On not getting out of bed

Philosophical Studies - This morning I intended to get out of bed when my alarm went off. Hearing my alarm, I formed the intention to get up now. Yet, for a time, I remained in bed, irrationally...     

Family interaction and the course of adolescent psychopathology: An analysis of adolescent and parent effects

This study focused on evaluating the utility of three family measures for predicting outcome in a sample of disturbed but nonpsychotic adolescents: (a) the affective quality of the adolescents' voice tone when communicating with his/her parents; (b) the predominant affective quality of the parents' voice tones when communicating with the adolescent, and (c) the affective quality of the content of the parents' verbalizations to the adolescent. These measures were derived from 5-minute face to face discussions between parents and their disturbed adolescent. Results indicated that adolescents using positive or neutral voice tones during emotionally laden discussions with their parents tended to show relatively adequate levels of psychosocial adjustment as young adults, while adolescents using exclusively negative voice tones tended to show sufficient adjustment difficulties in early adulthood to warrant diagnoses within the extended schizophrenia spectrum. Although adolescent voice tone was associated with outcome, considering both adolescent and parent affective response led to improved prediction, with consideration of adolescent and parent variables leading to accurate prediction of outcome for 30 of the 33 sample cases.     

Depression in child psychiatric inpatients: Cognitive and attributional patterns

Cognitive and learned helplessness models of depression view maladaptive cognitive and attributional patterns as core features of depressive disorders. This study examined cognitive and attributional patterns in depressed children, nondepressed children, and a subgroup of remitting depressives who had histories of depression but were not reporting depressive symptoms when evaluated during the first 2 weeks of hospitalization. When compared with nondepressed controls, depressed children reported significantly more hopelessness, more negative self-perceptions, and negative self-perceptions across a wider variety of domains, and they displayed more dysfunctional attributional styles. While 55% of depressed children displayed pervasive maladaptive cognitive patterns, the other 45% of depressed children scored more similarly to nondepressed children, suggesting that childhood depressive disorders may be heterogeneous with respect to cognitive patterns. Contrary to the notion of traitlike depressive cognitive and attributional patterns that persist after the remission of depressive episodes, children with remitting depressions scored similarly to nondepressed children.Partial support for this project was provided by a grant from the John D. and Catherine T. MacArthur Foundation as part of their Network on Risk and Protective Factors in the Major Mental Disorders. I wish to thank Donald Guthrie for providing statistical consultation, Gwen Gordon for her computer assistance, and Niels Mueller and Jean Keller for their help with data collection.     

Depression in youth: psychosocial interventions

Witnessed over the past 20 years are major advances in knowledge regarding depression in children and adolescents. Although additional research is needed, clinicians can now turn to treatment strategies with demonstrated efficacy. In this article we review the literature on psychosocial interventions for depression in youth and offer a working model to guide the treatment of depressed youth. We begin with a brief overview of the model, followed by a review of the treatment efficacy and prevention literatures. We offer some caveats that impact the ability to move from this treatment literature to the real world of clinical practice. We conclude by considering how extant research can inform treatment decisions and highlight critical questions that need to be addressed through future research.     

Use of a common software system for collaborative clinical research on attentional processes in schizophrenia and ADHD

MacArthur Network III, consisting of five nodes (locations) and over 100 investigators, was formed in 1983 to conduct collaborative clinical research on risk and protective factors associated with psychiatric disorders. The common measurement of attentional dysfunction associated with two specific disorders (schizophrenia and attention deficit-hyperactivity disorder) was a goal of a subgroup of 11 Network III investigators. In this paper, the experiences with five approaches for implementing common protocols on laboratory computers for collaborative clinical research are described. The reasons for selecting the approach provided by Schneider’s (1988) MEL system are presented and discussed.     

Span of apprehension in schizophrenic patients as a function of distractor masking and laterality.

Twenty schizophrenic patients, 10 depressed control patients, and 20 normal control subjects were compared in a forced-choice, target-detection method for assessing the span of apprehension. The detection task required the subject to report which of 2 target letters was presented among 7 other (distractor) letters. Performance accuracy was examined as a function of target location and whether the distractor letters were masked after their presentation. The backward masking of the distractors improved target-detection accuracy of both control groups but reduced accuracy of the schizophrenic group. In addition, schizophrenics performed particularly poorly on targets located in the left half or lower half of the display. These results suggest that response to the masking of distractors may be a new index of attentional shortcoming in schizophrenia. Various theoretical explanations for the target location findings are also discussed.     

Family interaction styles of children with depressive disorders, schizophrenia-spectrum disorders, and normal controls

Family interaction processes during a problem-solving task were examined in children with depressive disorders, children with schizophrenia-spectrum disorders, and a normal control group of community children screened for the absence of psychiatric disorder. Major findings were: a) children with depressive disorders were more likely than children with schizophrenia-spectrum disorders and children with no psychiatric disorder to direct guilt-inducing comments toward their parents; and b) parents of children with schizophrenia-spectrum disorders were more likely to direct harsh critical comments toward the child than were parents of depressed children or parents of normal controls. In addition, children's and mothers' use of benign criticism was linked, while children's harsh criticism was associated with intrusion from the father, and children's self-denigrating comments were related to specific paternal criticism. Implications of these results for understanding transactional processes associated with childhood-onset depressive and schizophrenia-spectrum disorders are discussed.