The aggression-coercion cycle: Use of seclusion and restraint in a child psychiatric hospital

The widespread use of seclusion and restraint in child psychiatric hospitals to manage aggression and noncompliance is based on the assumption that coercive consequences reduce the frequency of undesirable behaviors exhibited by the patients. We report a study of the use of seclusion and restraint in a public child psychiatric hospital during a 3-year period. Twenty-eight percent of the patients had been secluded or restrained a total of 1670 times. About 25% of these patients had been secluded more than five times during their hospitalization, and 32% had been placed in restraints more than once. Behaviors that typically resulted in repeated seclusion included physical aggression toward staff, verbal aggression toward peers, non-compliant or oppositional behavior, and self-harm. Variables that predicted patients most at risk for repeated seclusion included age, gender, and psychiatric diagnosis. The predictor variables for those most at risk for repeated restraint included age, property destruction, and self-harm. The high rates of use of seclusion and restraint suggest that these methods for controlling the behavior of children and adolescents in this child psychiatric hospital may not have been therapeutic. We suggest that staff in such hospitals engage in a pattern of behavior characterized by an aggression-coercion cycle, in which increasingly aggressive and coercive behaviors are exhibited by both patients and staff.     

Development of knowledge bases and the reliability of a decision support system for behavioral treatment consultation for persons with mental retardation: The Mental Retardation-Expert

The development of expert and decision support systems requires the collection, organization, codification, and storage of a body of specialized knowledge. The development, using reconstructive methods, of two such knowledge bases, the first containing the current scientific literature and the second containing an expert’s knowledge, is described for an automated decision support system, the Mental Retardation-Expert. This system provides practitioners with assistance in the treatment of aggressive, self-injurious, and destructive behaviors displayed by individuals with mental retardation or developmental disabilities. The average interobserver reliability of the expert knowledge base ranged from 92.5% to 95.0% when calculated across four clinicians’ assessments of 31 abstracted cases.     

Evaluating student achievement with a relational database

Commercial database programs such as dBase and Paradox, although developed originally for business applications, are versatile and powerful tools that can be used for an academic purpose such as evaluating student performance. They can be used to write and store test questions, assemble and print classroom or on-line laboratory tests, and calculate grades, test statistics, and so forth. Databases are flexible, unlike textbook “ancillary” test bank programs that are inextricably bound to the strictly linear format and brief shelf life of specific textbook editions. A prototypical relational database program is described, with which an instructor can produce tests based on generic terms adapted from Boneau’s (1990) study of psychological literacy, as well as on behavioral learning objectives adapted from Bloom’s (1956) taxonomy of educational objectives. As a relational database, the program integrates terms, objectives, questions, tests, and test scores, and avoids unnecessary data duplication and waste of computer storage space.     

Calibration of a color monitor for visual psychophysics

It has become common for stimuli used in visual psychophysical experiments to be presented on high-resolution color cathode-ray tubes (CRTs) such as the Barco CDCT 6551. These enable a flexibility of color, spatial-frequency content, temporal-frequency content, duration, size, and position that is not provided by most other media. CRTs are, however, not perfect; they suffer from the effects of temporal instability, spatial variability, lack of phosphor constancy, gun interdependence, and gun nonlinearity. This paper describes methods of assessing these aspects of monitor performance with respect to how significant each may be in psychometric terms. Although every application of CRT use in visual psychophysics is different, some general rules can be formulated to help ensure that unwanted effects are kept to a minimum. For the CRT used in this study (Barco CDCT 6551), a warm-up time of 30-45 min is necessary before chromatic and luminous stability ensues. Restriction of individual gun outputs to within 10%-90% of the possible range ensures that the effects of gun interdependence and lack of phosphor constancy are negligible. Calibration methods dealing with the linearization of gun output are also discussed.     

Disordered Communication and Grieving in Deaf Member Families

When a deaf child is born to hearing parents, a grieving process is initiated in the parents. Unresolved grieving over their child's deafness often makes it difficult for hearing parents to accept the importance of signing, thus increasing the child's problems — further source of grief for these parents. Clinical illustrations are provided of (1) the reciprocal relationship between disruption of the mourning process and disturbance of communication between family members, and (2) the transmission of the dysfunctional relationship between hearing parents and deaf children to the subsequent relationship between the deaf children, when they reach adulthood, and their hearing children.     

Structural Alignment during Similarity Comparisons

Similarity comparisons are a basic component of cognition, and there are many elegant models of this process. None of these models describe comparisons of structured representations, although mounting evidence suggests that mental representations are well characterized by structured hierarchical systems of relations. We propose that structured representations can be compared via structural alignment, a process derived from models of analogical reasoning. The general prediction of structural alignment is that similarity comparisons lead subjects to attend to the matching relational structure in a pair of items. This prediction is illustrated with a computational simulation that also suggests that the strength of the relational focus is diminished when the relational match is impoverished, or when competing interpretations lead to rich object matches. These claims are tested in four experiments using the one-shot mapping paradigm, which places object similarity and relational similarity in opposition. The results support the hypothesis that similarity involves the alignment of structured representations.     

Relevant consequence and empirical inquiry

A criterion of adequacy is proposed for theories of relevant consequence. According to the criterion, scientists whose deductive reasoning is limited to some proposed subset of the standard consequence relation must not thereby suffer a reduction in scientific competence. A simple theory of relevant consequence is introduced and shown to satisfy the criterion with respect to a formally defined paradigm of empirical inquiry.Research support was provided by the Office of Naval Research under contract No. N00014-89-J-1725 to Osherson and Weinstein, Swiss National Science Foundation under contract No. 21-32399.91 and by a Siemens Corporation grant to Osherson.