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The proliferation of categories in recent editions of the Diagnostic and Statistical Manual of Mental Disorders (e.g., 4th ed.; DSM: American Psychiatric Association, 1994) is discussed as an indication that the underlying classification scheme is inadequate and unlikely to produce the scientific progress originally envisioned. In any nosological system, it eventually becomes necessary to reduce the number of categories by an organizing theory that describes the fundamental principles underlying the taxonomy. The DSM has put itself in an awkward position by claiming to be atheoretical. Although taking such a tack had historical advantages to promote the acceptability of the 3rd edition of the DSM, it now limits the progression of science. It is argued that the DSM should not be used as the basis for guiding scientific research programs because it emphasizes primarily behavioral topography rather than providing an explicit theory that would allow for an evaluation of scientific progress. Theoretically driven taxonomies should be allowed to compete on the basis of how successful they are at achieving their specified goals that might include illuminating etiology, course, and response to treatment. Such systems are not likely to attend primarily to behavioral topography alone and would probably organize behavior differently than the current categorical syndromes seen in the 4th edition of the DSM.

This review provides a quantitative integration of research on the effectiveness of psychological and pharmacological treatments for nocturnal enuresis. With the use of experiments that compared treatments with either no treatment or another form of treatment, this article assesses (a) the overall effectiveness of psychological and pharmacological treatments, (b) the relative effectiveness of specific types of treatments, and (c) moderators of treatment effectiveness including investigator allegiance. Findings from the review confirm that enuretic children benefit substantially from treatment. However, more children improve from psychological than from pharmacological interventions. Moreover, psychological treatments involving a urine alarm are most likely to yield benefits that are maintained once treatment has ended.

Researchers have examined moral thought using selected philosophical standards without showing that such standards represent moral thinking. Recently, we examined the extent to which assumed standards actually organize moral knowledge (Quinn, Houts, & Graesser, this issue). We found dimensions not accounted for by previous theories. In his response (this issue), Shaffer misrepresents the aims of our research, and he overlooks the implications of assessing naturalistic rather than prescribed dimensions of morality.

Psychological research on morality has been based on researchers' definitions of morality or on philosophical theories. The present study examined naturally occurring conceptions of morality by using a knowledge-structure methodology borrowed from cognitive psychology. Subjects generated statements in response to a question designed to expose generic knowledge about their concept of morality. Answer frequency and conceptual clustering results suggested that a variety of diverse concepts undergirded subjects' moral thinking and revealed a person-based rather than a philosophy-based pattern for commonly held conceptions of morality. A three-dimensional scaling solution of the responses suggested that conceptions of morality were characterized by individual-social, general-specific, and absolute-relative distinctions. These findings raise questions about assumptions underlying previous theories of morality. Moreover, the present methodology offers a basis for developing a more representative account of moral thought that depends less on the beliefs of researchers.

In this commentary we consider some of the seemingly unresolved issues raised in the miniseries, 'Philosophical and Theoretical Problems for Behavior Therapy'. Some clarifying comments are offered, and implications of some of the abstract issues for the scientist-practitioners of behavior therapy are raised., There are many issues in the field of behavioral therapy such as the positions and meaningfulness of logical positivism, relativism, contextualism and the use of the scientific method that need be explored if the field is to prosper. These issues provide a broad field of intellectual exploration for those in this field, especially for practicing theorists. It was the purpose of 'The Mini-Series on: Philosophical and Theoretical Issues in Behavior Therapy' to present these issues to practicioners to do so.

Abstract Background Neutropenia is a common toxicity in chemotherapy but detailed information about how neutropenia is associated with changes in patients' quality of life is not readily available. This prospective study interviewed patients with grade 4 neutropenia to provide qualitative information on patients' experience of developing and coping with grade 4 neutropenia during a cycle of chemotherapy. Methods A sample of 34 patients who developed grade 4 neutropenia during the first cycle of chemotherapy completed a total of 100 structured clinical interviews. Interviews were transcribed, and 2 raters inductively developed 5 broad categories comprising 80 specific complaint domains nominated by patients. Thirty-five patient-nominated problems were mentioned in 5% or more of the interviews. Results Fatigue was the most common physical symptom. Interference in daily routine, negative self-evaluation, negative emotion, and social isolation were other common complaints associated with neutropenia. Conclusion Neutropenia is associated with a number of negative experiences among cancer patients undergoing chemotherapy, and these negative experiences have an adverse effect on the patient's quality of life. Oncology nurses can play a key role in helping patients manage adverse effects to maintain their quality of life.

Investigated influence of Christian values of clinicians and clients on judgments of prognosis, psychopathology, and locus of client problems. Both religious and nonreligious clinicians assigned moderately religious clients more pessimistic prognoses and greater psychopathology. Religious therapists made more internal attributions for the nonreligious client, whereas nonreligious therapists made more internal attributions for the religious client. (Author/BL)

Compared the effectiveness of live versus videotape delivery of a behavioral treatment package for enuresis. Outcome was superior for the live delivery. Pretreatment measures of family and child psychosocial adjustment failed to predict treatment response. Film delivery resulted in higher confidence in children of their parents, but lower confidence of parents in their children. (Author/KS)

A recent exchange with Shaffer (this issue) reveals several points of agreement underscoring the utility of our subject-based approach to understanding moral thought. Shaffer's latest reply raises the interesting question of whether thinking about morality, the focus of our study, constitutes moral thinking. Our response underscores how Shaffer's approach to studying moral thought differs from our own. More important, we emphasize how disagreements over what constitutes moral thinking can and should be settled empirically.

War Department Technical Bulletin, Medical 203 is presented in historical context as the first psychodynamic nomenclature. The history of Medical 203 is presented to show how Medical 203 was adapted to become DSM-I. Medical 203 then is compared and contrasted to DSM-IV to illustrate how changes in the modern DSMs have led to an 800% increase in the number of psychiatric diagnoses over the last half century. The role of critical history is emphasized in evaluating those changes and in speculating about the next 50 years of psychiatric nomenclature. [C] 2000 John Wiley & Sons, Inc. J Clin Psychol 56: 935-967, 2000. Keywords: psychiatric nomenclature; War Department; Medical 203; DSM-IV