Models of madness: Science and soul

The historical interplay between psychiatry and religion is placed in a contemporary context here. In their zeal to embrace new discoveries and technologies in neurophysiology, modern psychiatrists are losing sight of spiritual and cultural dimensions. From a biological perspective, there is confusion about what constitutes a cause, a concomitant, or a consequence of mental illness. Computer metaphors are being used to explain mental illness. This article examines such trends and questions whether, in the decade of the brain, psychiatry is in danger of losing its soul.     

Dream-sharing groups,spirituality, and community

This article examines the phenomenon of dream-sharing groups and argues that these groups offer a valuable source of spiritual revitalization and community healing in contemporary Western society. The article traces the historical development of dream-sharing groups, analyzes the various forms they take, and discusses their relation to the secularization of the modern West. Two concrete examples are offered—one from a public high school, the other from a prison—to illustrate the power of dream-sharing groups to stimulate a deep and powerful sense of relatedness to others, enabling people to recognize a shared humanity in the midst of social and cultural differences.     

Conditioned Inhibition Produced by Extinction of a Conditioned Stimulus

Four experiments used a conditioned taste aversion procedure to examine the potential for CS-alone extinction treatment to produce a conditioned stimulus that possesses inhibitory properties. In Experiment 1, saccharin was paired with LiCl, and then saccharin was presented alone for several trials to produce extensive behavioral extinction. Animals receiving this treatment were retarded in reacquiring conditioned responding to saccharin relative to control subjects receiving conditioning to the flavor for the first time. In Experiment 2, the extinguished saccharin stimulus was shown to decrease conditioned responding to a known excitor when the two stimuli were presented in compound as a summation test. Experiments 3A and 3B replicated the findings of Experiments 1 and 2 while providing evidence that the effects were not due to the differential effects of neophobia during testing. These three experiments revealed that an extinguished conditioned excitor passes retardation and summation tests for conditioned inhibition. Experiment 4 found that extinction of a known excitor was slowed when the excitor was extinguished in compound with a previously extinguished conditioned stimulus. That is, an extinguished CS provided protection from extinction to another CS, a finding also consistent with the view that extinction produces conditioned inhibition.     

Sex differences in ADHD: Conference summary

Clinical samples of attention deficit hyperactivity disorder (ADHD) have been dominated by males. Consequently, female manifestations and sex differences have been relatively neglected in the extensive ADHD research. Because ADHD is so common (3% to 5% of school children) and chronic (lifelong in many cases), even a small proportion of females multiplied by such a large base means hundreds of thousands of girls and women with ADHD, a significant public health problem. An NIMH conference concluded that research is needed not only on sex differences related to ADHD, but also on manifestations of ADHD in females as such. Areas of focus should include differences in life course (sex-differential age effects); effects of hormones; effects of ADHD parenting (in utero and postnatal) on the next generation; response to and implications for design of psychosocial treatment; effects of differential comorbidity; normative background sex differences that influence the manifestation of ADHD; differences in development of verbal fluency and social behavior; possible interactions of sex and ethnicity; a prospective study of both sex offspring of ADHD adults; and such methodological issues as appropriate instruments and diagnostic thresholds, power to prevent false negatives, valid impairment measures, validity and reliability of child self-reports, and more inclusive samples (all three subtypes: inattentive, hyperactive-impulsive, and combined).The following participants in the November 16–17, 1994, NIMH Conference on Sex Differences in ADHD may be considered ghost co-authors of the contents in this summary. Special thanks are due to Euthymia Hibbs, Ph.D., co-organizer of the conference; Peter Jensen, M.D., who suggested the successful format; Delores Parron, Ph.D., who gave much helpful advice on the conference arrangements; Emily Areia, Ph.D., who thoroughly critiqued the summary; Joan Cole, who helped abstract the recorded proceedings; and Jose Bauermeister, Ph. D., F. Xavier Castellanos, M.D., Stephen Hinshaw, Ph.D., and Mark Stein, Ph.D., who helped with referencing. Other participants, in alphabetical order, included Russell Barkley, Ph.D.; Joseph Biederman, M.D.; Caryn Carlson, Ph.D.; C. Keith Conners, Ph.D.; Monique Ernst, M.D.; Miranda Gaub; Jay N. Giedd, M.D.; Michael Gordon, Ph.D.; Jeffrey Halperin, Ph. D.; Betsy Hoza, Ph.D.; Hans Huessy, M.D.; Jean King, Ph.D.; Kathleen Kiely; Rachel Klein, Ph.D.; Benjamin Lahey, Ph.D.; Jan Loney, Ph.D.; Elizabeth Lorch, Ph.D.; Spero Manson, Ph.D.; Keith McBurnett, Ph.D.; Richard Milich, Ph.D.; Douglas Novins, M.D.; Daisy Pascualvaca, Ph.D.; Linda Pfiffner, Ph.D.; Jane Steinberg, Ph.D.; James Swanson, Ph.D.; Marcus Thomeer, Ph.D.; Lillie Williams, M.D.; Alan Zametkin, M.D.The opinions expressed herein are the views of the author and conference participants and do not necessarily reflect the official position of the National Institute of Mental Health or any other part of the U.S. Department of Health and Human Services.     

Gender and aggression II: Personal aggressiveness

To investigate how gender, ethnicity, age and education influence aggressiveness, we surveyed 115 male and female college students (56% male; 50% Anglo and 26% Hispanic) and 79 persons (72% male; 92% Anglo) working on a military base. Participants were administered the Buss-Perry Aggression Questionnaire and asked about their own aggressive behaviors. In both samples, men scored significantly higher than women on the Physical Aggression scale of the Aggression Questionnaire but not on the other scales. In the military sample, men indicated that they expected to behave more aggressively than women. Positive correlations among different aspects of aggressiveness were found for both men and women. Increasing age and education were associated with lower aggressiveness in both genders, suggesting that aggressiveness may be susceptible to modification over the course of one's life.We would like to thank Angela Bennett, Gail Bliss, Kayleigh Carabajal, Julie Depree, Carmen Gonzales, Deborah Good, Scott Griffin, Gladys Herrera, George Selix, Ruth Tangman, and Jon Woodland for their assistance with the development, distribution, and coding of the questionnaire.     

Pre-screening education in multiple marker screening programs: The effect on patient anxiety and knowledge

Previous studies have shown that unexplained deviations in maternal serum multiple marker screening (MMS) generate considerable anxiety during the remainder of pregnancy. While the role of education in decreasing anxiety is documented, to date there has been no prospective evaluation of which educational practices might minimize this emotional stress. In a pilot study, we prospectively examined the effects on anxiety and knowledge by providing information about MMS (1) by genetic counselor, (2) by pamphlet, and (3) by primary physician. Women randomized to one of these three modalities were administered the Spielberger State- Trait Anxiety Inventory [STAI] and knowledge questionnaires at their initial obstetrics visit, at their second visit after educational intervention and 1–2 weeks after MMS results were provided to patients. Education resulted in an increase in knowledge and post-education knowledge was different between educational modalities. Anxiety declined in patients educated through genetic counseling or a pamphlet.     

The effects of feedback consistency and feedback favorability on self-perceived task competence and perceived feedback accuracy

The present study, employing a 2 × 2 true-experimental design and regression analyses assessed the main and interactive effects of feedback consistency (consistent vs inconsistent), and feedback favorability (acceptable vs superior), for feedback given at two time periods on measures of perceived feedback accuracy and self-perceived task competence. Among the study's findings were that (a) the perceived accuracy of feedback at the second period was a function of the favorability of feedback received at the first time period, (b) the self-perceived task competence levels of subjects were jointly determined by the favorability of feedback received at both time periods, and (c) the perceived accuracy of feedback was a function of its consistency. Organizational implications of the study's results are offered.     

Career change and congruence of personality type: An examination of DOT-derived work environment designations

Holland's theory of congruence of work environments was examined by analyzing the career redirection of 62 men of managerial and professional level who changed occupations between the ages of 33 and 54. Three-letter personality codes for each subject were obtained by administering the Strong-Campbell Interest Inventory. Dictionary of Occupational Titles codes for first and second occupation were obtained and then translated into Holland codes. These were compared to the personality code for each man to determine whether the first or second job was more congruent. It was found that 26 men changed to careers more congruent with their personality, 25 to careers less congruent, and 11 made no change. The results of the study do not lend support to Holland's theory, probably because of the imprecision of DOT categories for research purposes. The need for a more reliable means for coding work environments is discussed.     

The effect of couples training and partner co-operativeness in the behavioral treatment of obesity

To evaluate the influence of spouse co-operativeness and couples training in the treatment of obesity, 29 obese men and women were assigned to three experimental conditions: (1) Co-operative spouse-couples training: subjects attended all meetings with spouses. Spouses were trained in modeling, monitoring, and reinforcement techniques; (2) Co-operative spouse-subject alone: subjects attended meetings alone even though their partners had agreed to become involved in treatment; (3) Non-cooperative spouse: subjects had spouses refusing to participate in the program, and attended sessions alone. At the 3-month and 6-month maintenance assessments. subjects in the spouse training condition lost significantly more weight than subjects in the other two conditions. Weight losses compared favorably to those of any controlled study with subjects in the couples training group averaging nearly 30 lbs lost after 8$\text{1}\text{2}$ months of treatment. In the absence of spouse training, subjects with co-operative spouses did no better than subjects with non-co-operative spouses. The findings suggest that spouse training may have a potent facilitative effect in weight reduction, and that this effect may promote long-term maintenance of weight loss.