Introduction to the Virginia Satir memorial Lecture

Delivered at the opening plenary session of the First World Family Therapy Congress, Dublin, Ireland, Monday, June 19, 1989.     

Cocaine—review of current literature and interface with the law

Cocaine use in the United States has currently reached epidemic proportions. This has resulted in syndromes of intoxication, overdose, and withdrawal, meeting all DMS-III criteria for a substance that can cause dependence as well as abuse syndromes. This paper reviews the current epidemiology of cocaine, its history and pharmacology with major focus on clinical syndromes. This is followed by a review of the current knowledge of the relationship between cocaine and violence and the forensic-psychiatric issues surrounding cocaine.     

An Empirical Test of the Three‐Step Theory of Suicide in U.K. University Students

The purpose of this study was to further our understanding of how individuals move down the pathway from first thinking about suicide to ultimately attempting to take their own lives by empirically testing the Three‐Step Theory (3ST) in a sample of university students (n = 665). Results largely support the theory's central propositions. First, an interactive model of pain and hopelessness accounted for substantial variance in suicidal desire. This result replicated in both men and women, and across age groups (i.e., below 35 and at or above 35). Also, as predicted, connectedness was protective against ideation in those high on both pain and hopelessness. However, contrary to our prediction, connectedness was similarly protective among everyone else. Finally, suicide capacity predicted suicide attempt history over and above current and lifetime suicide ideation. These findings provide further support to the 3ST.     

Accuracy of Clinician Predictions of Future Self‐Harm: A Systematic Review and Meta‐Analysis of Predictive Studies

Assessment of a patient after hospital‐treated self‐harm or psychiatric hospitalization often includes a risk assessment, resulting in a classification of high risk versus low risk for a future episode of self‐harm. Through systematic review and a series of meta‐analyses looking at unassisted clinician risk classification (eight studies; N = 22,499), we found pooled estimates for sensitivity 0.31 (95% CI: 0.18–0.50), specificity 0.85 (0.75–0.92), positive predictive value 0.22 (0.21–0.23), and negative predictive value 0.89 (0.86–0.92). Clinician classification was too inaccurate to be clinically useful. After‐care should therefore be allocated on the basis of a needs rather than risk assessment.     

Human social defeat and approach–avoidance: Escalating social-evaluative threat and threat of aggression increases social avoidance

Basic research on avoidance by Murray Sidman laid the foundation for advances in the classification, conceptualization and treatment of avoidance in psychological disorders. Contemporary avoidance research is explicitly translational and increasingly focused on how competing appetitive and aversive contingencies influence avoidance. In this laboratory investigation, we examined the effects of escalating social-evaluative threat and threat of social aggression on avoidance of social interactions. During social-defeat learning, 38 adults learned to associate 9 virtual peers with an increasing probability of receiving negative evaluations. Additionally, 1 virtual peer was associated with positive evaluations. Next, in an approach–avoidance task with social-evaluative threat, 1 peer associated with negative evaluations was presented alongside the peer associated with positive evaluations. Approaching peers produced a positive or a probabilistic negative evaluation, while avoiding peers prevented a negative evaluation (and forfeited a positive evaluation). In an approach–avoidance task with social aggression, virtual peers gave and took money away from participants. Escalating social-evaluative threat and aggression increased avoidance, ratings of feeling threatened and threat expectancy and decreased ratings of peer favorableness. These findings underscore the potential of coupling social defeat and approach–avoidance paradigms for translational research on the neurobehavioral mechanisms of social approach–avoidance decision-making and anxiety.     

Evidence for altered configural body processing in women at risk of disorders characterized by body image disturbance

Two studies were conducted to assess appearance-related visual processing mechanisms in populations at risk of disorders characterized by body image disturbance. Using inverted stimuli, Experiment 1 assessed visual processing mechanisms associated with body, face, and house viewing in adolescents. Experiment 2 applied the same protocol to assess appearance-related configural processing in high- and low-risk adolescent women, and women recovering from disorders characterized by body image disturbance. Experiment 1 found evidence for typical configural face and body processing, although adolescent women reported higher levels of body image concern (BIC) and self-objectified to a greater extent than adolescent men. In Experiment 2, typical body inversion effects were seen in the low-risk group, whilst there was some evidence to suggest a disruption to the configural processing of body stimuli in high-risk adolescents and in women recovering from body image disorders. Women in recovery were also quicker to respond to all stimuli, whilst high-risk adolescents took longer to respond to bodies than to other stimuli. Configural face processing was intact in all groups, and effects did not directly relate to BIC or self-objectification. These findings have implications for future research looking to inform early interventions and treatment, suggesting that there could be a tendency to visually process individual body parts at the expense of the whole-body form in women at risk of developing body image disorders, as well as those in recovery.     

Comparison of contingent and noncontingent access to therapy dogs during academic tasks in children with autism spectrum disorder

This study compared contingent and noncontingent access to therapy dogs during educational tasks for children with autism spectrum disorder using a multielement design. The experimenters assessed whether initial preference for the dog predicted reinforcer efficacy and how preference changed across time. A higher response rate during contingent dog sessions than baseline sessions occurred for 4 out of 5 participants, suggesting that the dog functioned as a reinforcer. One participant engaged in a high rate of responding in both contingent and noncontingent dog conditions. Preference assessments revealed idiosyncrasies, suggesting that further research is needed into the predictive nature of initial preference assessments with animals as part of the stimulus array. The experimenters also analyzed salivary cortisol before and after sessions to determine if learning about the upcoming interaction with a dog reduced salivary cortisol in children. Cortisol was variable across participants, with only some deriving a potential physiological benefit from expecting to interact with the dog.     

Evaluating adult interaction during the Step It UP! game to increase physical activity in children

A recent intervention, the Step it UP! game (Galbraith & Normand, 2017), consists of an interdependent group contingency to increase student physical activity. In addition, previous research demonstrated that adult interaction may reinforce physical activity (Larson et al., 2014). We extended research on the Step it UP! game by comparing the effects of no game, Step it UP! game, and Step it UP! game plus adult interaction on the number of steps taken by participants in a third-grade classroom during recess. Overall, 19 of the 25 participants took more steps during the Step it UP! game plus adult interaction compared to the Step it UP! game and no-game recesses. Furthermore, 20 participants preferred the Step it UP! game plus adult interaction. Results suggest that adult interaction can enhance the effects of the Step it UP! game to increase physical activity.     

Predicting having a best friend in young children: individual characteristics and friendship features

In this study, the authors investigated the characteristics that predict best friend status in young children. One hundred and twenty-four preschool, kindergarten, and first-grade children identified their "best friend" and up to four "other friends" in their class. Teachers completed a questionnaire about each friendship to determine positive and negative features of the relationships. First, the authors used individual characteristics to predict if a child had a best friend. The variables age, gender, and peer acceptance predicted that a child would have a best friend. Second, positive friendship features positively predicted best friendships in analyses of all friendship pairs. Best friendships are meaningful relationships to children even at this young age and offer children more positive experiences than do other friendships.