dec;137:572-3.
The assessment of the ego states.
Falkowski W, Ben-Tovim DI, Bland JM.
The hypothesis that ego states, as defined in Transactional Analysis, are
distinct and identifiable phenomena was tested. Ten TA therapists were asked to
assess which of the three ego states, Parent, Adult or Child, were present in
forty statements extracted from the tape of a family therapy session. The level
of agreement reached was statistically highly significant. There was a certain
amount of interrater variability, and potential sources of disagreement are
discussed.
511: Am J Psychiatry. 1980 Nov;137(11):1475.
Reconsidering some recent trends in psychotherapy.
Mitchell RA.
Publication Types:
Letter
512: Am J Psychiatry. 1980 Nov;137(11):1436-9.
Research directions in child psychiatry.
Philips I.
Current research in child psychiatry emphasizes the understanding of biological
mechanisms of behavior and its aberrations but neglects the transactional
relationships in interpersonal phenomena. This situation may led to an
unwarranted enthusiasm for biological forms of treatment. The author calls
attention to the importance of biopsychosocial elements of behavior in the
understanding of growth and development. He discusses research directions to
incorporate all elements of the behavioral sciences in the study of child
behavior.
513: Rev Med Suisse Romande. 1980 Jul;100(7):577-82.
[Indications for family therapy]
[Article in French]
Masson D.
[Patients' participation in terminal care: a trial with transactional analysis.
Psychological changes in patients after participation]
Mase M.
[Participation by patients in transactional analysis. A discussion]
Shirai Y, Kaizuka R, Mase M, Murakami K, Koga R, Nawagawa H, Suzuki T.
[Terminal care with patients' participation: transactional analysis and
patient's psychology. Case study: recordings of conversation between the
physician and patient in truth disclosure and changes after the disclosure]
Mase M.
Publication Types:
Case Reports
[Terminal care with patient participation: transactional analysis and patient's
psychology]
Shirai S.
518: J R Army Med Corps. 1980 Jun;126(2):73-6.
Quality in general practice.
Kilpatrick WG, Carroll J, Martin A.

519: Fam Process. 1980 Jun;19(2):161-8.
Some cotherapy techniques with families.
Hannum JW.
The use of cotherapists in family therapy is explored with particular attention
to the unique ways in which this form of therapy can aid the therapeutic
process. A basic cotherapy transactional pattern is described, and a number of
techniques specifically for use in cotherapy with families and couples are
discussed.
520: J Psychiatr Nurs Ment Health Serv. 1980 Jun;18(6):22-7.
Perception.
Montmeny R.
521: Psychother Psychosom Med Psychol. 1980 May;30(3):127-32.
[The therapeutic contract in transactional analysis and script analysis
illustrated by three examples (author's transl)]
[Article in German]
Kiltz RR.
Publication Types:
Case Reports
522: Med Rec News. 1980 Apr;51(2):96-9.
Transactional analysis: an effective management tool for medical record
practitioners.
Villere MF, Pettingill BF.
523: Can J Psychiatry. 1980 Mar;25(2):111-7.
Teaching psychotherapy. Learning objectives in individual psychotherapy.
Watters WW, Rubenstein JS, Bellissimo A.
This paper constitutes an initial attempt to establish specific end-point
objectives for the teaching (and learning) of individual psychotherapy skills. A
working framework for teaching psychotherapy, which includes intrapsychic as

well as interactional phenomena, is articulated. The framework also tries to
achieve an integration of basic concepts of psychotherapy and specific skills
for clinical practice. It draws on concepts derived from communication theory,
psychoanalytic theory, adaptational theory (ego theory), learning theory, and
transactional theory. In presenting these objectives three classes of skills are
articulated: perceptual, conceptual, and executive. The end-point objectives are
discribed for the following categories: 1) therapeutic stance, 2) history and
mental status, 3) models and concepts, 4) communication channels, 5) patient's
affect, 6) therapist's affect, 7) acceptance of affect, 8) interpretation, 9)
transactions and 10) reinforcement and adaptation. This framework is truly
eclectic in nature and effects a healthy compromise between the technique
oriented "ABC's of psychotherapy" school and proponents of the view that
psychotherapy is an art that cannot be taught. By drawing from more than one
model it encourages the student to recognize early the distinction between
theoretical formulation and ideological commitment in psychotherapy. It presents
these objectives in the form of an instrument that can, with continuous
refinement and testing, be used to evaluate student's progress in a
psychotherapy training program.
524: ASHA. 1980 Feb;22(2):86-9.
The rescue game and the speech-language pathologist.
Hornyak AJ.
525: Adolescence. 1980 Fall;15(59):683-9.
TA in brief psychotherapy with college students.
Jensen SM, Baker MS, Koepp AH.
This paper describes the use of Transactional Analysis with university students
in brief psychotherapy. In the clinical setting of a large university,
Transactional Analysis was introduced as an alternative to crisis intervention
and other mental health strategies. When Transactional Analysis was introduced
as a treatment modality, it was also introduced to all the staff clinicians as
an alternative therapeutic model and they were instructed in its basic theories.
References are made to TA as a technique and a model which is advantageous for
teaching adolescents and young adults in learning about themselves. The emphasis
is away from the medical model with its focus on disease and placed instead on
the learning model with its focus on solving problems in living. TA lends itself
well to the developmental issues especially relevant to adolecents and young
adults, i.e., autonomy, identity, and independence. In summary, the authors
report results of a survey from the students treated within this framework which
seem to support their thesis that TA in brief psychotherapy with university
students is an effective learning and therapeutic tool.
526: Int J Psychoanal Psychother. 1980-81;8:375-92.
The significance of Kleinian contributions to psychoanalysis I. Kleinian

instinct theory.
Grotstein J.
The history of Freud's instinct theory shows that it ambiguously contains two
separate roots of developments; one, the nutritional-transactional, and the
other, the autoerotic discharge model. The former is the forerunner of Klein's
instinct theory and the latter is considered classical theory. Kleinians and
Freudians have not fully understood that each holds an instinct theory which is
quite different from the other. The consequences of this theoretical dialectic
are of great importance in distinguishing the Kleinian theory of fantasy from
the Freudian theory of fantasy, the theory of repression, the theory of the
unconscious, and ultimately the theory of the internal world.
527: Psychol Res. 1980;41(4):389-401.
The correction of perceptual assumption during the period of growth.
Experimental research in transactional psychology.
Torre LV.
528: Kango Kenkyu. 1980 Spring;13(2):141-6.
[Measures of transactional analysis ego states for nurses]
Di Marco N.
529: S Afr Med J. 1979 Dec 8;56(24):1045-8.
Doctor effectiveness: Transactional analysis as a means of assisting movement
towards a holistic approach to medicine.
Cusins P, Gilbert M.
Transactional analysis (TA) is offered as one solution to the problems faced by
doctors attempting to move away from the traditional Cartesian approach towards
the holistic approach to medical practice. It can help to increase the doctor's
understanding of, and insight into, the emotional and interactional components
of his patients' problems.
530: J Fam Pract. 1979 Dec;9(6):1007-12.
A perspective on the brittle teenage diabetic.
Greydanus DE, Hofmann AD.
The brittle teenage diabetic presents a difficult problem well known to

clinicians. It is the authors' contention that its major component is
psychological and not biological, and that much of this poor control can be
avoided by proper developmental planning from the onset of disease. Failure to
modify transactional health care models appropriate for the child to that
appropriate for the adolescent accounts for much of this difficulty.
Anticipatory long-range planning is outlined to aid the physician in allowing
the youth to isolate and insulate his diabetes from becoming either a focus for
control contests and power struggles or a maladaptive, manipulative regressive
behavior. The reasonable goal is to prevent any further hospitalizations for
ketoacidosis or hypoglycemia beyond the first admission for diagnosis and
initial stabilization. Five illustrative cases augment this discussion.
Publication Types:
Case Reports
531: Nurs Leadersh. 1979 Dec;2(4):14-20.
Assertive behavior for nursing leaders.
Marriner A.
532: Superv Nurse. 1979 Nov;10(11):13-7.
Victims, persecutors, and rescuers.
Bunning RL.
533: Rev Infirm. 1979 Nov;29(9):34-9.
[United States' theories of nursing in France]
[Article in French]
Alluard E, Bal-Craquin MT.
534: Aviat Space Environ Med. 1979 Oct;50(10):1073-5.
Coping with expanding nursing practice, knowledge, and technology.
Gaudinski MA.
Nurses utilize transcultural, transactional, systems, primary, and
interdisciplinary approaches to physiological and psychosocial components of
patient care. Expanded roles, as well as advances in knowledge and technology
have prepared nurses for critical, specialized, primary, aerospace, and
independent nursing practice. Exciting as they are, nursing's expanded roles and
practices frequently contribute to the burnout and distress phenomena

increasingly observed in practicing health care professionals. Causes and
symptoms of the burnout distress phenomena are many and varied. Selye, Shubin,
Maslach, and others adeptly identified and wrote on the phenomena as it
specifically relates to nurses and the many facets of nursing practice. Rather
than utilizing crisis intervention coping techniques, preventive strategies and
adaptations are suggested. This paper reviews and discusses: 1. Factors
associated with burnout-distress phenomena identified in professional
literature; 2. Identification of factors associated with expanded roles and
practice which contribute to burnout stress; 3. Identification of factors in
military and civilian air ambulance and aeromedical evacuation systems which
contribute to burnout stress; 4. Recommendations for strategies to prevent and
cope with burnout distress factors.
535: J Psychiatr Nurs Ment Health Serv. 1979 Oct;17(10):19-23.
A therapeutic paradox--to support intimacy and regression or privacy and
autonomy.
Robinson L.
536: Am Correct Ther J. 1979 Sep-Oct;33(5):155-62.
Transactional analysis: an alternative approach to managing inappropriate
behavior.
Jansma P, French R.
537: Fam Process. 1979 Sep;18(3):293-302.
Toward a metacommunicational framework of couple interactions.
Bernal G, Baker J.
A multi-level, metacommunicational framework to understand couple interactions
is presented. Five interactional levels are defined following a mode of
abstraction that parallels the theory of logical types; case examples are
offered of couples interacting at each of the levels. The clinical implications
of the framework, as a metaphor for understanding transactional processes, are
discussed with an emphasis on the pragmatics of working with punctuational
diffferences, developing therapeutic strategies, measuring progress, and setting
goals for therapy with couples.
538: ANEC. 1979 Sep-Dec;10(28):71-80.
[Human behavior in literature]
Perdomo Rivera J.
539: Nurs Res. 1979 Sep-Oct;28(5):295-8.
Measures of transactional analysis ego states for nurses.
Di Marco N.
Factor analysis of 432 registered nurses' responses to three measures of the
transactional analysis ego states of parent, adult, and child were run in order
to develop shorter scales tailored to nurses. The analysis resulted in four
10-item scales labeled parent, adult, adapted child, and natural child.
Reliability coefficients ranged from .79 to .85. Interscale correlations ranged
from -.20 to .18. Means, standard deviations, and percentile scores were
presented for each scale. Implications for nursing research are discussed.
540: TIC. 1979 Jul;38(7):4-5.
TA and the dentist.
Andersen JA.
541: Perspect Psychiatr Care. 1979 Jul-Aug;17(4):176-86.
Problems displayed "in vivo" - a particular advantage of group therapy.
Sanderson MR, Blackley JJ.
Publication Types:
Case Reports
542: Health Serv Manager. 1979 Jun;12(6):8-9.
Using TA for better staff-patient relations.
Wells B.
543: Tijdschr Ziekenverpl. 1979 Apr 10;32(8):363-9.
[Transactional analysis--a short survey. II]
[Article in Dutch]
Hellinga G.

544: Tijdschr Ziekenverpl. 1979 Mar 27;32(7):295-302.
[Transactional analysis--a concise overview. 1]
[Article in Dutch]
Hellinga G.
545: Manage Rev. 1979 Apr;68(4):26-8, 37-40.
How to change a leadership pattern.
Weihrich H.
546: Superv Manage. 1979 Feb;24(2):2-9.
Using TA in career planning: how not to fall into the parent-child trap.
Cohen AM.
547: Am J Drug Alcohol Abuse. 1979;6(2):137-49.
Therapeutic communities, old and new.
Jones M.
The author attempts to clarify two largely different uses of term, Therapeutic
Community (TC). By "old" TC he describes a movement which originated in
psychiatry in the United Kingdom at the end of World War II. This was an attempt
to establish a democratic system in hospitals where the domination of the
doctors was replaced by open communication of content and feeling, information
sharing, shared decision making, and problem solving shared as far as possible
with all patients and staff. Daily meetings of all patients and staff formed the
nucleus of this process. In recent years developments in the areas of systems
theory, learning theory, and organization development have contributed to a
better understanding of social organization and change. The "new" TCs derive
from the more recent developments in the treatment of substance abuse. Central
to this movement is Synanon and its many modification which use the clients'
peer group to solve their own problems, largely eliminating mental health
professionals. Linked with these "new" TCs is the development of Asklepieion
units in prisons, which use Synanon "games" along with transactional analysis.
An attempt is made to distinguish the methodologies used in TCs, "old" and
"new".
548: Psychother Psychosom. 1979;31(1-4):361-6.
Psychosomatic medicine and cybernetics.

Ishikawa H.
In our daily psychosomatic medicine clinics, we have adopted four principles
from Wiener's cybernetics and von Bertalanffy's general system theory. We use
the polygraphic method for the diagnosis of psychosomatic disease (black box
principle). For the control of psychosomatic symptoms, we use the biofeedback
method (feedback principle). We use systematic desensitization to relieve social
stresses which cause psychosomatic disease (open and closed system principle).
And lastly, transactional analysis, which corresponds to the information and
energy principle.
549: Nurs Forum. 1979;18(1):43-51.
Transactional analysis: a model for psychiatric consultation in the general
hospital.
Freeman CK.
Publication Types:
Case Reports
550: Nurs Forum. 1979;18(1):60-8.
Saving the children.
Boe J.
Publication Types:
Case Reports
551: J Nurs Educ. 1979 Jan;18(1):28-32.
TA: a useful tool in the teaching-learning process.
Schroy IJ.
552: Child Dev. 1978 Dec;49(4):1155-62.
Fetal malnutrition: an experimental study of its consequences on infant
development in two caregiving environments.
Zeskind PS, Ramey CT.
Infants from low socioeconomic status families were randomly assigned to an
instructional day-care program designed to prevent socioculturally caused mental
retardation or to a nonintervention control group. This assignment procedure
resulted in an equal distribution of full-term, full-birth-weight, fetally

malnourished babies in 2 environments varying in intellectually supportive
characteristics. The condition of fetal malnourishment was defined by infants
having low ponderal indices (PI). At 3 months of age low-PI infants showed lower
Bayley Mental Development Index (MDI) scores than normal-PI infants, independent
of the environment. In the control group low-PI infants still had lower MDI
scores than normal-PI infants at 18 months of age. However, at that time in the
day-care group, low-PI infants scored as well as normal-PI infants. These
findings were replicated when the infants were 24 months of age with
Stanford-Binet intelligence tests. Observations of mothers' involvement with
their infants showed that, although all groups had similar amounts of maternal
involvement when the babies were 6 months of age, the mothers of low-PI infants
in the control group showed less involvement with their infants at 18 months of
age than the other mothers. We suggest that this longitudinal study provides
experimental evidence for a transactional model of development which emphasizes
both newborn infant characteristics and environmental quality as cocontributors
to the process of development.
Publication Types:
Clinical Trial
553: J Pers Assess. 1978 Aug;42(4):401-8.
Overinclusion and transactional thinking on the Object Sorting Test of
schizophrenic and nonschizophrenic patients.
Quinlan DM, Schultz KD, Davies RK, Harrow M.
Two aspects of "disordered thinking", overinclusion and transactional thinking
were studied on the Object Sorting Test responses of 20 young schizophrenic
patients and 20 comparable nonschizophrenic patients. Patients' parents were
also studied for comparison. In addition, idiosyncratic responses from WAIS
Comprehension items were assessed for comparison of another measure on another
test. Transactional thinking and idiosyncratic responses were greater in
schizophrenic patients. Conceptual overinclusion and bizarre responses also
tended to be more frequent in schizophrenics, but behavioral overinclusion
showed no differences. Conceptual overinclusion was consistently correlated with
transactional thinking and idiosyncratic responses, while behavioral
overinclusion showed an inconsistent pattern. The differences were attributed to
the differences in the specificity of measures of disordered thinking.
554: J Fam Pract. 1978 May;6(5):1015-8.
Group therapy in family medicine: part 1.
Friedman WH, Jelly E, Jelly P.
Group psychotherapy may often be the treatment of choice for patients whose
somatic symptoms are a reflection of interpersonal difficulties which are not of
sufficient magnitude to warrant referral to a mental health professional. This
type of treatment can be offered in the context of family practice, with benefit
to both patient and physician. The physician may function as co-therapist with a
more experienced group leader; it is essential, also, that competent supervision
be available. Such a group was established in a family practice center; it met
for 20 weekly sessions. Patient improvement ranged from minimal to considerable;
in addition, the frequency of visits to the Center for essentially non-medical
reasons decreased considerably, with the greatest decrease in such visits
occurring 6 to 15 months after termination of group treatment. This is the first
part in a four-part series dealing with group therapy in family medicine.
555: Z Krankenpfl. 1978 May;71(5):187-92.
[Human relations in geriatric activities]
[Article in French]
Poletti R.
556: Acta Psychiatr Belg. 1978 Mar-Apr;78(2):256-68.
Psychotherapy of the family as a measure for preventing relapses and improving
the prognosis in schizophrenic patients.
Cazzullo CL, Carta I.
The increasing interest in the relationship among psychoanalysis, linguistics
and higher nervous activity (neurodynamic) is recalled. As most of the works on
the therapy of the family have been based upon psychodynamic interpretations,
the authors shall try to speculate on how much room this field should be given
in the phenomena related to higher nervous activity. The study of Pavlov, Gantt
and others on biological and social factors influencing human behaviour have
been discussed in relation to the system represented by the family nucleus. Some
aspects have been taken in consideration like the double bind, the perverse
triangle and the formation of a scapegoat. Double bind theory and praxis is
representing a paradoxical situation similar to unavoidable conditioned
patterns. The behaviour of the "designed patient" may be interpreted as a
tentative escape to express his disagreement to the fixed situation. What
happens is a kind of abnormal conditioning which is realized through a
progressive stratification of discordant learning. The final result is the
disorganisation of cognitive processes. In the meantime, we observe a
discordance of the activity of the first and the second signaling system
because, very often, an apparent external calm is accompanied by intense
cardiovascular or visceral turmoil. Every kind of communication should take care
of both processes, the congnitive and the neurodynamic. The analysis of the
verbal, as well as the non-verbal communication in the family setting, may be
fruitfully based upon the study of the progressive significance of the
cognitive-emotional dissyntony, as well as the dissyntony between the 1st and
the 2nd S.S., and the transactional dissyntony implicit in the double bind. A
group of 25 families of schizophrenics followed by one up to five years has been
examined following the concepts above mentioned.
557: J Am Geriatr Soc. 1978 Feb;26(2):89-95.

Disengagement versus engagement - a need for greater expectations.
Bell JZ.
An attempt is made to clarify some existing perspectives of successful aging.
The environmental milieu of the aged is laden with potent and pervasive
implications about successful adaptation. Considerable exploration is required
to facilitate a realistic focus upon various theoretical contributions already
presented. The influence of stresses and adaptive energy depletions preceding
the senescent state is discussed in an effort to facilitate knowledgeable
assimilation of the potential impact of the socioeconomic milieu upon the aged.
It is the author's contention that the elderly person, upon retirement, presents
an adaptive energy reserve highly personalized in its ability to accommodate to
change, and especially dependent upon the nature, number and intensity of
environmental stressors to adapt, successfully or unsuccessfully, to senescence.
Various environmental stressors are identified (e.g., changes in social
opportunities and expectations which create new needs and constrict the realm of
emotional and vocational influence, thus reducing opportunities and diminishing
self-esteem). Heavy emphasis is placed upon role theory, interaction ritual, and
transactional analysis. These concepts are extended to the institutional setting
- an environment which serves only to magnify mechanisms occurring throghout the
social system while adding its own unique dimension to the stressors confronting
the elderly.
558: J Psychiatr Nurs Ment Health Serv. 1978 Feb;16(2):33-41.
Activity therapy as a reconstructive plan on the social competence of chronic
hospitalized patients.
Beard MT, Enelow CT, Owens JG.
559: Psychother Psychosom. 1978;29(1-4):168-73.
[Affective and rational factors in the psychotherapeutic process]
[Article in French]
Bloch C.
560: Am J Psychoanal. 1978 Summer;38(2):121-7.
Primary prevention: a breakthrough in sight.
Apolito A.
561: J Psychiatr Nurs Ment Health Serv. 1978 Jan;16(1):18-21.
Couples therapy: treatment of choice with the drug addict.

Personett JD.
562: Fam Process. 1977 Dec;16(4):467-75.
Parental focus of attention in a videotape feedback task as a function of
hypothesized risk for offspring schizophrenia.
Lieber DJ.
The families of 29 disturbed but nonpsychotic adolescents were observed in a
structured task in which they discussed their reactions to viewing themselves
interacting on videotape. Measures derived from the Singer-Wynne concenpt of
transactional style deviance were applied to the parental behaviors and related
to prior assessments of parental communication disorder based on individual
parental TAT protocols. The results confirm the Singer-Wynne hypothesis of the
cross-situational stability of transactional style deviance. The most striking
finding, however, is that an index of positive focusing behavior differentiates
more strongly parents of adolescents hypothesized to be at varying leves of risk
for schizophrenia than does the measure of transactional style deviance.
563: Z Krankenpfl. 1977 Dec;70(12):436-9.
[Responding in a novel way to a new situation. Transactional analysis]
[Article in French]
Babcock D.
564: J Fam Pract. 1977 Nov;5(5):853-7.
The tired patient.
Rockwell DA, Burr BD.
One of the most challenging diagnostic problems that comes into the physician's
office is the patient who complains of "being tired." It can prove to be a
frustrating experience for the physician (especially if the physician is also
tired) and to the patient. This article will propose and describe a two-pronged
systematic approach to the patient that can increase the probability of a
satisfying outcome for both physician and patient. This approach assumes the
"complaint" of every patient has both informational value ("I think there's
something wrong.") and transactional meaning (Please take care of me.").
Tiredness, fatigue, "exhaustion" need to be seen simultaneously as information
and need. Both aspects require simultaneous work-up.
565: J Am Pharm Assoc. 1977 Nov;17(11):703-7.

Self-management: a strategy for managing human relations.
Speranza KA Sr.
566: Fam Process. 1977 Sep;16(3):327-37.
Patterns of transactional style deviance in the TAT's of parents of
schizophrenics.
Jones JE.
Parents of schizophrenics show more transactional style deviance in diverse
situations than do other parents. In a sample of families of nonschizophrenic
outpatient adolescents, a manual for scoring such deviance on stories told for
seven TAT cards was developed. This scoring system was shown to be composed of
six meaningful factors. When this system was applied to the TAT's of parents of
offspring with a variety of psychiatric diagnoses, a total deviance score did
not discriminate among the parents. High scores on two particular factors were
found only in parents of hospitalized schizophrenics, but four factors were
nondiscriminating. Parents of young adults with schizophrenia spectrum disorders
were more likely to show high scores on at least one of these six factors than
other parents. Considering the scores of mothers and fathers together yielded
the best discrimination of parents of schizophrenia spectrum disorders from
other parents.
567: Can Psychiatr Assoc J. 1977 Aug;22(5):207-14.
The new psychotherapies: the courage to be.
Furlong FW.
The past decade has seen the emergence of popular "new psychotherapies" such as
Gestalt Therapy, Transactional Analysis, and Primal Therapy, each with
substantial followings. This paper puts forward a hypothesis about what these
divergent systems may possess in common. Certain aspects of these therapy
systems, in particular the induction of new patients and trainees, are examined
in terms of Paul Tillich's concepts of the universal necessity of a rationale
for courage. The significance of Tillich's analysis of courage for various
historical movements is reviewed. In each system an element of unconditional
commitment to a particular world view is required, as evidenced in the writings
of the proponents of these systems, for the patient to be accepted into the
particular system. These theoretically divergent systems possess, in common, a
factor of an initial commitment to and induction into a collective belief system
comparable to what Tillich describes as "the courage to be as a part".
568: J Nerv Ment Dis. 1977 Aug;165(2):88-98.
Dimensions of family therapy.
Madanes C, Haley J.
This article is a description of different approaches to therapy with a family
orientation. There are general categories of family therpay which had their
origins in individual therapy, such as the approaches based upon psychodynamic
theory, those derived from experiential procedures, and the behavioral
approaches. There are also family therapies which have not developed from
individual therapy, such as the extended family system approach and the
communication school of family therapy. The different therapy approaches are
described within a set of dimensions which characterize most therapy. Such
dimensions include whether the past or present is emphasized, whether the
therapist uses interpretation or directives, whether the approach is in terms of
growth or specific problems, whether hierarchy is a concern, and whether the
unit is an individual, two people, three people, or a wider network.
Illustrations of the different family therapy approaches are given in terms of
the kinds of information that would interest the therapist of each school and
the kinds of actions he or she would take to bring about change.
569: Genet Psychol Monogr. 1977 May;95(2):267-330.
The diagnosis, epidemiology, and etiology of childhood schizophrenia.
Marsh RW.
About half the Australian population of children who were functioning at a
moderate or greater level of intellectual subnormality and who also presented
schizophrenic behaviors were surveyed. From more than 300 such cases only 21
were confirmed as schizophrenic. Their average age was seven years eight months,
four were girls, and eight had histories of normal physical health. Individual
data were collected on antenatal and perinatal factors, childhood health,
developmental progress, family history, physical characteristics, neurological
signs, biochemical anomalies, and behavioral and psychiatric characteristics.
These data sustained the hypotheses that the (a) incidence of the condition is
slight, that (b) childhood schizophrenia is the result of a multicausal
transactional process; that (c) there is a continuum from organic to functional
conditions and that (d) the intellectual potential of these children is
generally overrated.
570: ASHA. 1977 Apr;19(4):244-8.
The application of transactional analysis to therapy with wives of adult aphasic
patients.
Porter JL, Dabul B.
571: J Psychiatr Nurs Ment Health Serv. 1977 Apr;15(4):17-23.
Family therapy: using a transactional approach.
Lantz JE.
The family can be viewed as a natural group which includes a mutual influence
phenomenon. Intervention follows relationship building and assessment and is
geared towards helping the family members challenge and change dysfunctional
coding, decoding and structural transactions which inhibit the family group from
meeting its idividual psychological needs.
572: Am J Nurs. 1977 Mar;77(3):408-9.
Scapegoating among professionals.
Wachter-Shikora N.
573: Schweiz Arch Neurol Neurochir Psychiatr. 1977;120(1):153-71.
[The anosognostic psychosyndrome. Studies and reflections on a case of acoustic
agnosia]
[Article in German]
Ulrich G, Simon J.
We analyse structure and dynamics of anosognostic behavior by means of a case
with auditory agnosia for both linguistic and non-linguistic material. First we
investigate on the observational level the structural interweaving of
conditions. Second we make an attempt of a structural dynamic analysis with
inclusion of both neurophysiological and psychodynamic aspects within a frame
which is orientated towards system theories. By doing this, the anosognostic
syndrome which is describable in a phenomenalistic sense as a disturbance of
body-scheme, neuropsychologically as a neglect-or extinction-syndrome and
psychodynamically as regressive Ego dissolution, appears as disintegration of
the transactional coherence between specific and non-specific functional
systems. At the time also the relations to the structure of focal brain
syndromes and organic psychoses are dealt with.
Publication Types:
Case Reports
574: Arch Gen Psychiatry. 1977 Jan;34(1):71-4.
Parental transactional style deviance as a possible indicator of risk for
schizophrenia.
Jones JE, Rodnick EH, Goldstein MJ, McPherson SR, West KL.
The presence of a pattern of parental transactional style deviance on the
Thematic Apperception Test (TAT) (a significant attribute of parents of
offspring with schizophrenia spectrum disorders) was used to identify a group of
disturbed nonpsychotic adolescents hypothesized to be at high risk for
subsequently developing schizophreniform psychopathology. High-risk male

adolescents came from two symptom groups, withdrawn adolescents and adolescents
in active family conflict, which are symptom patterns similar to the premorbid
pictures of two schizophrenia subtypes. High-risk parents also tended to show
transactional style deviance in direct interaction with their child and in a
written statement describing their child's problem. The degree of risk was
significantly related to the amount of therapy in which the family was
subsequently engaged and, at a four-year follow-up, to the level of adjustment
of the adolescents seen earlier in the project.
575: Int J Group Psychother. 1977 Jan;27(1):85-96.
Modifications of activity group therapy for children.
Maclennan BW.
576: Int J Group Psychother. 1977 Jan;27(1):75-84.
On the alternation of group transaction patterns and its therapeutic
actualization.
Vassiliou G, Vassiliou VG.
577: Child Welfare. 1977 Jan;56(1):776-86.
A transactional analysis group in residential treatment of adolescents.
Roth R.
578: Int J Aging Hum Dev. 1977-78;8(3):261-7.
Beyond despair and disengagement: a transactional model of personality
development in later life.
Glenwick DS, Whitbourne SK.
It is argued that ego analytic, disengagement, and symbolic interaction theories
of personality share an insufficient consideration of the dynamics of the
interaction between developmental and social forces transpiring during the aging
period. An alternative, transactional model is proposed, positing that the
effects of the environment to which the elderly person is subject are the
product of: (1) the people and settings comprising that environment and (2) the
manner in which the individual acts upon and is acted upon by these people and
settings. The model highlights the need for research in which present behavioral
and environmental events assume as much importance as past ones.
579: Ann Osp Maria Vittoria Torino. 1977 Jan-Jun;20(1-6):51-67.

[Association of adult obese-type diabetes and depressive psychosis (clinical
cases)]
[Article in Italian]
Fantoni A, Gamba S, Castellazzi R, Bollati C, Galimberti JM, Bruni B.
The conception of a specific association between maturity-onset diabetes and
manic-depressive psychosis, on a common basis with diencephalic functional
obesity, has been recently taken again in consideration by the psychiatric
literature. Investigations on this problem from diabetological point of view
have been so far completely lacking, and are proposed with the present study.
Symptomatic depressive conditions in diabetes are frequent and should be
primarily separated from depressive endogenous psychosis. The pathogenesis of
the association between diabetes of the adult-obese type and psychosis might be
discussed according to a transactional theoretical model, assuming a positive
feed-back mechanism of the two relationships: diabetes-psychosis and
psychosis-diabetes. With these criteria, 4 observations of the clinical
association were collected out of 274 admissions for diabetes, during 1976.
Diabetes is intended as overt diabetes; obesity presented with the stenic
picture; psychosis had a monopolar melancholic course. Similar clinical features
were characteristic in all cases. The relationship diabetes-psychosis showed no
evidence, unless importance should be given to a potential diabetes in 3 cases.
On the contrary, the relationship psychosis-diabetes could be demonstrated in
the four cases. A psychosomatic scheme connecting the neuro-hormonal
correlations to a genetically conditioned exhaustion of the beta-function, is
postulated. During melancholic recurrences, diabetes proved to be
insulin-dependent and even insulin-resistent in 2 cases. Tricyclic
antidepressant theraphy did not modify the metabolic situation.
Publication Types:
Case Reports
580: Int J Nurs Stud. 1977;14(4):215-21.
A study of schizophrenics in transactional analysis treatment report of
ethnographic research.
Childs-Gowell E.
581: Ned Tijdschr Geneeskd. 1976 Dec 18;120(51):2268-74.
[Family therapy and therapy for married couples]
[Article in Dutch]
Nevejan M.
582: Can Med Assoc J. 1976 Dec 4;115(11):1072-4.

Reflections for the holiday season.
Cooperman EM.
Publication Types:
Editorial
583: Am J Psychiatry. 1976 Nov;133(11):1290-4.
Patients' perceptions of the therapeutic relationship and group therapy outcome.
Gurman AL, Gustafson JP.
The authors review the empirical literature examining the hypothesized
relationship between the patient's perception of the therapeutic relationship
and treatment outcome in group therapy and describe studies of both inpatient
and outpatient group therapy. Their review indicates that, in contrast to the
overwhelming evidence in support of the perceived relationship-outcome
hypothesis in individual psychotherapy, there is no persuasive evidence in favor
of the proposed relationship between the therapist-patient relationship and the
efficacy of group treatment. The authors discuss the clinical and theoretical
differences between individual and group therapy that would contribute to this
result.
584: Schwest Rev. 1976 Oct 15;14(10):12-5.
[Psychology of human behavior]
[Article in German]
Stiksrud U.
585: Prim Care. 1976 Sep;3(3):387-98.
Team obstetrics and the nurse-midwife. Issues in patient acceptance.
[No authors listed]
In this discussion we have presented findings from a study of patient acceptance
of a nurse-midwife. The significance of the initial encounter for patient
acceptance has been interpreted in terms of a primacy effect. The negative
effect of the obstetrician's presence during initial encounters between patient
and nurse-midwife has been discussed in terms of expectation theory. The theory
leads us to predict that the patient's perceptions of competence of the
nurse-midwife were more favorable when the obstetrician was absent from the
initial encounter than when he was present. Finally we have interpreted the
overall ease of communication between the nurse-midwife and patients as a result
of mutual participation, and complementary rather than crossed interactions.
This ease of communication is a major factor accounting for the general

enthusiasm of patients for the nurse-midwife in the provision of office care.
The importance of interpersonal relationships between health professionals and
patients for effective patient care cannot be overstated. Romano has stressed
the importance of the doctor-patient relationship in obstetrics and gynecology
because of the many anxieties and concerns of women concerning their health
problems. Hopefully, our findings will encourage physicians to explore the role
of mid-level health professionals and particularly nurse-midwives in enhancing
the overall quality of health care for women.
586: Fam Process. 1976 Sep;15(3):277-88.
The dynamics of owning and disowning: psychoanalytic and family perspectives.
Stierlin H.
The dynamics of owning and disowning one's inner life have both intrapsychic and
transactional or interpersonal dimensions. Freud opened new vistas on our inner
world using psycoanalysis as a tool. Although not unaware of the effects of
family members upon each other, Freud's rejection of the seduction theory of
neurosis in 1897 fatefully influenced the future course of psychoanalysis,
placing the primary focus on intrapsychic relations. Until today, it has
remained the task-perhaps the principal one--of psychoanalytic theorists to do
justice to the interpersonal and family realm that Freud neglected, without
sacrificing the enormous insights we owe to Freud. Three conditions for
successful inner ownership are described: a capacity for self-object
differentiation; tolerance of ambivalence; and a sense of physical integrity, of
having a cohesive, nuclear ego. The pathology of inner ownership is related to a
pathology of interpersonal ownership as transacted on the family level. One form
of such relational pathology--parental overowning, as revealed primarily in
families with schizophrenic members--is discussed, with a case example.
Publication Types:
Case Reports
587: Sairaanhoitaja. 1976 Aug 10;(15):26-30.
[To reach out]
[Article in Swedish]
Lindstrom UA.
588: Int J Group Psychother. 1976 Jul;26(3):385-92.
Four models of transactional analysis.
Goulding RL.
589: Am J Nurs. 1976 Jul;76(7):1152-5.

Transactional analysis.
Babcock DE.
590: JAMA. 1976 Jun 7;235(23k0):2476.
Letter: Group therapy.
Milstone S.
591: Am J Psychiatry. 1976 Jun;133(6):679-83.
A new concept and finding in morbid jealousy.
Docherty JP, Ellis J.
The authors describe an unexpected coincidental finding in three couples who
sought therapy because the husband was pathologically jealous. In the course of
treatment they found that during early adolescence each of these men had
witnessed his mother engaged in extramarital sexual activity. The authors
discuss the implications of this finding for further understanding of the
etiology of the syndrome of pathological jealousy, its transactional dimensions,
and possible psychotherapeutic approaches. They also present a typology of
morbid jealousy that consists of excessive obsessional-delusional, and ego
dysfunctional forms.
Publication Types:
Case Reports
592: Can Ment Health. 1976 Jun;24(2):2-6.
Combined approaches in the treatment of conflicted children and their families.
Ney GP.
593: Can Psychiatr Assoc J. 1976 Jun;21(4):212-6.
Combined approaches in the treatment of latency children and their families.
Ney PG.
594: J Psychiatr Nurs Ment Health Serv. 1976 Jun;14(6):15-9.
Mental health consultation with public health nurses, using transactional

analysis as a tool.
Hover D.
595: Int J Group Psychother. 1976 Apr;26(2):163-72.
How and why do transactional-gestalt therapists work as they do?
O'Hearne JJ.
Symposium: contrasting models of leadership in group psychotherapy.
Introduction.
Neiberg NA.
597: Bull Am Protestant Hosp Assoc. 1976 Mar;40(2):34-8.
An examination of regression during a major medical crisis in the light of
transactional analysis.
Hughey W.
598: JOGN Nurs. 1976 Jan-Feb;5(1):31-6.
Transactional analysis in crisis intervention.
Dzik RS.
599: J Pract Nurs. 1976 Jan;26(1):16-8, 34.
The first half-hour.
Appell L, Baskin D, Smith J.
600: Ment Health Soc. 1976;3(5-6):286-99.
The duo-drama.
Kulcsar IS.
A model of psychotherapy based on a 'dramatic look' is presented. It is an
aspect developed from the demotorization of psycho-drama reduced to two actors

Dialogue - in the sense of Plato and Buber - is looked at as action and dealt
with accordingly. A pre-step of interpretation: confrontaion is used 'in
flagranti' within the framework of here and now. The patient is continuously
confronted with his 'action'.
601: Int J Psychoanal Psychother. 1976;5:283-99.
Toward a general concept of the therapeutic process.
Dewald PA.
Using clinical psychoanalytic theory as a unifying concept, an attempt is made
to observe, interpret, and integrate the therapeutic process in a wide variety
of psychotherapies. All psychotherapy, regardless of specific form or technique,
is viewed as an interpersonal or intrapersonal process, and should be
understandable from a psychoanalytic perspective. Ten common factors are
selected: structure of the therapeutic situation; the therapeutic relationship;
management of anxiety; drives and their derivatives; mechanisms of defense;
identification; regression; catharsis and abbreaction; external reinforcement;
structural change. The various psychotherapies are compared regarding each of
the ten factors.
602: Adolescence. 1976 Summer;11(42):228-32.
Assessment of the adequacy of the services provided by a halfway house for
adolescents.
Frede M, Holland TA.
603: Addict Dis. 1976;2(3):485-95.
Psychology and alcoholism: a case for paradigm change.
Keehn JD.
604: JAMA. 1975 Dec 15;234(11):1181-2.
Group therapy.
Weiner MF.
605: J Med Assoc State Ala. 1975 Dec;45(6):34-6.
Transactional analysis for the physician: psychological scripts.
Cerkevich TJ.
Comparative effectiveness of behavior modification and transactional analysis
programs for delinquents.
Jesness CF.
607: J Med Assoc State Ala. 1975 Nov;45(5):40-2.
TA for physicians: psychological games.
Cerkevich TJ.
608: J Psychiatr Nurs Ment Health Serv. 1975 Nov-Dec;13(6):5-10.
Concepts of transactional analysis and anxiety with persons in crisis.
Klingbeil GA, Alvandi OM.
609: J Psychiatr Nurs Ment Health Serv. 1975 Nov-Dec;13(6):20-2.
Women's lib and psychotherapy.
Hutchinson SA.
610: J Med Assoc State Ala. 1975 Oct;45(4):36-8.
Transactional analysis for the physician: stroking hunger and time structure.
Cerkevich TJ.
611: Am J Psychiatry. 1975 Oct;132(10):1045-8.
Basic concepts in family therapy: a differential comparison with individual
treatment.
Robinson LR.
The author presents basic differences between the approaches of family therapy
and of the individual therapies on three dimensions: personality development,
symptom formation, and the approach to producing therapeutic change. Family
therapy bases its view of these factors in psychotherapy on the idea that they
are determined by the family's functioning as an interderdependent transactional

unit; the individual therapies base their views of these factors on the idea
that they are determined by the dynamic intrapsychic functioning of the
individual alone.
612: J Med Assoc State Ala. 1975 Sep;45(3):49-51.
Transactional analysis for the physician: the ego states and psychopathology.
Cerkevich TJ.
613: J Med Assoc State Ala. 1975 Aug;45(2):36-7.
Transactional analysis for the physician: an introduction.
Cerkevich TJ.
614: Arch Gen Psychiatry. 1975 Aug;32(8):1013-7.
Predictions of therapeutic process and progress in conjoint family therapy.
Rakoff VM, Sigal JJ, Epstein NB.
Following initial diagnostic interviews with 20 families in an outpatient
psychiatric clinic, a group of therapists made predictions of the anticipated
responses of the families to therapy. Changes in family structure,
organization, and transactional patterns were predicted with use of the Family
Category Schema. The families' responses to the process of therapy was
predicted in a questionnaire. The results showed poor predictions of response
to process. However, a normative response picture of a family in therapy did
emerge. Also, all predictions erred in the direction of underrating the overall
effectiveness of conjoint family therapy.
615: Am J Orthod. 1975 Jul;68(1):8-14.
Plaque-control motivation in orthodontic practice.
Gold SL.
616: Am J Clin Hypn. 1975 Apr;17(4):260-2.
Hypnosis and transactional analysis theory.
Selavan A.
617: Am J Psychiatry. 1975 Apr;132(4):385-90.

Short versus long hospitalization: a prospective controlled study. II. Results
for schizophrenic inpatients.
Glick ID, Hargreaves WA, Raskin M, Kutner SJ.
The authors compared treatment results for 141 schizophrenic patients randomly
assigned to short-term or long-term hospitalization. The patients received
intensive treatment and were on partially fixed drug dosage schedules. Test
results indicated that the short-term group was functioning better at four
weeks. However, at discharge (21 to 28 days for short-term patients; 90 to 120
days for long-term) the long-term group showed significantly better functioning.
There were no significant differences between the groups on symptomatology at
discharge. The authors discuss the implications of these findings for decisions
regarding length and type of hospitalization for schizophrenic patients.
Publication Types:
Clinical Trial
Reflections on 25 years of the International Journal of Group Psychotherapy.
Peck HB.
Publication Types:
Historical Article
619: Can Psychiatr Assoc J. 1975 Mar;20(2):151-5.
[Family psychiatry, transactional systems, and the frontiers of child
psychiatry]
[Article in French]
Solomon ML.
Family therapists, seen as emphasizing interventions leading to change in family
structure and in sequences of behaviour, have been searching for an integrated
concept which transactional systems theory seems to offer. It takes into account
small group theory, social role theory, communications theory, and general
system theory, which are linked to psychic, somatic, socio-cultural,
politico-economic, and ecological factors. This idea of interlinked, open
systems which influence each other is used as a viewpoint for examining the
frontiers of child psychiatry. Adult patients often have children who are
affected by their parents' treatment, and child psychiatrists often intervene
with adults. Similarly, the boundaries between psychiatry and the para-medical
professions have grown less distinct as we have become aware of more elements to
assess in each case, and as the number of therapeutic techniques and possible
interventions increase. The problem of defining child psychiatry is discussed,

as is psychiatric training, in terms of the difficulty in integrating the many
theoretical and practical levels.
620: Am J Community Psychol. 1975 Mar;3(1):59-67.
Brief hotline training. An effort to examine impact on volunteers.
Margolis CG, Edwards DW, Shrier LP, Cramer M.
In response to community needs and pressures, increasing numbers of small crisis
centers and hotline services have emerged. This emergence of services has been
possible in part because of the mounting number of eager and interested
volunteers. These services want and need training for the volunteers. This
article examines the problem of evaluating the kind of information and the kind
of training that hotline volunteers were given in a brief training program.
621: Hosp Financ Manage. 1975 Feb;29(2):26-8.
TA applied to communication.
Pledger R.
Some dynamic and transactional aspects of family theraphy with psychotic
patients.
Klein H, Erlich HS.
The application of family therapy to families with psychotic patients involves
both technical and theoretic observations and underpinnings. The implications of
these for the understanding of certain family dynamics and the use of family
therapy in general are investigated. The rhythm of real participation and
observation on the therapist's part and the utilization of co-therapists is
contrasted with a more authoritarian, 'director' model of intervention.
Tendencies in these families towards frozenness and immobility, as well as
splitting and chaos, must be counteracted, and are reflected in interactions and
transactions between co-therapists. The importance of unravelling these patterns
and aiding therapists in the framework of a specially designed, ongoing
supervisory seminary is stressed.
623: Psychosomatics. 1975;16(4):164-70.
The Oriental version of transactional analysis.
Ikemi Y, Sugita M.

624: Int J Addict. 1975;10(1):29-33.
Altering the gambler's maladaptive life goals.
Aubry WE.
This paper will serve as an explanation of how clinical counselors from various
schools of thought, e.g., Freudian, Transactional Analysis, and Adlerian, work
with or treat the excessive gambler. Because the presentation is short, it will
be impossible to thoroughly cover the three schools of thought in depth.
However, because of the writer's bias, the paper will examine in some detail the
way in which an Adlerian counselor or therapist encourages his maladaptive
clients to act and think more constructively, i.e., give up excessive gambling.
625: J Miss Dent Assoc. 1975 Spring;31(1):7.
Congratulations and A-men.
Field RD.
Publication Types:
Case Reports
Editorial
626: J Stud Alcohol. 1975 Jan;36(1):166-70.
A mandatory treatment program for skid row alcoholics; its implication for the
Uniform Alcoholism and Intoxication Treatment Act.
Pratt AD Jr.
Mandatory and voluntary treatment programs for Skid Row alcoholics are
described, and the implications of the Uniform Alcoholism and Intoxication
Treatment Act are discussed.
627: Nurs Care. 1974 Oct;7(10):26.
The stroke bank.
Wagner F.
628: Nurs J India. 1974 Sep;65(9):245, 256.
Skills in basic human relations; application in a nursing situation.
Walshe.

629: J Psychiatr Nurs Ment Health Serv. 1974 Sep-Oct;12(5):25-30.
Transactional analysis strategies for dealing with pain.
Gowell EC.
630: Rev Neuropsiquiatr. 1974 Mar;37(1):44-56.
[Physician-patient relations]
Adis Castro G.
631: J Am Psychoanal Assoc. 1974 Jan;22(1):182-99.
The influence of theoretical model of schizophrenia on treatment practice.
[No authors listed]
632: Int J Aging Hum Dev. 1974 Spring;5(2):197-203.
Behavior modification of geriatric grief: a transactional perspective.
Flannery RB Jr.
Publication Types:
Case Reports
633: Br J Med Psychol. 1973 Dec;46(4):373-9.
Two kinds of groups.
Meares R.
634: Int J Group Psychother. 1973 Oct;23(4):474-513.
The group psychotherapy literature: 1972.
Lubin B, Lubin AW.
Publication Types:
Bibliography
Review
635: Mod Hosp. 1973 Sep;121(3):85-8.
The "crisis minister" at work: reducing hostility, maintaining dignity, and
controlling emotions in the emergency room.
Downey GW.
636: Z Psychosom Med Psychoanal. 1973 Jul-Sep;19(3):272-8.
[Technic of marriage and family therapy]
[Article in German]
Sperling E.
637: Arch Gen Psychiatry. 1973 May;28(5):722-6.
Psychotherapy of narcissistic injuries.
Goldberg A.
Gestalt therapy and transactional analysis as new methods for the treatment of
psychosomatic ailments.
Kertesz R.
639: Int J Psychiatry Med. 1973 Summer;4(3):291-300.
Psychiatric consultation to the non-physician staff of an outpatient oncology
clinic.
Craig TJ.
640: Nurs Forum. 1973;12(1):82-95.
Transactional analysis in sensitivity groups for students of nursing.
George JA, Gowell EC.
641: Int J Orthod. 1972 Sep;10(3):81-90.

The application of transactional analysis to the orthodontic patient.
Yates CD.
642: Curr Psychiatr Ther. 1972;12:132-50.
Developments in transactional analysis.
Karpman SB.
643: Gerontologist. 1970 Autumn;10(3):228-32.
Toward person-environment transactional research in aging.
Schwartz AN, Proppe HG.
644: Int Psychiatry Clin. 1970;7(4):125-71.
Symptoms from a family transactional viewpoint.
Framo JL.
645: Rocky Mt Med J. 1969 May;66(5):37-43.
Transactional-semantic psychotherapy.
Chemodurow T.
646: J Educ Psychol. 1967 Oct;58(5):290-302.
A twenty-college study of student x college interaction using tape
(transactional analysis of personality and environment): rationale, reliability,
and validity.
Pervin LA.
647: J Soc Psychol. 1967 Aug;72(2):285-95.
Student dissatisfaction with college and the college dropout: a transactional
approach.
Pervin LA, Rubin DB.

648: Arch Gen Psychiatry. 1967 Apr;16(4):494-504.
Transactional disqualification. Research on the double bind.
Sluzki CE, Beavin J, Tarnopolsky A, Veron E.

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1: Harv Bus Rev. 2005 Jul-Aug;83(7):106-14, 192.

Manage your human sigma.

PMID: 15910146 [PubMed - indexed for MEDLINE]

Department of Psychology, University of South Carolina, Columbia, SC 20208, USA.

Nursing Department, School of Health Professions, Sackler Faculty of Medicine,

Shanahan MJ, Bauer DJ.

12: Psychol Addict Behav. 2004 Dec;18(4):350-61.

PMID: 15582861 [PubMed - indexed for MEDLINE]

demonstrate a visible commitment to safety, best indicated by the time they

Bono JE, Judge TA.

22: J Dev Behav Pediatr. 2004 Oct;25(5):311-7.

case-matched controls, less maternal affectionate, proprioceptive, and

PMID: 15279917 [PubMed - indexed for MEDLINE]

model showed only perceived efficacy of antiretrovirals and one measure of

the relative importance of religious versus existential well-being in relation

influenced by the appraisals measured. CONCLUSION: Halstead et al.'s Revised

of sex differences in leadership styles.

[Multidimensional assessment of coping: validation of the Brief COPE among

validation in its situational format. 178 additional students answered this

PMID: 15028542 [PubMed - indexed for MEDLINE]

in autism: social and emotional development, and the cognitive development of

likely relation of several areas of brain and biological functioning with

diagnosed with JRD. Children completed measures of depressive symptoms

Becoming "at home" in assisted living residences: exploring place integration

Condition C, the No Treatment Condition (NTC), the participant received just an

Greene RW, Ablon JS, Goring JC.

PMID: 12807807 [PubMed - indexed for MEDLINE]

Non use of health information kiosks examined in an information needs context.

Predicting unit performance by assessing transformational and transactional

culture, and burnout in their program. Results show transformational leadership

a moderate degree of value congruence between nurse executives' personal and

PMID: 12520893 [PubMed - indexed for MEDLINE]

that transformational, situational, and servant leadership styles are most

Eighty infants' nighttime sleep-wake patterns and associated variables were

88: Int J Audiol. 2002 Jul;41(5):308-20.

Hassig M, Vollrath M, Thun R.

the confessional nature of clinical supervision reflects contemporary practice

Conclusion - This french version of TESI emotional list appears to be suitable

on long-term child development. However, the clustering of confounding variables

Richmond, Virginia 23284, USA.

coping and psychological outcome, respectively were generated. Principal

Department of Psychology, Transylvania University, Lexington, KY 40508-1797,

recent progress in neurobiological and personality research promises significant

Department of Public Health, Centre des Sciences Hospitalieres, Universite

122: J Consult Clin Psychol. 2001 Jun;69(3):481-8.

126: J Med Philos. 2001 Jun;26(3):285-98.

driven, empirically justified approaches to the prevention of depression in

Department of Psychology, University of Manchester, Oxford Road, Manchester M13

Massachusetts General Hospital/Harvard Medical School, Boston 02114, USA.

Department of Psychology, University of California, Berkeley 94720-1650, USA.

PMID: 11200297 [PubMed - indexed for MEDLINE]

Individual client-to-server channels can be secured using a double key-pair

Five-factor model of personality and transformational leadership.

Transactional conflict between psychobiology and culture in the etiology of

Department of Sociology, University of Alberta, Edmonton.

temperament may influence the type of secure and insecure attachment

Toward an interpersonal life-stress model of depression: the developmental

satisfaction ratings-up to 40 percent of the total variance. CONCLUSIONS:

disruption of neuropsychological processes during pregnancy and parturition. It

Peer sexual harassment: a barrier to the health of adolescent females?

Department of Psychiatry and Biobehavioral Sciences, UCLA, USA.

J Clin Child Psychol. 1999 Dec;28(4):558-62.

PMID: 10587896 [PubMed - indexed for MEDLINE]