A NEUROBIOLOGICAL ALTERNATIVE TO THE PERCEPTUAL REINFORCEMENT HYPOTHESIS OF STEREOTYPED BEHAVIOR: A COMMENTARY ON “SELF-STIMULATORY BEHAVIOR AND PERCEPTUAL REINFORCEMENT”

A perceptual reinforcement theory of stereotyped movements is advanced by Lovaas, Newsom, and Hickman (1987) in an effort to integrate a number of diverse observations about the origins and maintenance of this behavior. We, in turn, argue that the theory, as presented, is logically flawed and fails to take into account important biological findings and theory concerning pathological stereotyped acts. An alternative theory, derived primarily from neurological concepts, is briefly described.     

PSYCHOLOGY AND HEALTH: CONTRIBUTIONS OF PSYCHOLOGY TO THE IMPROVEMENT OF HEALTH AND HEALTH CARE

Psychology as both a science and a profession has been closely identified with other disciplines in the broad field of health since the turn of the century. Recent advances in health care have reinforced the growing belief that the promotion of health and the prevention and treatment of illness can be greatly enhanced by incorporating the scientific findings and modern technology of psychology into everyday practices. Outlining the contributions of psychology to health care throughout the world is the primary purpose of this report. In this brief survey, only some of the most timely and relevant issues can be mentioned, together with examples of current work in the field. The reader interested in pursuing these psychological contributions more thoroughly is encouraged to review pertinent references from the citations at the end of this report. After an introductory overview, special attention is given to each of the major areas within the broad field of health care where psychological applications have been particularly useful.     

Generalised anxiety: A controlled treatment study

The effects of anxiety management training were evaluated by allocating 66 generally anxious clients to either a wait list condition, non-directive counselling, or a combination of relaxation and brief cognitive therapy. Anxiety management was significantly more effective than the wait list condition on a number of relevant measures at post-treatment, but there were relatively few differencs between anxiety management and non-directive counselling, either at post-treatment or at 6 months follow-up. Those differences which were found could plausibly be explained in terms of the demand characteristics of training in relaxation or cognitive therapy. It was concluded that anxiety management is clearly better than a non-treatment control condition, but that its superiority to plausible alternatives which lack the specific components thought to be responsible for improvement has yet to be demonstrated.     

Galef’s Transfer-of-Information Effect Occurs in a Free-Foraging Situation

Galef and his colleagues have repeatedly shown that one rat may transfer information regarding the type of food it has consumed to other conspecifics. Such experiments typically have been conducted in wire-mesh cages or a wooden maze. The present experiments sought to extend this paradigm to the open-field foraging situation having six food patches to choose from. Following interaction with a demonstrator that had consumed either a cocoa or a cinnamon diet, single observers (Experiment 1) were tested in the foraging situation. Food-consumption scores indicated that observers consumed significantly more of their specific demonstrator’s diet than a second diet that was available also. Experiment 2 involved the simultaneous testing of two observers in the foraging laboratory. In Experiment 3 two observers were once again tested, but each had been provided a different food-type message prior to foraging. Positive results, mirroring those of Experiment 1, were obtained in both Experiments 2 and 3. The results of these three experiments underscore the robustness of this phenomenon and its generalizability to other testing conditions.

     

Anomalous dominance in sibling stutterers: Evidence from CT scan asymmetries, dichotic listening, neuropsychological testing, and handedness

Two left-handed siblings with developmental stuttering are comprehensively described. The methods of study included speech and language evaluation, neurological and neuropsychological examinations, dichotic listening, auditory evoked responses, electroencephalogram, and CT scan asymmetry measurements. The data from each sibling showed evidence of anomalous cerebral dominance on many of the variables investigated. The CT scan measurements showed atypical asymmetries, especially in the occipital regions. These findings support the theory that stuttering may be related to anomalous cerebral dominance, both on functional as well as structural bases. Implications of anomalous dominance and the resultant effect of hemispheric rivalry on speech fluency are discussed.     

Work site group meetings and the effectiveness of a televised smoking cessation intervention

At the work site, smoking accounts for increased health care expenses and worker absenteeism due to smoking-related illness and reduced productivity and lost wages. Developing comprehensive and accessible smoking cessation programs at the work site is an important objective for health care professionals. In this study, employees of 43 corporations participated in a televised smoking cessation program accompanied by self-help manuals. The media component involved presenting a smoking cessation program on a network television affiliate station during the 4:30 p.m. and 10:00 p.m. news for 20 days. Employees at half the corporations also had access to semiweekly self-help group meetings. Adding self-help support groups to a program involving self-help manuals and the media reports was found to significantly increase abstinence and its maintenance over time. The implications of using the media, self-help groups, and work site locations in large-scale community-based interventions are discussed.     

The word frequency effect in lexical decision: Finding a frequency-based component

Subjects making lexical decisions are reliably faster in responding to high-frequency words than to low-frequency words. This is known as the word frequency effect. We wished to demonstrate that some portion of this effect was due to frequency differences between words rather than to other dimensions correlated with word frequency. Three groups of subjects (10 engineers, 10 nurses, and I0 law students) made lexical decisions about 720 items, half words and half nonwords, from six different categories (engineering, medical, low-frequency nontechnical, medium-frequency nontechnical, and two groups of high-frequency nontechnical). Results of two analyses of variance revealed a crossover interaction such that engineers were faster in responding to engineering words than to medical words, whereas nurses were faster in responding to medical words than to engineering words. The engineering and medical words were equally long and equally infrequent by standard word counts. We take this as support for a frequency-based component in the word frequency effect. The practical implications of this research for estimating the readability of technical text are discussed.     

Ethical dilemmas in forensic evaluations

Ethical issues emerging from forensic assessments are addressed from clinical and research perspectives. The relevance of agency, forensic identification, and attitudes toward defendants are explored within the framework of ethical practice. Finally, the ethical role of mental health professionals in the courtroom, the scope and basis of their testimony, and the rendering of conclusory opinions are discussed within a psycholegal context.     

Juvenile homicide: The need for an interdisciplinary approach

Most of the empirical literature on juvenile homicide has emerged from the clinical experience of mental health professionals who have diagnosed and/or treated youngsters who killed. After a critical review of this literature, data on 787 juvenile homicide offenders are presented and discussed. These data indicate that intrafamilial killings represent but a small fraction of all homicides perpetrated by juveniles and that there are clear differences between intrafamilial and extrafamilial juvenile homicides.     

An introduction to organic brain syndromes

Organic brain syndromes are of forensic interest for several reasons. First, patients with organic brain syndromes may require judicial determination of competence in any of a number of areas, e.g., testamentary capacity, need for financial guardianship, or competence to make medical decisions. Second, any patient whose mental state is of legal interest will need evaluation for contributing organic factors; uncovering these factors may have considerable medical and legal consequence. Third, the discovery of organic factors may be decisive in the outcome of a judicial proceeding, where “hard” biological data are often accorded more weight, and are thus more persuasive, than “soft” psychological data. This article provides an introductory overview of the organic brain syndromes. For each syndrome, the clinical features are described and are illustrated with a case vignette, the more common etiologies are presented, and selected aspects to the evaluation are highlighted. In addition, since the detectian of malingered mental illness is a key component in many forensic contexts, characteristics are described which help to distinguish actual from malingered mental illness.