The pathological left-handedness syndrome

A clinical syndrome of pathological left-handedness (PLH) is proposed to identify the pattern of correlative changes in lateral development associated with early brain injury in some manifest left-handers. This syndrome is believed to be caused by a hemispheric lesion that is predominantly left-sided (or bilateral asymmetric), which onsets before Age 6, and which encroaches upon the critical speech zones of the frontotemporal/frontoparietal cortex. The pattern of changes may include any or all of the following features: shifts in manual dominance, trophic changes in the extremities, transfer of hemispheric speech, and/or intrahemispheric reorganization of visuospatial cognitive functions. Although some of these correlates of PLH have long been known, they have not been recognized as an interrelated pattern of traits that constitute a clinical syndrome. Identification of these individuals, all manifest left-handers, will be shown to have implications for diagnosis/remediation and for models of recovery of function.     

Seeking urgent pediatric treatment: factors contributing to frequency, delay, and appropriateness

The present study explored the factors that contribute to mothers' decisions to seek urgent medical attention for their children when symptoms are not of a traumatic nature. One hundred mothers seeking treatment for their children at a prepaid clinic completed a questionnaire eliciting their expectations regarding the course of their children's problems, seriousness of the problems, perceived responsibility for the symptoms, and extent to which a variety of factors contributed to their decisions to seek treatment. Demographic data and information about each child's symptoms and medical history were also obtained. Four major "reasons for seeking treatment" factors were identified: family history of the presenting complaint, worry regarding the symptoms, situational variables, and the extent of the child's illness behavior. The appropriateness of the visit, delay in seeking treatment, and frequency of mothers' use of the pediatric clinic were predicted by the nature of the presenting symptoms (particularly the presence of fever), the ages of the mother and child, and two of the reasons for seeking treatment factors (i.e., family history and child's illness behavior). The present study suggests that mothers pay more attention to presenting symptoms and to the children's behavior than to psychosocial stressors in deciding to seek urgent care.     

Co-occurrent use of cigarettes, alcohol, and coffee in healthy, community-living men and women

Previous studies have examined intra-individual aggregation in the use of cigarettes, alcohol, and coffee by examining the co-occurrent use of any pair of these three substances. A recent literature review failed to find a single investigation that studied use of all three in the same sample. In the present study, co-occurrent use of all three of these substances was examined in crossvalidated subsamples of 226 male and 245 female healthy, community-living, middle-class Americans. A log-linear analysis was used to compare the proportion of smokers, ex-smokers, and nonsmokers categorized as users of more or less amounts of coffee and alcohol. Although most of the intercorrelations were not strong, the results indicate that for both sexes, smokers and ex-smokers were more likely than nonsmokers to drink greater amounts of alcohol and coffee. Furthermore, for smokers, ex-smokers, and nonsmokers, a majority of individuals who reported drinking more alcohol also reported drinking more coffee. Interestingly, the coffee and alcohol consumption levels of ex-smokers resembled those of smokers more than those of nonsmokers. Also, ex-smokers reported drinking more wine and decaffeinated coffee than either smokers or nonsmokers. Finally, the number of cigarettes smoked per day (daily quantity) was positively related to total alcohol and coffee consumption in men, but not in women. Further studies are recommended to examine the role of individual differences in the development, maintenance, and modification of these three appetitive habits and their co-occurrence.     

Doctoral training in behavior analysis: Training generalized problem-solving skills

This essay provides guidelines for designing a doctoral program in behavior analysis. First, we propose a general accomplishment for all behavior analytic doctoral students: that they be able to solve problems concerning individual behavior within a range of environments. Second, in order to achieve this goal, we propose that students be trained in conceptual and experimental analysis of behavior, the application of behavioral principles and the administration of behavioral programs. This training should include class work, but it should emphasize the immersion of students in a variety of environments in which they are required to use behavior analytic strategies. Third, we provide an example of a hypothetical graduate program that involves the proposed training. Finally, an evaluation plan is suggested for determining whether a training program is in fact producing students who are generalized problem-solvers. At each step, we justify our point of view from a perspective that combines principles from behavior analysis and educational systems design.     

Spatial location judgments as a function of intention to learn, and mood state: an evaluation of an alleged automatic encoding operation

An assessment of the Hasher and Zacks (1979) conceptualization of the automatic nature of the acquisition of spatial location information was made in the context of manipulations of subjects' intention to learn and mood state. The Velten (1968) mood induction procedure was used to establish depressed and nondepressed subjects. Half of each group was then presented with a matrix of geometric forms under instructions to learn the location of the forms (intentional) or to evaluate the pleasantness of the array (incidental). Subsequent tests of spatial location performance found no differences as a function of subjects' mood state, but did find a strong effect for instructional condition. The superior performance of the intentional subjects raises questions about the automatic nature of the encoding of spatial location.     

Determinants of object choice in adulthood: a test case of object-relations theory

A clinical example of the effects of the absence of the father during the early childhood of a male analysand and its consequences for his later object choice is presented. This patient's biological father left the household when the patient was only a few months old, and his mother did not remarry until he was five years of age. Unconscious fantasies of the lost father, with whom the patient had no contact in reality, and longing for him organized the patient's drives and determined his self-identity as well as his later object choice. The patient developed both a positive and negative identification with the lost father. The identification was with a fantasy object not a real one. The case highlights the need to use a precise term in talking of the object, namely the mental representation of the object which may or may not be built up out of experiences with the real object.     

Superego formation, adolescent transformation, and the adult neurosis

The superego is heir to the Oedipus complex but has a much larger developmental legacy which includes preoedipal precursors and the influence of latency and adolescence. The superego continues to change in function and content throughout life, and radical transformation in adolescence may result in developmental discontinuity as well as core developmental continuity. A case is discussed in which adolescence was overlooked in previous analysis and in which adolescent superego modification had a major impact on the patient's character and his adult neurosis. The developmental significance of adolescence experienced under conditions of social isolation and rejection with forebodings of the Holocaust was unrecognized in sanctioned silence and shared analytic denial. These repeated earlier experiences of silent submission and stifled protest, and the silent suffering of the patient and his family, were an integral part of his humiliating and emasculating adolescent experiences. The intimidated adolescent, threatened from within and without, identified with the aggressor as well as with the victim. Identification with the aggressor and glorified victor contributed to a final adolescent structuralization of a punitive, sadistic superego and a rigidly perfectionistic ego ideal. As an adult, he tended to passive masochistic compliance with diminished self-esteem and unconscious self-denigration. He was prone to shame and guilt, self-criticism, and hidden hypercritical attitudes toward others. The adolescent internalization of aggression, intense castration anxiety, and pervasive narcissistic mortification led to retreat from resolution of revived oedipal conflict and to concomitant detrimental superego alteration. These issues were of major importance for analytic understanding and therapeutic progress.