Somatization is a phenomenon that poses a tremendous challenge for patients and physicians alike. No health problem raises more confusion, anxiety, frustration and helplessness than distressing physical symptoms, such as pain or fatigue, which doctors are unable to explain. A phenomenological-hermeneutic investigation was therefore conducted to better understand this mysterious phenomenon and to determine why the Western health care system has such difficulty understanding and treating somatizing patients who suffer from medically unexplained physical symptoms. It was hypothesized that flawed philosophical, theoretical and/or methodological assumptions are partially at fault. As such foundational assumptions are implicit and taken-for-granted their validity is rarely questioned, yet their implications for treatment are profound. To explore this hypothesis, four models of somatization were reviewed and critically evaluated to identify how their foundational assumptions may be contributing to or impeding progress in the conceptualization and treatment of somatization. These include the neuropsychiatric, biopsychosocial, psychoanalytic and narrative models of somatization. After outlining the foundations of a phenomenological-hermeneutic approach, the models of somatization were presented, along with a description of how the symptoms of a particular clinical case would likely be conceptualized. Each model was then evaluated in three stages: (1) explication of foundational assumptions, (2) evaluation of strengths and weaknesses, and (3) implications for the problematic of somatization. As a result of this evaluation, specific foundational assumptions have been identified which interfere with the ability of certain models to adequately capture the richness and complexity of somatization as it is lived and experienced by individual sufferers. These flawed foundational assumptions result in inaccurate or incomplete conceptualizations which hinder the ability of proponents to design effective treatments. As a result, some models are contributing inadvertently to the suffering experienced by their patients. While the models varied significantly in terms of their strengths and weaknesses, a cross-model comparison identified a number of foundational, conceptual and treatment issues that remain unresolved or inadequately addressed by the models as a whole. The final chapter described how a phenomenological-hermeneutic approach can begin to address these issues and provide a novel contribution to the understanding and treatment of somatization.

Event-related potentials (ERPs) and reaction time (RT) were recorded concurrently during the performance of six simple cognitive tasks for subjects (N = 30) who varied in mental ability as assessed by the Multidimensional Aptitude Battery (MAB). Results showing negative relationships between reaction time measures and mental ability were consistent with previous findings (Vernon, 1983). For the first stimulus in paired stimuli tasks, both P300 amplitude and latency were affected by task difficulty. Mental ability group differences were noted for P300 amplitude only. For the target stimulus, P300 latency increased with increasing task difficulty in the same manner as reaction time and it was inversely related to mental ability, in particular for the more difficult tasks. P300 amplitude varied between tasks, but was not related to mental ability. First unrotated factors were extracted from the intercorrelations of each variable. Results showed that each factor accounted for considerable variance. Correlations between factor scores revealed significant negative relationships between intelligence and P300 measures and between RT and P300 amplitude. Five predictor variables produced a multiple correlation of.583 with IQ. Results suggest that P300 latency and reaction time may assess respectively the stimulus evaluation time and response production time components of cognitive information processing that vary inversely with general intelligence.

This was a 6-month cohort study of secondary traumatization in parents following child disclosures of extrafamilial sexual abuse. Sixty-one case families (59 mothers, 27 fathers) were matched on child's age, sex, family constellation and occupational status with a normative comparison group of 59 families (58 mothers, 40 fathers) recruited from the local children's hospital. Case parents were recruited from the hospital's Child Protection Team, as well as from regional Children's Aid Societies, and Victim/Witness Programs. Parents were assessed at 3 and 6 months post-disclosure using the Brief Symptom Inventory, the Dyadic Adjustment Scale, the Parent Sense of Competence Scale, the Family Adaptability and Cohesion Evaluation Scales III, the Impact of Event Scale, and the Child Behavior Checklist. Adjustment was conceptualized as being related to 2 sources of trauma: the type of abuse, and the subjective experience of the event (cognitive appraisal, environmental sensitivity, and baseline emotional functioning). Two mediating variables, parent sexual abuse history, and court involvement were examined. Results indicated a generalized pattern of distress for case mothers. They experienced poorer functioning in all areas except dyadic adjustment relative to comparison mothers at both time periods. Case fathers did not show such distress but had significantly higher levels of parent efficacy relative to the comparison group. Although case parents initially had significantly better dyadic adjustment, case primary caretakers showed a significant deterioration in marital adjustment over time. Case mothers also experienced significantly higher levels of intrusive and avoidant symptoms and lower parent satisfaction relative to case fathers at both time periods. Although the nature of the sexual abuse was not a significant predictor of parent emotional distress, intrusive symptoms, parenting satisfaction, perceptions of child internalizing problems, quality of social support, and satisfaction with family adaptability were relevant predictors for mothers at 3 months. At 6 months, social support was no longer a significant predictor. No significant differences emerged as a function of court status. Parent and child sexual abuse history were significantly related to clinical risk for parent emotional distress. The clinical and research implications of working with parents following disclosure are discussed; risk groups for secondary traumatization are identified; and revisions to the secondary traumatization model are recommended.

Using a procedure that borrowed from both a quantitative and a qualitative research approach to psychotherapy, this study investigated audiotaped recordings of six sessions of Gestalt therapy conducted by five distinguished therapists. This in-depth, discovery-oriented research explored the interrelations between in-session client conditions, therapist operations and very good moments. In the first phase of the study, composite descriptions of six categories of very good moments were generated, based on the identification and the subsequent descriptions of 17 instances of very good moments made by a team of twelve judges. The six categories of very good moments were: From Neutral to Strong Feeling; Strong Expression Directly Toward Therapist; Extratherapy Behavior Change Intention; Acceptance of Problem-Self; State of General Well-Being; and New, Deeply Felt Personality Process-State. In the second phase of the investigation, judges identified explicit therapist operations and methods which, when carried out under identified client conditions or states, were judged as being instrumental in the subsequent occurrence of the given category of very good moments. The main finding was as follows: (a) The skilled and competent use of specific therapist operations, (b) with a client who is ready and willing to use the operations, and to move toward that very good moment, (c) appeared to result in the occurrence of that very good moment. For practitioners who value these categories of very good moments, the findings may be used as provisional suggestions for ways of facilitating the occurrence of these very good moments. For researchers, the findings are illustrative of continuing explorations into how psychotherapy works, into the relations between in-session client conditions or states, therapist operations, and consequent in-session very good moments. By means of careful, in-depth examination, researchers can learn what practitioners do to help bring about important and useful in-session client events.

Naturalistic observations were made on 72 preschoolers in four daycare centres to determine whether preschoolers preferred certain areas of the playground and whether specific social and cognitive behaviors were localized in particular parts of the playground. Each playground area was classified in one of four ways (enclosed/private areas, play structures, pavement, and sand) to determine whether different areas elicit different behaviors. Whether individual differences in internalizing or externalizing behaviors or sex influenced amount of time spent in different types of areas or number of areas played in were also examined. Results indicated that preschoolers spent more time on pavement and sand than on play structures and private areas and that there was more unoccupied activity in the former two areas than in the latter. Sand appeared to promote fine motor play whereas play structures promoted gross motor play. Results did not support the hypothesis that externalizing or internalizing behaviors or sex influenced the use of space.

Numerous anecdotal reports from athletes and coaches suggest that performance of a physical skill can be improved by imaginal practising of that skill. Practising a skill in one's imagination has been called symbolic rehearsal, mental practice, mental rehearsal, conceptualizing practice, imaginal practice, covert rehearsal, and instructed human imagining behaviour (IHIB). For at least 50 years, researchers have attempted to empirically demonstrate the effects of instructed human imagining behaviour on subsequent performance. A review of the IHIB and related literature suggests (a) that although IHIB can influence skill performance, it may not always do so; (b) that the conceptual schemes involved in IHIB need careful development; and (c) that before IHIB can be used to effectively and systematically improve performance, we need to identify critical variables involved in IHIB. An alternative explanation of IHIB and its effects on subsequent performance based on radical behaviourism is described and examined. This conceptual scheme proposes that IHIB is similar to the overt behaviour and thus, shares similar controlling variables. Three experiments, investigated the effects of presenting task-specific auditory stimuli during IHIB procedures. The results suggest that task-specific auditory stimuli increase the similarity between IHIB and the target behaviour, and that it is this similarity that mediates the effects of IHIB on subsequent performance.

The present investigation is a prospective follow-up cohort study of 47 children who experienced extrafamilial sexual abuse (ESA). The children were referred by several child protection agencies in the Ottawa-Carleton and southeastern region of Ontario between 1989 and 1992. All participants were assessed within the first three months post disclosure and six months later. The abuse of children ended within the year prior to the disclosure. A comparison group, matched on child's age, gender, and family constellation was recruited from the medical records of the Children's Hospital of Eastern Ontario. The children were evaluated from three different perspectives: self-perceptions of emotional functioning, parental reports of behavioral functioning and teachers' evaluations of behavioral functioning. Standardized measures of depression, self-concept, anxiety, general and abuse related fears, and social functioning were used. The results of multivariate analyses of covariance (MANCOVAs), conducted to control for the variability in children's intellectual functioning and family socioeconomic status, revealed that, in comparison to non-abused children, children in the sexually abused group reported more symptoms of depression and fearfulness, were evaluated by the parents as exhibiting more externalizing and internalizing behaviors, and evaluated by the teachers as showing more externalizing difficulties. These problematic behaviors were present within the first three months post disclosure and at the sixth-month follow-up. No significant group differences were revealed on the social self-efficacy measure at either assessment time, and self-reports of fearfulness did not differentiate between the groups at the follow-up assessment. As a group, the sexually abused children reported symptoms of post-traumatic stress at both assessments. The results of standard regression analyses revealed, that among the sexually abused children, elevated levels of post-traumatic symptomatology, feelings of guilt and blame for the abuse were predictive of the children's self-reports of emotional functioning. These variables were not predictive of either the parental or teachers' reports. The objective aspects of the abusive experience and the demographic characteristics of the sexually abused group did not predict significantly the children's functioning, except for the gender of the child which was predictive of fearfulness. The discussion of the results points to the importance of utilizing multidimensional assessments conducted from different perspectives. The need to evaluate in a consistent way the children's own perceptions of abusive experiences is underscored. A specific emphasis is placed on the evaluation of perceived self-blame and guilt, perception of social supports and reports of intrusive thinking, avoidant behavior, and anxiety related to sexuality. Implications for therapeutic interventions are noted. The limitations of the study and suggestions for further research are discussed. Finally, the advantages of working within a comprehensive theoretical model are presented.

Social learning theory (Abrams & Niaura, 1987) assumes that individuals who lack effective coping strategies are more likely to drink in response to stressful situations. A review of the literature suggests that coping strategies have not typically been studied in the context of a specific theory of alcohol abuse. Consequently, little progress has been made in the understanding of possible links between alcohol abuse and the use of coping strategies. The primary objective of the present study was to assess whether drinking problems are associated with specific coping strategies. Coping strategies were defined according to the coping models of Lazarus and Folkman (1984), Tobin, Holroyd, Reynolds and Wigal (1989) and Rosenbaum (1980). It was hypothesized that students with drinking problems, in comparison to students with no drinking problems, would report engaging less in self-control and problem-focused strategies and more in avoidant coping strategies. A secondary objective was to determine whether these coping characteristics are associated with a family history of drinking problems, a risk factor for drinking problems. One hundred and eighty-nine male university students completed screening questionnaires about their alcohol and drug consumption and about the drinking behaviors of their family members. Students accepted for this study met the criteria for one of the following groups: (a) no family history of drinking problems (FH$-$) and no drinking problems, (b) FH$-$ and drinking problems, (c) family history of drinking problems (FH+) and no drinking problems, or (d) FH+ and drinking problems. Students completed self-report questionnaires on the reactions they experience in stressful situations. Self-control strategies were assessed by the Self-Control Schedule (Rosenbaum, 1980), and task-oriented and avoidant strategies by the Coping Inventory for Stressful Situations (Endler & Parker, 1990a). The last questionnaire was repeated for three different situations: (a) negative emotion, (b) interpersonal conflict, and (c) pressure to drink. Multivariate analyses of variance showed that students with drinking problems, in comparison to students without drinking problems, reported engaging less in self-control and task-oriented coping strategies. However, students with drinking problems did not report engaging more in avoidant strategies. This finding was contrasted with the results of other studies in which avoidant strategies were found to be related to alcohol abuse. Finally, there were no significant differences in coping between FH+ students and FH$-$ students. The potential relevance of coping to a model of alcohol abuse was discussed as well as its practical implications. For example, students with drinking problems might benefit from being taught task-oriented strategies and self-control skills, in addition to specific skills to reduce drinking.

Chaining procedures (forward chaining, backward chaining, and whole task craining) are used to teach sequences of behaviors to diverse populations. Recent research comparing the three procedures has revealed differences between the procedures in terms of acquisition variables e.g., number of errors made during learning, time required to the learn a sequence). Much less research has examined whether the procedures produce differences in performance following acquisition. A series of six experiments investigating performance differences following exposure to four chaining procedures are presented. The four chaining procedures included the three traditional chaining procedures--forward, backward, and whole task--as well as a random chaining technique. Overall, results indicated that forward chaining led to the most accurate and fastest performance of responses in the absence of the external antecedent stimuli used during training. Forward chaining also led to more accurate ordering of these stimuli following training. Random chaining led to the most accurate and the fastest performance of responses following presentation of the antecedent external stimuli out of sequence order. The theoretical and practical implications of these findings are discussed.

A total of 49 couples, in which the women were experiencing inhibited sexual desire (ISD), were randomly assigned to Emotionally Focused Therapy for Couples (EFT) or a wait-list control group condition. An additional 15 couples were recruited as a non-ISD comparison sample. The purpose of the study was to investigate the effect of marital therapy (EFT) on ISD, and examine differences between ISD and non-ISD couples. At post-treatment, EFT couples' levels of marital and overall sexual adjustment were not significantly different from those of the control group following the wait-list period. On a measure of sexual desire, however, treatment group females had post-treatment levels of sexual desire that were significantly higher than those of control group females following the wait-list period. In most areas assessed, treatment group levels of clinically significant improvement were found to be superior to those of the control group. Treatment group within-group gains from pre-treatment to post-treatment were largely maintained at follow-up. For Treatment females, better pre-treatment marital adjustment predicted better post-treatment overall sexual adjustment. The main difference found between ISD couples and non-ISD couples was that ISD couples had significantly more sexual distress. Results are discussed in light of an interpersonal conceptualization of ISD.