Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.     

Linguistic Phenomena and Language Selection in the REM Dreams of German-English Bilinguals

Sixteen German-English bilinguals were studied in a sleep laboratory for four nonconsecutive nights each. Half were native English speakers living in Zürich, and half native German speakers living in Atlanta. Presleep thought samples were solicited each evening and REM dream reports each night; subjects judged the waking appropriateness of their imagined speech and language phenomena, and also identified waking sources of their dream imagery, the following mornings. Incidences of dreaming and of speech therein generally were similar to those of monolinguals. Whether sessions were conducted in German (two nights) or English (two nights) did directly influence language selection in subjects' dreams. Judged appropriateness of language selection to imagined events was very high for thought samples, and high for REM dreams. Sources for thought samples were generally consonant with the language dominant at study site; for REM dreams this relationship was considerably weaker. Judged waking appropriateness to imagined situations was more strongly related to language selection than was the language reference of the supposed sources of those situations.     

Sex Roles, Interpersonal Control, and Depression: Who Can Get Their Way?

This study is one of a series of investigations examining the contribution of sex roles to the development of depression within a learned helplessness framework. Utilizing 143 pairs of undergraduate female participants, the present study explored subjects′ abilities to gain and maintain control in an interpersonal context. Interpersonal control was operationalized as successful persuasion in a two-person discussion task, wherein one participant had hidden instructions to be maximally persuasive in discussing a questionnaire about social behavior. The results indicated that less successful persuasion was associated with increases in depressed mood. Furthermore, women with high masculinity and low femininity were able to gain interpersonal control regardless of the sex role of their partner. The results also suggested that high femininity is associated both with giving up control in interpersonal tasks and with increases in depressed mood when one is faced with the task of exerting interpersonal control. The findings were interpreted in terms of the importance of sex role characteristics in learned helplessness and depression.     

A stochastic model for inter-keypress times in a typing task

A mathematical model for the inter-keypress times (IKT) in a typing task is proposed. The model, which includes a diffusion process terminated by a single response threshold, was evaluated using data obtained from typists. The differences in performance for successive cross-hand and within-hand keypresses were examined using IKT distributions and hazard functions, and it was shown that the empirical hazard functions could be fit by the theoretical hazard function derived from the convolution of normal and inverse Gaussian random variables. Some possible applications of the model for the evaluation of fatigue and strategic effects in typing are suggested.     

The relationship of appraisal and coping to chronic illness adjustment

There is evidence that adaptation to chronic illness may be affected by psychological factors, especially how patients appraise and cope with the stress of their illness. The purpose of the present study was to examine the relationship of stress appraisal and coping responses to multiple behavioral indices of illness adjustment among patients with diverse chronic medical conditions. One hundred and one patients admitted to a multidisciplinary medicine/psychiatry unit completed measures of functional impairment, depression, symptom severity, and the Ways of Coping Checklist--Revised. Hierarchical regression analyses indicated that emotion-focused coping was positively related to poor psychosocial adjustment and depression after controlling for physician rated disease severity. Appraising chronic illness as holding one back predicted greater emotion-focused coping responses and poorer adjustment to illness. The use of problem-focused coping strategies was generally unrelated to illness adjustment. These findings suggest the presence of an emotion-focused coping triad consisting of wishful thinking, self blame, and avoidance, all of which appear to be maladaptive strategies when coping with chronic medical conditions. Implications for coping skills training and the need for longitudinal research is discussed.     

Pessimistic explanatory style and response to illness

Previous studies have shown that a pessimistic explanatory style is a risk factor for illness, but the factors linking explanatory style and illness are unknown. One's characteristic response to poor health may mediate this relationship. Perhaps pessimistic individuals act helplessly in the face of their symptoms, thereby exacerbating disease. In the present study, we investigated this possibility by asking 96 young adults to complete measures of explanatory style, habitual response to illness, and ways of coping during their most recent episode of illness. Subjects who explain bad events pessimistically (with internal, stable, and global causes) reported more frequent illnesses during the past year and rated their overall health more poorly than those who habitually favor external, unstable, and specific explanations. When ill, the pessimistic subjects were less likely than their optimistic counterparts to take active steps to combat their illness. Our results suggest that one pathway leading from pessimistic explanatory style to poor health is mundane: passivity in the face of disease.     

Psychoanalytic observation

The recent focus on empathy as the essential activity in psychoanalytic data gathering has underemphasized the complexity of psychoanalytic observation and has failed to identify what truly makes it unique among modes of psychological investigation. It is a process that includes introspection and empathy. However, it also includes the analyst's observation of the patient's behavior, and particularly verbal behavior, in a way that is not necessarily empathic. The psychoanalytic use of introspection and behavioral observation together, as they are modified by the analysand's free association and the analyst's evenly hovering attention, provides a unique method of data gathering. The transient, mutually related regressions of analyst and analysand which partly constitute the analyzing instrument modify the field of observation available to both, providing better access to derivatives of the analysand's unconscious mental functioning. This more complex concept of psychoanalytic observation, as opposed to that in which empathy is predominant, has important implications for psychoanalytic training, clinical work, and theory.     

ASSESSING FOOD PREFERENCES AMONG PERSONS WITH PROFOUND MENTAL RETARDATION: PROVIDING OPPORTUNITIES TO MAKE CHOICES

Increased attention has been directed recently to assisting persons with severe handicaps to express preferences concerning events in their lives. We evaluated a program for assessing choice-making skills to provide opportunities for persons with profound mental retardation to express food and drink preferences. In Experiment 1, the assessment procedure involving repeated, paired-item presentations resulted in active choice making and the identification of preferences for all 5 participants. Results also indicated that caregiver opinion was not predictive of participant food and drink preferences. A survey of service providers supported the importance of meal-related choices in this population. In Experiment 2, the practicality of the assessment procedure was supported by demonstrating that (a) routine caregivers could apply the procedure with appropriate supervision to provide choice opportunities, and (b) results of the procedure were predictive of participant choices when a less structured and more normal opportunity to express a preference was provided during regular mealtimes. Results are discussed in terms of extending the developing technology of preference and reinforcer identification to other important areas for persons with severe disabilities.