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.     

Anxiety in adolescence and its significance for psychoanalysis

The theme of this paper is the well-known resistance of adolescents to participate in analytic treatment and analysts' reservations about treating adolescents, which is perhaps less well known. Several reasons are discussed: For adolescents, the revival of separational and fusional anxieties during the process of individuation as well as resistance to the analytic setting are held responsible; analysts may lack sufficient awareness of their own adolescence and its resulting anxieties to be able to confront this developmental period. In addition, there are countertransference anxieties that are triggered and kept alive by the behavior of the juvenile patient. The different types of analyst anxieties as well as those of the adolescent under analysis are explained and their significance in the process of individuation and the course of therapy is noted.     

Intolerance of responsibility for internal conflict

A type of patient is described, who has marked intolerance of taking responsibility for his internal conflicts so as to confront them, analyze them, and change. Defensive repetition in pathological object relations aims to avoid what is wrong within and to engage another so as to protect oneself. Genetic, dynamic, and technical aspects of such defensive, dependent relating are considered. Responsibility for oneself and for what is within oneself is held to be terrifying--more than anyone can bear on his own. How destructiveness has become, and remains, so terrifying is discussed.     

Psychoanalytic enlightenment and the greening of diplomacy

The author reviews aspects of psychoanalytic theory which have helped him in his career as an American diplomat and political analyst. He cites the works of Erikson (1950, 1968, 1969), Volkan (1979, 1987), and Mack (1979, 1983) as especially helpful, and praises the late Jeanne Knutson, founder of the International Society of Political Psychology, for her work on the psychology of victimhood. The role and function of completed and incomplete mourning are discussed as fundamental aspects of unresolved ethnic and sectarian conflict, and the importance of asking and granting forgiveness in the resolution of violent political conflict is explored. The paper ends with a specific application of the meaning of forgiveness in the relationship between Christians and Jews.     

The changing face of visual persistence

In three experiments, the effect of target luminance on estimates of visual persistence was determined on a popular successive-field task. Even though the experiments differed from each other only in terms of minor changes in stimulus conditions, very different effects were obtained across the three experiments. The different findings were attributed to the often overlooked roles of masking and target degradation on tasks of persistence. Implications for the numerous contradictory findings in the persistence literature are discussed, and the current popularity of the successive-field task is questioned.     

Recency effect in recall of a word list when an immediate memory task is performed after each word presentation

Subjects studied 12-word lists for free recall. During presentation of the lists, each word was followed by a supraspan sequence of digits, which the subjects tried to reproduce. This task, unlike those used in previous research with this continual distractor procedure, presumably taxed immediate memory capacity to the full. Nevertheless, the word recall data showed a pronounced recency effect. Moreover, the magnitude of the recency effect was found to be just as great with this task as with a more typical task in which the demands on immediate memory are likely to be fewer. These findings reinforce the emerging view that the recency effect need not be the product of immediate memory.     

Interserial and intraserial interference processes in morning recall of mental sleep experience

This study investigated ways in which predictions from interference theory might explain partial or total failure in the morning recall of mental sleep experience (MSE) episodes reported after provoked night awakening. Interference could take place either between the contents of one MSE episode (intraserial interference) or between the contents of different MSE episodes (interserial interference) and would be more likely to affect morning recall where similar (i.e., interrelated) contents in MSEs are involved. If interference were mainly intraserial, in the morning there would be no change in the difficulty of retrieving interrelated contents, whereas, if it were mainly interserial, there would be increased difficulty in the retrieval of such contents. All the possible pairs of reports obtained by awakening 8 subjects four times in REM sleep during each of four experimental nights spaced at weekly intervals were scored for interrelated contents, using Clark's (1970) system of analysis of paired units, which operates by matching linguistic features. Results showed that interrelations in morning report pairs are as frequent as in night report pairs, maintaining the same linguistic characteristics and with little transfer of contents from one MSE to another. Overall these findings are compatible with the hypothesis that interference is primarily intraserial rather than interserial. It is consequently suggested that morning recall failure may be due to temporary blocking of retrieval.     

Reducing smoking among pregnant adolescents

Pregnant adolescents who smoke present a double obstetrical risk. Not only is the adolescent mother at risk from the biological, social, educational, and economic factors associated with childbearing at a young age, she and her developing infant also risk the complications associated with maternal smoking. This paper describes a psychosocial intervention designed to reduce smoking in a group of pregnant adolescents. Five modules are presented. Each is designed to: (1) heighten awareness of the issue, (2) provide motivational messages, (3) enhance the adolescent's social skills, and (4) teach specific smoking-cessation skills.