The utilization of genetic counselors within a newborn screening program

Genetic counselors have participated in the Michigan Newborn Screening Program on a contractual basis since 1988. Their role includes newborn screening education and training, newborn nursery site visits, and monitoring newborn screening in hospitals. Their impact has been to improve the quality of newborn screening services by reducing errors and increasing completion of data fields on newborn screening cards, improving hospital nursery cooperation and problem solving, and enhancing health department response to specific problems.     

Reflections on human pavlovian decelerative heart-rate conditioning with negative tilt as US: Alternative approaches

The negative-tilt preparation that has been reported since the late seventies is a specific form of Pavlovian conditioning that is of scientific interest and has potential applications. In this paper I reflect on the usefulness, to the development of this preparation, of two approaches to Pavlovian conditioning. One approach is the older S-R learning, stimulus-substitution paradigm exemplified by learning texts of the sixties. The other is the modern, Tolman-like view, according to which the phenomenon of Pavlovian conditioning is “now described as the learning of relations among events so as to allow the organism to represent its environment.” The three assumptions encapsulated by this approach are: (a) that only CS-US contingency relations are learned; (b) that teleological modes of explanations are adequate; (c) that the representational theory of knowledge is sound. Concerning Pavlovian conditioning in general, questions been raised in the literature for all three assumptions; they have not been adequately answered. Regarding the specific problem of developing the human Pavlovian heart-ratedecelerative conditioning with negative tilt as the US, I suggest that the cognitive approach has been much less helpful than the older, S-R, stimulus-substitution paradigm. Nevertheless, other literature clearly indicates that the cognitive, S-S approach has generated considerable interest and research, especially in preparations like the conditioned emotional response (CER), which are CS-IR ones in the sense that the effects on the CR are assessed indirectly through measuring an indicator or instrumental response (IR). Finally, even in CS-CR preparations like human GSR conditioning, it is important to study the cognitive, S-S learning process through using such dependent variables as continuously assessed subjective CS-US contingency.     

The epidemiology of suicide and attempted suicide

Since more than one century suicides have been registered in national statistics of death causes. They thus furnish one of the few parameters of psychiatrically relevant behaviour by means of which trends, cohort, age-group and period effects can be studied over longer periods. Since the second half of last century, the suicide rates for Swiss males--similar to those found in England and Wales--show a decrease in consecutive birth cohorts up to males born in the decade 1930-1940, and a continued decline in the total trend until about World War II. From then on the suicide rates of males in consecutive birth cohorts have been slowly increasing in the majority of European and North American countries--but not so in Sweden. Opposite to this, the predominantly low rates for females display little change. Further to the considerable differences between nations and the predominance of suicides committed by females in some Asian countries and Cuba, the changes indicate the significance of cultural and economic environmental factors. Typical period effects are mainly the result of changes in conception and conditions of life. In attempted suicide they proceed in a more sensitive and more rapid way and are about ten times higher. Such a period effect showing increases by about 300% in younger age-groups followed by a decline, attaining its peak about 1976, was ascertained in large cities of the Federal Republic of Germany. By the example of the effects of a television serial, the study of causal processes turning collective environmental factors into individual suicidal behaviour, proved that regularities are effective in learning by a process of modelling. Besides, the epidemiological data give essential hints how to treat suicidal behaviour.     

HIV infection: trauma and coping with trauma

The initial results of a German-Swedish research project demonstrate the at times active-resistant and at times passive-resigned approaches of AIDS patients toward their illness.     

Threshold tracking for assessment of long-term adaptation and sensitization in pain perception

To assess temporal variations in the perception of "phasic" heat pain stimuli a psychophysical tracking procedure was developed that enables repeated assessment of the pain threshold at short intervals. This "double-tracking" procedure produces two tracking curves simultaneously, one that approaches the pain threshold gradually from above, the other from below. The threshold for phasic heat pain was measured in 80 tracking trials with stimuli at temperatures near the pain threshold. Concurrently, the threshold for "tonic" heat pain was determined after every 20 tracking trials with a stimulus adjustment procedure. Eleven healthy subjects (age: 26.4 yr. +/- 6.0) participated in 2 sessions each. Phasic stimulation near the pain threshold did not produce any trends in either of the two threshold measures. Hence there was no long-term adaptation or sensitization. However, there were random variations (random walks) in the tracking curves, which we interpret as resulting from a stochastic relationship between stimulus and sensation. In agreement with other reports, discrimination seemed to be better at painful than at nonpainful temperatures.     

Decision time and movement time in depression: differential effects of practice before and after clinical improvement

Choice reaction time involves, at least two components of response latency, decision time and movement time. Studies of choice reaction time usually provide values of these two components averaged over a given number of trials. The aim of the present study of depressed subjects was to investigate changes across practice on Decision Time (DT) and Movement Time (MT) before and after clinical improvement. 19 depressed subjects were given two sessions of 50 trials each, one before treatment (Di) and one after recovery (Df). Decision time and movement time exhibited quite different patterns. Decision time significantly decreased with clinical improvement. No significant variation across trials was found, in either session. Movement time values varied across trials but the variations observed on Di and Df were significantly different, whereas before treatment latencies recorded at the end of the session were greater than those scored at the start, the contrary was observed after clinical recovery. No significant difference was found between values of movement time scored at the start of the two sessions.