When More is Better than Less; Three Theories of Psychosis—Projection, Double Bind, and Possession

Three psychological theories of psychosis are described, each of which has standing in psychiatry. Defined by the terms projection, double bind, and possession, they initially appear to have little or nothing in common to explain psychosis, but converge at four points: (1) A high degree of anxiety precipitated by a dilemma or conflict perceived to be unsolvable by the person; (2) the anxiety triggers a shift from one thought or motive in the direction of its opposite, because the original was believed too antagonistic to the wishes of significant others; (3) the opposite, in order to remain opposite, requires that the original thought or motive be forgotten, (4) a singular means to produce and reinforce forgetting is the interposition of psychiatric symptoms. In psychiatry today treatment would fit more consistently with the three theories taken as a whole rather than any one, and a rationale for this viewpoint is elaborated.     

Prevalence of ADHD and comorbid disorders among elementary school children screened for disruptive behavior

In the context of a school-based prevention of conduct disorder program, 7,231 first- through fourth-grade children were screened for cross-setting disruptive behavior. Frequencies of DSM-III-R psychiatric disorders and patterns of comorbidity were assessed. We also examined the association of psychiatric diagnosis with child and parent characteristics to determine differential risk based on diagnostic subgroups. Attention deficit hyperactivity disorder (ADHD) and oppositional-defiant disorder (ODD) were the most frequent diagnoses. Mood and anxiety disorders were infrequent as single diagnoses. Patterns of comorbidity demonstrated that both externalizing and internalizing disorders commonly cooccurred with ADHD. More severe degrees of psychopathology and psychosocial risk accrued to the subgroup of youths with ADHD plus a comorbid externalizing disorder.This study was supported by grant MN-46584 from the National Institute of Mental Health.     

The truncated nuclear family

The truncated nuclear family is defined: it is the garden-variety family pathology found. The critical role of polarized continuity and discontinuity values in producing the truncated nuclear family is discussed. There is a brief review of factors in American society which, over the decades since the Second World War, have evolved the nuclear family as a dominant family unit, and of how those and other factors in society have produced the large numbers of truncated nuclear families seen in clinics, particularly in the past decade. Family therapy is the treatment of choice for the truncated nuclear family, provided there is a readiness of the family to undertake the stress of therapy.Dr. Zuk is family therapy consultant to agencies in New Orleans and elsewhere, and clinical professor (psychology) in the Department of Psychiatry and Neurology at Tulane University Medical School.This paper is a chapter in the forthcoming 2nd edition ofProcess and Practice in Family Therapy, to be published by Human Sciences Press of New York City in 1985.     

Relationships between perceptions of organizational size and the organizational choice process

Expectancy theory concepts were used to predict (a) the attractiveness of, (b) the amount of effort directed toward entering, and (c) the eventual choice of a job in relatively big and small work organizations. It was found, among a group of graduating seniors from a technical college, that antecedent perceptions regarding organizational size (expectancy, valence, instrumentality) were significantly related to the relative attractiveness of different-sized organizations and the number of job interviews taken with relatively big and small companies. In addition, economically tied extrinsic outcomes were seen as more readily attainable in big organizations, whereas certain intrinsic outcomes were perceived to be more easily obtained in small organizations.     

Training children's self-control: A field experiment in self-monitoring and goal-setting in the classroom

A field experiment investigated the effects of training in self-monitoring and goal-setting skills on classroom study behavior and academic achievement among elementary school students in an individualized mathematics program. In the Self-Monitoring Conditions, students were shown a simple system for observing and maintaining daily records of their own study behavior during their math classes; orthogonally, in the Goal-Setting Conditions, students were shown a simple method of setting and recording daily performance goals during their math classes. Exposure to self-monitoring procedures produced significant increases in both appropriate study behavior and in actual achievement in the mathematics program, while exposure to goal-setting procedures had no effect on either study behavior or academic achievement. Nor, contrary to expectation, did exposure to the goal-setting instructions enhance the effectiveness of the self-monitoring system. The implications of these results in terms of implicit and explicit models of self-reinforcement processes were discussed.     

The contribution of visual persistence to the perceived duration of brief targets

Two experiments were conducted to examine the role of sensory persistence on tasks of perceived duration employing very brief visual stimuli. Using a standard temporal judgment task, the first experiment replicated both the “size effect” and “empty-filled” illusion reported by previous investigators. However, entirely comparable results were also found with a probematching task, which theoretically assesses the degree of persistence exhibited by a stimulus. The second experiment examined the effect of target luminance on perceived duration. Consistent with a sensory persistence interpretation, judgments of duration increased with increasing luminance. The results from the two experiments were discussed in terms of varying degrees of retinal persistence produced by different stimuli. This view was contrasted with currently dominant interpretations that postulate changes in perceived duration to reflect different information-processing requirements across stimulus conditions.     

The effects of spatial frequency and target type on perceived duration

Two experiments are reported that attempt to demonstrate a critical role played by sensory persistence on a standard perceived-duration task employing brief visual stimuli. Experiment 1 examined the effect on perceived duration of varying the spatial frequency of a target. For both 40- and 70-msec flashes, increased spatial frequency resulted in reduced estimates of perceived duration. These results were contrasted with predictions derived from cognitive processing models of duration perception. In Experiment 2, three typical types of target employed in current research (an outlined circle, a “noise”-filled circle, and a completely filled circle) were shown to differ significantly in their perceived duration and in their sensitivity to increases in physical duration. The results were discussed in terms of variable degrees of retinal persistence produced by the three types of targets. The possible implications for specific discrepancies in the literature and across-study comparisons in general were enumerated.     

The Pittsburgh Initial Neuropsychological Testing System (PINTS): A neuropsychological screening battery for psychiatric patients

This paper presents a new neuropsychological screening battery for psychiatric patients. It takes 1.5 to 2 hr to administer and briefly assesses general level of performance, memory, language skills, attention, and spatial-constructional abilities. Scoring and profiling are computerized. Initial validation based on discriminant analysis of a group of brain-damaged and non-brain-damaged psychiatric patients yielded a diagnostic accuracy level of 84.51%. Cross-validation on a different population led to a substantial attrition of classificatory accuracy, but cross-validation based on a comparison between two samples drawn from a homogeneous population yielded substantially less attrition. It was concluded that while the battery discriminates accurately in a homogeneous population, it is necessary to develop separate norms for populations varying in level of impairment.     

Written spelling deficit of Broca''s aphasics

The purpose of this study was to investigate the nature of the written spelling deficit manifested by Broca's aphasics. Four spelling tests were given to eight Broca's aphasic patients. Analysis of misspelling errors led the investigators to conclude that Broca's aphasics do not spell phonically, but rather adhere exclusively to a visual/orthographic strategy. Possible cognitive deficits underlying the spelling problem are identified. The written spelling deficit is related to other features of the syndrome of Broca's aphasia, and finally, speculations are offered concerning the neurological substrate of written spelling in Broca's aphasic patients.     

A case report of pathological rule-governed syllable intrusion

A detailed analysis of a unique speech disturbance, marked by the frequent appearance in the speech stream of a meaningless intrusive syllable, is presented. Following a lengthy thoracic surgery, an American English speaking patient began to speak with non-English prosodic patterns, which evolved to a conspicuous intrusion in his speech of the syllable /sis/. This syllable and its variants were attached to words in a manner which conformed to the regular phonological rules in English (for formation of plural, possessive, and third person singular morphemes). The distribution and frequency of the intrusive syllable are described, and possible explanations for the abnormal occurrence of this particular syllable are discussed.