A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia

A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.     

Adolescent suicide attempters presenting to a pediatric facility

This study profiles the characteristics of adolescent suicide attempters and the treatment they received in a pediatric emergency room (ER). A retrospective chart review of 4,072 adolescents seen in the ER at a children's hospital (CH) from July 1984 to June 1985 was undertaken. Twenty-seven adolescents who had deliberately injured themselves were identified. The average age was 14 years 7 months (range 11-19 years). Fifty-two percent of the patients were white and 78% were female. Ingestion was the most common method (78%), followed by attempted hanging (11%), and wrist laceration (7%). After evaluation by a pediatrician in the ER, 30% of the patients were treated and released, 11% were transferred directly to a psychiatric hospital, and 59% were admitted to the CH, with an average hospital stay of 1.88 days. Once hospitalized, consultations from psychiatry (81%), social service (50%), psychology (19%), and neurology (6%) were obtained. At the time of discharge from either the ER or CH, the patients had a variety of plans for ongoing care, with 52% being referred to outpatient counseling, 37% being transferred to a psychiatric hospital, and 11% having no documented plan for ongoing care. These results demonstrate that the evaluation of suicidal adolescents cared for in a pediatric facility may be episodic and suggest the need for a comprehensive program to approach the problem.     

The changing face of visual persistence

In three experiments, the effect of target luminance on estimates of visual persistence was determined on a popular successive-field task. Even though the experiments differed from each other only in terms of minor changes in stimulus conditions, very different effects were obtained across the three experiments. The different findings were attributed to the often overlooked roles of masking and target degradation on tasks of persistence. Implications for the numerous contradictory findings in the persistence literature are discussed, and the current popularity of the successive-field task is questioned.     

Interserial and intraserial interference processes in morning recall of mental sleep experience

This study investigated ways in which predictions from interference theory might explain partial or total failure in the morning recall of mental sleep experience (MSE) episodes reported after provoked night awakening. Interference could take place either between the contents of one MSE episode (intraserial interference) or between the contents of different MSE episodes (interserial interference) and would be more likely to affect morning recall where similar (i.e., interrelated) contents in MSEs are involved. If interference were mainly intraserial, in the morning there would be no change in the difficulty of retrieving interrelated contents, whereas, if it were mainly interserial, there would be increased difficulty in the retrieval of such contents. All the possible pairs of reports obtained by awakening 8 subjects four times in REM sleep during each of four experimental nights spaced at weekly intervals were scored for interrelated contents, using Clark's (1970) system of analysis of paired units, which operates by matching linguistic features. Results showed that interrelations in morning report pairs are as frequent as in night report pairs, maintaining the same linguistic characteristics and with little transfer of contents from one MSE to another. Overall these findings are compatible with the hypothesis that interference is primarily intraserial rather than interserial. It is consequently suggested that morning recall failure may be due to temporary blocking of retrieval.     

Occult participation: its impact on adolescent development

This study investigated the relationship between occult participation, substance abuse, and level of self-esteem in adolescents. Data were collected from 50 adolescents who ranged in age from 12 to 19 years and who spoke English as their primary language. The combined group of adolescents consisted of 25 clinical and 25 nonclinical youth. Participants completed a three-part questionnaire package which included Rosenberg's Self-Esteem Scale, the Adolescent Magic Questionnaire, and the Drug and Alcohol Assessment Scale. Results indicated that adolescent substance abuse and occult participation were significantly related. High and low occult participation groups were determined, and significant differences were found between the high versus low occult groups when compared on the primary variables of self-esteem and substance abuse. Significant differences were also noted when comparing the high versus low occult groups with various psychosocial developmental variables. Included is a discussion of the impact of occult participation on the psychosocial elements of adolescent self-esteem, self-concept, tolerance for deviance, and religious involvement.     

The Social Phobia and Anxiety Inventory: concurrent validity with a clinic sample

The Social Phobia and Anxiety Inventory (SPAI) is an empirically derived self-report inventory developed as a specific measure of social phobia. The current investigation included two studies. The first examined the correlation of the SPAI with daily social behavior of a clinic sample of social phobics. The results indicated that the SPAI provides a reasonable indication of the distress experienced during daily social encounters in three dimensions: behavior, cognitions, and overall distress. The second study examined the validity of the SPAI with reference to the somatic response and avoidance behavior of social phobics. The results indicated that the somatic items of the SPAI are related to the somatic response of social phobics and that performance on the SPAI is associated with avoidance behavior in an anxiety-producing task.     

Sensory preconditioning and UCS inflation in human 'fear' conditioning

This study describes a human electrodermal conditioning experiment involving processes of sensory preconditioning and UCS inflation. In stage 1 of the experiment Ss received six presentations of a CS+ paired with an innocuous 65 dB tone (UCS) and six presentations of an unpaired CS-. In stage 2, Ss in the experimental group had the aversiveness of the UCS inflated as the intensity of the 65 dB tone was increased to 115 dB. In stage 3, Ss were given test presentations of CS+ and CS-. A differential CR to CS+ was found only in stage 3 of the experiment and only in Ss who had experienced the UCS inflation procedure. These results suggest that (i) sensory preconditioning had occurred in stage 1 despite the failure to observe a differential CR in this stage, and (ii) the differential CR observed in stage 3 was mediated by an internal representation of the UCS whose aversiveness had been inflated in stage 2. As well as confirming that processes of sensory preconditioning and UCS inflation can be observed in human as well as animal Ss, these findings have important implications for contemporary conditioning models of clinical fears. In particular, they suggest that a contemporary conditioning model of acquired fears is not bound by the need to discover contiguous stimulus-trauma experiences in the histories of clinical phobias since, in humans at least, processes of stimulus association and UCS revaluation appear to be relatively independent.     

Dynamic organization of intersensory function

Issues related to infant intersensory functioning are reviewed. The argument is offered that limitations of sensory inputs during early stages of development are necessary and provide structure and organization which determine behavioural characteristics at later stages. It is also suggested that infant organisms respond to the intensity of stimulation rather than organizational characteristics and that this is responsible for the form of sensory equivalence apparent during early development. A scheme for the investigation of sources of intersensory organization is presented which involves a prospective analysis of how consideration of the times of onset of sensory functions helps us to understand intra- and intersensory development. The advantages of this experimental approach are outlined.