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.     

Uses and limitations of Kohut's self psychology in the treatment of borderline patients

The treatment of borderline patients provides a setting in which the analyst can evaluate the clinical usefulness of Kohut's theories. The issues that arise in this treatment can also highlight aspects of Kohut's theories that are incomplete and require other theoretical models in order to understand the patient optimally.     

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.     

Rats and bunnies: core kids in an American mall

Although adolescents use shopping malls as important places of congregation, very little attention has been paid to this phenomenon by social scientists. This paper reports on a qualitative, interview-based study of adolescents in a New England shopping mall. Regular, day-to-day frequenters (N = 23) were identified and interviewed extensively over a six-week period in 1988. These "core kids" exhibited a good deal of alienation from both family and school, and used the mall as a neutral ground on which to create a fragile but mutually supportive community of kind.     

The effects of kinetic occlusion and categorization on amodal completion. A comment on Gerbino and Salmaso (1987)

The experimental study of Gerbino and Salmaso (1987) focused on the process of amodal completion, i.e. the process that leads to the impression of a total pattern in the absence of information about all parts of the pattern. One of the questions that they have attempted to answer with respect to this process is whether or not it depends on the categorization of the modal part (i.e. the part about which visual information is present) as a modification of a complete prototype. The major conclusion of their experiments is that amodal completion does not depend upon categorization. Furthermore, they interpret their results as indicating that neither the truncated form of the occluded part nor the unification/segregation of contour segments are phenomenally real. We designed some variants of the tunnel effect to demonstrate (1) that the explicit categorization of some parts of the input can have an influence on amodal completion and (2) that the truncated form of a pattern can be phenomenally real. Our results corroborate these hypotheses and can, therefore, interpreted as refuting two rather central claims of Gerbino and Salmaso (1987). The conclusion of our experiment must be that amodal completion is not as primary as they have supposed but can be influenced by kinetic occlusion and categorization stored in visual memory.     

Acquired affective-evaluative value: conservative but not unchangeable

In a previous study on Evaluative Conditioning it was found that unlike signal-learning, evaluative learning is resistant to extinction. In the present experiment we tried to replicate and corroborate this finding. In addition, we investigated the effectiveness of a counterconditioning procedure to alter acquired evaluative value. On a within-subject base (n = 30), it was found that the mere contingent presentation of neutral with (dis)liked pictures of human faces was sufficient to change the affective-evaluative tone of the originally neutral stimuli in (negative) positive direction. Next, we replicated the finding that an extinction procedure does not have any influence on the acquired evaluative value of the originally neutral stimuli, and this even in subjects fully aware of the extinction presentations. We demonstrated the effectiveness of a counterconditioning procedure to alter acquired evaluative value, and in addition, found some evidence that awareness of the counterconditioning manipulations is not a prerequisite for its effectiveness. The theoretical consequences of these findings are phrased in terms of a fundamental distinction between signal-learning and evaluative learning, and some important implications for the behavioral treatment of affective-emotional disorders are suggested.     

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.     

Visual search along the colour dimension

Subjects searched for a chromatic target among coloured background items. With low target-background chromatic similarity, response latencies remained uniformly short whether the target was present or not and whether the items were chromatically homogeneous or not. Latencies increased with increases in target-background similarity and were longest with heterogeneous backgrounds, with which the effects of trial type also became manifest. We employed Treisman's model of visual search to account for these findings. In particular, we suggest that similarity increases forced a shift from a preattentive to an attentive search, the latter being importantly shaped by the background's level of chromatic variance.