The making of contemporary American psychiatry, part 1: patients, treatments, and therapeutic rationales before and after World War II

This article, the 1st in a 2-part series, uses patient records from California's Stockton State Hospital to unearth the midcentury roots of contemporary American psychiatry. These patient records allow the authors to examine 2 transformations: the post-World War II expansion of psychiatry to include the diagnosis and treatment not only of psychotic patients but also of nonpsychotic patients suffering from problems of everyday living, and the 1950s introduction of the first psychotropic drugs, which cemented the medical status of these new disorders, thus linking a new therapeutic rationale to biological understandings of disease. These transformations laid the groundwork for a contemporary psychiatry characterized by voluntary outpatient care, pharmacological treatment of a wide range of behaviors and distress, and a doctor-patient relationship and cultural acceptance of disease that allow psychiatric patients to identify themselves as consumers.     

Whither causal models in the neuroscience of ADHD?

In this paper we examine the current status of the science of ADHD from a theoretical point of view. While the field has reached the point at which a number of causal models have been proposed, it remains some distance away from demonstrating the viability of such models empirically. We identify a number of existing barriers and make proposals as to the best way for these to be overcome in future studies. These include the need to work across multiple levels of analysis in multidisciplinary teams; the need to recognize the existence of, and then model, causal heterogeneity; the need to integrate environmental and social processes into models of genetic and neurobiological influence; and the need to model developmental processes in a dynamic fashion. Such a model of science, although difficult to achieve, has the potential to provide the sort of framework for programmatic model-based research required if the power and sophistication of new neuroscience technologies are to be effectively exploited.     

Development of selective attention: perceptual load influences early versus late attentional selection in children and adults

The moderating effect of perceptual load on visual selective attention was examined in 2 studies. In Study 1, children and young adults searched displays of varying set size flanked by irrelevant distractors. Children's performance was as efficient as adults' under conditions of high but not low loads, suggesting that early selection engages rapidly maturing neural systems and late selection engages later-maturing systems. In Study 2, 4 age groups were tested, and place markers were set at empty locations to examine perceptual grouping effects. Study 1's pattem was replicated in all age groups, with onset of early selection occurring at lower loads for younger children. Overall, children initiated early selection at lower loads to compensate for immature anterior-system interference control processes.     

The effects of noncontingently available alternative stimuli on functional analysis outcomes

The effects of noncontingently available alternative stimuli on functional analysis outcomes were evaluated for 2 individuals. Results suggested that noncontingent access to preferred items resulted in reduced levels of attention-maintained behavior. The results are interpreted in terms of establishing operations.     

A longitudinal investigation of anxiety sensitivity in adolescence

This investigation sought to expand existing knowledge of anxiety sensitivity in a sample of high school students (N = 2,365) assessed over 4 years. The stability of anxiety sensitivity levels across assessment periods was examined, and cluster analyses were used to identify different developmental pathways in levels of anxiety sensitivity. Groups of adolescents with stable low, stable high, and escalating anxiety sensitivity levels were identified. Adolescents with stable high or escalating anxiety sensitivity were significantly more likely to report experiencing a panic attack than individuals with stable low anxiety sensitivity. Results also indicated that Asian and Hispanic adolescents tended to report higher anxiety sensitivity but that their anxiety sensitivity was less strongly associated with panic than that of Caucasian adolescents.     

Differential reinforcement with and without instructional fading

We evaluated a differential-reinforcement-based treatment package for the reduction of problem behavior during instructional situations. Differential reinforcement of alternative behavior (DRA; compliance) was implemented across two conditions. During one condition, instructions were presented approximately once every other minute. This condition was considered the terminal goal for treatment. During the second condition, the rate of instructions was gradually increased (beginning at zero and ending when instruction rate was similar to the first condition). Results indicated that DRA with instructional fading resulted in less problem behavior than DRA without instructional fading. These results are similar to previous studies regarding the utility of instructional fading.     

Cognitive theories of early gender development

The contribution of cognitive perspectives (cognitive-developmental theory and gender schema theory) to a contemporary understanding of gender development is evaluated. Recent critiques of cognitive approaches are discussed and empirical evidence is presented to counter these critiques. Because of the centrality of early gender development to the cognitive perspective, the latest research is reviewed on how infants and toddlers discriminate the sexes and learn the attributes correlated with sex. The essence of cognitive approaches--emphasis on motivational consequences of gender concepts; the active, self-initiated view of development; and focus on developmental patterns-is highlighted and contrasted with social-cognitive views. The value of cognitive theories to the field is illustrated, and recommendations are made concerning how to construct comprehensive, integrative perspectives of gender development.     

Architectural design of a secure forensic state psychiatric hospital

This article describes the architectural design of a secure forensic state psychiatric hospital. The project combined input from staff at all levels of the client organization, outside consultants, and a team of experienced architects. The design team was able to create a design that maximized patient dignity and privacy on one hand, and the ability of staff to observe all patient activity on the other. The design centers around 24-bed units, broken into smaller living wings of eight beds each. Each eight-bed living wing has its own private bathrooms (two) and showers (two), as well as a small living area solely reserved for these eight patients and their guests. An indoor-outdoor dayroom allows patients to go outside whenever they choose, while allowing staff to continue observing them. The heart of the facility is a large treatment mall, designed to foster the acquisition of social, emotional, cognitive, and behavioral skills that will help patients to safely return to their communities.     

The psychological contract and individual differences: The role of exchange and creditor ideologies

The present study examines exchange and creditor ideologies (two dispositional characteristics that are strongly related to exchange relationships) and their moderating effects on the psychological contract. Five hundred public-sector employees were studied over a 3-year period. Respondents’ were surveyed as to their perceptions of what they believed their employer owed them (e.g., job security, training, involvement in decision making, etc.) and the extent to which these “employer obligations” had been met. In addition, we assessed respondents’ perceptions of their own obligations to their employer (e.g., agreeing to work extra hours, volunteering for non-job-related activities, working unpaid hours, etc.) and the extent to which they believed that these “employee obligations” had been fulfilled. The results indicate that creditor ideology related positively to employee perceptions of their obligations to the employer and the extent to which they fulfilled those obligations while exchange ideology related negatively to employee obligations and fulfillment of obligations. Exchange ideology moderated the effects of perceived employer obligations on employee obligations and fulfillment of obligations while creditor ideology moderated the relationship between perceived employer fulfillment of obligations and employee obligations. This article provides preliminary evidence to the benefits of examining the role of individual dispositions in psychological contract research—a previously neglected topic—and discusses the potential implications for the practice of management.