The aggression-coercion cycle: Use of seclusion and restraint in a child psychiatric hospital

The widespread use of seclusion and restraint in child psychiatric hospitals to manage aggression and noncompliance is based on the assumption that coercive consequences reduce the frequency of undesirable behaviors exhibited by the patients. We report a study of the use of seclusion and restraint in a public child psychiatric hospital during a 3-year period. Twenty-eight percent of the patients had been secluded or restrained a total of 1670 times. About 25% of these patients had been secluded more than five times during their hospitalization, and 32% had been placed in restraints more than once. Behaviors that typically resulted in repeated seclusion included physical aggression toward staff, verbal aggression toward peers, non-compliant or oppositional behavior, and self-harm. Variables that predicted patients most at risk for repeated seclusion included age, gender, and psychiatric diagnosis. The predictor variables for those most at risk for repeated restraint included age, property destruction, and self-harm. The high rates of use of seclusion and restraint suggest that these methods for controlling the behavior of children and adolescents in this child psychiatric hospital may not have been therapeutic. We suggest that staff in such hospitals engage in a pattern of behavior characterized by an aggression-coercion cycle, in which increasingly aggressive and coercive behaviors are exhibited by both patients and staff.     

Evaluating a computational model of perceptual grouping by proximity

A formal approach to the phenomenon of perceptual grouping by proximity was investigated. Grouping judgments of random dot patterns were made by the CODE algorithm (van Oeffelen & Vos, 1982) and several related algorithms, and these judgments were compared with subjects’ grouping judgments for the same stimuli. Each algorithm predicted significantly more subject judgments than would be expected by chance. The more subjects agreed on how a given dot pattern should be grouped, the more successful was the algorithms’ ability to match the judgments for that pattern. CODE predicted significantly fewer subject judgments than did some of the other algorithms, largely because of its overemphasis on the extent of interactivity among dots as they are being grouped.     

Visual influences on auditory pluck and bow judgments

In the McGurk effect, visual information specifying a speaker’s articulatory movements can influence auditory judgments of speech. In the present study, we attempted to find an analogue of the McGurk effect by using nonspeech stimuli—the discrepant audiovisual tokens of plucks and bows on a cello. The results of an initial experiment revealed that subjects’ auditory judgments were influenced significantly by the visual pluck and bow stimuli. However, a second experiment in which speech syllables were used demonstrated that the visual influence on consonants was significantly greater than the visual influence observed for pluck-bow stimuli. This result could be interpreted to suggest that the nonspeech visual influence was not a true McGurk effect. In a third experiment, visual stimuli consisting of the wordspluck andbow were found to have no influence over auditory pluck and bow judgments. This result could suggest that the nonspeech effects found in Experiment 1 were based on the audio and visual information’s having an ostensive lawful relation to the specified event. These results are discussed in terms of motor-theory, ecological, and FLMP approaches to speech perception.     

Disordered Communication and Grieving in Deaf Member Families

When a deaf child is born to hearing parents, a grieving process is initiated in the parents. Unresolved grieving over their child's deafness often makes it difficult for hearing parents to accept the importance of signing, thus increasing the child's problems — further source of grief for these parents. Clinical illustrations are provided of (1) the reciprocal relationship between disruption of the mourning process and disturbance of communication between family members, and (2) the transmission of the dysfunctional relationship between hearing parents and deaf children to the subsequent relationship between the deaf children, when they reach adulthood, and their hearing children.     

Bipolar Disorder and the Family: An Integrative Model

The relationship between major mental illness and the family is complex. This article describes a model that recognizes biological, individual, and familial aspects of illness, and the interaction and reciprocal effects of these different levels. This model is illustrated using the example of bipolar illness, with particular emphasis on the effects of the illness on the family. Many characteristics previously noted in bipolar families can be understood as consequences, rather than causes, of the illness. A framework for integrated treatment is also described.     

Intermittency in human manual tracking tasks

We confirm Craik's (1947) observation that the human manual1y tracking a visual target behaves like an intermittent servo-control1er. Such tracking responses are indicative of "sampled" negative-feedback control but could be the result of other, continuous, mechanisms. Tracking performance therefore was recorded in a task in which visual feedback of the position of the hand-held joystick could be eliminated. Depriving the subjects of visual feedback led to smoother tracking and greatly reduced the signal power of their responses between 0.5-1.8 Hz. Their responses remained intermittent when they used feedback of their own position but not of the target to track a remembered (virtual) target. Hence, intermittency in tracking behavior is not exclusively a signature of visual feedback control but also may be a sign of feedback to memorized waveforms. Craik's (1947) suggestion that the intermittency is due to a refractory period following each movement was also tested. The errors measured at the start of each intermittent response, during tracking of slow waveforms, showed evidence of a small error deadzone (measuring 0.7 cm on the VDU screen or 0.80 degrees at the eye). At higher target speeds, however, the mean size of starting errors increased, and the upper boundary of the distribution of starting error was close to that expected of a refractory delay of approximately 170 ms between responses. We consider a model of the control system that can fit these results by incorporating an error deadzone within a feedback control loop. We therefore propose that the initiation of intermittent tracking responses may be limited by a positional error deadzone and that evidence for a refractory period between successive corrective movements can be satisfied without evoking an explicit timing or sampling mechanism.     

Asymmetries in the regulation of visually guided aiming

An experiment was conducted to examine the contribution of sensory information to asymmetries in manual aiming. Movements were performed in four vision conditions. In the full-vision condition (FV), subjects were afforded vision of both the hand and the target throughout the course of the movement. In the ambient-illumination-off condition (AO), the room lights were extinguished at movement initiation, preventing vision of the moving limb. In the target-off (TO) condition, the target was extinguished upon initiation of the movement. In a no-vision (NV) condition, ambient illumination was removed and the target was extinguished upon initiation of the response movement. Results indicated that accuracy was superior in the full-vision and target-off conditions and when movements were made by the right hand. Movements made by the right hand were also of shorter mean duration. The magnitudes of performance asymmetries were uninfluenced by vision condition. Analyses of movement kinematics revealed that movements made in conditions in which there was vision of the limb exhibited a greater number of discrete modifications of the movement trajectory. On an individual-trial basis, no relationship existed between accuracy and the occurrence of discrete modifications. These data suggest that although vision greatly enhances accuracy, discrete modifications subserved by vision reflect the imposition of nonfunctional zero-order control processes upon continuous higher-order control regimes.     

Is the cerebellum a smith predictor?

The motor system may use internal predictive models of the motor apparatus to achieve better control than would be possible by negative feedback. Several theories have proposed that the cerebellum may form these predictive representations. In this article, we review these theories and try to unify them by reference to an engineering control model known as a Smith Predictor. We suggest that the cerebellum forms two types of internal model. One model is a forward predictive model of the motor apparatus (e.g., limb and muscle), providing a rapid prediction of the sensory consequences of each movement. The second model is of the time delays in the control loop (due to receptor and effector delays, axonal conductances, and cognitive processing delays). This model delays a copy of the rapid prediction so that it can be compared in temporal register with actual sensory feedback from the movement. The result of this comparison is used both to correct for errors in performance and as a training signal to learn the first model. We discuss evidence that the cerebellum could form both of these models and suggest that the cerebellum may hold at least two separate Smith Predictors. One, in the lateral cerebellum, would predict the movement outcome in visual, egocentric, or peripersonal coordinates. Another, in the intermediate cerebellum, would predict the consequences in motor coordinates. Generalization of the Smith Predictor theory is discussed in light of cerebellar involvement in nonmotor control systems, including autonomic functions and cognition.