Psychiatric hospitalization after deliberate self-poisoning

The decision for psychiatric hospitalization after deliberate self-poisoning (DSP) is not well understood. This study, a longitudinal cohort study of 3,148 consecutive DSP patients found 920 (29.2%) subjects were referred for psychiatric hospitalization, 576 (18.3%) on involuntary basis. A logistic regression analysis showed increased risk for: age 25 or older, homelessness, unemployment, previous self-harm, psychiatric inpatient treatment within 12 months, earlier psychiatric inpatient treatment, suicidal ideation or plan, mood or psychotic disorders, and lower clinician experience; and lower risk for being married/defacto, and after hours presentation. Recommendation for psychiatric hospitalization was based on complex decision making. These findings have implications for clinical practice guidelines, service costs, and service organization.     

Risk Versus Effort in the Assessment of Motor Fatigue

The choice of probability leffort (COPE) devices require fatigued subjects to choose between risk and effort. In a first experiment, where fatigue was induced by an intense or by a prolonged motor task and where the required effort was perceptual, the fatigue did not generalize to the test mode. A second experiment used motor fatigue of the arm or leg, and tested with arm muscle effort, showing that subjects fatigued with either limb chose riskier alternatives in order to avoid the effort. The data correlated with self-rated fatigue, and closely paralleled earlier work using perceptual fatigue and perceptual effort.     

Multi-domain Models of Risk Factors for Depression and Anxiety Symptoms in Preschoolers: Evidence for Common and Specific Factors

Relatively few studies have examined multiple pathways by which risk factors from different domains are related to symptoms of anxiety and depression in young children; even fewer have assessed risks for these symptoms specifically, rather than for internalizing symptoms in general. We examined a theoretically- and empirically-based model of variables associated with these symptom types in a diverse community sample of 796 4-year-olds (391 boys, 405 girls) that included factors from the following domains: contextual (SES, stress and family conflict); parent characteristics (parental depression); parenting (support/engagement, hostility and scaffolding); and child characteristics including negative affect (NA) effortful control (EC) sensory regulation (SR), inhibitory control (IC) and attachment. We also compared the models to determine which variables contribute to a common correlates of symptoms of anxiety or depression, and which correlates differentiate between those symptom types. In the best-fitting model for these symptom types (a) SES, stress and conflict had indirect effects on both symptom types via long-chain paths; (b) caregiver depression had direct effects and indirect ones (mediated through parenting and child effortful control) on both symptom types; (c) parenting had direct and indirect effects (via temperament and SR); and temperament had direct effects on both symptom types. These data provide evidence of common risk factors, as well as indicate some specific pathways/mediators for the different symptom types. EC was related to anxiety, but not depression symptoms, suggesting that strategies to improve child EC may be particularly effective for treatment of anxiety symptoms in young children.     

The role of attitudes towards the targets of behaviour in predicting and informing prenatal testing choices

Research considering the role of attitudes in prenatal testing choices has commonly focused on the relationship between the attitude towards undergoing testing and actual testing behaviour. In contrast, this study focused on the relationship between testing behaviour and attitudes towards the targets of the behaviour (in this case people with Down syndrome (DS) and having a baby with DS). A cross-sectional, prospective survey of 197 pregnant women measured attitudes towards the targets of prenatal testing along with intentions to use screening and diagnostic testing, and the termination of an affected pregnancy. Screening uptake was established via patient records. Although attitudes towards DS and having a baby with DS were significantly associated with screening uptake and testing and termination intentions, unfavourable attitudes were better than favourable ones at predicting these outcomes. For example, in the quartile of women with the ‘most favourable’ attitude towards people with DS 67% used screening although only 8% said they would terminate an affected pregnancy. Qualitative data suggested that not all women considered personal attitudes towards DS to be relevant to their screening decisions. This finding has implications for the way in which informed choice is currently understood and measured in the prenatal testing context.     

Prosody in Infant-Directed Speech Is Similar Across Western and Traditional Cultures

When speaking to infants, adults typically alter the acoustic properties of their speech in a variety of ways compared with how they speak to other adults; for example, they use higher pitch, increased pitch range, more pitch variability, and slower speech rate. Research shows that these vocal changes happen similarly across industrialized populations, but no studies have carefully examined basic acoustic properties of infant-directed (ID) speech in traditional societies. Moreover, some scholars have suggested that ID speech is culturally specific and does not exist in some small-scale societies. We examined fundamental frequency (F₀) production and speech rate in mothers speaking to both infants and adults in three cultures: Fijians, Kenyans, and North Americans. In all three cultures, speakers used higher F₀ when speaking to infants relative to when speaking to other adults, and they also used significantly greater F₀ variation and fewer syllables per second. Previous research has found that American mothers tend to use higher pitch than do mothers from other cultures, but when maternal education was controlled in the current study, we did not find a significant difference in average pitch across our three populations. This is the first research systematically comparing spontaneous ID and adult-directed speech prosody between Western and traditional societies, and it is consistent with a large body of evidence showing similar acoustic patterns in ID speech across industrialized populations.     

The influence of cognitive and emotional suppression on overgeneral autobiographical memory retrieval

Over-general autobiographical memory (OAM) retrieval is characterized by retrieval of categoric autobiographical memories. According to the CarFAX model, this tendency may result from avoidance which functions to protect the person against recalling details of upsetting memories. This study tested whether avoidance strategies impact on the ability to retrieve specific autobiographical memories. Healthy participants (N = 51) watched a negative video clip and were instructed to either suppress any thought (thought suppression), suppress any feeling (emotional inhibition), or think and feel naturally (controls) in response to the video. Participants then completed the Autobiographical Memory Test. Participants engaging in either thought suppression or emotional inhibition retrieved fewer categoric autobiographical memories than controls. These findings challenge the affect regulation component of the CarFAX model insofar as they suggest that regulatory strategies that aim to reduce awareness of adverse emotional memories do not necessarily lead to increased recall of categoric autobiographical memories.     

PTSD Symptom Patterns Following Traumatic and Nontraumatic Events

This study extends research examining posttraumatic stress disorder symptoms following different types of potentially traumatic events. Specifically, the study examined and compared the symptom patterns observed in those who suffered a major accident, the unexpected death of a loved one, or sexual assault. Based on recent findings, this project also examines those who reported nontraumatic (but stressful) events, as well as comparing symptom patterns across gender. Findings suggest different types of traumas might be associated with differences in severity and patterns of symptoms for women (but not for men), suggesting symptom patterns manifest differently in men and women. Results also call into question the assumption that traumatic events demonstrate different symptom patterns than other types of events.     

Thought control strategies in acute stress disorder

Intrusive trauma-related thoughts and the means to manage them are a central dynamic in posttraumatic stress. Thought control strategies were investigated in survivors of motor vehicle accidents with either acute stress disorder (ASD; n=20) or no ASD (n=20). Participants completed the Acute Stress Disorder Interview, the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale, and the Thought Control Questionnaire (TCQ) within four weeks of their accident. Although distraction, social control, and reappraisal were the most common strategies in both groups, ASD participants engaged in punishment and worry more than non-ASD participants. Worry and punishment were also strongly associated with severity of intrusive, avoidance, arousal, and depressive symptoms. Findings are discussed in terms of the role of cognitive strategies in resolving posttraumatic stress.     

Book reviews

DIMSOND, S. The Double Brain. Edinburgh: Churchill Livingstone. 1972.Pp. 229. £ 3.50.

ANDERSON, J. R. and BOWER, G. H. Human Associative Memory. Washington: V. H. Winston and Sons. 1973. Pp. 524. £ 8.55.

SOMMERHOFF, G. Logic of the Living Brain. London: John Wiley and Sons. 1974. Pp. 413. £ 5.75.

KLAUSMEIER, H. J., GHATALA, E. S. and FRAYER, D. A. Conceptual Learning and De-velopment. London: Academic Press. 1974. Pp 284. £ 7.00.

RATCLIFF, F. (ED.) Studies on Excitation and Inhibition in the Retina. A Collection of Papers from the Laboratories of H. Keffler Hartime. London: Chapman and Hall. 1974. Pp. 668. £ 8.50.

ROCK, I. orientation and Form. London: Academic Press. Inc. (London) Ltd. 1973-Pp. 165. £ 5.60.

BOWER, T. G. R. Devolopment in Infancy. Reading: W. H. Freeman and Co. 1974. Pp. 258. £ 2.90

CONNOLLY, K. J. and BRUNER,J. S. (Eds). The Growth of Competence. London: Aca-demic Press. 1974. Pp. 327. £ 6.80.

PIAGET, J. and INHELDER, B. (Translated by POmerans, A.) The Child's Construction of Quantities. London: Routledge and Kegan Paul. 1974. Pp. 285. £ 5.75.

GARNER, W. R. The Processing of Information and Structure. Potomac: Lawrence Erlbaum Associates. 1974. Pp. xi + 203. £ 6.00.

CARTERETTE, E. C. and FRIEDMAN, M. P. (Eds). Handbook of Perception. Vol. III. Bilogy of Perceptual System. London: Acadmic Press, Inc. (London) Ltd. 1973. Pp. 521. £ 00.00.