A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia

A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.     

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.     

The "second skin": perceptions of disturbed and nondisturbed early adolescents on clothing, self-concept, and body image

The purpose of this investigation was to determine if there were differences between regular education and emotionally disturbed early adolescents with respect to self-concept, body image, and selected uses of clothing. A questionnaire was administered to 74 regular education students from three middle schools. An additional 27 students labeled emotionally disturbed were surveyed from one of the schools. The questionnaire contained existing measures of self-concept and body cathexis and a revised clothing scale developed by the authors. Analysis of the data using t tests revealed significant differences between the groups with regard to self-concept and body image. In both cases, regular education students perceived themselves more positively than did those labeled emotionally disturbed. Factor analysis of the clothing-use measure gave rise to five distinct factors, one of which revealed a significant difference between the groups when analyzed by t tests. This factor, "dependence," examined the emotional effects of the use of clothing on individuals, such as the ability to influence mood. The emotionally disturbed students were less likely to use clothing to influence mood than were the regular education students. The results of this investigation lend further credence to the importance of self-concept in the education curriculum, and imply that the usual aspects of the curriculum that deal with self-concept may be served better by helping the individual become more realistic and self-accepting. The use of clothing as a tool to enhance self-concept merits further investigation.     

Occult participation: its impact on adolescent development

This study investigated the relationship between occult participation, substance abuse, and level of self-esteem in adolescents. Data were collected from 50 adolescents who ranged in age from 12 to 19 years and who spoke English as their primary language. The combined group of adolescents consisted of 25 clinical and 25 nonclinical youth. Participants completed a three-part questionnaire package which included Rosenberg's Self-Esteem Scale, the Adolescent Magic Questionnaire, and the Drug and Alcohol Assessment Scale. Results indicated that adolescent substance abuse and occult participation were significantly related. High and low occult participation groups were determined, and significant differences were found between the high versus low occult groups when compared on the primary variables of self-esteem and substance abuse. Significant differences were also noted when comparing the high versus low occult groups with various psychosocial developmental variables. Included is a discussion of the impact of occult participation on the psychosocial elements of adolescent self-esteem, self-concept, tolerance for deviance, and religious involvement.     

Visual control of movement patterns and the grammar of action

In this experiment adult subjects copied three types of material (letters, reversed letters and geometric shapes) with and without sight of the hand and the writing trace. Without vision the number of movement segments decreased and the sequence and direction of movements were altered. This means that subjects did not use a fixed stored representation to produce items nor did they obey the rules of Goodnow and Levine's (1973) grammar of action. When spatial location is made more difficult by the removal of vision, movement production is simplified to reduce the number of relocations required. The use of consistent directions of movement depends on the ability to use visual control of spatial location.     

Patterns of movement in the first 6 months of life: new directions

The field of infant perceptual development has relied heavily on the preferential-looking and habituation paradigms. Despite the obvious advantages of employing standardized methodologies, there is a need to study how perceptual variables give rise to and guide action beginning in the neonatal period. It is argued here that, in the first 5 months of life, it is important to distinguish reflexive patterns of movement from voluntary and cortically controlled patterns. Some criteria are defined. This paper describes three experiments which utilized movement counters to record developmental changes in the frequency and synchrony of limb movements in infants under 5 months. The results show that there is a general increase in frequency of limb movements from 1 to 5 months, but with a plateau or even a decrease in activity from the middle of the third month to the end of the fourth month. It was also demonstrated that synchrony scores (co-activation) for pairs of limbs showed significant increases from 1 month to 5 months. Finally, in all three experiments the presentation of an attractive toy resulted in suppression of activity. The results of the three experiments are interpreted to measure a gradual increase in cortically controlled movement patterns.     

Visual search along the colour dimension

Subjects searched for a chromatic target among coloured background items. With low target-background chromatic similarity, response latencies remained uniformly short whether the target was present or not and whether the items were chromatically homogeneous or not. Latencies increased with increases in target-background similarity and were longest with heterogeneous backgrounds, with which the effects of trial type also became manifest. We employed Treisman's model of visual search to account for these findings. In particular, we suggest that similarity increases forced a shift from a preattentive to an attentive search, the latter being importantly shaped by the background's level of chromatic variance.     

Helping through touch: The embodiment of caring

There is a power to touch, and a magic. Some call it mystery. The purpose of this paper is to reflect on the various meanings and uses of touch, particularly within the context of relationship and helping. There will be no attempt to formulate a protocol for touch or to lay claim to a definitive meaning for touch. Reflection about touch may instead clarify some of its meanings and dynamics while encouraging care providers to embrace the experience of helping-through-touch. This paper supports a considered use of empathie touch because of its power and its ability to embody care.