Psychiatry under tyranny: A report on the political abuse of Romanian psychiatry during the ceausescu years

Romanians suffered incredible deprivations of every sort during the decades of Communist dictatorship. Most of the country’s 1,000 psychiatrists, and most of their patients, were victimized by the political system. A few psychiatrists actively engaged in practices amounting to torture. Many, however, became willing or unwilling participants in the political abuse of their profession. Such political abuses were fostered by abusive legislation and abusive law enforcement by the secret police. Abuses included: mass detentions in psychiatric hospitals of dissidents and political undesirables; abusive interpretation of the laws in detaining persons not suffering from mental illness; false, politically motivated diagnoses and treatment; and detention in secret facilities. While there are honest efforts to come to grips with the past, to compensate victims of psychiatric abuse, and to institute proceedings against abusers, there is also much resistance to reform. Reform-minded Romanian psychiatrists deserve the support of their western colleagues in the effort to restore Romanian psychiatry. In particular, professional colleagues all over the world are asked to comment on the draft law currently pending before the Romanian parliament, which is intended to restore the rule of law to the practice of psychiatry in Romania. Report of a consultative mission to Bucharest, on behalf of the Geneva Initiave on Psychiatry, 7 June to 12 June 1992, by Nanci Adler, Historian-Sovietologist, Geneva Initiative on Psychiatry, Amsterdam, The Netherlands; G.O.W. Mueller, Distinguished Professor of Criminal Justice, Rutgers — The State University of New Jersey, U.S.A.; Mohammed Ayat, Professor of Criminology and Penal Law, Université de Fes, Faculté des Sciences Juridiques, Economiques et Sociales, FEs, Morocco. The Geneva Initiative on Psychiatry is a nongovernmental, nonprofit organization, dedicated to the introduction and preservation of ethical practices in the psychiatric profession, in accordance with medical ethics, the Universal Declaration of Human Rights, and U.N. standards and guidelines. Headquartered in Amsterdam, the organization is currently providing technical and financial assistance to the newly established free, independent, democratic psychiatric associations in Russia, Ukraine, Romania, and other countries. The General Secretary of the organization is Robert van Voren; the board is composed of professionals from some twenty countries. This article was based on meetings at governmental and parliamentary offices, nongovernmental organizations, and embassies as well psychiatric institutions with, among others, the following persons: Dr. Lucian Alexandrescu, V-P Radu Ciuceanu, Mr. Comsa, Proc. Gen’l. Ulpiu Cereceanu, Mr. Nistor Cristea, Mr. Dinu Ianculescu, Prof. Dr. George Ionescu, Miss Cristina Luzoscu, Dr. Zaharia Nicolae, Mr. Iancu Petrescu, Dr. Dan Prelipcianu, Min. Mircea Ionescu-Quintus, Dr. Aurel Romila, Av. Nicolae Stefanescu-Draganesti, Dir. Dr. Tomescu, Dr. Alexandru Trifan, Dr. Valeriu Tuculescu, and numerous victims, diplomats, and Romanian citizens.     

CHANGING PROTECTIVE AND RISKY BEHAVIORS TO PREVENT CHILD-TO-PARENT TRANSMISSION OF CYTOMEGALOVIRUS

Child-to-parent transmission of cytomegalovirus may be reduced by increasing protective behaviors (handwashing and glove use) and decreasing risky behaviors (intimate contact between child and parent). This study showed that an educational intervention resulted in increases in reported and objective measures of protective behaviors and decreases in reported risky behaviors. Further study must determine if changes in protective and risky behavior are maintained and prevent cytomegalovirus transmission.     

Preference for familiar humans by rats

Many “higher” animals are commonly assumed to distinguish between individual humans. This belief is based largely on anecdotal reports; in reality, there is little empirical evidence to support human recognition in nonhuman species. We report that laboratory rats consistently chose a familiar human over an unfamiliar human following fourteen and five 10-min exposures and even following a single 10-min exposure. Furthermore, this preference was retained in the absence of additional contact for at least 5 months. These results confirm that laboratory rats can tell individual humans apart, a prerequisite for associating them with hedonic events. Such human-based conditioning, described by Pavlov and by Gantt, Newton, Royer, and Stephens (1966), may have important implications for animal research in a variety of settings.     

“Make things as simple as possible, but no simpler.” A rejoinder to Scruggs and Mastropieri

Scruggs and Mastropieri (Behaviour Research and Therapy, 32, 879–883, 1994) take issue with criticisms of their PND (Percent of Nonoverlapping Data) statistic that we offered in our recent article (Allison & German, Behaviour Research and Therapy, 31, 621–631, 1993), which advocated a regressionbased method for obtaining effect sizes in single-subject studies. They contend that their PND approach has several advantages over our approach because: (1) they believe that, unlike ours, it can take advantage of the small number of observations that are typically available in single-case studies; (2) it is simple to compute; (3) it frees researchers from traditional regression assumptions of normality, homogeneity of variance, and independence of observations and residuals; and (4) it correlates with visual judgements made by experts. As we shall argue, these claims are built upon very questionable assumptions and they are very difficult to substantiate. In addition, we show that the expected value of the PND is so strongly related to sample size as to be rendered meaningless.     

Effects of surface texture on weight perception when lifting objects with a precision grip

In this paper, we show that, when lifting an object using a precision grip with the distal pads of the thumb and index finger at its sides, the perceived weight depends on the object’s surface texture. The smoother the surface texture, the greater the perceived weight. We suggest that a smoother object is judged to be heavier because the grip force, normal to the surface, required to prevent it from slipping is greater. The possibility of there being an influence of surface texture per se is excluded by a second experiment that employed a variant of the precision grip in which the thumb supports the weight of the object from underneath. With the grip oriented in this way, there is no need to match grip force to surface texture and, under these conditions, there is no effect of surface texture on weight perception. In the first two experiments, the test and comparison weights were lifted successively by the same hand. In a third experiment, the effect of surface texture was replicated for sequential lifts made with separate hands. Thus, the effect is not restricted to comparisons made with the same hand.     

Beyond the relational principle of reinforcement

Behavior under baseline conditions in which the contingency is absent can shed some light on the individual's performance under a schedule, but is insufficient as a basis for prediction of performance. This insufficiency of the baseline data runs counter to a recent formalization of the relational principle of reinforcement (Donahoe, 1977). A more satisfactory predictive model must incorporate not only the baseline level of the instrumental response and that of the contingent response, but also the schedule requirements, the character of each response in relation to the other, and the behavior required in simply switching from each to the other.     

Behavioral coaching in the development of skills in football, gymnastics, and tennis

A review of the literature indicates that methods of skill acquisition based on the operant paradigm have been scientifically validated with many motor behaviors. However, these procedures have been limited to the use of positive reinforcement for correct performance when applied to the acquisition of complex sports skills in natural settings. To find complementary procedures to enhance skill acquisition, a coaching method involving several behavioral techniques was developed that focused on remediation of errors. This coaching method combined the following components: (1) systematic use of verbal instructions and feedback, (2) positive and negative reinforcement, (3) positive practice, and (4) time out. Three sports, football, gymnastics, and tennis, were selected to determine the effectiveness and generality of this behavioral coaching method. A total of 23 male and female subjects, ranging in age from 11 to 35, was included in this study. Baseline data were first collected for each sport under standard coaching conditions. Next, the behavioral coaching method was evaluated depending on the sport in either a multiple baseline or a reversal design. The behavioral dimensions selected were blocking in football; backward walkovers, front hand springs, and reverse kips in gymnastics; and the forehand, backhand, and serve in tennis. Behavioral coaching was immediately effective in increasing the correct execution of complex skills in all three sports. Gains of up to 10 times the baseline performance were achieved in each sport. In football, behavioral coaching resulted in an increase in correct blocking performance from a baseline average of 5% to 51.3%. Gymnasts' performances increased from baseline averages of 2.7% to 52.6% across the three skills. In tennis, standard coaching produced an average of 6% correct performance which increased dramatically under behavioral coaching to 57% across the three strokes. The success of the behavioral coaching package used here suggests that a technology of behavior may offer additional and complementary strategies to the acquisition of motor skills in the natural environment.     

Virtual Reality One-Session Treatment of Child-Specific Phobia of Dogs: A Controlled,Multiple Baseline Case Series

Specific phobia (SP) typically onsets in childhood and frequently predicts other mental health disorders later in life. Fortunately, childhood SP can be effectively treated with cognitive behavior therapy (CBT), including the exposure-based one-session treatment (OST) approach. Despite empirical support for CBT and OST, clinicians, for various reasons, frequently fail to implement exposure-based therapy in routine clinical practice, including perceived difficulties in implementing exposure. Virtual reality (VR) exposure therapy may overcome some of these challenges and provides an alternative modality of therapy. This preliminary study examined the efficacy of VR OST for 8 children with a SP of dogs (aged 8–12 years) (M = age 10.25; SD = 2.11) using a multiple-baseline controlled case series. Following a stable baseline period of either 2, 3, or 4 weeks, it was expected that specific phobia severity would significantly decline after VR OST and remain improved over the 3-week maintenance phase. Assessments were conducted posttreatment and at 1-month follow up (study end-point). It was found that phobia symptoms remained relatively stable across the baselines, with significant reductions from pretreatment to posttreatment and to follow-up on clinician severity ratings (pre- to post- g = 1.12; pre- to follow-up g = 2.40), target symptom ratings (g = 1.14; 1.29), and behavioral avoidance (g = -1.27; -1.96). The treatment was also associated with clinically significant outcomes, whereby at one-month follow up, 75% of children were considered “recovered” and 88% completed the BAT (interacted with their feared stimuli). This study provides support for the effectiveness of VR OST.