A two year audit of a family therapy clinic in adult psychiatry

This paper reports a 2 year audit of a family therapy clinic in a psychiatric department, focusing especially on the relationship between diagnosis and outcome. Patients with affective disorders–especially where anxiety predominated–and eating disorders had good outcome. Structural change occurred in families with psychotic members, even though psychotic symptoms were often unchanged. Difficulties with an acute onset were more responsive than long-term problems, but a substantial number of the latter did improve. Families receiving between four and 10 sessions had the best outcome, and improvement was generally maintained at 2 year follow-up.     

Deontic logic and the possibility of moral conflict

Standard dyadic deontic logic (as well as standard deontic logic) has recently come under attack by moral philosophers who maintain that the axioms of standard dyadic deontic logic are biased against moral theories which generate moral conflicts. Since moral theories which generate conflicts are at least logically tenable, it is argued, standard dyadic deontic logic should be modified so that the set of logically possible moral theories includes those which generate such conflicts. I argue that (1) there are only certain types of moral conflicts which are interesting, and which have worried moral theorists, (2) the modification of standard dyadic deontic logic along the lines suggested by those who defend the possibility of moral conflicts makes possible only uninteresting types of moral conflicts, and (3) the general strategy of piecemeal modification standard dyadic deontic logic is misguided: the possibility of interesting moral conflicts cannot be achieved in that way.     

Performance objectives in the stance phase of human pathological walking

Permanent disruption of aspects of a highly learned skill such as walking force adaptations to occur to the movement. Firstly the body must determine what factors will guide the formation of the new walking pattern, and secondly that new movement pattern must be learned. Frequently the questionable assumption is made that the performance objectives of the new skill are the same as the original. This work used non-linear optimal control and multiple segment simulation to evaluate the ability of several possible objective functions to predict pathological walking patterns. These predictions were then also compared to the results from normal walking. Preliminary results indicate the performance objectives of pathological gaits may be quite different from those of normals. Some support was also provided for the existence of simultaneous multiple performance objectives in complex movements.     

Risk perceptions and participation in colorectal cancer screening

Compared individuals at high versus average risk for colorectal cancer (CRC) with respect to factors they cited as affecting their risk of developing CRC. We also examined the relationship of these risk-factor perceptions to perceived susceptibility and participation in a CRC screening test. All individuals in the high-risk group were informed that, as a sibling of someone with CRC, they were more likely to get this cancer themselves. We found minimal differences among siblings with respect to perceived susceptibility. Further, although high-risk siblings were more likely to participate in screening, only 20.2% cited heredity as a risk-increasing factor, and, among these siblings, there was no relationship between screening participation and the citation of any specific risk factors, including heredity. These findings demonstrate the need for more research examining how high-risk individuals process risk-relevant information and the effect of this information on health behavior.     

Efficacy of behavioral management and patient education on vascular access cleansing compliance in hemodialysis patients

Compared four treatment conditions to test their ability to enhance compliance with vascular access cleansing (VAC) procedures in a group of 56 hemodialysis patients. The conditions were patient education, behavioral management with monetary incentive, patient education/behavioral management, and attention control. Behavioral observers rated VAC behavior at pretreatment, posttreatment 1-month follow-up, and 1-year follow-up. Knowledge of VAC procedures was also assessed via a questionnaire at pretreatment and posttreatment. Data were analyzed using repeated-measures multivariate analyses of variance. Results indicated that the patients in the education/behavioral, behavioral, and education groups gave significantly more correct answers on our VAC knowledge questionnaires at posttreatment than did patients in the attention control group. Further, patients in the education/behavioral and behavioral groups completed significantly more VAC steps at posttreatment and 1-month follow-up than did patients in the education group and in the attention control group. Differences were not maintained at 1-year follow-up, although more than 50% of the patients were lost to follow-up. Implications of the present findings for behavioral and educational interventions are discussed.     

Relationship between JAS- and FTAS-Type A behavior and non-CHD illness: a prospective study controlling for negative affectivity

In addition to posing a risk for coronary heart disease (CHD), Type A behavior has been suggested as a risk factor for non-CHD illness. Past evidence, however, has relied chiefly on retrospective studies of self-reported illness that failed to control for the potentially confounding effects of negative affectivity. The present investigation was an 18-month prospective study of Type A behavior and medical records of illness in which chronic negative affectivity was also assessed. Negative affectivity was associated with retrospective self-reported illness, but only Type A, as measured by the Jenkins Activity Survey (JAS) and the Framingham Type A Scale (FTAS), predicted medical records of subsequent illness severity and number of illness-related medical visits. Controlling for negative affectivity did not reduce these significant relationships. It was concluded that persons scoring high on the JAS or the FTAS may be a greater risk of minor illness when objective measures of illness are assessed over a period of 1 year or more. Alternative explanations and future directions for research are discussed.     

Inquiry into intentional systems I: Issues in ecological physics

Summary The role of intention in guiding the behavior of goal-directed systems is a problem that continues to challenge behavioral science. While it is generally agreed that intentional systems must be consistent with the laws of physics, there are many obvious differences between inanimate, physical systems and sentient, intentional systems. This suggests that there must be constraints over and above those of physics that govern goal-directed behavior. In this paper it is suggested that generic properties of self-organizing mechanisms may play a central role in the origin and evolution of intentional constraints. The properties of self-organizing systems are first introduced in the context of simple physical systems and then extended to a complex (biological) system. Whereas behavior of an inanimate physical system is lawfully determined by force fields, behavior of an animate biological system is lawfully specified by information fields. Biological systems are distinguished from simple physical systems in terms of their ubiquitous use of information fields as special (biological and psychological, social, etc.) boundary conditions on classical laws. Unlike classical constraints (boundary conditions), informational constraints can vary with time and state of the system. Because of the nonstationarity of the boundary conditions, the dynamic of the system can follow a complex trajectory that is organized by a set of spatially and temporally distributed equilibrium points or regions. It is suggested that this equilibrium set and the laws that govern its transformation define a minimal requirement for an intentional system. One of the benefits of such an approach is that it suggests a realist account for the origin of semantic predicates, thereby providing a basis for the development of a theory of symbolic dynamics. Therefore, the principles of self-organization provide a comprehensive basis for investigating intentional systems by suggesting how it is that intentions arise, and by providing a lawful basis for intentional behavior that reveals how organisms become and remain lawfully informed in the pursuit of their goals.     

Do different metamemory judgments tap the same underlying aspects of memory?

We compared the predictions from several kinds of metamemory judgments (on the same set of items), both in terms of their predictive accuracy and in terms of the commonality of predictions. Undergraduates made judgments about the ease with which they could learn each item in a list (ease-of-learning judgments); then they learned every item, either to a minimal criterion of learning or with overlearning, and made judgments about how well they knew each item (judgments of knowing); finally, they returned 4 weeks later for a retention session and made feeling-of-knowing judgments on every time they could not recall, after which a recognition test assessed predictive accuracy. Ease-of-learning judgments had the least predictive accuracy. Surprisingly, however, the recognition of nonrecalled items was predicted equally well by judgments of knowing (made 4 weeks earlier) as by feeling-of-knowing judgments (made immediately prior to recognition). Moreover, those two kinds of judgments were only weakly correlated with each other, which implies that they do not tap memory in the same way.     

Maternal aggression: disruption by perioral anesthesia in lactating Long-Evans rats (Rattus norvegicus)

Role of perioral somatosensation in the display of maternal aggression in Long-Evans Norway rats (Rattus norvegicus) was investigated during early lactation by local anesthesia of the mystacial pads with lidocaine, which blocks conduction in the infraorbital nerve. Acute perioral anesthesia markedly reduced the likelihood that maternal aggression was expressed; this effect of perioral anesthesia was not ameliorated by a repeated test with the same treatment or by pretreatment fighting experience. The dams that fought with the intruder during perioral anesthesia did so after greatly increased sniffing contact and with decreased vigor compared with controls. Males that were attacked tended to freeze, whereas males that were not attacked were active. Thus, trigeminal afferents are critical for the initiation and normal execution of maternal aggression responses in Norway rats.