Psychopharmacological treatment of unipolar depression within the elderly: A discussion paper

Depressive disorders are known to affect all aspects of a person's functioning and are often associated with significant psychosocial impairment. What is unclear is whether these psychosocial issues are consequences or causes of depression; what is known is that these problems do not disappear when the biological symptoms resolve. Existing data on the treatment course and outcome of depression are not generally considered as representative of the older depressed person. Discussion will take place as to whether later life depression should be conceptualized not as a categorical disorder, but as a geriatric syndrome, with multiple aetiologies requiring a combination of treatment interventions. There is general consensus that when intensive psychotherapy is directed towards appropriate patients, geriatric clientele are as able to deal with the viscitudes of intensive therapy as well as any age group. An examination will be undertaken regarding the utilization of psychotherapeutic interventions, namely psychodynamic, interpersonal and cognitive behavioural. Comparative studies have demonstrated all three to be effective, particularly in the treatment of depression. There is a great need for further understanding and research into the appropriateness and efficacy of an integration of psychotherapeutic and pharmacotherapeutic intervention in the treatment of depression, particularly within the elderly. A tantalizing array of research possibilities emerge. If we accept that unipolar depression is a bio-psychosocial phenomena, then we need to understand more about which psychopharmacological treatment paradigms need to be employed, and that perhaps the way forward inclines towards pragmatic integrationism rather than puritanist intervention.     

Deconstructing the Enterprise Culture

A notion as pervasive and much-used as 'enterprise' will, inevitably, have done harm as well as good. The core concepts in the notion are explored, and examples are examined of how they have been put to teachers and counsellors in careers education and guidance work. While the libertarian text of education for enterprise may be unacceptable to many, the struggle to deal with it has forced a realisation of its more valuable subtext. This illustrates how 'education for enterprise', or any other change, cannot be implemented without paying attention to the organisation and management of change as well as to its intended outcomes, and how this process may have its own sometimes more beneficial effects.     

MANIPULATION OF POTENTIAL PUNISHMENT PARAMETERS IN THE TREATMENT OF SELF-INJURY1

The self-injurious behavior (SIB) of a blind, profoundly retarded male was observed within a field setting as multiple forms of punishment were applied. The effects of hair-tug punishment were first systematically examined, then hair-tug and electric shock punishment were administered in varing ratios (of punishment deliveries per SIB response) supplemented by continuous restraint contingencies and made contingent on recurrent antecedents of SIB cycles. Treatments were applied over six months of consecutive daily sessions ranging from 30 min to 8 hr duration. Posttreatment followup observations were taken 12, 24, and 34 months after treatment. Partial suppression was produced as a direct function of hair-tug punishment in the initial phase. A generally progressive decrement was produced on already lowered SIB rates with the succeeding components of the treatment package. Extended periods of total SIB suppression occurred as punishment was rendered contingent on antecedent components of each SIB response cycle. Followup observations of nearly 3 yr duration indicated total suppression generalized over all settings in which the subject functioned. The findings were related to the contrasting limits prevailing in most reports of punishment-based SIB suppression.     

Disinhibition of aggression through diffusion of responsibility and dehumanization of victims

The present study tested derivations from social learning theory on the disinhibition of aggression through processes that weaken self-deterring consequences to injurious conduct. Subjects were provided with opportunities to behave punitively under diffused or personalized responsibility toward groups that were characterized in either humanized, neutral, or dehumanized terms. Both dehumanization and lessened personal responsibility enhanced aggressiveness, with dehumanization serving as the more potent disinhibitor. Escalation of aggression under conditions of dehumanization was especially marked when punitiveness was dysfunctional in effecting desired changes. The uniformly low level of aggression directed toward humanized groups, regardless of variations in responsibility and instrumentality of the conduct, attested to the power of humanization to counteract punitiveness. Results of supplementary measures are consistent with the postulated relationship between self-disinhibiting processes and punitiveness. Dehumanization fostered self-absolving justifications that were in turn associated with increased punitiveness. Findings on the internal concomitants of behavior performed under different levels of responsibility suggest that reducing personal responsibility heightens aggressiveness more through social than personal sources of disinhibition.     

Simulating night visual conditions during the day with light attenuating filters

This paper describes a research technique used to simulate night visual conditions during the day with light-attenuating filters. Some of the considerations in choosing light-attenuating techniques such as attenuation of infrared and ultraviolet illumination, neutrality, and clarity are discussed. A dual density filter with less attenuation in the lower field was chosen for aviation applications so that the major instruments would be available. This dual density concept was found to be more successful for piloting than for navigation. A density of 5.1 was shown to simulate a bright clear night with a full moon; a density of 5.5 simulated a much darker night with no moon.     

On the interdependence of temporal and spatial judgments

Three experiments are reported on the tau and kappa effects, the dependence of judgments of distance upon duration (tau) and of judgments of duration upon distance (kappa). In Experiment 1, three lights in a horizontal sequence were used to define two temporal and two spatial intervals over a total duration of 160 msec. The subject was required to choose the shorter of either the two durations or the two distances. The results confirmed Collyer’s (1977) findings that the two effects are inconsistently observed across subjects when the display duration is brief. In Experiment 2, display duration was systematically manipulated from 160 to 1,500 msec. It is argued that relative temporal judgments should become easier as the total display duration is increased and that, hence, the kappa effect should become less marked. On the other hand, relative spatial judgments should become more difficult as the total duration of the display is increased, and the tau effect should become more marked. The data were in conformity with the hypothesis. In Experiment 3, data are presented for a tau experiment which fit the assumption that the effect depends upon a weighted average of distance and the expected distance which would be traversed in the given time at constant velocity.     

THE USE OF CONTINGENT-INTERRUPTED MUSIC IN THE TREATMENT OF DISRUPTIVE BUS-RIDING BEHAVIOR

The present study evaluated the efficacy of using contingent-interrupted music in treating the disruptive bus-riding behavior of an 8-year-old profoundly retarded female. Music was played during each bus ride as long as the subject was sitting appropriately, and interrupted contingent upon each response defined as disruptive bus riding, during an ABCDCDCDA design. A significant reduction in disruptive bus riding occurred with each introduction of contingent-interrupted music. The treatment procedure described in this report was easy to administer, produced rapid treatment gains, and showed virtually no regression during an 8-week follow-up period.     

Elementary school principals assess services of school psychologists nationwide

A one-page questionnaire was sent to 400 elementary school principals nationwide to assess their opinions regarding services of the school psychologist. These elementary school principals indicated that the school psychologist was found to be most helpful when providing the traditional services of psychological testing, personality and emotional assessment, consultation, and screening. Changes in school psychological services desired by the elementary school principals were more time from the school psychologist and an increase in individual and group counseling, preventive mental health, and inservice training. If elementary principal opinion is to be regarded, gross alterations to existing services of the school psychologist are not indicated by the results of this study.     

Book reviews

GEOGRAPHY, R. L. and GOMBRICH, E. H. (Eds). Illusion in Nature and Art. Gerald Duckworth and Co Ltd. 1973. Pp. 288. £7.50/£3.25.

HARTMANN, E. L. The Functions of Sleep. London: Yale University Press. 1974. Pp. 198. £ 3.50.

RADFORD, J. and BURNTON, A. Thinking: its Nture and Devolopment. London: Wiley. 1974. Pp. 440. £ 6.95. Soft cover £ 3.25.

MACE, C. A. Selected Paper. London: Methuen and Co Ltd. 1973. Pp. 420. £ 6.50.

WOLFF, J. G. Language, Brain and Hearing. London: Methuen and Co. Ltd. 1973 Pp. 237. £ 3050.

BATTRO, A. M. Piaget: Dictionary of Terms. Oxford: Pergamon Press Ltd. 1973. Pp. 186. £ 5.75.

MUSSEN, P. H. and ROZENSWEIG, M. R. Annual Review of Psychology. Annual Reviews Inc: Palo Alto, Califonia. Pp. 551. 12.50.     

Orientational anisotropy in the human visual system

When a target stimulus in a predesignated location is identified by a keypress response, responses are slightly faster if noise stimuli in adjacent locations are identical to the target than if they are a different stimulus assigned to the same response (a repeated-stimulus superiority effect). An exception to this result has been found in experiments that used randomly intermixed letter and digit stimuli. These experiments showed slower responding for identical noise than for nonidentical, response-compatible noise (a repeated-stimulus inferiority effect). The present study investigated these phenomena in three experiments. Experiments 1 and 2 established that both the superiority and inferiority effects can be obtained in the same experiment. They also provided evidence that the repeated-stimulus inferiority effect is a function of the intermixing of letters and digits and not of the larger target-set size that has been used for mixed lists. Experiment 3 demonstrated that, with unmixed presentation, the repeated-stimulus superiority effect is enhanced by an increase in the number of stimuli assigned to each response. The experiments are consistent with accounts that attribute the repeated-stimulus superiority effect to competition that occurs when different internal recognition responses are activated. Moreover, the experiments suggest that the repeated-stimulus inferiority effect has its basis in processes that occur subsequent to feature extraction.