Clinical controversy and the domains of scientific evidence

The diversity of mental health care "schools" or therapeutic perspectives poses problems in selecting and using any single therapeutic perspective. This article describes the genesis of clinical controversy--that is, how two or more therapeutic perspectives of the same clinical situation can be so different yet not necessarily differ in outcome. Ideas drawn from contemporary philosophy of science show how different "schools" derive separate, incompatible sets of scientific evidence from the same clinical situation. The school or theory determines (in part) not just what evidence is used, but what evidence is actually perceived. The authors conclude by recommending a pluralistic approach to mental health care; they map out some consequences of this pluralism and suggest some strategies for minimizing the disadvantages of "mixing and matching" therapeutic perspectives.     

Control of gait initiation

The initiation of gait from a standing posture by 6 subjects, who took controlled-length steps, was analyzed. Using an inverted pendulum model, we found that the duration of gait initiation was independent of gait velocity. This finding suggests that subjects' biomechanical constants are the determining factors for initiating movement. Both the instantaneous velocity of the center of gravity at the end of the first step (resulting in the propulsive forces measured on the ground) and the steady-state velocity (resulting in the step length and frequency) varied with step length, whereas step frequency did not. But step frequency and progression velocity were linked, for step frequency always increased in parallel with increased progression velocity. We interpret the correlation between velocity and frequency variations to be a peripheral expression of the posturodynamic control of the step parameters by the progression forces.     

A comparison of five-factor personality dimensions in males with sexual dysfunction and males with paraphilia.

We compared personality profiles of men with sexual dysfunction (n = 51) to those of age-matched men with a primary diagnosis of paraphilia (n = 51) employing the NEO Personality Inventory (NEO-PI), a measure of the five-factor model. Preliminary analyses in a large sample of patients in a sexual behaviors consultation unit supported the reliability and factorial validity of the NEO-PI for this population. Analysis of variance showed significant differences between the dysfunctional and the paraphilic groups on two of the five NEO-PI domains, Neuroticism (N) and Agreeableness (A). The group personality profile of the sexually dysfunctional men was comparable to the normative sample of the NEO-PI, except for a slight elevation in N. By contrast, men with paraphilia had a personality profile marked by high N, low A, and low Conscientiousness (C). Treatment implications of the average personality profile of the sexual dysfunction group and the distinctive personality profile of paraphilic men are discussed.     

Assessment of coping: an empirical illustration of the problem of inapplicable items

The prevalence and effects of inapplicable items on the Ways of Coping Questionnaire (WOC) were studied. Three hundred seventy-six college students completed the WOC twice, referring to both heterogeneous (i.e., different types of) and homogeneous (the same) stressors. In addition to the standard procedure for administering this questionnaire, subjects were asked to identify items that were inapplicable to the stressors with which they were coping. Item inapplicability ranged from 2.1% to 83.9%, with a mean of 21.5% inapplicability across all WOC items. Application of a correction for item inapplicability demonstrated that situational effects are confounded by this phenomenon and may not hold up when the correction is applied. Implications of these findings include the possibility that previous research has over- or misidentified situational effects on coping.     

Sources of auditory masking in infants: distraction effects.

Previous work has demonstrated that infants' thresholds for a pure tone are elevated by a masker more than would be predicted from their critical bandwidths. The present studies explored the nature of this additional masking. In Experiment 1, detection thresholds of 6-month-old infants and of adults for a 1-kHz tone were estimated under three conditions: in quiet, in the presence of a 4- to 10-kHz bandpass noise at 40 dB SPL, and in the presence of the same noise at 50 dB SPL. The noise was gated on at the beginning of each trial. Adult thresholds were the same in all three conditions, indicating that little or no sensory masking took place in the presence of the noise. Infant thresholds were about 10 dB higher in the presence of the noise. We term this effect distraction masking. In Experiment 2, the effect of gating the noise on at trial onset was examined. Thresholds for the same tone were estimated in quiet and in the presence of the band-pass noise at 40 dB SPL, but the noise was presented continuously during the session. Under these conditions, distraction masking was still observed for infants. These findings suggest that a masker can have nonsensory effects on infants' performance in a psychoacoustic task.     

Stimulus-response compatibility and the Simon effect: toward a conceptual clarification.

The current view that the Simon effect (Simon & Small, 1969) reflects stimulus-response compatibility (SRC) is questioned. Previous accounts of the Simon effect have overlooked stimulus congruity (SC), the correspondence relation borne by the two simultaneous aspects of the stimulus, a factor inevitably confounded in the Simon paradigm with irrelevant spatial S-R correspondence. The Hedge and Marsh (1975) reversal effect, replicated in Experiment 1, is reinterpreted as decisive evidence that the Simon effect is entirely accounted for by SC. Furthermore, in Experiment 2 irrelevant S-R correspondence was manipulated in the absence of any variation of SC, and the Simon effect vanished. It is concluded that the Simon effect, contrary to current opinion, represents a spatial variant of the Stroop effect and is irrelevant to the SRC issue. The view that mental operations proceed automatically at the stage of response determination loses one of its strongest empirical arguments.     

Paroxysmal speech disorder following left frontal brain damage

The patient was a 61-year-old female who suffered from the sudden attack of a speech disorder. The episodes of speech disorder lasted for less than 1 min, but occurred several times a day, paroxysmally. A CT revealed a low density area on the surface of the left frontal lobe and an EEG showed an abnormal wave at the frontoparietal area, more dominantly on the left. This condition was diagnosed as a kind of epilepsy. The paroxysmal speech disorder occurred very often during the 2 months after the first episode. However, with therapy using anticonvulsives and antibiotics, the condition began to improve after 4 months and disappeared completely after 6 months. It is assumed that the inflammatory change which occurred at the frontal lobe stimulated the supplementary motor area paroxysmally, and subsequently the speech disorder occurred as a kind of epilepsy.     

Power and status differentials in minority and majority group relations

Using a variant of the minimal group paradigm (Tajfel and Turner, 1986), this study tested the effects of power, status and group numbers on intergroup behaviours and perceptions. Subjects (N = 160) were categorized into groups that varied on status (high or low), power (dominant or subordinate) and group numbers (majority or minority) variables within a 2 × 2 × 2 experimental design. Based on their evaluations of others' creative products, subjects distributed credit points to ingroup and outgroup others using the Tajfel matrices. Results showed that dominant group members were much more discriminatory and less parity oriented towards outgroup others than subordinate group members. High status group members were more discriminatory and less parity oriented than low status group members. Minority group members who were dominant and of high status were highly discriminatory and were unique in showing no parity whatsoever towards outgroup others. Subordinate low status minorities did not discriminate and were exceptional in showing out-group favouritism. Relative to group status and group numbers, group power seemed more predictive of actual discriminatory behaviour. Group status accounted for the greatest variance in social identification and intergroup perceptions measures. Results also showed that social categorization was sufficient to elicit more in-group than outgroup liking amongst all group members regardless of their position in the intergroup structure. Overall, this study indicated that power, status and group numbers independently and in combination, have a strong impact on intergroup behaviours and perceptions.     

Crossmodal versus intramodal evaluation of the knee joint angle : A normative study in a population of young adults

Normative data on position sense in the knee joint were obtained from a population of young adults (N = 46, mean age: 22). Kinaesthetic and visual evaluation of the knee joint angle was measured in crossmodal and intramodal matching tasks. In terms of absolute errors, the scores, although similar in both crossmodal tasks, were significantly lower in the unimodal matching task; the subjects' laterality had no significant effects. In terms of signed errors, the scores had opposite polarities between the kinaesthetic-visual and the visual-kinaesthetic tasks; moreover, the kinaesthetic intramodal task showed an obvious laterality bias. The angle reference value was found to affect the magnitude and sign of error variably depending on the task. The smallest errors were observed around the resting position in crossmodal matching, whereas they increased monotonically from extension to flexion in unimodal kinaesthetic matching. The data are interpreted in terms of the underlying physiological mechanisms and psychophysical determinants. Some clinical and sport applications are suggested.     

Mediating mechanisms in a school-based drug prevention program: first-year effects of the Midwestern Prevention Project

Describes (a) the effects of a social-influences-based drug prevention program (the Midwestern Prevention Project) on the mediating variables it was designed to change and (b) the process by which the effects on mediating variables changed use of drugs (tobacco, alcohol, and marijuana). Students in 42 middle schools and junior high schools in Kansas City, Missouri, and Kansas City, Kansas, were measured in the fall of 1984 (N = 5,065) and again 1 year later (N = 5,008) after 24 of the schools had been through the program. Compared to students in control schools, students in program schools became less likely to express belief in the positive consequences of drug use, less likely to indicate that they would use such drugs in the future, more likely to report that their friends were less tolerant of drug use, and more likely to believe that they were better able to communicate with their friends about drug or school problems. Change in perceptions of friends' tolerance of drug use was the most substantial mediator of program effects on drug use. There was evidence that intentions to use and beliefs about the positive consequences of use may also mediate program effects on drug use.