Child and adolescent psychopathology research: Problems and prospects for the 1990s

In November 1990 the National Institute of Mental Health (NIMH) convened a special conference of over 100 scientists and leaders to outline specific strategies and research initiatives that should be developed to implement the recently released National Plan for Research on Child and Adolescent Mental Disorders.Participants included journal editors, educators from psychology and psychiatry, representatives from private foundations, and leaders of research program areas in public funding agencies. Critical knowledge gaps were identified in five areas of child and adolescent psychopathology, including depression, attention deficit hyperactivity disorder, conduct disorder, the anxiety disorders, and the developmental disorders. For each of these areas, special emphasis was placed on developing new ideas and obtaining critical input from other areas of investigation. This report summarizes the identified research gaps and recommends research initiatives to implement the National Plan, as outlined by the conference participants.     

A Legacy of Silence: Bioethics and the Culture of Pain

For over 20 years the medical literature has carefully documented the undertreatment of all types of pain by physicians. During this same period, as the field of bioethics came of age, the phenomenon of undertreated pain received almost no attention from the bioethics literature. This article takes bioethicists to task for failing to recognize the undertreatment of pain as a major ethical, and not merely a clinical, failing of the medical profession. The nature and extent of the problem of undertreated pain is examined, as well as possible reasons for its disregard by bioethicists. The factors contributing to undertreated pain in the clinical setting are considered, as well as the hazards posed by recent failures to address ethically questionable clinical practices. Finally, suggestions are offered for refocusing the attention of bioethicists to this significant problem.     

Deterrence, Opportunity, and Choice

Traditional studies of deterrence have focused on punishment with less regard for the rewards of both crime and noncrime. Influenced by work in economics and behavioral psychology, more recent studies have departed from tradition by incorporating rewards for crime. To this extent, they should be regarded as advances over the more traditional approaches. Notwithstanding these advances, variations in both the probability and magnitude of reward for noncrime have not been systematically included in these more recent theories of choice. In an attempt to determine whether opportunities for noncrime are either central or trivial to the criminal decision-making process, the present study fitted two alternative models to experimental data involving risk-taking: (a) the economic utility model employed by Piliavin, Gartner, Thornton, and Matsueda (1986) in their study of criminal choice; and (b) the satisfaction balance model developed by Gray and Tallman (1984). Results showed that while both models explained significant amounts of variation in the dependent variable, the Gray-Tallman model provided a substantially better fit of the data. Despite limitations inherent in experimental studies as, for example, limitations surrounding the issue of external validity, the findings strongly suggest that opportunities for noncrime are as important as rewards and costs for crime in the process by which criminal decisions are made.     

Compassion: An east‐west comparison

Compassion is an emotion that occupies a central position in Mahāyāna Buddhist philosophy while it is often a neglected subject in contemporary western philosophy. This essay is a comparison between an Eastern view of compassion based upon Mahāyāna Buddhist perspectives and a western view of the same emotion. Certain principles found in Mahāyāna Buddhist philosophy such as the Bodhisattva Ideal, and suffering (dukkha) to name two, are explored for the information they contain about compassion. An essay by Lawrence Blum is taken as representative of a Western view (but not exclusively) and it is analyzed for its shortcomings in light of the Buddhist view. The conclusion briefly describes the value of understanding an eastern view on compassion as a means of filling the void one finds in western medical ethics discourse which focuses so heavily, and redundantly, upon issues such as patient autonomy and paternalism.     

Evidence that blocking is due to associative deficit: Blocking history affects the degree of subsequent associative competition

Rats were trained on an appetitive discriminated operant procedure according to a blocking design, in which training with a compound stimulus (A + B) was given with or without prior training with A alone. Stimulus B was then presented in compound with a new stimulus (B + C compound). The ability of Stimulus B to block acquisition of control by Stimulus C was decreased by B having itself been blocked by A during the prior training. The results imply that the mechanism of blocking during the initial blocking procedure was a reduced association between Stimulus B and the reinforcer, and not a performance deficit such as that postulated by comparator models of learning.     

The changing pattern of perceptual analytic strategies and response selection with practice in a two-choice reaction time task

In the experiment reported here the primary hypothesis proposed, which was supported by the data, was that subjects performing a two-choice self-paced serial RT task would learn to change their strategy of perceptual analysis of signals presented to them as they became progressively more practised. Early in practice each signal is identified as a particular state of the display and an appropriate response is then made. Well practised subjects, however, select their responses by reference to the change or constancy between successive displays. This strategy implies that the assumptions made by the generally accepted simple S-R connectionist model of two-choice serial RT may be quite misleading, since the choice of any particular response must be determined not only by the display state but also by what the previous response had been.     

Alphanumeric category effects: Evidence against the sufficiency of a localization explanation

The Hatfield Polytechnic, Hatfield, Herts ALIO 9AB, England The experiment utilized a serial choice reaction time (RT) paradigm in which only one alphanumeric stimulus was presented per trial, and the target set consisted of a single identified item. The categorical relationship between the target and nontarget items was varied as a property of blocks of trials. Target and nontarget RTs were smaller when the specified target item (e.g., the number 6) was categorically distinct from the nontargets (e.g., letters) than when it was from the same category (e.g., digits). The processing of catch-trial stimuli (items from the alternate category to the nontargets) and homographie category-ambiguous items was inhibited only in the former, between-category, condition. The results are contrasted with those obtained in visual search tasks. They suggest that a “locational-cue” explanation of alphanumeric category effects is inadequate.     

An instrumented method for assessment and remediation of stuttering: A single-subject case study

A single-subject experimental design was used to investigate the feasibility of applying non-invasive laboratory instrumentation for examining speech physiology to assessment and biofeedback-based remediation of stuttering. Physiologic assessment facilitated the development of behavioral goals directed at changing respiratory and phonatory behaviors for this subject. Visual biofeedback therapy produced reduction in respiratory discontinuities and increased phonatory continuity, concomitant with reduced perceivable molar dysfluency. Methods used in this case illustrate a variety of options and problems related to clinical use of instrumentation. Results suggest that signals which represent respiratory, phonatory, and articulatory physiologic events may be clinically practical for evaluating and altering perceivable dysfluency.     

A faith for all seasons

A FAITH FOR ALL SEASONS:ISLAM AND WESTERN MODERNITY. By Shabbir Akhtar. London: Bellew Publishing, 1990. 251pp. Hb. £25.00. ISBN 0–947792–41–4.