Tag Archives: Behavior

What Effect Does Violence have on Kids? – Practical Application of Stanley Greenspan’s Theory of Emotional Development to Violent Behavior


I have chosen to apply the Theory of Emotional Development as seen by Stanley Greenspan to violent behavior.  I can see where this theory can explain how violent behavior gets embedded into a person, especially when the behavior is experienced from birth or from a young age, either by witnessing or by being victimized by violence.

Greenspan’s Theory assumes that children learn behavior by experiencing it.  The behavior would then continue into adulthood unless something drastic affects them.  It would have to be to the point that they feel they need to change the behavior.  In the case of violence, this drastic happening could be, going to jail or prison, going too far with the violence, or even being injured bad enough to be hospitalized for a while.  This of course depends on the person.

There are several assumptions from the theory that I will compare to the affects of violence on children.  I will also compare the milestones within the stages of emotional development to the stages the children go through when submerged in a violent environment.

There are also several reasons why violence would be someone’s first reaction to any situation.  There are many signs that a child could have violent tendencies, we could see these as they grow older.  Some children show behavioral problems at very young ages, their mental health status could grow worse and there are often problems academically and behaviorally throughout adolescence.

It seems that how often someone is exposed to violent behavior and the age at which they are first exposed determines the severity of the violent actions the child may eventually commit.

If a child is exposed to violence through a victim standpoint, it is most likely that as parents, the violence will be committed against their immediate family, but it is also likely that violence will be committed against outsiders as well.

If a child is exposed to violence through a witness standpoint, negative results could include becoming aggressive and having developmental challenges. Also, some criminal behavior could be seen.

There are many long-term effects that can take hold of a person when they are exposed to violence, especially if it was for a very long period of time.   These effects include depression, antisocial behavior, and substance abuse.  The child also learns to associate a positive attitude to violent behavior, if they are continually exposed.  They end up feeling as if the perpetrator is rewarded for the behavior.

In the Theory of Emotional Development one assumption is, “the capacity to organize experiences is present early in life”.  When violence is present in a person’s life, it is generally something that has been experienced from a very early time in their life.  Generally it is in the form of domestic violence toward a parent or themselves.

The violence that is experienced through the child’s life is organized when the child either accepts this behavior as normal or decides that the behavior is wrong and then fights against it.

This theory, “Assumes that initially organization is emotion based rather than cognition based”.  The research associated with violent behavior shows the learning of violence is cognition based.  It is a learned behavior in that, the more a child is exposed to various types of violence, the more likely they are to become offenders and the worse the offences become.

It also says, “Infants organize their emotions differently at different stages of ego development”.  Infants who emerge into life where violence is prevalent will organize their emotions accordingly.  These babies will startle easily, as loud noise and yelling does anyway, but then will grow into toddlers who may sense something is wrong, but will also be desensitized to the violent behavior around them.  Also, because of the actions that are prevalent in the home, they will see the violence as normal because they have no ability to compare it to others’ behavior.

This theory says, “With the maturation of the brain, interpreting progresses to higher levels of organization”.  As the child progresses into elementary school age, and they are exposed to other children’s life styles, they will begin to understand, maybe truly for the first time, that the behavior they are experiencing is wrong.

At this point, and as they grow, they will start to compare their own home life to their friends’ and then start to really organize how they feel as to whether the behavior is normal in other peoples lives.  Because they are starting to comprehend what’s happening in their household, they will generally devise a way to hide what’s happening to them in order to appear normal to everyone else.

This theory also states, “Emotional organization is acquired through relationships with those who care for the child”.  The child’s primary caretaker is generally their abuser.  Because of this, the emotions acquired in this relationship are generally those of confusion.  This is because the parent usually tells them that they are loved, but then the actions of that parent don’t agree with the words.  The child unknowingly learns to develop hate; sometimes toward the abuser and sometimes toward themselves because they feel they can never do what it takes to feel the love promised them so often.  These emotions carry through to adulthood and usually affect their own relationships, even as early as Jr. High or High School relationships.

Another assumption from this theory is, “Socialplay is the vehicle for promoting emotional organization”.  Children who live with violence in the home are more likely to try to stay away from the home as much as possible.  As soon as they realize they have an escape at a friend’s house they will make any excuse to try to go there in order to get away from either viewing the violence or becoming a victim of it.

Socialplay then becomes more and more about what their friends have access to that the child doesn’t feel they have.  These things do not necessarily have a monetary value, but emotional value.  Affection, courteousness, and other familial values are not found at home, so they take comfort in finding them in other people’s homes.

Greenspan also says, “Experiences must be age appropriate; have range, depth, and stability; and be personally unique.”  Unfortunately for children who experience violence on a daily basis there are not many age appropriate experiences.  These children quickly learn the keys to survival and how to fend for themselves.  These methods become intertwined into daily life and as the child grows, it becomes a way of life.  This is usually the start of the person committing violent acts when they are older.  It is not generally something they see as being a chosen action, but more something that just happens.

Greenspan has defined six milestones within the stages of emotional development. These milestones are self regulation, intimacy, two-way communication, complex communication, emotional ideas, and, emotional thinking.  Each of these milestones represents a phase or stage of a child’s life, and what they should accomplish during that phase where emotional development is concerned.

The first stage of emotional development is engagement.  This stage usually lasts from about three weeks of age until about eight months of age.

During this stage the “infants learn to share attention, relate to others with warmth, positive emotion, and expectation of pleasant interactions, and trust they are secure”.  This is the stage in which self regulation and intimacy are learned.  During these crucial early weeks and months of a child’s life, if they are involved in a violent environment, they would learn the opposite of what is involved in engagement.  They would eventually learn there are not many, if any, pleasant interactions and would not feel secure in their own actions.  In fact their first reaction to attention would come to be the flight reaction and then when older the fight reaction.

Two-way communication is the second stage of emotional development.  This stage usually lasts from about six months of age until about 18 months of age.  During this stage “infants learn to signal needs and intentions, comprehend others’ intentions, communicate information (motorically and verbally), make assumptions about safety, and have reciprocal interactions”.  This is the stage in which two-way communication is learned.  The children in this age group are still too young to recognize that the violence in their environment is not normal; yet, they are learning skills to survive there.  The two-way communication they are learning is how to signal their needs in the least threatening way.  Whether they are experiencing violence by witnessing it or are being abused, they learn the other person’s intentions could be painful and their safety could be compromised if not handled with care.  They carry this skill into later life when dealing with others.

The third stage of emotional development is shared meanings.  This stage usually lasts from about 18 months of age until about 36 months of age.  During this stage “children learn to relate their behaviors, sensations, and gestures to the world of ideas, engage in pretend play, intentionally use language to communicate, and begin to understand cognitive concepts”.  There are two milestones associated with this stage, complex communication and emotional ideas.  A lot of children who are exposed to violence from an early age end up learning things like complex communication at a later time than other children.  Because of this, these children sometimes develop learning disabilities which eventually become a sore spot for these children.  When other children don’t understand what is happening in that child’s life and choose to use that child’s slower development as something hurtful, the violent feelings tend to erupt as this is what that child has been taught at home.

The fourth and final stage in Greenspan’s theory is emotional thinking.  This stage usually lasts from about three years of age to about six years of age.  During this stage, “children can organize experiences and ideas, make connections among ideas, begin reality testing, gain a sense of themselves and their emotions, see themselves in space and time, and develop categories of experience”.  Emotional thinking is developed in this stage.  This is the age when children start to recognize that things in their home environment are not quite right.  They start to put together the fact that other children’s home lives do not involve violence on a regular basis.  At this point the child is still unsure of what, if anything, they can do about the violence in their own home.  This can be the turning point in a child’s life.

It can be when they subconsciously decide if they will incorporate the violence their caregiver has unknowingly taught them into their own lives and become violent with other people, or if they will become more docile and turn inward.

I feel that this theory, if taken further into research about violent behavior, would be a good one to look at in order to help predict violent tendencies in children.  If we do this we can try to incorporate treatment earlier and possibly cut out a lot of the violence we are seeing today.  The assumptions and the stages of the theory for emotional development are very helpful when looking at violence from an outside perspective.

References

Cullen, P.  (2009, May 21). Physical, emotional and sexual abuse was widespread in State institutions. The Irish Times p. 9.

Fagan, J.  (1996). The Criminalization of Domestic Violence: Promises and Limits
National Institute of Justice. Retrieved from LexisNexis database.

Nader, C. (2008, December 3). Death often tragic end to history of domestic violence.  The Age p. 11.

Murrell, A.R., Christoff, K.A., Henning, K.R. (2007, July 17).  Characteristics of Domestic Violence Offenders: Associations with Childhood Exposure to Violence.                                  J Fam Viol, 22:523-532

Appleyard, K., Egeland, B., van Dulmen, M.H.M., Sroufe, L.A. (2004. February 2). When more is not better: the role of cumulative risk in child behavior outcomes. Journal of Child Psychology and Psychiatry, 46:3, 235-245

Bergen, D. (2008). Human Development Traditional and Contemporary Theories. Pearson Prentice Hall.

Dysthymic Disorder


My choice of Dysthymic Disorder for purposes of this essay was both personal and professional.  First and foremost, I was attracted to this disorder because it resides in the gray area somewhere between an Axis I disorder and a personality disorder.  Because of this unique diagnostic positioning I feel as though I could reasonably justify techniques that are traditionally associated with all of the major schools of psychotherapy I have studied to date: Behavior Therapy, Cognitive Behavior Therapy, Schema Therapy, Existential Psychotherapy, and/or (perhaps most importantly) my own personal brand of psychotherapy that shall remain unnamed.  With some amalgamation of techniques derived from the above, as dictated by individual client needs, I have confidence I would have a reasonable chance of having “success” (however we mutually choose to define that) with the majority of clients that present with Dysthymic Disorder.  Secondly, it seems to me a young clinician’s time is best spent on the disorders he is mostly likely to encounter.  Prevalence rates of Dysthymic Disorder could be as high as 6% in a nationally representative sample, and as high as 22% in outpatient mental health settings.  (Dougherty, Klein, & Davila, 2004)  It’s extremely unlikely that I will not encounter Dysthymic Disorder during the course of my professional life.  Third and finally, this disorder is close to me because someone I love endured it for the better part of 10 years.  Thankfully – I can report at this time that it is in full remission.  The journey to full remission was one that tested all of our capacities for change and growth.  This essay represents a personal and professional journey that is has led to significant gains in my own understanding of mood disorders.  Successfully navigating through the dark forest that is Dysthymic Disorder is no easy task.  It is my hope that my clients don’t have to endure the dark thoughts any longer than is absolutely necessary.

The essential feature of Dysthymic Disorder is a chronically depressed mood that occurs for most of the day, more days than not, for at least two years.  (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2000, p. 376)  During periods of depressed mood, at least two of the following additional symptoms are present: poor appetite or overeating, insomnia (sleep too little?) or hypersomnia (sleep too much?), low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness.  (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000, p. 377)  In my example case the individual was laden with hypersomnia, fatigue, and poor concentration.  It is noteworthy that are over 700 different combinations of symptoms that any single individual could potentially present with and still have the same diagnosis of Dysthymic Disorder.  As a result, it bears mentioning that the following analysis is in no way suggesting that this is the only right way to treat the disturbance.  Manualized treatment is probably doomed to failure when it comes to treating Dysthymic Disorder.  Any reasonable attempt to work toward complete remission of Dysthymic Disorder should be guided by a professional.

Differential diagnosis can be a challenge with Dysthymic Disorder.  “This is the way it’s always been” is not an unexpected response from patients whom suffer from Dysthymic Disorder.  There is no rest for the wicked: During the two year period of the disturbance, the individual may not have been without the qualifying symptoms in for more than 2 consecutive months.  Furthermore, no major depressive episode should be present during the first two years of the disturbance and the disturbance cannot be better accounted for by the diagnoses of chronic Major Depressive Disorder, or Major Depressive Disorder, In Partial Remission.  (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000, p. 380)  Double depression, or the comorbid combination of Major Depressive Disorder and Dysthymia, is also a very real consideration since major depressive episodes are often superimposed on mild chronic depression.  (Dougherty et al., 2004, p. 1012; Morrison, 2007, p. 139)  There should never have been a manic, hypomanic, or mixed episode that would be contraindicative of Dysthymic Disorder and indicative of either Cyclothymic Disorder or Bipolar Disorder (I or II).  The disturbance should not occur exclusively during the course of a chronic psychotic disorder (like schizophrenia, for example) or be the direct physiological effects of a substance (like methamphetamine, for example) and/or general medical condition (like a traumatic brain injury, for example).  As is the case with most DSM diagnoses, the disturbance should cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.  (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000, p. 381)  This differential diagnosis quandary is further exacerbated by the fact that depression “shares borderlands with bereavement and other losses, problems of living, and adjustment disorders.”  (Morrison, 2007, p. 127)  A thorough investigation of antecedents and mitigating factors is absolutely critical to accurately “anchor your boat” so you can “wade into the river” with a correct diagnosis.

Family history is an important consideration when determining the hypothetical etiology of a disturbance, especially in the case of mood disorders.  “Family history is more useful in starting the train of diagnostic thought than in determining its final destination.”  (Morrison, 2007, p. 133)  Research suggests that the strongest predictors for Dysthymic Disorder include a history of sexual abuse, quality of the patient’s relationship with both parents, and higher familial loadings for drug abuse and ‘Cluster A’ personality disorders.  Unfortunately, we could use that same laundry list of antecedent events for just about every personality disorder in the DSM-IV-TR… so that doesn’t tell us much.  Childhood adversity and familial psychopathology and have greater predictive utility for Dysthymic Disorder when compared with demographic and clinical variables.  (Durbin, Klein, & Schwartz, 2000)  Translation: nurture appears to trump nature.  Nature continues to play a significant role in the development and maintenance of the disturbance, however.  A patient with a parent (or parents) with unipolar depression exhibited significantly higher rates of Affective/Mood Disorders including Major Depressive Disorder and Dysthymic Disorder – yet another marker that can guide the patient-clinician dyad in the right direction.  (Klein, Clark, Dansky, & Margolis, 1988)

A full exploration of the potential therapeutic interventions is beyond the scope of this paper, but there are a few empirically supported treatments that are noteworthy.  Supportive therapies, coupled with cognitive behavioral interventions, have been effective in extinguishing negative verbalizations and normalizing daily functioning.  (Elligan, 1997)  This is consistent with my “necessary but not sufficient” position when it comes to person centered therapies practiced by the late great Carl Rogers (1902-1987).  Although I concede that the research I found doesn’t specifically point to Schema Therapy as a potential treatment modality for Dysthymic Disorder, I would consider it based in part on event-related brain potential research.  (Yee, Deldin, & Miller, 1992)  Processing deficits including selective attention may be modified and corrected vis-à-vis Schema therapy.  Since research suggests that resource allocation is the issue, not resource capacity, the goal of Schema Therapy would be to allow for attention resources to be more effectively and efficiently focused on task performance.  (Yee & Miller, 1994)  Pharmacological interventions have been less effective on Dysthymic Disorder when compared with other mood disorders, so I would not consider this to be a first line of defense except in cases of Double Depression or in cases where talk therapy would be otherwise unproductive without the value added by antidepressant medications.  Other noteworthy psychological treatments that have garnered empirical support for the treatment of clinical depression include Behavior Therapy (Behavioral Activation), Cognitive Therapy, Cognitive Behavioral Analysis System of Psychotherapy, Interpersonal Therapy, Problem-Solving Therapy, Self-Management/Self-Control Therapy, Acceptance and Commitment Therapy, Behavioral Couples Therapy, Emotion-Focused Therapy (Process-Experiential), Reminiscence/Life Review Therapy, Self-System Therapy, and Short-Term Psychodynamic Therapy.  (Hayes & Strunk, n.d.)  In the end, the choice is one that will be made based on the training and expertise of the respective therapist and the needs of the individual patient.  Not all therapists are created equal.  In the end, every clinician should know a little about most of the treatment options above so they can make a referral if your particular variant of Dysthymia will not be well served by the treatment modalities that your clinician is versed in.

Knowing nothing about my potential client, I would begin the treatment from a cognitive behavioral perspective because I believe that it is the “best bang for the buck” in a brief therapy environment.  The most likely scenario for a first session could be summed up in the word “triage.”  Something brought the client into therapy and we need to “stop the bleeding.”  Behavioral activation in the form of cognitive behavioral homework is absolutely critical to get the ball rolling.  Although we can only speculate without a specific case study to reference, we would likely begin with some simple behavioral activation like “going on a walk with a friend for one hour, once a week.”  Ideally the target behavior would be specific, measurable, and relatively easy to complete (at least at the beginning).  Reversing that “downward spiral” as soon as is possible is an important first step in the treatment of Dysthymic Disorder.  (Beck, 2011, p. 80)  After identifying avoidance behaviors and potential reinforcing activities, I would endeavor to implement some form of self-reinforcement whereby transfer, generalization, and long-term maintenance of the desired behavior can be established and maintained.  (Spiegler & Guevremont, 2010, p. 135)  It should be a foregone conclusion but it bears mentioning that the homework should be customized for the specific patient and, if deemed necessary, “contracted” to increase the likelihood of compliance.

Furthermore, I would work to identify chronic stressors that appear to be contributing to the maintenance and onset-recurrence of the disturbance.  (Dougherty et al., 2004, p. 1012)  I typically engage in a series of assessments including interviews, behavioral checklists, assessments (ex: Beck Depression Inventory), and direct ecological observation to obtain both direct and indirect data regarding the antecedent variables and functional relations that serve to perpetuate the disturbance.  (Cooper, Heron, & Heward, 2007, p. 50)  I would pay particular attention to social, medical, family circumstances in the past, present, and anticipated future.  I would also make certain to note any vested friends and family without whom behavior change cannot be successful.  (Cooper et al., 2007, p. 51)  Parallel to that search for natural supports, I would engage in a systematic search for pool of appropriate people whom the individual could potentially model.  (Cooper et al., 2007, p. 413)  Finally, it bears mentioning that the continued inclusion of data from multiple sources (people) and situations (cultural contexts and mediating factors) makes the process of culturally competent cognitive behavioral therapy a possible since “identification of important, controllable, causal functional relationships” is an intimately subjective process laden with unique cultural issues and challenges.  (Hays & Iwamasa, 2006, p. 255-256)

The next logical step after the aforementioned behavioral interventions is a series of cognitive interventions that help the patient establish a bridge between automatic thoughts and behavior.  The cognitive elements of belief modification may need to be undertaken in parallel with behavioral interventions if the patient isn’t “buying the rationale” or is repeatedly unable to traverse unforeseen cognitive obstacles.  (Beck, 2011, p. 295)  The process of teaching a patient to identify and monitor automatic thoughts is of paramount importance for long term success and maintenance.  If the patient-clinician dyad comes to consensus about a longer treatment course, Schema Therapy would be my personal tool of choice since we can reasonably anticipate it will take at least 12-24 months to modify an individual’s core belief system.

There are a number of anticipated complications that we can reliably predict before treatment commences.  The first and most obvious complication is that negative self talk and poor self image are so much a part of the typical patient with Dysthymic Disorder that compliance is likely to be a huge issue.  Resistance is likely to be moderate to high, especially once core issues are identified.  Metaphorically, we are talking about convincing someone that gravity doesn’t exist… it’s sure to be an uphill battle.  By virtue of the fact that I have endured the disorder myself, countertransference is a real and pertinent issue.  I would personally address this by attending my own individual sessions to ensure that I don’t get in the way of the best interest of my patient.  Finally, it must be noted that an individual with Dysthymic Disorder should be considered extremely vulnerable and handled with the utmost care.  For example, individuals with Dysthymic Disorder often exhibit symptoms such as fatigue and low self-esteem.  These symptoms may lead to tension in interpersonal relationships, thereby increasing the probability of terminating therapy.  Although these life events may appear to be the “cause” a major depressive episode, the episode is often predated by deficits in informational processing that lead to pre-morbid deterioration of the relationship.  (Harkness & Luther, 2001)

Because Dysthymic Disorder is largely defined and distinguished by its protracted course, longitudinal studies are uniquely positioned to investigate the prognosis of the disorder.  Due to the staggering costs associated with longitudinal studies, few have been conducted on the naturalistic course of Dysthymic Disorder.  (Klein, Norden, Ferro, Leader, & Kasch, 1998)  The overall consensus is that success treating Dysthymic Disorder is better addressed on a case by case basis – making a generalization about expected treatment outcomes and prognosis is probably ill advised.  However, we can reasonably expect that there will be some measure of improvement in cognitive functioning, motivation, mood, and affect.  I would be cautious about setting expectations for full recovery or total remission until the underlying core beliefs are identified.  Assuming I could obtain permission from the patient, I would endeavor to track relevant data over the course of treatment as we consider the transition to schema therapy together, if applicable.  Individuals whom suffer from Dysthymic Disorder often find that the minor daily hassles that happen to everyone may spiral into more serious life events that trigger depression.  (Harkness & Luther, 2001, p. 570)  Tracking those hassles seems to a reasonably simple way to measure the effectiveness of the therapy being provided and adjusting it if necessary.

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

Beck, J. S. (2011). Cognitive behavior therapy: Basic and beyond (2nd ed.). New York, NY: Guilford Press.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis (2nd ed.). Upper Saddle River, NJ: Pearson Education.

Dougherty, L. R., Klein, D. N., & Davila, J. (2004, Dec). A growth curve analysis of the course of dysthymic disorder: The effects of chronic stress and moderation by adverse parent-child relationships and family history. Journal of Consulting and Clinical Psychology, 72(6), 1012-1021. doi: 10.1037/0022-006X.72.6.1012

Durbin, E. C., Klein, D. N., & Schwartz, J. E. (2000, Feb). Predicting the 21/2-year outcome of dysthymic disorder: The roles of childhood adversity and family history of psychopathology. Journal of Consulting and Clinical Psychology, 68(1), 57-63. doi: 10.1037/0022-006X.68.1.57

Elligan, D. (1997). Culturally sensitive integration of supportive and cognitive behavioral therapy in the treatment of a bicultural dysthymic patient. Cultural Diversity and Mental Health, 3(3), 207-213. doi: 10.1037/1099-9809.3.3.207

Harkness, K. L., & Luther, J. (2001, Nov). Clinical risk factors for the generation of life events in major depression. The Journal of Abnormal Psychology, 110(4), 564-572. doi: 10.1037/0021-843X.110.4.564

Hayes, A., & Strunk, D. (n.d.). Depression. Retrieved May 28, 2012, from http://www.div12.org/PsychologicalTreatments/disorders/depression_main.php

Hays, P. A., & Iwamasa, G. Y. (Eds.). (2006). Culturally responsive cognitive-behavioral therapy. Washington DC: American Psychological Association.

Klein, D. N., Clark, D. C., Dansky, L., & Margolis, E. T. (1988, Aug). Dysthymia in the offspring of parents with primary unipolar affective disorder. The Journal of Abnormal Psychology, 97(3), 265-274. doi: 10.1037/0021-843X.97.3.265

Klein, D. N., Norden, K. A., Ferro, T., Leader, J. B., & Kasch, K. L. (1998). Thirty-month naturalistic follow-up study of early-onset dysthymic disorder: Course, diagnostic stability, and prediction of outcome.. The Journal of Abnormal Psychology, 107(2), 338-348. doi: 10.1037/0021-843X.107.2.338

Morrison, J. (2007). Diagnosis made easier: Principles and techniques for mental health clinicians. New York: Guilford Press.

Spiegler, M. D., & Guevremont, D. C. (2010). Contemporary Behavior Therapy (5th ed.). Belmont, CA: Wadsworth: Cengage Learning.

Yee, C. M., & Miller, G. A. (1994, Nov). A dual-task analysis of resource allocation in dysthymia and anhedonia. The Journal of Abnormal Psychology, 103(4), 625-636. doi: 10.1037/0021-843X.103.4.625

Yee, C. M., Deldin, P. J., & Miller, G. A. (1992, May). Early stimulus processing in dysthymia and anhedonia. The Journal of Abnormal Psychology, 101(2), 230-233. doi: 10.1037/0021-843X.101.2.230

B.F. Skinner – Baby in a Box


The baby in a box project performed by B.F. Skinner is testament to power of Applied Behavior Analysis (ABA).  It is remarkable that Aircribs didn’t get picked up and massively produced considering the improvements in the lives of the owners that come as a result of use.  What impressed me the most was the precision of the experiment despite all indications that such an undertaking would surely succumb to the scope of the undertaking.  With some many confounding variables that remain unaccounted for (individual differences between babies, parents, environments) he managed to put together what I consider to be a pretty convincing argument.  How often do people get published without going through the peer-review grinder?

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The Aircrib represents a state of the art solution to one of the most troubling social ills of modern childrearing… quite honestly, I don’t understand why the resistance to this breakthrough?  The correlation between maintaining a regulated environment for infants and health seems to pass the common-sense “eye test.”  What would have made this particular research effort interesting is if baby skinner had a twin that was raised in a more “traditional” fashion.  I don’t mean to diminish the quality of the work that was done, but having a control group would have given him the opportunity to measure net change from baseline.

The frustrating part of the research is that it is suitably difficult to determine which variable is contributing to the behavior change… Skinner is manipulating a lot of variables at once… temperature, light, sound, presence of clothing, etc.  It would have been nice if Skinner had isolated specific variables and given us insight into which specific independent variables had effect on the measured dependant variables… like regular sleep or regular bowel movements.  There is no indication as to whether we can attribute regular bowel movements to the regular feeding schedule (that may or may not have been maintained without the “box”).  It’s problematic, mostly because he’s turning too many knobs at once.

References

Bergen, D. (2008). Human development: Traditional and contemporary theories. Upper Saddle River, NJ: Pearson Prentice Hall.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis (2nd ed.). Upper Saddle River, NJ: Pearson Education.

Founding Mothers & Fathers of Counseling


Abstract

This essay explores three of the most significant founding fathers of psychology, W. Wundt, B. F. Skinner, and S. Freud.  Beyond his well lauded contributions as an experimental psychologist, we explore Wundt’s often neglected contributions to social psychology and the legacy of his Völkerpsychologie.  Skinner is explored both in the context of a behaviorist and as a social philosopher.  Finally, treatment is given to S. Freud and his continued relevance into the 21st Century.

Wilhelm Wundt has been described as “one of the anchors of our collective consciousness; one of the fixed points from which we extrapolate our intellectual position and from which we derive the place of our discipline in the family of the sciences.”  (Kroger & Scheibe, 1990, p. 221)  Through a distinctly social lens, Wundt attempted to explain the theoretical and logical necessities that serve as antecedents to empirical regularities.  Contemporary psychological historians frequently credit Wundt with an early recognition of the social dimensions of cognition, emotion, and behavior.  Wundt suggested that cognition, emotion, and behavior are predisposed to align themselves with the cognition, emotion, and behavior of members of social networks or organizations with whom the individual associates.  As a result… beliefs, attitudes, and behaviors are held or engaged by individuals because they are represented as held by the people with whom we socialize.  (Greenwood, 2003, p. 70)

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There is a curious dichotomy surrounding Wundt, however.  While his contributions as an experimental psychologist are repeatedly lauded, the social theory that guided his experimentation is decidedly missing of influence or impact.  “His concepts of the higher synthesis, the social mind, the reality of folk-psychological actuality, etc., are all seemingly firmly anchored in a monumental philosophical system; but Wundt’s conceptual scheme breaks down when applied.”  (Haeberlin, 1916, p. 301)  “Wundt asked questions about how the relationship between individual consciousness and cultural heritage ought to be conceptualized, how mind is embedded in, and shaped by, culture.”  (Kroger & Scheibe, 1990, p. 227)  One might deduce that Wundt represents the first multicultural social theorist in the field of psychology.  “Wundt’s Völkerpsychologie contributed substantially to the clarification of the role of culture in the time scale of human phylogeny.”  (Wong, 2009, p. 258)  Aside from his obvious contributions to the field of experimental psychology, I have not included him for that reason.  He is foremost on my list due to contributions to the understanding of the collective consciousness, which are only recently being explored and lauded as his most important contributions to the field of social psychology.

Although he was preceded by great minds like John B. Watson, the field of behaviorism was radically changed by the work of B. F. Skinner.  “By the 1970s, B. F. Skinner was woven into the fabric of American culture both as an experimental psychologist and as a prominent social commentator whose radical behaviorist philosophy, and the technology of behavior arising from it, challenged traditional American outlooks on life, liberty, and the pursuit of happiness.”  (Rutherford, 2003, p. 371-372)  Skinner revised the Watson Stimulus-Response (S-R) model of respondent behavior to include a third contingency, known as the Stimulus-Response-Reinforcing Stimulus (S-R-S) or operant behavior model.  “Operant behaviors are not elicited by preceding stimuli but instead are influenced by stimulus changes that have followed the behavior in the past.”  (Cooper, Heron, & Heward, 2007, p. 10)  His “experimental analysis of behavior” has been described as a “revolutionary conceptual breakthrough” that “continues to provide the empirical foundation for behavior analysis today.”  (Cooper et al., 2007, p. 11)

Aside from his contributions as a behaviorist, he was a frequent contributor as a social philosopher.  The sociopolitical Skinner reached its pinnacle following the publication of Beyond Freedom and Dignity in 1971.

The main thesis of the book, pared down to its essentials, was that the freedom or free will that we all cherish is an illusion; our behavior is actually controlled by subtle and complex systems of environmental contingencies. Skinner’s message was that these contingencies must be recognized and deliberately manipulated through a technology of behavior if we are to improve our prospects for long-term cultural and social survival.  He argued that this deliberate control would be possible only if we gave up our antiquated and sentimental belief in “autonomous man.”  (Rutherford, 2003, p. 383-384)

B. F. Skinner set out to prove that we are capable of controlling ourselves. How is this possible?  Manipulate the contingencies under which your behaviors are reinforced by the environment in which you reside.  (Throne, 1992)  “Toward his goal he contributed 19 books; 2 of these, Behavior of Organisms and Verbal Behavior, certainly rank among the most important contributions to human thought.”  (Holland, 1992, p. 665)  Jack Michael introduced the ideas of B.F. Skinner to Montrose M. Wolf before he was exiled to the University of Houston due to the fact that “the department told me that they didn’t need a Skinnerian in the K.U psychology department, and I should find another job somewhere else.”  (Risley, 2005; Michael, 2006)

How can an essay of the founding fathers of counseling come to pass without mention of Sigmund Freud?  Despite the fact that most books that mention both Skinner and Freud tend to focus on differences instead of similarities, it is worth noting that B.F. Skinner cited Freud more often than any other author.  (Overskeid, 2007)  I have intentionally saved Freud for last, not because I want to finish strong, but because I believe the following statement to be true:

The contemporary attitude toward psychological problems that is fueled by a wish (and promise) of symptom relief (by psycho-pharmacologists and behavior therapists) and the reliance on third-party payments (that limit the number of sessions that will be covered), make Freud’s method (that is many times a week and an intense and comprehensive analysis of the interaction between patient and analyst) admittedly, not relevant for the “climate” of the 21st Century.  (Frank, 2008, p. 377)

Despite the hostile climate, it would be difficult to diminish the contribution of S. Freud.  Freud put the unconscious mind on the map.  (Lothane, 2006)  Twemlow and Parens (2006) advance the view that “Freud’s main legacy will be the application of psychoanalysis to community and social problems and issues, rather than in contributions to the treatment of mental illness.”  (Twemlow & Parens, 2006, p. 430)  Despite repeated attempts to move Freud off the couch, he still has a presence there.  “Recent research findings on the process and mechanisms of change within psychoanalytic forms of treatment now provide much needed empirical support for some of the basic tenets of psychoanalytic theory and practice, challenge long-standing notions regarding the link between therapeutic technique and clinical improvement, and suggest that factors once believed to be unique to psychoanalytic psychotherapy might be playing a crucial role in the promotion of change in other therapeutic modalities.”  (Schut & Castonguay, 2001, p. 40)  The latter opinion might suggest that the theories of Freud are not quite ready to be shoved off the couch just yet.

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References

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis (2nd ed.). Upper Saddle River, NJ: Pearson Education.

Frank, G. (2008, Apr). A response to “The relevance of Sigmund Freud for the 21st century.. Psychoanalytic Psychology, 25(2), 375-379. doi: 10.1037/0736-9735.25.2.375

Greenwood, J. D. (2003, Feb). Wundt, Völkerpsychologie, and experimental social psychology. History of Psychology, 6(1), 70-88. doi: 10.1037/1093-4510.6.1.70

Haeberlin, H. K. (1916, July). The theoretical foundations of Wundt’s folk-psychology. Psychological Review, 23(4), 279-302. doi: 10.1037/h0075449

Holland, J. G. (1992, May). B. F. Skinner (1904–1990): Obituary. American Psychologist, 47(5), 665-667. doi: 10.1037/0003-066X.47.5.665

Kroger, R. O., & Scheibe, K. E. (1990, July). A reappraisal of Wundt’s influence on social psychology. Canadian Psychology, 31(3), 220-228. doi: 10.1037/h0078919

Lothane, Z. (2006). Freud’s legacy–is it still with us?. Psychoanalytic Psychology, 23(2), 285-301. doi: 10.1037/0736-9735.23.2.285

Michael, J. (2006). Starting a career in academia. Retrieved June, 20 2010, from http://jackmichael.org/about/index3.html

Overskeid, G. (2007, Sep). Looking for Skinner and finding Freud. American Psychologist, 62(6), 590-595. doi: 10.1037/0003-066X.62.6.590

Risley, T. (2005, Summer). Montrose M. Wolf (1935–2004). J Appl Behav Anal, 38(2), 279–287. doi: 10.1901/jaba.2005.165-04

Rutherford, A. (2003, Nov). Radical behaviorism and psychology’s public: B. F. Skinner in the popular press, 1934–1990. History of Psychology, 3(4), 371-395. doi: 10.1037/1093-4510.3.4.371

Schut, A. J., & Castonguay, L. G. (2001). Reviving Freud’s vision of a psychoanalytic science: Implications for clinical training and education. Psychotherapy: Theory, Research, Practice, Training, 38(1), 40-49. doi: 10.1037/0033-3204.38.1.40

Throne, J. M. (1992, Dec). Understanding Skinner. American Psychologist, 47(12), 1678. doi: 10.1037/0003-066X.47.12.1678

Twemlow, S. W., & Parens, H. (2006). Might Freud’s legacy lie beyond the couch?. Psychoanalytic Psychology, 23(2), 430-451. doi: 10.1037/0736-9735.23.2.430

Wong, W. (2009, Nov). Retracing the footsteps of Wilhelm Wundt: Explorations in the disciplinary frontiers of psychology and in Völkerpsychologie. History of Psychology, 12(4), 229-265. doi: 10.1037/a0017711

Oppositional Defiant Disorder (ODD) | Conduct Disorder (CD) | Disruptive Behavior Disorders


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While Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) are both categorized under the general heading of “Disruptive Behavior Disorders,” there are specific features that allow us to compare and contrast them during diagnosis.  Primary features of ODD include a pattern of negativistic, defiant, noncompliant, and uncooperative behaviors.  Primary features of CD include a pattern of behavior in which the basic rights of others and/or major age-appropriate norms or rules are violated.  The primary feature that distinguishes ODD from CD is the emphasis in CD on the recurrent violation of the rights of others and/or societal norms and rules.   (Netherton, Holmes, & Walker, 1999, p. 118)  The diagnosis (of ODD) is not made if the disturbance in behavior occurs exclusively during the course of a Psychotic or Mood Disorder; or if the criteria are met for Conduct Disorder of Antisocial Personality Disorder (in an individual over age 18 years).  (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2000, p. 100)

Despite our ability to differentiate the diagnoses, current etiological evidence suggests that they do follow a common developmental course.  Genetic, temperamental, family interaction and environmental stress variables have all been implicated in the development of ODD/CD.  (Netherton et al., 1999, p. 122)  In a comprehensive study of gender and its relationship to genetic influence of ODD/ADHD, Derks and associates (2007) concluded that the size of the genetic influences does not depend on the child’s sex, but partly different genes are expressed in boys and girls.  They also found that parent and teacher ratings may be inconsistent because qualitative description depending on the context in which they are observed.  Compensating for that inconsistency, there is no quantitative evidence indicating that ODD/CD is more common in boys than girls.  (Derks, Dolan, Hudziak, Neale, & Boomsma, 2007)

These children often exhibit deficits in social skills, including difficulties developing and maintaining peer relationships.  They are more aggressive, less empathetic, and more deficient in the social-problem-solving skills, and they tend to misperceive the social environment, often incorrectly attributing hostile intentions to others.  (Netherton et al., 1999, p. 119)  Considering these deficiencies are displayed in childhood, I would posit the question; how do they fare as adults?  A recent study utilized data from a 20-year community follow-up study to investigate the extent to which youth irritability (one of the DSM-IV criteria for ODD) is a risk for adult psychiatric disorders.  The results measured irritability in children and found that they could reliably predict depressive disorders and generalized anxiety disorder in same subject adults.  (Stringaris, Cohen, Pine, & Leibenluft, 2009)

A recent study performed by Glantz and associates (2009) focused on early onset mental disorders and their ability predict substance dependence into adulthood.  The study chose to focus on dependence rather than abuse because mental disorders are known to predict the dependence more strongly than abuse.  Glantz and associates inquired about the efficacy mounting mental health treatments in childhood to produce results in substance dependence among adults.  Although the study concluded that “treatment of prior mental disorders would not be a cost-effective way to prevent substance dependence,” they did acknowledge that “prevention of substance dependence might be considered an important secondary outcome of interventions for early-onset mental disorders.”  (Glantz, Anthony, Berglund, & Degenhardt, 2009)  This study serves to emphasize the lifelong benefits we can provide children as our efforts continue to yield dividends into their adult lives.

Ramchand and associates raised the stakes and underscored the possible outcomes of we fail to address ODD/CD in childhood.  They examined outcomes for adolescent offenders, and gave them the opportunity to express how they were faring in young adulthood.  Seven years after court referral to long-term residential group-home care, 12 of our sample of 449 youths were dead before turning 25, almost one third were in prison or jail, close to one half did not have a high-school diploma, two thirds reported ongoing criminal activity, and almost two thirds reported illegal drug use in the previous year (and more than half of those acknowledged the use of hard drugs).  Nine of the 11 known causes of death involved gunshot wounds or murder, highlighting the dangerous conditions to which many delinquents are exposed even after long-term rehabilitative care.  Supplemental analyses provided further evidence of this danger: 60% of the 383 surveyed respondents reported having been shot at with a gun, and 19% reported having suffered a gunshot wound.  (Ramchand, Morral, & Becker, 2009)

Despite our challenges in determining a specific etiology, and subsequently diagnosing ODD/CD, it is clear that there is an unprecedented demand for work within the context of these two pathologies.  Aside from the fact that they are among the most commonly referred for professional help, the stakes couldn’t be higher to resolve these mental health issues in childhood so as to prevent future problems for our clients in the future.  Although current research provides a baseline for analysis, further research is needed to determine the specific effects mental health treatment in children as it relates to the punitive effects it can have leading into adulthood.

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References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

Derks, E., Dolan, C., Hudziak, J., Neale, M., & Boomsma, D. (2007, Jul). Assessment and etiology of attention deficit hyperactivity disorder and oppositional defiant disorder in boys and girls. Behavior Genetics, 37(4), 559-566. doi: 10.1007/s10519-007-9153-4

Glantz, M. D., Anthony, J. C., Berglund, P. A., & Degenhardt, L. (2009, Aug). Mental disorders as risk factors for later substance dependence: estimates of optimal prevention and treatment benefits. Psychological Medicine, 39(8), 1365-1378. doi: 10.1017/S0033291708004510

Netherton, S. D., Holmes, D., & Walker, C. E. (1999). Child and adolescent psychological disorders: A comprehensive textbook. Oxford, NY: Oxford University Press.

Ramchand, R., Morral, A. R., & Becker, K. (2009, May). Seven-year life outcomes of adolescent offenders in los angeles. American Journal of Public Health, 99(5), 863-871. Retrieved from http://ezproxy.bellevue.edu:80/login?url=http://proquest.umi.com.ezproxy.bellevue.edu/pqdweb?did=1683162651&sid=2&Fmt=3&clientId=4683&RQT=309&VName=PQD

Stringaris, A., Cohen, P., Pine,  . S., & Leibenluft, E. (2009, Sep). Adult outcomes of youth irritability: A 20-year prospective community-based study. The American Journal of Psychiatry, 166(9), 1048-1055. doi: 10.1176/appi.ajp.2009.08121849