A factor analytic and psychometric examination of pathology of separation-individuation.

Two studies are described that attempt to determine if standard-scale-reduction techniques could yield a construct-valid diagnostic screen of pathology of separation-individuation for use in nonclinical university settings. In Study 1 (N = 210), a measure of pathology of separation-individuation (PATHSEP) was reduced successfully to a single, internally consistent factor, accounting for 36% of the variance. In Study 2 (N = 304), these items also coalesced around a single factor, accounting for 35% of the variance. Study 2 also showed that PATHSEP is correlated moderately and positively with indices of insecure attachment, with the Center for Epidemiological Studies-Depression Scale, and with indices of psychiatric symptomatology (Hopkins Symptom Checklist). PATHSEP also was associated with a poorer profile of adjustment to college. Males reported more pathology of separation-individuation than did females. Evidence supports the construct validity of a shortened version of PATHSEP. Directions for future research are noted.

Pathological attachment and attachment style in late adolescence.

Attachment theory is frequently invoked to account for patterns of adaptation within relationships. West and Sheldon derived a measure of dysfunctional adult attachment from Bowlby's theory. Four patterns are identified: compulsive self-reliance; caregiving; care-seeking; and angry withdrawal. The aim of this study was to assess the psychometric properties of this promising measure, and to assess its ability to predict symptomatology relative to measures of attachment style. Participants included 209 late adolescents who were involved in committed relationships. They responded to categorical and continuous measures of attachment style and various measures of symptomatology and college adjustment. The four dimensions of pathological attachment showed strong internal consistency and few gender differences. Compulsive care-seeking, angry withdrawal and compulsive self-reliance were particularly strong predictors of psychiatric symptomatology and insecure attachment style. Attachment pathology and insecure attachment style predicted symptomatology similarly, though variations were evident depending on how style was assessed. This study is the first to provide evidence of convergent, discriminant and predictive validity for this measure. Directions for future research are noted.

Comparative efficacy and tolerability of low-dose pravastatin versus lovastatin in patients with hypercholesterolemia.

BACKGROUND: The HMG CoA reductase inhibitors have quickly become the most widely prescribed family of agents for the treatment of patients with elevated low-density lipoprotein (LDL) cholesterol. The incidence of side effects with these agents increases as the dose increases within the recommended dosage range. A lower dosage presumably would have a lower incidence of adverse effects. In addition, lower doses should translate into reduced drug costs. METHODS AND RESULTS: We compared the efficacy of 10 mg of pravastatin and 10 mg of lovastatin in a randomized, crossover design trial among 30 patients with hypercholesterolemia. At baseline, their total cholesterol and LDL cholesterol levels were 249.0 +/- 27.3 and 185.1 +/- 25.5 mg/dL. After 4 weeks of treatment with lovastatin, the total cholesterol and LDL cholesterol levels fell to 202.8 +/- 29.6 and 141.0 +/- 25.3 mg/dL, decreases of 19% and 24%, respectively. Four weeks of pravastatin treatment resulted in levels of 212.6 +/- 30.8 and 150.5 +/- 25.5 mg/dL, or 15% and 19%, respectively. CONCLUSIONS: There were highly significant changes in total cholesterol and LDL cholesterol levels with each agent and no differences in effect between the 2 agents. In 13 (43%) of the 30 patients, LDL levels were reduced to

Usefulness and tolerability of hirulog, a direct thrombin-inhibitor, in unstable angina pectoris.

In an open-label pilot study of 20 patients with unstable angina (Braunwald class I-IIIB), hirulog was administered as a continuous intravenous infusion for 5 days in a dose of 0.2 mg/kg/hour to produce an activated partial thromboplastin time of approximately 200% of control. The primary end points of the study were: death, development of a transmural myocardial infarction, and intractable angina needing interventions such as an intraaortic balloon pump insertion, angioplasty and surgery. The secondary end points were the presence of an intracoronary thrombus detected on angiography and hemorrhagic complications during therapy. There was no death or transmural infarction in this study cohort; however, 1 patient developed intractable angina. Intracoronary thrombus was documented in 2 patients. Infusion of hirulog resulted in a steady prolongation of the activated partial thromboplastin time without any hemorrhagic or other adverse effect. Hirulog appears to be an effective antithrombotic agent that is tolerated well and may have advantages over heparin in the management of patients with unstable angina.

Toward an integrated theory of adolescent ego development: the "new look" at adolescent egocentrism.

The theoretical and empirical status of the traditional theory of adolescent egocentrism is examined and found wanting. An alternative theory is reviewed that reconceptualizes the ideational patterns of "egocentrism" as adaptational and coping functions of ego development, avoids anomalies found in the traditional theory, and promises a progressive research program.

Changes in septal regional ejection fraction early and late following coronary artery bypass grafting in patients without postoperative myocardial infarction.

Changes in regional ejection fraction (rEF) of the interventricular septum following coronary artery bypass graft (CABG) surgery were examined using first-pass radionuclide ventriculography (RNVG) in patients without objective evidence of postoperative myocardial infarction (MI). One hundred and one patients had pre- (mean 6.3 days) and early postoperative (mean 8.7 days) RNVGs, and 60 of these patients had follow-up studies at 14-39 months (mean 27 months) postsurgery. Early post-CABG, mean rEF in the proximal septum was unchanged from the preoperative value (35.3%), with almost equal numbers of patients showing increased (n = 36), unchanged (n = 33) or decreased (n = 32) rEFs. In the distal septum, mean rEF increased from 47.1 to 50.7%, with more than twice as many patients having increased (n = 44) as decreased (n = 20) rEF. At late follow-up, proximal septum rEF in individual patients tended to revert to the presurgery baseline, with 72% (13/18) of regions with early decrease improved and 61% (14/23) of those with early improvement decreased. In the distal septum, rEF was less than early post-CABG in 76% (19/25) of patients with early improvement, while being improved in 27% (3/11) of those with early decrease in rEF. In the absence of MI, changes in rEF in the proximal septum early post-CABG tend to resolve over time. While global changes in cardiac systolic motion are the probable cause of many new post-CABG septal abnormalities, persistent septal dysfunction probably reflects effects of permanent damage as a result of the operative procedure.

Significance of changes in resting left ventricular ejection fraction after coronary artery bypass grafting.

The prognostic significance of changes in resting left ventricular ejection fraction was examined in 102 patients who underwent successful coronary artery bypass grafting. Between preoperative and early postoperative radionuclide ventriculography, mean resting left ventricular ejection fraction improved from 47.2% to 53.9% (p less than 0.01). Left ventricular ejection fraction increased by 5% or greater in 64 patients (63%), remained unchanged (within 4%) in 31 (30%), and decreased by at least 5% in 7 (7%). During 14 to 39 months (mean 27 months) of clinical follow-up, patients with normal preoperative left ventricular ejection fraction had a lower prevalence of recurrent angina, congestive heart failure, and mortality resulting from cardiovascular disease. Cardiovascular morbidity and mortality occurred with equal frequency for patients who did and did not show early postoperative improvement in left ventricular ejection fraction (36% versus 39%). Among 69 patients who had a third radionuclide ventriculography at late follow-up, left ventricular ejection fraction was less than the early postoperative value in 69% and less than the preoperative result in 36%. Patients with early postoperative improvement in left ventricular ejection fraction were more likely to retain resting left ventricular contractile function, at least at the preoperative level (71% versus 46%).

Rapprochement in late adolescent separation-individuation: a structural equations approach.

Adolescents' movements toward individuation are believed to be supported by secure attachments to parents. Previous research has found that individuation could be operationalized with indices of connectedness and separateness, but the relationship between these variables has not been fully explored. The present study demonstrated that attachment and differentiation variables were positively related using different and multiple operationalization procedures. Furthermore, a more comprehensive model of adolescent ego development was proposed which included parental control, individuation, and ego identity constructs. Results suggest parental control restricts successful individuation, but that adjustment on individuation indices predicts advanced identity development.

Do economic conditions influence how theorists view adolescents?

Eighty-nine articles in thePedagogical Seminary and theJournal of Genetic Psychology appearing during two economic depressions and the two world wars were analyzed for their adolescent ideologies. A systematic, ideological bias in the content of these articles was found to be statistically significant. In times of economic depression theories of adolescence emerge that portray teenagers as immature, psychologically unstable, and in need of prolonged participation in the educational system. During wartime, the psychological competence of youth is emphasized and the duration of education is recommended to be more retracted than in depression. The objective, scientific nature of theory building is questioned and discussed.

A clinical model for enhancing adolescent ego identity.

A model of identity formation based on the cognitive developmental stages of social perspective-taking is described. The model assumes that identity can be achieved through cognitive strategies of considering the self in relation to one friend, one's family, the peer group, and society. Two studies were undertaken to test the model. In Study 1, 28 college students participated in a two week program in which the experimental students were asked to take the perspective of each social entity above and then to consider how the self was like and unlike these. The experimentals gained more than the controls on the identity subscale of Rasmussen's EIS. Fifty-nine college students participated in Study 2 which used a more sensitive discrepancy score measure on a revised identity scale. Discrepancy scores in an analysis of covariance indicated that the experimentals were higher than the controls at post-test and at a one month follow-up.

Moral judgment, personality, and attitude to authority in early and late adolescence.

The purpose of this study was to examine the personological features of moral judgment and to determine the extent to which principled moral reasoning is politically biased. We also attempted to determine the relation between moral judgment and attitude to authority and the developmental patterning of attitude to authority from early to late adolescence. Attitude to authority was assessed in terms of specific sources of authority (mother, father, police, government) and by the Attitude to Authority Scale, which assesses attitudes along the liberal-conservative political continuum. The conservative personality syndrome was assessed by the Conservatism Scale, while moral judgment was assessed by the Defining Issues Test. The results indicated that moral reasoning is unrelated to attitudes to specific sources of authority and negatively related to political conservatism and to conservative personality features. Attitudes toward sources of personal authority (mother, father) were more similar than attitudes toward impersonal authority (police, government), though attitudes toward Father were related to attitudes toward Government and Police. Age trends showed that younger adolescents are more politically conservative and more conforming to authority than older adolescents. Results are discussed in terms of the political and personological features of Kohlbergian moral judgment and in light of recent research on the transformation of adolescent-parent relations in adolescence.

Coordination of perspectives: the importance of stimulus dimensionality.

An evaluation of the importance of the dimensionality of the spatial stimuli in a coordination of perspectives task is presented. It was hypothesized that using three-dimensional comparison stimuli and two-dimensional choice stimuli might result in the tapping of different cognitive skills than when both sets of stimuli are two-dimensional. Children (N = 96) aged between 5 and 12 years as well as college students (n = 24) were tested with either two-dimensional or three-dimensional comparison stimuli and two-dimensional choice stimuli. The lowest error rates for all except the kindergarten groups were found in the two-dimensional condition. It was concluded that the three-dimensional condition may have created a cognitive overload that lessened the likelihood of making correct perspective-taking judgments.

Belief discrepancy reasoning in the elderly.

The development of belief discrepancy reasoning, or how people evaluate disagreeing others, was examined with forty-four college and elderly respondents. Dogmatism and IQ measures were also administered. The results showed that the elderly were significantly lower in belief discrepancy reasoning and higher in dogmatism than the college sample, despite statistically greater IQ for the former sample and controls for education. For belief discrepancy, the elderly sample did not evidence intolerance, but rather relativism and open-mindedness toward disagreeing others. Implications for the construct validation of belief discrepancy and senescent intolerance are discussed.

Adolescent egocentrism-sociocentrism and self-consciousness.

A standardized and objectively scored scale of adolescent egocentrism-sociocentrism (AES) and a self-consciousness scale were given to 44 subjects each in the sixth, eighth, tenth, and twelfth grades and college. The AES assesses three components of egocentrism including the personal fable, the imaginary audience, and general self-focuses, as well as sociocentrism and nonsocial subscales. As predicted, the personal fable and imaginary audience declined with age. The self-focus subscale showed a curvilinear relationship with age, while, again as predicted, sociocentrism increased and nonsocial focuses declined. Adolescent egocentrism, as expected, correlated positively with self-consciousness even with age controlled. Implications for the theories of egocentrism and sociocentrism in the adolescent years are discussed.

Parental influences on the development of adolescent autonomy and identity.

Two studies were undertaken to examine parental influences on autonomy and identity development. In Study 1, 262 adolescents in seventh and eleventh grades were given Kurtines's autonomy measure, Simmons's identity measure, and Elder's questions regarding the adolescents' perceptions of their parents' autocratic, democratic, or permissive parenting styles. Study 2 was a replication with 168 subjects. Across both studies it was found that sex-role socialization is more influential for automony development than is either level of parental power or age. Both age and father's use of democracy were the most influential variables on identity development.