BEHAVIORAL ASSESSMENT FOR PEDIATRIC INTENSIVE CARE UNITS1

Two studies were conducted to analyze behaviors of staff and patients on a Pediatric Intensive Care Unit (PICU). In the first study, behavioral observation procedures were employed to assess patient state, physical position, affect, verbal behaviors, visual attention and activity engagement, and staff verbal behavior. On the average, one-third of the patients were judged to be conscious and alert but markedly nonengaged with their environment. In the second study, a member of the hospital staff provided alert patients with individual activities to determine whether a simple environmental manipulation could positively affect behavior of children in intensive care. Employing a reversal design, the activity intervention was found to increase attention and engagement and positive affect, and to decrease inappropriate behavior. Both studies demonstrate that behavioral assessment procedures can provide an empirical basis for designing PICU routines affecting children's psychosocial status, and, thus, complement current procedures designed to provide quality medical care.     

Learning family therapy: The dilemmas of an individual therapist

Individual therapists who begin doing family therapy often encounter some special difficulties directly related to their prior training and experience. Some therapeutic techniques of individual therapy, such as understanding and explaining the patient's problems on the basis of faulty parenting, must be relinquished and alternative means of alleviating guilt must be adopted. In doing family therapy individual therapists must adapt to the fact that they are less important than they are used to being and have less control over content and emotional tone of sessions. They must change their conceptions about the importance of privacy and secrecy. This article discusses some of the problems encountered when one is not thoroughly committed to a family therapy approach to treatment. Countertransference difficulties, problems stemming from wanting change, and the differing nature of the gratifications in the two therapeutic modalities are other topics discussed.     

Direct Open Supervision: A Team Approach

Created in the absence of one-way mirror facilities, Direct Open Supervision combines elements of live supervision with team participation in training family therapists. The theory and application of this approach to direct supervision are described.     

Preservation of global order equivalence

Psychological data frequently can only be gives rank-order significance. This paper investigates and characterizes those cluster methods suitable for use in such a situation. The work is carried out in an abstract order theoretic setting but a relation is shown to earlier models due to Jardine and Sibson as well as Matula. It deals with that portion of the clustering process that starts with a dissimilarity measure defined on a set P and produces a nested sequence of reflexive symmetric relations on P.     

Focus of attention, chronic expectancy, and responses to a feared stimulus.

An attentional model of fear-based behavior is proposed and a study that tested the model is reported. It was predicted that among subjects with moderate fear of snakes, heightened self-attention during an approach attempt would cause increased awareness of existing anxiety, followed by one of two courses of events: Subjects who believed that they could do the behavior in spite of their fear were expected to redirect their attention to the behavior--goal comparison and exhibit no behavioral deficit. Subjects who doubted their ability to do the behavior were expected to divert their attention from the behavior--goal comparison and to withdraw behaviorally from the approach attempt. The results of the study support this reasoning. Discussion centers on relationships between the proposed model and previous theory.     

I. Validity of WISC-R factor scores in predicting achievement and attention for four sociocultural groups

The predictive validity of WISC-R factor scores was examined with samples from the four sociocultural groups of Anglo, Black, Chicano, and native American Papago. The Full Scale IQ and Verbal Comprehension (VC) factor scores were significantly better predictors of achievement as measured by teacher ratings and the Metropolitan Achievement Test. The Perceptual Organization and Freedom from Distractibility (FD) factor scores were also significantly related to achievement, but at a lower level than Full Scale and VC. The correlations of the WISC-R and achievement measures were nearly the same for three of the four groups (exception was native American Papago). The relationship of the FD factor score to ratings of attention was statistically significant, but relatively low. Cautions in interpreting FD as a measure of attention were recommended due to overlap of distributions and low proportion of variance in attention accounted for by FD.     

Temporal control of behavior and the power law

The performance of rats and pigeons under fixed-interval schedules was studied in two experiments. The duration of postreinforcement pause was a declining proportion of fixed-interval duration. For pigeons this was true both when the duration of the reinforcer was fixed and when it was increased in direct proportion to increases in fixed-interval duration; the longer reinforcer durations did, however, lengthen the postreinforcement pause at higher schedule values. A quantitative analysis of data from Experiments 1 and 2 and from other studies showed that fractional exponent power functions described the relationship between postreinforcement pause and fixed-interval value; similar functions have previously been observed in studies of temporal differentiation. It was concluded that power functions reflect a direct causal, rather than artifactual, relationship between performance and the temporal requirements of reinforcement schedules.     

Response preference within the Rotter I-E Scale: perceived locus of control of self, average, and ideal others

The Rotter I-E scale was administered to college juniors in education under five different instructional sets. Subjects were asked to complete it (a) as they would ordinarily (self-perception), (b) as they believed an average person of the same sex would, (c) as an average person of the opposite sex would, (d) as an ideal person of the same sex would, and (e) as an ideal person of the opposite sex would. As hypothesized, subjects saw the ideal person of both sexes as significantly more internal than themselves, while they saw the average person of both sexes as more external than themselves. These results suggest the general desirability of being perceived as internally oriented.     

Oculomotor programming disturbances in the dementia syndrome

Three types of oculomotor programming disturbances are described in patients with the dementia syndrome. This report describes two of these abnormalities, poorly regulated gaze patterns and a programming type of gaze perseveration. All patients showed poorly regulated gaze patterns in contrast to the normal controls, whereas on the whole only the moderately affected patients showed the programming type of gaze perseveration. The third type of oculomotor programming disturbance is efferent perseveration of gaze (a hypokinetic, "staring" type of gaze pattern) and can be seen with severe dementia. The possible significance of these findings is discussed.