Advances in Psychology Research, Vol. 78

ADVANCES IN PSYCHOLOGY RESEARCH

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ADVANCES IN PSYCHOLOGY RESEARCH

ADVANCES IN PSYCHOLOGY RESEARCH. VOLUME 78

ALEXANDRA M. COLUMBUS EDITOR

Nova Science Publishers, Inc. New York

Copyright © 2011 by Nova Science Publishers, Inc. All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers‘ use of, or reliance upon, this material. Any parts of this book based on government reports are so indicated and copyright is claimed for those parts to the extent applicable to compilations of such works. Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS. Additional color graphics may be available in the e-book version of this book. LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA

ISSN: 1532-723X ISBN: 978-1-61470-789-9 (eBook)

Published by Nova Science Publishers, Inc. † New York

CONTENTS Preface Chapter 1

Chapter 2

vii Treating a Clinical Sample of Highly Gifted Underachievers with Music Therapy an Exploratory Study Lony Schiltz-Ludwig

1

Marital Patterns and Psychological Adjustment among Immigrants from Ethiopia and FSU Gila Markovitzky and Hadas Doron

17

Chapter 3

Memory for Object Location: Encoding Strategies in Children Annalisa Lucidi, Clelia Rossi-Arnaud, Laura Pieroni and Vincenzo Cestari

Chapter 4

The Role of Contextual Cues and Logical Training in Differentiating Conditional from Biconditional Statements in Inference Task Olimpia Matarazzo and Ivana Baldassarre

Chapter 5

Empathy: Reflexions on a Concept C. Boulanger and C. Lançon

Chapter 6

The Context of Domestic Violence: Social and Contextual Factors Associated with Partner Violence against Women Enrique Gracia

37

57 81

97

Chapter 7

Extraversion and Suicidal Behavior David Lester

113

Chapter 8

Alcohol Related Experiences – The Good, the Bad and the Ugly Karin Helmersson Bergmark

123

Chapter 9

Physiological Assessment of Forgiveness, Grudges, and Revenge: Theories, Research Methods, and Implications Everett L. Worthington and Goli Sotoohi

135

vi Chapter 10

Chapter 11

Chapter 12

Chapter 13

Chapter 14 Index

Contents The Effect of Sexually Explicit Rap Music on Sexual Attitudes, Norms, and Behaviors Lucrezia M. Alcorn and Anthony F. Lemieux

155

Treatments for Cystic Fibrosis: The Role of Adherence, Importance and Burden Lynn B. Myers

185

The Relationship between Adolescents‘ Music Video Viewing and Risky Driving: A Two Wave Panel Survey Kathleen Beullens, Keith Roe and Jan Van den Bulck

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Extraversion and the Autonomic Nervous System: An Alternative to Eysenck‘s Theory David Lester

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Extraversion and Interviewing for Employment Joshua Fogel and Mayer Schneider

223 241

PREFACE This continuing series presents original research results on the leading edge of psychology. Each article has been carefully selected in an attempt to present substantial results across a broad spectrum. This book reviews research on the marital patterns and psychological adjustment among immigrants; treating a clinical sample of highly gifted underachievers with music therapy; memory for object location and encoding strategies in children; the context of domestic violence; extraversion and suicidal behavior and a psychological assessment of forgiveness, grudges and revenge. Chapter 1 - Published literature as well as personal observation show that gifted adolescents suffering from severe intellectual inhibition may generally not be helped by pedagogical means alone. This special syndrome results from a deep disturbance of the affective and drive functioning and may be treated by psychodynamic music therapy in individual sessions, combined with psycho-pedagogical applications of music in group sessions. Data drawn from an exploratory study, based on a mixed research methodology, combined a psychometric scale, a projective test and an observational frame for the therapeutic sessions and showed changes induced in the cognitive, emotional and conduct variables by music therapy treatment. We compared two clinical subgroups of students treated by the above described psychotherapeutic approach (N = 20, N = 23) to a control group (N = 43) of students who had only pedagogical measures. Case material helps to illustrate the psychotherapeutic process. The discussion stresses the opportunity to offer music psychotherapy to gifted underachievers as a means of tertiary prevention. Chapter 2 - The research examines the contribution of marital patterns (role division, decision making, and marital quality) to the psychological adjustment (psychological wellbeing, emotional state, and satisfaction) of new immigrants in Israel, according to country of origin and gender. Self reported questionnaires were filled by 236 new immigrants: 112 from the FSU and 124 from Ethiopia, who came to Israel between 1990 and 2001. The findings indicate that the most important predictor of adjustment was country of origin: immigrants from Ethiopia displayed a higher level of psychological adjustment relative to those from the CIS. Among women and men from Ethiopia, level of egalitarianism in role division and decision-making was found to correlate significantly with psychological responses. In comparison, the immigrants from the FSU reported more equality in the family, but this was

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not correlated with psychological adjustment. Of all the subgroups, the Ethiopian women demonstrated the highest level of adjustment. Chapter 3 - A number of studies suggest that two separate spatial processes may be involved in short-term object location memory. First, one needs to remember the precise position occupied in a given space (positional encoding per se), then one has to decide which object was at which position (object-to-position assignment). The aim of the present study was to investigate the way children of different ages code for object locations referring to the theoretical framework of working memory. In particular, the main questions addressed in this chapter were: a) when children have to remember the location of objects do they recode visual material verbally? b) Is this process age-dependent? A modified version of Postma and De Haan‘s (1996) object location task was used and three relocation conditions were examined. In the first condition, subjects had to remember spatial positions in a twodimensional matrix. In the second task, object-location associations were examined and previously occupied positions were signalled so that children only had to remember object-toposition assignment (i.e., ―what was where‖) while in the third condition, the ―combined‖ condition, children had to perform both positional reconstruction and object-to-position assignment. In order to examine which encoding strategy children aged 5 and 11 years spontaneously use in temporary memory for object location, we interfered with the activity of the phonological loop and the visuo-spatial sketch pad adopting a dual task methodology. In the second experiment, to further investigate the object-to-location binding, the visual and verbal characteristics of the stimuli used in the test were manipulated and children of the same two age groups were tested. Our results show that children of age 11, like adults, use mainly a phonological recoding for pictorial stimuli while younger children show a ―mixed strategy‖ based both on visual and phonological information. Chapter 4 - In two studies we examined the role of contextual cues and logical training in differentiating conditional from biconditional statements (i.e. the statements of the form ―if p then q‖ from the statements of the form ―if and only if p then q‖) in deductive inference task (i.e. establishing which conclusions necessarily follow from syllogisms whose major premise is formed by a conditional clause). We assume that the well-documented tendency to interpret conditionals as biconditionals is due not only to pragmatic factors, such as a large amount of literature posits, but also to cognitive factors: it is much easier to understand a symmetrical (biconditional) relation between two states of affairs rather than an asymmetrical (conditional) one. We expected that this tendency would be inhibited not only by the presence of contextual cues - as alternative antecedents (e.g. c, m, r) showing that the consequent (q) can be implied by other states of affairs besides the one (p) presented in conditional clause but also by a ―logical‖ training, that is, by elucidating the formal difference between conditionals and biconditionals. On the contrary, we expected that the statement content (abstract vs. thematic) did not affect the interpretation of conditionals as biconditionals. In the first study, three hundred twenty participants performed in counterbalanced order a conditional and a biconditional inference task introduced by a very short scenario. The experimental conditions varied in function of the following variables: discrimination between conditionals and biconditionals (embedded in the scenarios vs. inferred by participants after reading the scenarios), information facilitating the appropriate interpretation of the statements (present vs. absent), content (abstract vs. thematic). The results revealed that (1) biconditional syllogisms were easily solved in any experimental conditions; (2) conditionals generated a large amount of patterns of inferences, among which the most frequent was the biconditional

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one when facilitating information (i.e. alternative antecedents) was absent; on the contrary, when this information was presented, the conditional pattern of inferences was the most frequent one and the biconditional one decreased dramatically. In the second study, two hundred participants performed a conditional and a biconditional task introduced merely by the respective statements. The manipulated variables were: logical training (present vs. absent) and content (abstract vs. thematic). The results were analogous to those of the first study. On the whole, these experiments corroborate the idea that (1) biconditional interpretation of conditional statements - reconstructed from the participants‘ patterns of inferences – is due both to cognitive and pragmatic factors and that (2) reasoners are able to rectify this misinterpretation both in presence of contextual cues and of logical training. The theoretical implications of these results are discussed. Chapter 5 - Under the influence of Scottish philosophy the concept of empathy changed, it is still shaky and still defined by many currents of thought. It is different from sympathy (emotional contagion). Empathy is the capacity to put oneself in another person‘s position to understand its feelings or to imagine its mental representation. So empathy shows itself in different phenomena such as projection, identification and altruism. Husserl, in phenomenology, regards empathy as the decisive phenomenon from which inter-subjectivity emerges to elaborate a common world. Indeed, he renewed the comprehension of empathy and anticipated the development of neurosciences. Depraz, following Varela, shows primacy granted to others is embodied in the personal practice of compassion. Chapter 6 - Available data indicates a high prevalence of partner violence against women in our societies. The World Health Organization in its ―World Report on Violence and Health‖ offers a summary of 48 population-based surveys from around the world in which between 10% to 69% of women reported being physically assaulted by an intimate partner at some point in their lives. Different surveys in western countries estimate that about one in four women experience intimate partner violence at some point in their lives. For example, an analysis of 10 prevalence studies of partner violence against women in European countries also concluded that about 25% of women suffered domestic violence during their lifetime, and between 6% to 10% of women suffered violence in a given year. Despite the high prevalence of partner violence against women, however, many instances of partner violence against women are never reported to legal authorities. The ―Report of the American Psychological Association Presidential Task Force on Violence and the Family‖ (1996) concluded that all indications are that family violence and abuse are significantly under-reported at all levels of society, and estimates that female victims of domestic violence are 6 times less likely to report the crime to law enforcement officials than female victims of stranger violence. For example, in a national crime survey sponsored by the Bureau of Justice Statistics, when an injury was inflicted upon a woman by her intimate partner, she reported the violence to the police only 55% of the time and she was even less likely to report the violence when she did not sustain injury. Chapter 7 - There has been a great deal of research on the relationship between suicidality and extraversion/introversion, but no systematic review of this research has yet appeared. The present paper reviews this body of research in order to see if there are any consistent trends and then suggests future directions for research into this issue. Chapter 8 - When asked about how they feel about alcohol and drinking, Swedes have tended to display negative and ambivalent attitudes. For this study reports of alcohol related

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experiences were used for the study of an eventual new emerging drinking culture. The aim was to analyse frequency distributions and patterns for explanatory variables, for different groups of alcohol related experiences. As drinking levels have increased in Sweden during the last decades, on the one hand we expected to find an increase of reports of alcohol related experiences. On the other hand, we could well expect less such experiences in a time when alcohol and drinking tends to be put into an every-day practise. Experiences from the good sides of drinking were more often reported, compared to the bad sides. A factor analysis resulted in four dimensions measuring aspects of pleasure (1), bad sides of drinking (2), ugly sides of drinking (3) and one on sexuality/aggression (4). Logistic regression analyses were used to see if these dimensions have unique characteristics that could be revealed with predictor variables. No clear such patterns were, however, found, even though some results indicate the upsurge of more pleasure-driven drinking styles. Chapter 9 - Forgiveness is a prosocial intrapersonal response to a transgression experienced in interpersonal context. Theorizing about forgiveness makes a myriad of distinctions, differentiating between decisions to forgive and emotional experience, and among emotions, motivations, cognition, and behavioral intensions. Research to date has not considered the conceptual advances in understanding forgiveness. Research has linked unforgiveness with poor health outcomes, but relatively little attention has been given to the physiological mechanisms that mediate the forgiveness-health connection. In the present chapter, we locate 19 empirical articles seeking to explicate the physiological processes involved in forgiving. We review the articles within an emphasis on theory. We seek to apply stress-and-coping, self-control, and broaden-and-build theories to uncovering potential questions that researchers could use to make a research agenda. Not surprisingly, in this burgeoning new field of study—forgiveness studies—more and more sophisticated research is needed. Chapter 10 - In this chapter, we review the recent literature on music and social influence, with a particular emphasis on the influence of music on sexual attitudes and behaviors. We also present an experimental study that provided an empirical investigation of the relationships between sexually explicit rap music and sexual attitudes, perceived norms, and behaviors. Results indicated no significant short-term effects of rap music on the expression of sexual attitudes or perception of norms. However, we found marginal support for sexually explicit rap in priming condom-related sexual behavior. Chapter 11 - Introduction. Cystic fibrosis (CF) is the most frequent lethal genetic disease of childhood. Nowadays due to improvements in treatment most people with CF can lead fairly normal lives. To achieve this people with CF need daily treatment consisting of various medications, chest physical therapy and pancreatic enzymes as well as paying attention to dietary needs. There has been a gradual but significant improvement in the life expectancy of CF patients due to advances in the efficacy of treatment. So what was considered a disease of childhood has now also become a chronic condition of adulthood. The current study investigated factors associated with treatments in adults with CF. Method. Participants were 563 adults with CF recruited from the UK‘s Cystic Fibrosis Trust mailing list. Patients rated adherence to each treatment and reported any other treatments e.g. complementary therapies. Other measures included importance of each treatment, burden of each treatments and demographic information.

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Results. The mean number of current treatments was high (10.49). Adherence varied with different behaviors, with the highest adherence for enzymes, insulin and antibiotics and lowest for physical therapy, exercise, overnight feeding and dietary supplements. Statistical analyses were correlations and Analysis of Variance. Adherence was correlated with importance and burden for the majority of treatments, meaning high adherence was related to high importance and low burden. Treatments varied in importance, with insulin and antibiotics rated the highest and dietary treatments the lowest. For burden, treatments which are administered by injection or are time consuming were rated the highest e.g. insulin, nebulized medications, with easily administered treatments rated the lowest e.g. oral steroids, enzymes. For most treatments importance and burden were positively correlated, meaning that the more important the treatment the least troublesome it was rated. Nearly a quarter reported using some form of complimentary therapy with more females reporting such use. However, over 50% said that CF never or only occasionally interfered with their enjoyment of life. There were few gender differences, but some age differences. Conclusion .Results from this study provide an insight into treatments for adults with CF, indicating a complex picture of adherence and indicate that adherence, importance and burden are usually related. Chapter 12 - Purpose: Music video viewing is a very popular pastime among adolescents. The public criticism of music videos has encouraged researchers to examine the effects of music video exposure. Although an association between music video exposure and several health risk behaviors (e.g. drinking) has been found, the relationship between music video viewing and risky driving has remained largely unexamined. In this study the relationship between adolescents‘ music video viewing and risky driving such as driving after consuming alcohol and joy riding is explored. Methods: Participants were 354 adolescent males and females who participated in a panel study (2-year interval). Respondents were 17 or 18 years old during the first wave of data collection and did not have their driver‘s license yet. They completed a questionnaire on music video viewing, sensation seeking, aggression, attitudes towards joy riding and driving after the consumption of alcohol, and the intention to perform these behaviors in the future. Two years later the respondents had obtained their driver‘s license and were questioned on their actual risky driving behavior. The relationships between these constructs were analyzed using structural equation models. Results: The results indicate that music video viewing is indirectly associated with joy riding and driving after the consumption of alcohol through the attitudes towards these behaviors and the intention to perform these behaviors in the future. More music video viewing resulted in a more positive attitude towards risky driving, even after controlling for sensation seeking and aggression. These attitudes are positively related to the intention to perform these reckless behaviors in the future and these intentions are, in turn, a good predictor of the actual risky driving behavior two years later. Conclusions: The results indicate that music video viewing during adolescence is an important and significant predictor of risky driving two years later. Chapter 13 - An hypothesis is proposed that balance in the autonomic nervous system is the physiological basis for extraversion-introversion, with extraverts as S-types and introverts as P-types. Chapter 14 - The personality trait of extraversion is often used as a factor for understanding and predicting successful job applicants. This article reviews the empirical

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research from scholarly journals on what is known about extraversion and job interviews. The search terms of ―(extraversion) AND (employment or job) AND (interview)‖ were searched in the databases of Medline, PsycINFO, CINAHL, and Business Source Premier from the year of 1998 to 2008. The article reviews 21 articles. Almost all of the reviewed articles indicate that extraversion is associated with positive outcomes for employment interviews, promotion interviews, and also better job performance. Individuals that evaluate applicants for new jobs or consider current employees for promotion should assess extraversion as part of this initial hiring or promotion process. Versions of these chapters were also published in International Journal of Psychology Research, Volume 2, Numbers 1-4, edited by Alexandra M. Columbus, published by Nova Science Publishers, Inc. They were submitted for appropriate modifications in an effort to encourage wider dissemination of research.

Advances in Psychology Research. Volume 78 Ed: Alexandra M. Columbus

ISBN: 978-1-61209-442-7 © 2011 Nova Science Publishers, Inc.

Chapter 1

TREATING A CLINICAL SAMPLE OF HIGHLY GIFTED UNDERACHIEVERS WITH MUSIC THERAPY AN EXPLORATORY STUDY Lony Schiltz-Ludwig Fondation François-Elisabeth, Luxembourg

ABSTRACT Published literature as well as personal observation show that gifted adolescents suffering from severe intellectual inhibition may generally not be helped by pedagogical means alone. This special syndrome results from a deep disturbance of the affective and drive functioning and may be treated by psychodynamic music therapy in individual sessions, combined with psycho-pedagogical applications of music in group sessions. Data drawn from an exploratory study, based on a mixed research methodology, combined a psychometric scale, a projective test and an observational frame for the therapeutic sessions and showed changes induced in the cognitive, emotional and conduct variables by music therapy treatment. We compared two clinical subgroups of students treated by the above described psychotherapeutic approach (N = 20, N = 23) to a control group (N = 43) of students who had only pedagogical measures. Case material helps to illustrate the psychotherapeutic process. The discussion stresses the opportunity to offer music psychotherapy to gifted underachievers as a means of tertiary prevention.

Keywords: emotional instability, intellectual ability, music psychotherapy, over adaptation, quasi experimental design, underachievement.



Schiltz Lony, Ph.D. psychologist, music therapist, doctor in clinical psychology, HDR. Head of Laboratory in Clinical Psychology, Health Psychology and Arts therapies, Fondation François-Elisabeth, Luxembourg Head of studies of the postgraduate curriculum in arts therapies (DESS en Art thérapie, Université du Luxembourg) Professional address: Fondation François-Elisabeth, Luxembourg. Hôpital Kirchberg. 9, rue Edward Steichen. L-2540 Luxembourg. e-mail: [email protected] Mailing address : 10, rue Gabriel de Marie. L-2131 Luxembourg. Tel 00352 433668.

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INTRODUCTION Recent research results (Terrassier, 1999; Schiltz, 2002a;b; Catheline, 2003; Schiltz, Desor, Lorang and Schiltz, 2005) show that one third of students with an I.Q. of 130 or more are suffering from school failure in secondary school. Among these gifted underachievers 20 to 25% present dysfunction on the cognitive, volitional and emotional level and meet the psychiatric diagnosis of ―conduct disorders‖ or ―adjustment disorders‖ (Schiltz, 1995; 2002b; 2004b). Our personal clinical experience of more than 30 years with these pupils has shown that they need a specific kind of integrated psychotherapy to overcome their difficulties. The outcome of these interventions, as well as the therapeutic process itself, was investigated by several studies (Schiltz, 2004a;b). The psycho therapeutic sessions were offered in a regular public school.

1. THEORETICAL BACKGROUND Psychological indicators for giftedness are, among others, the quickness of thought and understanding and great emotional sensitivity that begin in the first years of life (Renzulli, 1978; Grubar, Duyme and Cote, 1997; Terrassier, 1999; Terrassier and Gouillou, 2000). These children may react impatiently to other persons who need longer explanations and may be rejected by others. While most of them develop quite positively (De Groot, 1974; Webb, 1993; Vichot-Chalan, 1997) and show their intellectual creativity in many realms, about one third of them are confronted with various psychological problems (Adda, 1999; Sudres, Brandibas and Fourasté, 2004). If a gifted adolescent fails at school, a thorough psychological assessment is necessary to uncover the origin of his or her difficulties. A retrospective study over 10 years, done in the psychology service of a secondary school, showed that, with a total group of 185 gifted underachievers, there was a diagnosis of personality disorder for 20 %, that 35% presented adjustment disorders, i.e. depressive reactions to recent events (for example emigration, the death of a loved one or a serious somatic disease), and that 45% of them presented minor conduct problems linked to identity issues (Schiltz, 2002c). The inhibition we encounter among these students meets the criteria of Marcelli and Braconnier (1999) who distinguished three areas of inhibition: (a) intellectual inhibition, also called ―neurotic dullness―, (b) inhibition of fantasy, and (c) relational inhibition or timidity. It is important to note that intellectual inhibition impacts school results exclusively and not the results of the intelligence test. The pupils belonging to our experimental group had an I.Q. of 128 or higher (Cvalue ≥ 9 at the LPS, Horn, 1962), and yet their intelligence was judged mediocre by their teachers, their parents and often by themselves as well. Let us stress that according to the European norms, an IQ. of 128 is the conventionally accepted inferior limit for the definition of gifted pupils.

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2. METHODOLOGY OF TREATMENT These gifted underachievers were treated by a combination of music psychotherapy in individual sessions and supportive music therapy combined with pedagogical measures in group sessions. The weekly one-hour sessions of individual music psychotherapy followed the restructuring method we had developed for adolescents suffering from borderline personality disorder (Schiltz, 2003a; 2004d; 2005a), combining free musical improvisation with the writing of stories under musical induction. This procedure, which functioned like a projective test, with sound as sensory stimulus (Schiltz, 2002a; 2005b), was followed up by verbal elaboration. The general design of an individual session included first a free verbal exchange about recent events and actual feelings, then a musical improvisation with ethnical instruments chosen by the student himself, then the creation of a literary text while listening to music, followed up by a second improvisation stage and a verbal elaboration based on free associations to the musical and literary production. These sessions produced a mutual enrichment of the musical and literary production; the themes of the stories were used for musical improvisation, which led to a freer floating of images and feelings and to a more personal implication in the stories written afterwards. The model of thought used here is that of the Psychology of Self of Kohut (1991) who stressed the importance of mature narcissism and postulated that the development lines for the narcissistic and objectal needs are distinct one from the other. The main goal is to resume the blocked process of subjectivation. (Cahn, 1998). The method consists in reacting to the student's musical propositions with musical responses, by reassuring him, or respectively confronting him, before moving on to verbalisation. In this process we are attentive to the manifestations of the unconscious, to any transference or counter-transference, but we leave it up to the client to discover the sense of his behaviour, proposing an interpretation in exceptional cases only. Fragments of the past eventually emerge and are elaborated upon by means of imagination, artistic production and symbolization. The therapeutic process becomes a quest to find the meaning of one's personal history. During the music therapy sessions, repressed fantasies are slowly released, imagination becomes more fertile, and students produce stories more authentically, corresponding to their intimate needs. During the process of verbal elaboration, free association to the literary production corrects both negative attitudes about oneself and dysfunctional cognitive schemata (Cottraux, 2001). The adolescents also participated in weekly two-hour group sessions based on free musical improvisation at the level of the whole group or of subgroups like duos, trios, etc. (Lecourt, 2002), combined with classical concentration and memorization training and with verbal therapeutic interventions based on group dynamics. The concentration exercises were derived from relaxation techniques, proposed in the cognitive perspective, like respiratory control, muscular release, focusing of attention, visualization (Servan, 2007). The memorization training was based on elements drawn from the school context, like foreign language vocabulary, poems, mathematical and chemical formulas, geographical maps. The goal consisted in reinforcing learning skills, motivation, self-esteem and assertiveness in the participants (Schiltz and al., 2005). The effects of both therapy situations were complementary.

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Thus we could call this approach eclectic or cognitive-psychodynamic. (Chambon and Marie-Cardine, 1994)

3. METHODOLOGY OF EVALUATION The effectiveness of music psychotherapy was assessed by using a methodology which is both quantitative and qualitative (Schiltz, 2003b), and on the basis of a quasi-experimental design using a control group (Raulin and Graziano, 1995). In accordance with ethical principles, all the adolescents who asked for treatment were accepted in the clinical group. It consisted of 43 twelve to fourteen-year-old adolescents. They were selected according to the criterion: general performance ≥ 9th percentile at the LPS (corresponding to an IQ ≥ 128). The LPS (Leistungsprüfsystem, Assessment of Cognitive Achievement, Horn, 1962) is a broadly used test in German clinical and scholastic orientation centres working with adolescents. It is based on Thurston‘s Primary Mental Abilities and combines measures of convergent and divergent thinking. Its norms, differentiated according to age and gender, are based on N=10 000 subjects. The pupils belonging to our clinical group were treated by the above described methodology during a period lasting from six to eight months, i.e. from the midst of the fall term to the end of the summer term. The control group was comprised of adolescents who underwent pedagogic measures but did not request a psychotherapeutic intervention. They were matched to the clinical group by age, gender, I.Q. and school results (N=43). In a quasi-experimental or non-equivalent control-group design (Graziano and Raulin, 1993) the role of the control group is to check that the results of the experimental group are not merely due to spontaneous maturation (normal changes in subjects in the course of time) or to contingent events of personal history (changes in subjects during the study due to events other than the independent variable, i.e. the treatment). The results may be interpreted in a causal sense if the experimental or clinical group changes markedly in the predicted direction, whereas the control group remains at the same level. The general hypothesis of the research is that gifted underachievers can be effectively treated through the above described kind of integrated psychotherapy, because it leads to an imaginative and symbolic elaboration of archaic fantasies, overcoming the tendency towards cognitive, emotional and volitional inhibition of further personal evolution (Schiltz, 2002a; 2004d), and also because it eventually reinforces motivation and self-esteem and improves learning strategies. Table 1. General descriptive parameters of the clinical group and the control group Variable Age School results (fall term) LPS (C value) Gender

Clinical group (N = 43) md = 13;1 md = 25,8 (max = 60) md = 9,5 Boys: N = 26, girls: N = 17

Control group (N = 43) md = 12;9 md = 46,4 (max = 60) md = 9,3 Boys: N = 26, girls: N = 17

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Table 2. General experimental design

Clinical group Control group

Pretest A A

Therapeutic sessions B, B‘, etc

Posttest A‘ A‘

As we worked with small samples and handled data of a mixed level of measurement, we used largely non parametric statistics (Colman, 1995; Bijleveld and van der Kamp, 1998). The clinical assessment was based on a mixed quantitative and qualitative methodology, combining a psychometric test, i.e. the FAF (Fragebogen zur Erfassung von Aggressivitätsfaktoren, Questionnaire for Components of Aggressivity, Hampel and Selg, 1995), an expressive test, i.e. the stories written under musical induction (Schiltz, 2003c; 2005b) and an observational frame for the therapeutic situation, (Schiltz, 1999). The tools of research contain the following general dimensions:  



Second order factors of the FAF : Spontaneous Aggressiveness, Reactive Aggressiveness, Irritability, Self Aggression, Inhibition, Dimensions of the rating scale for the stories: Primary Aggressivity, Elaborated Aggressivity, Anxiety, Depressive Feelings, Creativity, Quantitative Productivity, Bodily and Emotional Implication, Sensitivity to the Expression of Emotions Dimensions of the observational frame : Non Verbal Expression, Verbal Communication, Musical Production

The FAF has an internal consistency of scales ranging from r = .61 to r = .79. The rating scale and the observational frame are scored at the nominal or ordinal level of measurement and have an inter rater reliability ranging from r = .75 to r = .83; their content validity was explored in several previous studies (Schiltz, 1999-2004e). We made separate evaluations for two clinical sub-groups of gifted underachievers. The first group was characterized by a false self and over adaptation (sub group I; N = 20); the second one by impulsivity and emotional instability (sub group II, N = 23). The assignment to the subgroups was made through a semi-structured clinical interview conducted by experienced clinical psychologists. It was based on a thorough anamnesis with the parents and the clients and on behavioural criteria drawn from the ICD10.

4. EXPERIMENTAL RESULTS For mathematical reasons, analysis of variance does not apply to small groups and non metrical data. Thus all the between groups and within groups comparisons have been computed separately. As the whole study, i.e. the complete within and between groups comparisons are to be presented in detail in a research report (Schiltz and al., 2008), I shall focus in this article on the data allowing to understand the mode of action of music therapy, presenting the pretest-comparisons at the level of the clinical subgroups and the results of the total clinical group versus control group comparison at the level of the external validation criteria.

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4.1. Pretest- Posttest Comparison of the Stories Written under Musical Induction For the stories written under musical induction, for which we have shown that they function like a projective test and are complementary to the Rorschach and the TAT (Schiltz, 2005b), we have constructed a rating scale in the phenomenological and structural tradition (Mucchielli, 1983). It contains the following general dimensions: Personal implication, Quality of imaginary elaboration, Type of aggressivity, Formal qualities, Level of elaboration, Nature of conflict, and Archetypal themes. The scale closes the gap between qualitative analysis and the use of inferential statistics suited to nominal and ordinal data. In the clinical subgroup I (N = 20), which is characterized by over-adaptation, we see a significant increase in elaborated aggressivity, qualitative creativity, sensitivity to the expression of emotions, quantitative productivity, as well as in emotional and bodily implication. There is a significant reduction of depressive feelings. In the clinical subgroup II (N = 23), characterized by impulsivity, we also see a significant reduction in primary aggressivity, qualitative creativity, bodily and emotional implication, sensitivity to the expression of emotions, and there is a significant reduction of anxiety. Table 3. Pretest-posttest comparison of the stories: clinical subgroup I, N = 20 (Wilcoxon’s Sign Rank Test) Variable

Z

Elaborated aggressivity Creativity Depressive feelings Quantitative productivity Bodily and emotional implication Sensitivity to the expression of emotions

-3.130 -2.646 -2.394 -2.070 -2.070 -2.011

Bilateral significance P < .01 P < .01 P < .05 P < .05 P < .05 P < .05

Direction of difference Pre < post Pre < post Pre > post Pre < post Pre < post Pre < post

Risk α > .10 for the following variables : primary aggressivity, anxiety.

Table 4. Pretest-posttest comparison of the stories: clinical subgroup D, N = 23 (Wilcoxon’s Sign Rank Test) Variable

Z

Primary aggressivity Creativity Anxiety Bodily and emotional implication Sensitivity to the expression of emotion

-3.122 -2.646 -2.303 -2.280 -1.972

Bilateral significance P < .01 P < .01 P < .05 P < .05 P < .05

Direction of difference Pre > post Pre < post Pre > post Pre < post Pre < post

Risk α > .10 for the following variables : elaborated aggressivity, depressive feelings, quantitative productivity.

The findings in the two clinical subgroups are very close and corroborate the statements we made in other studies (Schiltz, 2004d;e); the fact that music therapy leads to a similar

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evolution, independent of the diversity of prior surface symptoms, speaks in favour of the broader, psychodynamic conception of the underlying personality organization (Dulz and Schneider, 1996). In the control group (N = 43), the only significant change concerns sensitivity to the expression of emotions (Z = -2.343; p = .05); the other variables remained stable during the treatment period of the clinical group.

4.2. Pretest- Posttest Comparison of the FAF The FAF (Fragebogen zur Erfassung von Aggressivitätsfaktoren, Questionnaire for Components of Aggressivity, Hampel and Selg, 1975) is a self-reported questionnaire made up of the following general dimensions : Spontaneous aggressivity, Reactive aggressivity, Irritability, Interiorized aggressivity, and Inhibition of aggressivity. These dimensions allow evaluation of self perception of aggressive feelings and behaviour conducts. In the clinical subgroup I, we see a significant reduction of irritability and of interiorized aggressivity, whereas in the subgroup II we see a tendency towards an increase of controlled aggressivity and towards a reduction of global exteriorized aggressivity. Thus, on the symptomatic level, as measured by the self-reported questionnaire FAF, both subgroups show a compensatory evolution concerning their self-image. In the control group, global exteriorized aggressivity and reactional aggressivity increased during the same period of time. Thus, the control group partially evolved in an opposite direction to that of the clinical group. This case constitutes a probate figure according to the criteria of Raulin and Graziano (1995) for quasi experimental designs, showing that the changes are probably not merely due to contingent external events or to spontaneous developmental maturation. Table 5. Pretest-posttest comparison of the FAF: clinical subgroup I, N = 20 (Wilcoxon’s Sign Rank Test) Variable FAF 3 FAF 4

Z -2.646 -2.029

Bilateral significance P < .05 P < .05

Direction of difference Pre > post Pre > post

Risk α > .10 for the following variables : FAF 1, FAF 2; FAF 5, FAF sigm.

Table 6. Pretest-posttest comparison of the FAF: clinical subgroup D, N = 23 (Wilcoxon’s Sign Rank Test) Variable Z Bilateral significance Direction of difference FAF 5 -1.844 P < .10 Pre < post FAF Sigm -1.660 P < .10 Pre > post Risk α > .10 for the following variables : FAF 1, FAF 2, FAF 3, FAF 4.

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Table 7. Pretest-posttest comparison of the FAF: control group, N = 43 (Wilcoxon’s Sign Rank Test) Variable FAF Sigm FAF 2

Z -2.394 -1.844

Bilateral significance P < .05 P < .10

Direction of difference Pre < post Pre < post

Risk α > .10 for the following variables : FAF 1, FAF 3, FAF 4, FAF 5.

Table 8. External validation criteria: total clinical group, N = 43 (Wilcoxon’s Sign Rank Test) Variable School results Creative pleasure activities

Z -2.217

Bilateral significance P < .01

Direction of difference Pre < post

-2.078

P < .05

Pre < post

4.3. External Validation Criteria The external validation criteria show long lasting positive results from our integrated approach. In the total clinical group, there were significant positive changes in school results and creative leisure activities. Seventy-six percent of the pupils who suffered from a complete school failure at the beginning of the year (general median of school results in the fall term: 25,8) and who were treated by the above described form of psychotherapy had overcome their difficulties by the end of the summer term (median 38,6). In the final between groups comparison there is still a difference between the control groups and the total clinical group, but the superiority of the control group is less important (general median in the summer term: 44,5). In leisure activities there is no more difference between the groups.

5. DISCUSSION Our pretest-posttest comparison shows the advantage of using a mixed methodology that combines a psychometric test, a projective test, and an observational frame for the evaluation of psychotherapy. This combination allows us to consider the structural functioning of personality as well as the descriptive one and yields a more adequate interpretation. The observed changes are plausible in the light of structural psychopathology (Dulz and Schneider, 1996), which stresses that the same underlying personality organization (i.e. of the psychotic, borderline or neurotic type) may give expression to various fluctuating symptoms at the observational level. Our research with borderline adolescents (Schiltz, 2004e) leads to the conclusion that long term music psychotherapy may permit the restructuring of personality; in fact, the profile of the clinical group approached that of normal control group. Our results with gifted underachievers, as evaluated through the projective test, suggest a personal maturation and a reduction of the cognitive, volitional and emotional inhibitions in the two clinical subgroups. That the first group shows an increase in elaborated aggressivity

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and the second one a reduction in primary aggressivity is a result that may also be interpreted in structural terms. On the descriptive level of a self-reported questionnaire, interiorized aggressivity has diminished with adolescents suffering from over-adaptation, whereas with those suffering from impulsivity the aggressive reactions appear to be better integrated and controlled. These positive effects allow us to understand the long term improvement in school results and the personal implication in more creative leisure activities. There is more energy available when frightful fantasies and negative feelings are elaborated on an imaginary and symbolic level instead of being acted out or directed towards one‘s own body.

6. CLINICAL VIGNETTES ILLUSTRATING THE THERAPEUTIC PROCESS 6.1. John John is a puny fourteen-year-old boy coming from a family of refugees. He has done very badly in school since the beginning of the year. John appears to be a shy, anxious and depressive boy who does not dare to stand up to his father and who is longing for his native country. He invents lies to escape punishment. He suffers from sleep disorder and frequent nightmares and he is tormented by suicidal thoughts. He has been the target of his school friends' racist reactions. We invited John to participate in a music communication group in order to resolve his social exclusion problem and to attend individual sessions at the same time. From the beginning he tried to get involved, but his instrumental play remained timid and monotonous for a long time. When playing a duet, he completely adapted to his partner's play without doing anything on his own initiative. The themes of his imaginary productions show his authentic feelings and are clearly suicidal as his story written to Plate 4 of the TAT proves.

TAT Plate 4 "His parents didn't look mean at all, but you never know what their character is like. His mother was a real beauty; his father looked like a grey devil, with blazing eyes and black hair. His parents buried their heads in the sand or tried to achieve their own ends at the others' expense. They put their heads in the sand like an ostrich. His father is an unemployed tramp who has eyes only for television, but not for his family. More than ten years had passed when the boy committed suicide. He threw himself off the red bridge. "Why?" asked the others. It's quite logical. All his life the boy felt remorse. He could not put up with it, so he committed suicide."

Although John never criticises his real parents, this dramatic story reveals his persecuted feelings; it is remarkable for using denial and splitting and for the pre-eminence of the bad object and the massive expression of primary affects. In an alarming way, it also shows that the author of the story does not have many options. Despite the pejorative description of his parents, the nameless hero of the story "the boy", who is not present on the plate, does not feel angry with them at all; instead, he turns his aggressivity against himself.

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It is only after some months that John describes his real family situation. His father is very violent; his mother is too weak to protect him. However, the boy says that under no circumstances would he leave his family for an institution and that he is very attached to both his parents. Little by little, as his anguish is verbally elaborated, John starts playing more spontaneously, preferring African melodic instruments like the balafo and the sanzar. One day, in the group session, he is fascinated when discovering a balalaika among the instruments. He tries to play it and cannot leave it alone. His friends understand that something important is happening to him, and they let him be the soloist and listen to him admiringly. For the first time, he talks about his uprooting, about the nostalgia he feels for his native land. At the end of the session, he grips the balalaika as if he would like to take it with him. As of this moment his musical play becomes much more energetic. He starts investigating rhythmic variations and becomes interested in the big percussion instruments. At the same time, the tone of his imaginary texts changes. The negative image of his father seems to fade into the background in favour of a positive image of his mother. He writes to TAT, Plate 8GF: "…Then his mother came back from work, she couldn't believe her eyes, then she ran towards her son, hugged him, caressed him, gave him a radiant smile, and that's the way it was."

This was the first imaginary expression of his unfulfilled need for affection. At the end of the year he writes an eloquent poem which reveals the significant reduction in the intensity of his state of depression and a recently acquired sense of the possibility to free himself from his sadness and to pass fluently from one emotional state to another.

Vivaldi Viola d'Amore " The violin is playing his favourite story, which is a very sad one; while playing, he expresses all his feelings, but he is also thinking about love. Now he is happy, he joyfully travels over mountains, dancing, he talks to himself and plays for himself. He is married and the father of two children. Oh! play the violin, isn't it beautiful!! I'm so happy. Yes, this way, life is pleasant. Yes, yes! I dance! I play! I live. Oh, isn't life beautiful And once again. Yes, I'm happy, I live, I play, I dance, I live. Olé! I make music and I like it very much. And once again. It's the play of my life. And now it's your turn. And think of it, life is pleasant. And now it's over, and now it's your turn."

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Anxious and depressive sideration has given way to movement, dance and love. John emphasises both his narcissistic restoration and the fulfilment of his object needs. He has found his place in relation to the others. At the same time, John begins to pass his school exams. He no longer feels rejected by his friends. He has distanced himself from his father and he describes the family relations with more realism. At the end of the year, he writes in a free text: "Sometimes, when I don't hear music, I hear it in my head, I have feelings, I feel fantastically well. I sometimes sing without instruments, only with my feelings."

John now has an intra-psychic space of his own, a mental stage on which" the play of his life" can develop itself. Music therapy allowed him to elaborate his repressed ambivalent feelings in an imaginary and symbolic way, overcoming his sense of rejection and permitting integration into his peer group.

6.2. Mary We shall present a shorter clinical illustration from the subgroup characterized by emotional instability. Mary is 17 years old. She is very oppositional with adults and aggressive with her classmates. At the beginning of the therapy, her stories are quite commonplace. One of her last texts shows an astonishing insight into the stages of her psychological maturation.

Beethoven: Violin Concerto ―It is night in the big forest. In the middle of the forest, there is a lake. On its surface the moon and the surrounding firs are mirrored. Sometimes you can see everything with precision. The scene makes one think of a movie. But sometimes, when a breeze is getting up, you can see the firs swaying. Then everything seems horrifying and far away you can hear the howling of the wolf. If you go a little further, you come to a waterfall which is flowing slowly and quietly. At the top of the rock where the water is calm, a wolf is mirroring himself with the moon at the background. Though he looks terrifying, he is quite peaceful. He remains sitting and watching at me. Suddenly I have the impression that he is smiling. He comes nearer and licks my hands. I begin stroking him and I am feeling quite happy, because I have desired this for ever; wolves are my favourite animals. Suddenly I wake up and I become aware that all this was only a dream. From that moment I return to my friend in the forest every night.‖ This story symbolizes first the freezing of her emotions and drive, then her being overwhelmed by her repressed feelings, going through a stage of anxiety; finally there is the integration of her longing for love into her conscious self. Mary‘s therapy was marked by an evolution from factual, descriptive stories and melodic poverty to personal implication and sensitive integration of rhythm and melody, her

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emotional stability and her ability to elaborate the conflicts of daily life on an imaginary and cognitive level have very much increased, whereas her temper tantrums have diminished. The tender part of her personality has emerged and it is much easier for her to find new friends. At the same time her school results have improved.

CONCLUSION According to our clinical experience and our research results, the severe inhibition of gifted underachievers may be overcome if we offer them a thorough psychotherapeutic treatment. The artistic mediation is well adapted to their special sensitivity to intrusion. Pedagogical measures alone are insufficient as is underlined by the outcome of several studies (Vichot-Chalon, 1997; Terrassier, 1999; Catheline, 2003; Schiltz and al., 2005), whereas psychiatric measures for conduct disorders or school phobia are often proposed in an hospital setting (Perisse and al., 2005; Gaspard and al. 2007), focusing on medication and short therapeutic interventions, without addressing the specific means of gifted underachievers. Without treatment the students belonging to our clinical group risk leading a diminished life, never realizing their true potential (Rogers, 1961). They risk becoming more openly depressive later on, because, at an unconscious level, they may be aware of the discrepancy between their actual functioning and their potential (Brandibas and al., 2004). Psychic health is linked to the possibility of realisation of one self in accordance with innate and acquired abilities (Kohut, 1991; Becker, 1997). Thus it is important to propose to this population an adapted psychotherapy as a means of self actualisation and of tertiary prevention, i.e. treating people as soon as they show the first symptoms of possible psychopathological complications. Music therapy can be easily introduced into the natural surroundings of school.

REFERENCES Adda, A. (1999). Le livre de l'enfant doué. The Book of the Gifted Child. Paris: Ed. Solar. Becker, P. (1997). Psychologie des seelischen Gesundheit. Psychology of Mental Health. Göttingen: Hogrefe. Bijleveld, C.J.H., and van der Kamp, L.J.T. (1998). Longitudinal Data Analysis. Designs, Models and Methods. London : Sage. Brandibas, G., Jeunier, B., Clanet, C., and Fourasté,R., (2004). Truancy, School Refusa and Anxiety. School Psychology International, 25 (1); 117-126. Cahn, R. (1998). L'adolescent dans la psychanalyse. L'aventure de la subjectivation. The Adolescent in Psychoanalysis. The Advanture of Subjectivation. Paris: PUF. Catheline, N. (2003). Psychopathologie de la scolarité. School Psychopathology. Paris : Masson. Chambon, O.,and Marie-Cardine, M. (1994). Psychothérapie cognitive des psychoses chroniques. Cognitive Psychotherapy of Chronic Psychoses. Paris : Masson. Colman, A.M., (Ed).(1995). Psychological Research Methods and Statistics. London: Longman.

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Cottraux, J.(2001). La répétition des scénarios de vie. Demain est une autre histoire. Repetition of Life Scenarii. To-morrow another Story Will Begin. Paris : Ed. Odile Jacob. De Groot, J.(1974). Statistische Redundanzbildungsprozesse in ihrer Beziehung zur Intelligenz. Processing Statistical Redundancy Related to Intelligence. Diplomarbeit am Psychologischen Institut von Erlangen. Dulz, B.,and Schneider, A.. (1996). Borderline Störungen. Theorie und Therapie. Borderline Disorders. Theory and Therapy. Stuttgart: Schattauer. Gaspard, J.-L., Brandibas, G., and Fourasté, R. (2007). Refus de l‘école: les strategies thérapeutiques en medicine générale. School Refusal: Therapeutic Strategies in general medicine. Neuropsychiatrie de l’enfance et de l’adolescence, 55; 362-366. Graziano, A. M. and Raulin, M.L. (1993). Research Methods : A Process of Inquiry (2nd edn.). New York : Harper Collins. Grubar, J-C., Duyme, M., and Cote, S. (Eds).(1997). La précocité intellectuelle. Intellectual Precocity. Sprimont: Mardaga. Hampel, R., and Selg, H. (1975). FAF Fragebogen zur Erfassung von Aggressivitätsfaktoren. Questionnaire for Components of Aggressivity. Göttingen: Hogrefe. Horn, W. (1962). Leistungsprüfsystem. Assessment of Intellectual Achievement. Göttingen : Hogrefe. Kohut, H. (1991). Analyse et guérison (trad. fr.). How Does Analysis Cure ? Paris: PUF. Lecourt, E. (2002). La musicothérapie, le groupe, et la musicothérapie de groupe. Music Therapy, Group and Group Music Therapy. Revue de Psychothérapie Psychanalytique de Groupe, 37 ; 97-100. Marcelli, D., and Braconnier, A. (1999). Adolescence et psychopathologie. Adolescence and Psychopathology. Paris: Masson. Muchielli,A. (1983). L‘analyse phénoménologique et structurale en sciences humaines. Phenomenological and Structural Analysis in Humanities. Paris : PUF. Perisse, D., Gerardin, P., Cohen, D., Flament, M., and Mazet T. (2006). Le trouble des conduites chez l‘enfant et l‘adolescent : une revue des abords thérapeutiques. Conduct Disorders with Children and Adolescents : a Survey of Therapeutic Approaches. Neuropsychiatrie de l’enfance et de l’adolescence, 54 ; 401-410. Raulin, M.L, and Graziano, M..(1995). Quasi-Experiments and Correlational Studies. In A.M. Colman, (Ed). Psychological Research Methods and Statistics (pp 58-77). London: Longman. Renzulli, J.S. (1978). What Makes Giftedness? Re-examining a Definition. Phi Delta Kappau; 60; 180-184. Rogers, C. R. (1961). On Becoming a Person: A Therapist's View of Psychotherapy. Boston: Houghton Mifflin. Schiltz, L. (1995). De l‘utilisation de la musicothérapie avec des adolescents souffrant d‘un blocage du fonctionnement pulsionnel. Using Music Psychotherapy with Adolescents Suffering from Inhibition of Desire. Paris : D.U. Art en Thérapie et en Psychopédagogie, Université René-Descartes- Paris V. Schiltz, L. (1999). Musique et élaboration imaginaire de l‘agressivité à l‘adolescence Evaluation d‘une expérience thérapeutique. Music and Imaginary Elaboration of Aggressivity in Adolescents. Assessment of a Therapeutic Experiment. Thèse de doctorat en psychologie clinique. Paris : Université René Descartes- ParisV.

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Schiltz, L. (2002a). Archétypes signalant la reprise du processus de subjectivation. Archetypes Linked to the Resumption of Subjectivation, La Revue de Musicothérapie, XXII,1 ; 8-11. Schiltz, L. (2002b) Motivation de performance et mécanismes d'ajustement. Approche longitudinale. Achievement Motivation and Coping Strategies. A Longitudinal Approach. Rapport de recherche. Luxembourg: MENPFS-SCRIPT. Schiltz, L. (2002c). Elèves surdoués en situation d'échec scolaire. Gifted Pupils Failing at School. Rapport de recherche. Luxembourg: MENFPS-SCRIPT. Schiltz, L. (2003a). The Restoration of a Broken Self in Adolescence. Some Results of an Efficiency Study of Music Therapy. In: R. Hampe, and P. Martius (Eds). Trauma, Kreativität, Therapie mit künstlerischen Medien. Trauma, Creativity, Arts Therapies, (pp 435-443). Bremen : Verlag Universität Bremen. Schiltz, L (2003b). Some epistemological considerations about music therapeutic research. In: L. Schiltz, (Ed). Epistemology and Practice of Research in the Arts Therapies, (pp 4555). Luxembourg: CRP-Santé et FNR. Schiltz, L. (2004a). Motivation de performance, destinée scolaire et mécanismes d'ajustement. Quelques implications d'une étude longitudinale comparée. Achievement Motivation, School Destiny and Coping Strategies. Implications of a Comparative Longitudinal Study. Neuropsychiatrie de l'enfance et de l'adolescence, 52, 2 ; 70-77. Schiltz, L. (2004b). Le blocage cognitif, émotionnel et motivationnel des élèves surdoués en situation d'échec scolaire grave. Résultats d'études cliniques et expérimentales sur la" résignation apprise. Cognitive, Emotional and Motivational Inhibition of Gited Underachievers. Results of Clinical and Experimental Studies on « Acquired Resignation », La Revue française de Psychiatrie et de Psychologie médicale, VII, 79 ; 39-44. Schiltz, L. (2004c). Psychodiagnostik, Psychotherapie und Forschung mit Hilfe von musikalisch induzierten Geschichten. Stories Written under Musical Induction: A Tool of Psycho diagnosis, Psychotherapy and Research, In: I., Frohne-Hagemann (Ed). Rezeptive Musiktherapie; Theorie und Praxis. Receptive Musictherapy. Theory and Pratice, (pp 3950). Wiesbaden: Reichert Verlag.. Schiltz, L. (2004d). Musicothérapie et processus de symbolisation chez les adolescents à fonctionnement limite. Music Therapy and Symbolization with Borderline Adolescents. La Revue française de Psychiatrie et de Psychologie médicale, VII, 73, 17-20. Schiltz, L. (2004e). La subjectivation entravée. Approche clinique et expérimentale intégrée. Hampered Subjectivation. A Clinical and Experimental Approach. Habilitation à Diriger des Recherches.Metz : Université Paul Verlaine-Metz. Schiltz, L. (2005a). La créativité entravée. Données cliniques et expérimentales sur les élèves surdoués en situation d‘échec scolaire. Hampered Creativity. Clinical and Experimental Results with Gifted Underachievers. La Revue de Musicothérapie, XXV, 1, 81-89. Schiltz, L. (2005b). Dysfonctionnements cognitifs liés aux pathologies limites à l'adolescence. Etude comparée de quelques tests projectifs. Cognitive Dysfunctioning related to Borderline Disorders in Adolescence. A Comparative Study of some Projective Tests. Neuropsychiatrie de l’Enfance et de l’Adolescence, 53, 3 ; 107-113. Schiltz, L., Desor, D., Lorang, G.,and Schiltz, J. (2006). Elèves surdoués en situation d‘échec scolaire. Approche multidisciplinaire de la « résignation apprise ». Gifted

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Underachievers. A Multidisciplinary Approach of the « Acquired Resignation ». Luxembourg : Editions Saint-Paul. Schiltz, L., Schiltz, J., and Soulimani, R., (2008). Application de l‘art thérapie à quelques problèmes cruciaux de la société luxembourgeoise. Rapport de recherche. Application of Arts Therapies to some Crucial Problems of Luxembourg Society. Research Report. Luxembourg : FNR. Sudres, J.L., Brandibas, G.,and Fouraste, R. (2004) La phobie scolaire : symptôme, entité spécifique, syncrétisme ou syndrome d‘inadaptation. School Phobia : Symptome, Specific Entity, Syncretism or Maladjustment Syndrome. Neuropsychiatrie de l’Enfance et de L’Adolescence, 52 ; 556-566. Terrassier, J-C. (1999). Les enfants surdoués ou la précocité embarrassante. Gifted Children or Embarrassing Precocity. Issy-les- Moulineaux : ESF. Terrassier, J-C.,and Gouillou, P. (2000). Guide pratique de l‘enfant surdoué. Practical Guide of the Gifted Child. Issy-les-Moulineaux : ESF. Vichot-Chalon; M.C. (1997). Reconnaissance et devenir des enfants précoces non reconnus. Possibilities of Screening and Development of Gifted Children. In : J.C. Grubar, M. Duyme and S. Côte ,(Eds). La précocité intellectuelle. Intellectual Precocity, (pp 187198). Sprimont : Mardaga. Webb, J.T. (1993). Social-emotional Development of Gifted Children. In: K.A. Keller, F.J. Mönks and A.H. Panow (Eds). International Handbook of Research and Development of Giftedness and Talent,(pp 528-538). Oxford: Pergamon Press.

Advances in Psychology Research. Volume 78 Ed: Alexandra M. Columbus

ISBN: 978-1-61209-442-7 © 2011 Nova Science Publishers, Inc.

Chapter 2

MARITAL PATTERNS AND PSYCHOLOGICAL ADJUSTMENT AMONG IMMIGRANTS FROM ETHIOPIA AND FSU Gila Markovitzky and Hadas Doron Tel-Hai Academic College, Israel

ABSTRACT The research examines the contribution of marital patterns (role division, decision making, and marital quality) to the psychological adjustment (psychological well-being, emotional state, and satisfaction) of new immigrants in Israel, according to country of origin and gender. Self reported questionnaires were filled by 236 new immigrants: 112 from the FSU and 124 from Ethiopia, who came to Israel between 1990 and 2001. The findings indicate that the most important predictor of adjustment was country of origin: immigrants from Ethiopia displayed a higher level of psychological adjustment relative to those from the CIS. Among women and men from Ethiopia, level of egalitarianism in role division and decision-making was found to correlate significantly with psychological responses. In comparison, the immigrants from the FSU reported more equality in the family, but this was not correlated with psychological adjustment. Of all the subgroups, the Ethiopian women demonstrated the highest level of adjustment.

Keywords: Immigration, Psychological adjustment, Marital relations, Ethiopian women.



Address for correspondence: Dr. Hadas Doron, 127 Nahal Keret St. Yokneam Hamoshava. 20600 Israel. e-mail: [email protected]

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INTRODUCTION Marital Patterns and Immigration Immigration is a powerful, stressful event which requires adaptation to a new, culturally unfamiliar environment that involves changes and challenges within the immigrant's family. The relationship with the host culture and the coping efforts to adjust to the new country, may be accompanied by changes in the relationship within the family (Booth, Crouter, and Landale,1997). These demands may follow with distress and in some case with crisis and trauma (Padilla and Perez, 2003; Stamm, Stamm, Hundnall, and Higson, 2004). On the one hand, the transition between countries may bear potential benefits for individuals and families including a solution to economic difficulties, opportunities for new status or a better future for the children. On the other hand it also involves potential losses, such as separation from extended family members left behind or disturbances in the spouse equilibrium (Fox, 1991; Lipson and Miller, 1994). Due to immigration, a family may suffer a loss of resources like skills, roles, values, social status, and culture, and must learn to change in order to acquire a new equilibrium (Anson, Pilpel, and Rolnik, 1996; Furnhan and Bochner, 1986). The period of adjustment is accompanied by distress for both the individual (Markovitzky, 1998) and the family (Berry, Kim, and Mindel, 1987). The process calls for flexibility and different styles of coping strategies. Successfully coping with crisis depends upon personal as well as familial and social resources (Aroian and Norris, 2003; Fox, 1991). Numerous studies have been devoted to different aspects of immigrants' family life: the impact of immigration on the quality of family life (Ben-David, 1994; Grant, 1982; Poskanzer, 1995; Thomas, 1995); the influence of various aspects of family life on the adjustment of the immigrants (Aroian and Spitzer, 1996; Boyd, 1989; Scott and Scott, 1989); and relations between the family and social support institutions (Ben-David, 1995; Krausz, 1994). No studies have dealt with the relationship between marital patterns and psychological adjustment (PA). Marital patterns may play an important role during the acculturation period, which tests family strengths and resources available to them (Mirsky, Barasch, and Goldberg, 1992). Gender, also, has been reported to be strongly related to emotional well-being of recent immigrants (Ritsner, Ponizovsky, Nechamkin and Modai, 2001), as well as culture of origin. Investigators found that women have higher rate of psychological distress than men (Ritsner, Ponizovsky and Ginath, 1999). and exposure to more role-related stressors < (Nazroo, Edwards and Brown, 1998).

Immigration to Israel Israeli society has absorbed a constant influx of immigrants from the Jewish Diaspora throughout the world. It expressed the central theme in the Israeli national ethos – the reunification of the Jewish nation (Leshem, 2003). Almost 40% of the actual Jewish population today was born abroad and in its 56 years of independence, Israel has absorbed more than 50% of its population through immigration. Much of the immigration to Israel

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came in waves from common demographic origins. Two current waves of immigration are from the Former Soviet Union (FSU) and Ethiopia. The largest wave of Russian immigration began in 1989 and brought to Israel 1 million immigrants, currently representing more than one fifth of the total population (Leshem and Sicron, 1998).As a minority group in the Former Soviet Union, the Jews were not allowed to practice their religion (Cohen and Yitzhak, 1989). Thus the transmission of Jewish private culture took place within the family. They valued work and were educated to believe that all types of work are equally accessible to women and men. In their private culture, Jews maintained a conservative and highly gendered perception of family roles (Shouval, Kav Venaki, Bronfenbrenner, Devereux and Kiely, 1986). In their public culture, Former Soviet Union family was encouraged, in cases of conflicts in the family, to rely on medical services whereas in their private culture they rely on psychological and social services, family members and friends (Slonim-Nevo and Shraga, 1999). Jews of Ethiopia enjoyed a unique cultural context in which Jewish tradition was preserved for many generations in relative isolation from Western influences. Most Ethiopian Jews were farmers and resided in rural areas; only a minority received a formal education. The Jewish Ethiopian culture places strong emphasis on family relationships and values mutual help in the community (Ben-Ezer, 1992a). One of the main values it transmits, is respect for elders and authority figures in the family and community (Ben-Ezer, 1992b). Immigration to Israel from Ethiopia was essentially comprised of two waves in the 1980s and 1990s and involved approximately 80,000 people. The motives for this migration are structurally similar to the parallel migration from the Former Soviet Union, namely acute economic distress, an unstable political climate and a wish to live in a Jewish society. The traditional, religious Ethiopian families were faced with dramatic transformations upon immigration to Israel and were also exposed to remarks related to their color. The culture shock of a drastically different society and a growing perception of racial discrimination led the community to painful feelings of hopelessness and despair (Ben David and Ben Ari, 1997). The degree of the alienation from the host culture may cause confusion, stress or resistance to change that may lead to low level of adaptation. It is important to understand the differences between Western and traditional cultures regarding views of the "self": in Western cultures, the individual is most important while in traditional cultures, the family and community are dominant (Airhibenbuwa and Obergon, 2000).

LITERATURE REVIEW Psychological Adjustment and Marital Patterns among Immigrants The adjustment of immigrants to their new country may be a difficult process that can produce stress within the spousal and/or family relationship and lead to increased tension and conflict, deterioration in quality of relationships, and disorganization of family life. Changes in marital composition and patterns may be stressful as well as important to the social, economic, and cultural transformations in a society. Family support and positive relations in the family is important to the process of adaptation to immigration (Booth, Crouter and Landele, 1997) and has implications for the adjustment itself (Balcazar, Peterson

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and Krull, 1997; Lay et. Al, 1998:Lee, Moon and Knight, 2004). The gap between cultural patterns of family relations of the immigrant vis-à-vis those relations in the host culture, may play an important role in the adaptation process and for the status of the family members. Studies have found that a high degree of social support, including family support, decreases the impact of acculturation stress and help individuals to cope with the pressures of living in the new environment (Kue and Tsai, 1986). Family issues are related to cultural beliefs, norms and values, especially with respect to gender roles (Treas and Widmer, 2000). Research indicates that changes in marital roles and transition from traditional patriarchal cultures to modern Western ones, usually involves redefinition of gender roles and power relations regarding decision-making in the family (Comas-Diaz and Green, 1994; Gil and Vazquez, 1996; Menjivar, 1999). Women's education and their participation in the work force, are emerging as especially critical catalysts for bringing about changes in other aspects of marital patterns (McDonald, 1985; Isiugo-Abanihe et al, 1993). Numerous studies have examined different aspects of immigrants' family life, including: the impact of immigration on the quality of family life (Ben David, 1994; Grant, 1982, Poskanzer, 1995, Thomas, 1995) and the influence of various aspects of family life on the adjustment process (Aroian and Spitzer, 1995, Scott and Scott, 1989). Israel, a modern country that emphasizes liberalization and emancipation of women, absorbs immigrants from Eastern and Western countries that represent different cultures and different family relations. Women have an important role in the coping of the family with immigration difficulties and are also increasingly involved in work outside the home.

Psychological Adjustment and Socio-Demographic Differences: General, Gender and Country of Origin Demographic factors (age, gender, occupation, education, and length of stay) were found as important predictors of adjustment and acculturation to immigration.(Neto,-Felix, 2002; Ouarasse, O.A. and V., Fons., 2005). Research shows that loss of occupational and communication resources are associated with emotional distress more than personal variables such as gender, age, and marital status (Aroian and Norris, 2003). However, the cultural gaps between the country of origin and country of immigration reveal acculturative difficulties that are not necessarily associated with psychological distress (Lackland and Erkki, 2003). Loss of former social support and experiences of traumatic events are physical and mental negative factors that may be linked to both male and female immigrants. In spite of this, many female immigrants succeed in learning a new language and finding jobs (Akhavan, Bildt, Franzen and Wamala, 2004). Other researchers have found a higher level of distress among immigrant women, especially those employed in low-level jobs relative to their education (Kaufman and Mirsky, 2004). With regard to the link between age and acculturation, it was found that younger males from Russia adjusted better than the females did (Katz and Lowenstein, 1999). Older and divorced or widowed immigrants (both men and women) were more likely to report high levels of distress (Ritsner, Ponizovsky, Kurs, and Modai, 2000). Gender-related adjustment

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differences exist mainly during middle age, and most of them disappear with age (Ritsner, Ponizovsky, and Ginath, 1999). Education is another socio-demographic variable that is associated with adjustment. Immigrants with higher levels of education are more flexible and egalitarian and adapt better to Western culture (Waller and Hovav, 1976). However, other researchers have found a higher level of distress among immigrant women who are employed in low-level jobs relative to their education (Kaufman and Mirsky, 2004).

Gender Gender is an important variable in terms of adjustment to immigration. Some studies indicate that females adjust more quickly than men, and are more flexible in adapting to the new culture and new occupations (Itzhaky and Levy, 2002). However, other studies have found that women reported higher psychological distress and incidence of related symptoms (Ritsner, Ponizovsky, Nechamkin and Modai, 2001). Women were found to have higher levels of symptoms of anxiety and depression when compared to men (Ritsner, Ponizovsky, Kurs, and Modai, 2000; Tabassum, Macaskill and Iftikar, 2000). Women who immigrated from the Former Soviet Union to Israel report higher levels of psychiatric symptoms when compared to men, on most scales of distress (Kohn, Flaherty, and Levav, 1989; Ritsner, Ponizovsky, and Ginath, 1999; Ritsner, Ponizovsky, Kurs, and Modai, 2000). Immigrant women often encounter a two-sided situation: since they tend to be more flexible and willing than men to compromise and accept unskilled jobs, they often find jobs and increase their income more quickly than men, who tend to remain unemployed longer. This, in turn, creates a new order, altering the traditional gender roles (Foster, 2001). Although most women work outside of their homes due to economic need, both spouses still believe that women should stay at home and fulfill their traditional roles (Kim and Kim, 1998). This finding is also supported by Ki-Tov and Ben David‘s (1993) research among Ethiopian immigrants in Israel. This group of immigrants is faced with rapid change in their traditional family patterns, which were based on the religious, traditional family. In Israel, the concepts of family and community change and, consequently, so do the gender roles. The Ethiopian women have been absorbed more successfully; they learned the new language and adjusted to the new situation more quickly. Women who live with spouses often have to cope with the unemployment of their husbands, who feel threatened by the altered division of power in the family. In some groups of immigrants, these conditions have been found to correlate with a heightened asymmetry in power relations leading to violence (Comas-Diaz and Greene, 1994; Straussner, 2000). When a husband still maintains a patriarchal ideology, changes in the wife‘s economic role often lead to a rise in stress and conflict in the marriage. Among these groups of immigrants, the economic power of the women increases while the social role and status of the men as breadwinners, weakens significantly (Min, 2001). Among immigrants from Morocco to Canada it was found that there is greater egalitarianism in couples in which the women‘s power increased, but greater satisfaction of both spouses with the marriage in couples that maintained the traditional gender roles of their

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country of origin. In other words, changes in family power relations correlate with decreased satisfaction with the marriage (Elhaieli and Larsy, 1998). Simon (1992) found that gender differences in distress were explained by differences in exposure to parental role strains, but salience of the parental identity contributed to both women's and men's vulnerability to parental distress. Research has shown that marital quality among immigrant couples declines as a result of conflicts between parents and children, especially in families with adolescent children. Gender gaps over issues of control and tradition constitute a focal point of pressure and conflict (Bean, Perry, and Bedell, 2001). New immigrants in a new culture generate a high level of uncertainty with their family patterns and required adaptation to the patterns characterized by the host society (Sharlin and Moin, 2001). The above review suggests that marital patterns are significant variables in the adjustment of immigrants to a new country.

Culture and Country of Origin The different cultures of origin may have implications on the rate and direction of sociocultural change that family members make (Booth, Crouter, and Landale,1997). Information on the gender-related differences in psychological adjustment (PA) among Ethiopian immigrants to Israel is very sparse. A study that compares distress symptoms among immigrants from Ethiopia with those from the Former Soviet Union suggests a similar level of distress among men in both groups but greater distress among the women from the Former Soviet Union than their Ethiopian counterparts. These findings are explained by the change in status of the women in both groups. Women from the Former Soviet Union may experience a decline in professional status, while the women from Ethiopia enjoy opportunities they did not have in the past, such as equal rights with men, the possibility of studying, and economic rights (Ponizovksy, Ginath, Durst, and Wondimeneh, 1998). Another study, which examines the integration and absorption of immigrants from Ethiopia, reveals better integration of Ethiopian women than Ethiopian men in Israeli society (Benita and Noam, 1995). The two populations differ in their cultural background, family relations and marital patterns but are similar regarding the motivation for their immigration -- escape from a political regime. The purpose of this study is to compare the levels of psychological adjustment (PA) between men and women (gender differences) of the two populations according to the countries of origin. Since family is important to the adjustment of the immigrant, and can represent either a source of stress or a source of support, our research was directed to examine how demographic features and marital patterns affect the psychological well-being of the new immigrants to Israel. The high proportion of immigrants to Israel from two countries of origin — Ethiopia and the Former Soviet Union — provide an opportunity to examine the contribution of these variables to psychological adjustment while comparing and contrasting family and cultural differences between the Former Soviet Union and Ethiopian immigrant populations to Israel.

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METHOD Participants and Procedure The sample included 236 participants comprised of 77 married couples as well as 82 nonmarried singles in a couple relationship (mainly cohabitating couples). They all arrived in Israel between 1990 and 2001, and at the time of the research they resided in northern Israel. This area absorbed 34% of all the immigrants from the Former Soviet Union (FSU) who came to Israel, a higher percentage than in the overall population (20%). Twenty-nine couples came from FSU (mean age 37.6, SD=6.1), and 48 couples from Ethiopia (Mean age 43.97, SD=12.0) (t(75) = 3.07, p