Naturalistic observations of pathological behavior in hospitalized psychiatric patients

Naturalistic observations were conducted on 19 acutely ill psychiatric patients in the hospital ward milieu. The study was designed to determine relationships between selected social and environment variables and overt atypical behavior. Patients were observed on an individual basis with time-sampling techniques. In total, 16 pathological behaviors were coded and the most frequent (postural deviance, pace, agitation, hyperactivity, withdrawal, foot shake/body sway, leg swing) were selected in order to determine variation in frequency of these behaviors as a function of the following variables: area within hospital, week of hospitalization, distance between the focal subject and his/her nearest neighbor, number of people in an area, and time of day. Results showed differential changes in pathological behavior as a function of week of hospitalization, number of people in a given area, and distance from the focal subject's nearest neighbor. There was no significant change in the frequency of pathological behaviors as a function of area within hospital or time of day. In addition, most pathological behaviors decreased significantly when patients were engaged in the sending or receiving of verbal behavior. Cluster analyses revealed varying degrees of dissociation between pathological behaviors and social-interaction behaviors. These results support (a) a nonunitary concept of the general category pathological and (b) the view that there are inhibitory effects of social interaction on the enactment of atypical behaviors. Clinical implications of these findings are discussed.R.H.P. completed this research during his tenure as a postdoctocal fellow in the Department of Psychiatry, Human Ethology Laboratory, UCLA (NIMH Fellowship 1 F32MHO7627-01). Support for this research also came from the Veterans Administration.     

Substance use by adolescent psychiatric inpatients and their parents

The relationship between adolescent psychiatric inpatients' and their parents' drug use was studied using a questionnaire format. The major finding was that there was no systematic relationship. It is hypothesized that due to recent family realignments, adolescents are turning away from their parents and toward peers for their role models in drug use.     

Early impact of the BEST intervention for parents stressed by adolescent substance abuse

Youth involvement in substance abuse can be a source of considerable distress for their parents. Unilateral family interventions have been advocated as one means by which concerned family members can be supported to assist substance‐abusing family members. To date there has been little research examining the impact of unilateral family interventions on the directly participating family members. In this study the early impact of an 8‐week parent‐group programme known as Behavioural Exchange Systems Training (BEST) was evaluated using a quasi‐experimental, waiting list control design. The professionally led programme had been developed to support and assist parents in their efforts to cope with adolescent substance abuse. Subjects were 66 parents (48 families) accepted for entry into the programme between 1997 and 1998. Comparison was made between 46 parents offered immediate entry into the programme and 20 parents whose entry to the programme was delayed by an 8‐week waiting list. At the first assessment 87% of parents showed elevated mental health symptoms on the General Health Questionnaire. Evidence suggested exposure to the intervention had a positive impact on parents. Compared to parents on the waiting list, parents entered immediately into the intervention demonstrated greater reductions in mental health symptoms, increased parental satisfaction, and increased use of assertive parenting behaviours. Copyright © 2001 John Wiley & Sons, Ltd.     

Spiritual and religious concerns of the hospitalized adolescent

One of the tasks of adolescence is the development of a value system. The way in which these values are expressed in relationship to illness in adolescence, however, has not been studied. The authors conducted a social science survey to study the spiritual concerns of hospitalized adolescents. One hundred and fourteen hospitalized adolescents, ranging in age from 11 to 19, answered a Likert scale questionnaire on Spiritual and Religious Concerns (SRQ). Analysis of variance was performed to correlate responses with sex, race, religion, type of school, and severity of illness. A subgroup of hospitalized adolescents, those with more serious disease, experienced intensified spiritual and religious concerns. In response to the questionnaire, over 15% of the patients requested further help. Our findings suggest that training in adolescent health care and the provision of services to teenagers ought to include teaching in the area of spiritual and religious values of teenagers, with emphasis on the hospitalized adolescent.     

Risk status of adolescent children of problem-drinking parents

These studies assessed the risk status of children of untreated alcoholics. In Study 1, a cross-sectional survey of 208 high school students identified 18% as having serious concern about their parents' drinking. In Study 2, 32 children of problem-drinking parents and 39 others who participated in self-help groups were surveyed. Children of problem-drinking parents were more at risk of depression, low self-esteem, and heavy drinking than their peers in the general high school population. Within self-help groups, however, children's symptomatology was not related to their parents' drinking status. The results support the need for preventive intervention for children of problem-drinking parents and for developing strategies for improving the participation rate of such children in the intervention programs that are available.     

Coaching preferences of adolescent youths and their parents

Abstract

This study compared preferred coaching styles of children and their parents using the Leadership Scale for Sport (LSS; Chelladurai & Saleh, 1980). The LSS preferred form was revised and then administered to children ranging from 10 to 18 years of age who competed in summer youth sport leagues and to one parent within each family unit (n = 239). A doubly multivariate repeated measure MANOVA revealed a significant multivariate difference for adolescent athletes and their parents on the five subscales of the LSS. Discriminant function and univariate analyses indicated that male and female children and their parents differed on autocratic and democratic behavior and children had a significantly higher score on democratic behavior and social support than did their parents. Parents, coaches, and researchers in youth sports could use the revised LSS to determine children-athletes’ preferences for coaching styles and for developing more effective programs.     

Clinical observations of play of hospitalized suicidal children

This paper emphasizes the usefulness of play observation for diagnosis, treatment, and understanding suicidal behavior of children. Predictive indicators of play for potential suicidal behavior are themes of separation and loss, repetition of dangerous and reckless behavior, misuse and destruction of toys, and repetitive acting out of omnipotent fantasies. The selection of a suicidal method is partly derived from unconscious motivations that are illustrated in play themes. This study revealed a characteristic suicidal technique of latency age children seems to be jumping from heights.     

Dyadic personality effects on family functioning in parents of newly hospitalized children

This study prospectively examined dyadic influences of parental personality on levels and change of family functioning in parents of a newly hospitalized child. A total of 183 couples whose child sought treatment for Type 1 diabetes, cancer, or an unintentional injury were assessed at 1 and 6 months posthospitalization with tests measuring personality, and family functioning. Analyses used structural equation modeling based on the actor–partner interdependence model. Family functioning in both parents showed substantial differential stability and interdependence. Mothers' Neuroticism and Agreeableness and fathers' Openness and Conscientiousness influenced their own family functioning. Fathers' Conscientiousness influenced their spouse's family functioning. Both parents' personalities influenced their family functioning over time, underlining that the parents' perspectives should be studied jointly.     

Changes in adolescent and parent hopefulness in psychotherapy: effects on adolescent outcomes as evaluated by adolescents,parents, and therapists

We examined the role of hope in the behavioral and socioemotional outcomes of adolescents referred to psychotherapy. Adolescents (n = 3517), aged 12–17 years, and their parents rated adolescents’ behavior problems, adolescents’ adaptive behavior, and their own subjective experience of hopefulness at intake and at 3-month follow-up. Therapists also rated adolescents’ behavior problems and adaptive behavior at intake and follow-up. Adolescents who reported increased hopefulness during treatment showed significantly fewer problems and significantly greater adaptive behavior at follow-up than adolescents who reported stable or decreased hopefulness. Similarly, adolescents’ outcomes were significantly associated with parents’ change in hopefulness during treatment. Results were consistent for adolescent, parent, and therapist ratings of outcomes. Our findings provide some of the first empirical evidence for the importance of hopefulness in the psychosocial treatment of adolescents and highlight the need to attend to hopefulness in both youths and their parents.     

Parentification and its impact on adolescent children of parents with AIDS.

Parentification refers to children or adolescents assuming adult roles before they are emotionally or developmentally ready to manage those roles successfully. We assess predictors and outcomes of parentification among adolescent children of Parents with AIDS (PWAs) in two phases. In Phase 1, relationships among parental AIDS-related illness, parent drug use, parent and adolescent demographics, and parentification indicators (parental, spousal, or adult role-taking) were assessed among 183 adolescent-parent pairs (adolescents: 11 to 18 years, M = 14.8 years, 54% female; parents: 80% female). Adult role-taking was associated with maternal PWAs, female adolescents, and greater parent drug use. Greater parental AIDS-related illness predicted more spousal and parental role-taking. Parent drug use predicted more parental role-taking. In Phase 2, we examined the impact of parentification on later adolescent psychological adjustment (N = 152 adolescents). Adult role-taking predicted more internalized emotional distress; parental role-taking predicted externalized problem behaviors: sexual behavior, alcohol and marijuana use, and conduct problems. Given these dysfunctional outcomes, we discuss interventions to mitigate parentification among children of PWAs.     

Preference for consonance over dissonance by hearing newborns of deaf parents and of hearing parents

Behavioral preferences for consonance over dissonance were tested in hearing infants of deaf parents and in hearing infants of hearing parents when they were 2 days old. Using a modified visual-fixation-based, auditory-preference procedure, I found that both 2-day-old infants of deaf parents and those of hearing parents looked longer at a visual stimulus when looking produced the original version of a Mozart minuet as opposed to a version altered to contain many dissonant intervals. The relative magnitude of such preference did not significantly differ whether their parents were deaf or hearing. Infants prefer consonance over dissonance, and the preference is present from birth and is not dependent on any specific prenatal or early postnatal experience.     

Suicidal tendencies in schizophrenic patients hospitalized for the first time

180 (15%) patients from 1208 first-hospitalized schizophrenic patients had suicidal tendencies. Our findings show that the suicidal tendencies of schizophrenic patients have their own features. These conclusions can be supported by the differences between the determinants of the suicidal tendencies of schizophrenic and non-schizophrenic population; such different determinants are: sex, age, family and suicidal method. Suicidal tendencies are more frequent among patients without formal thought disturbances. We explain this fact with an "incoherence of decision processes". The features of the suicidal tendencies of schizophrenic patients are based on the grounds of psychosis own dynamic.     

Communication in relationships and adolescent substance use: the influence of parents and friends

This study focused on the openness of communication in teenagers' relationships with mother, father (or parental figure), and closest friend, and its correlation with teenagers' use of cigarettes, alcohol, marijuana, and other drugs. The predictive value for substance use of perceived pressure from friends, friends' substance use, and parents' substance use was also analyzed. The findings from questionnaires and interviews conducted with 37 students at an urban and a suburban/rural high school in New England are reported. The results suggest that the degree to which adolescents talk openly with their parents may influence the extent of their substance use. The presence of at least one "open" parental figure was associated with lower levels of all substance use. However, there was no evidence that openness with a close friend or perceived pressure from friends is related to substance use.