PREVENTION OF DEPRESSIVE SYMPTOMS IN SCHOOLCHILDREN:

Abstract— After teaching cognitive and social-problem-solving techniques designed to prevent depressive symptoms, we followed 69 fifth- and sixth-grade children at risk for depression for 2 years. We compared these children with 49 children in a matched no-treatment control group The prevention group re- ported fewer depressive symptoms through the 2-year follow-up, and moderate to severe symptoms were reduced by half. Surprisingly, the effects of the prevention program grew larger after the program was over. We suggest that psychological immunization against depression can occur by leaching cognitive and social skills to children as they enter puberty     

The modification of auditory hallucinations

The ABAB withdrawal design was used to document the effectiveness of a behavioral treatment package in reducing the duration of auditory hallucinations of a chronically mentally ill inpatient. Results revealed clear functional control of the treatment package over the occurrence of the subject's auditory hallucinations during a 2-hr time period.     

Mental health service utilization among Puerto Rican children ages 4 through 16

This paper examines those children receiving mental health services in Puerto Rico, their demographic and psychosocial characteristics, and describes service providers and nature of facilities. The survey was done on a probability sample of children ages 4 through 16 across the island of Puerto Rico (N=777). Need for services was clinically defined as presence of a DSM-III diagnosis and functional impairment. The overall rate of service utilization for Puerto Rican children was 6% (26.2% of definite cases and 5.1% of probable cases). In most cases services were provided by psychologists and/or social workers, and they were mainly provided in schools and general medical facilities. In over 60% of the children assessed as cases, who did not receive services, the reason, given by the parent was that they considered the problem not serious. Factors associated with service utilization were measures of psychopathology, teacher's perceived need, and parental rates of criticism and hostility. These findings suggest that there is a need for more research on the motivating factors for service use (impairment and parental criticism). Teachers could benefit from receiving special training to help them readily recognize behavioral problems in children, communicate them to parents and set up services alternatives.     

New directions for the education of clinical psychologists: The primary care setting,the VA's PRIME program,and the in-depth generalist model

As part of this special issue on psychology in primary care settings, we describe the Department of Veterans Affairs' (VA's) new approach to education for practice in the primary care setting and we concurrently address some general issues related to the education of clinical psychologists for practice in this setting. In this article we argue that the primary care psychologist, in parallel with the generalist in medicine, must have a strong generic background in clinical psychology in order to gain the broad range of clinical skills necessary to function effectively as an in-depth generalist (IDG) who is capable of addressing the variety of psychological issues that emerge in the primary care setting. The IDG model of professional practice, which we believe is best suited for primary care/managed care settings, requires extensive training in generic clinical skills and increased time devoted to its implementation at both the predoctoral and the postdoctoral levels.     

Predictive testing and oncogenes

Case vignette: sharing unanticipated genetic information. The Questor family has experienced an unusual number of malignancies in the past two generations and has been advised by an oncologist that the p53 oncogene known as Li-Fraumeni Syndrome may be present in the family genome. The option of predictive genetic testing has been raised and several branches of the family have chosen to undergo screening to determine whether they are at risk for cancer because of the gene. Roger and Liz Questor have arranged for screening of themselves and their three children, ages 12, 10, and 7. The couple has, by all appearances, been happily married for 14 years. None of the family members are found to carry the oncogene; however, the geneticist conducting the analyses has made an interesting incidental discovery. The 10-year-old child is not the biological progeny of Roger Questor. Although the 12- and 7-year-olds are clearly the biological children of the couple, it is evident that the 10-year-old born to Liz Questor was fathered by a person other than Roger. What are the ethical obligations of the geneticist with respect to any sharing or disclosure of the information that has been discovered incidentally? What course of action, if any, do you recommend?     

Illness, the problem of evil, and the analogical structure of healing: on the difference Christianity makes in bioethics.

A Christian bioethic needs to place the medical approach to sickness, suffering, and death within the context of redemption and the renewal of humanity in the image of God. This can be done by accounting for the way in which the disruptions of the human life-world that attend the illness experience manifest the structure of the problem of evil and point toward an answer that transcends the individual and the medical community. Further, the disease-oriented approach to medicine, when understood in the context of the analogia entis, can be taken as an analogy for a deeper spiritual healing, and can thus become a vehicle through which one can minister to the disruptions of a patient's life-world. An appreciation of the analogical structure of healing provides the basis for a Christian ethic of care.     

Active control in interrupted dynamic spatial orientation: The detection of orientation change

Gibson (1966, 1979) suggested that an important property of perception is that the observer is active. Two experiments were conducted to examine the benefits of active observation in determining dynamic spatial orientation. Subjects were presented with displays simulating locomotion through a three-dimensional environment. Active observers continuously controlled locomotion, whereas passive observers viewed the display. During the trial, the display was blacked out for a brief period, followed by a static image that was at either the correct or the incorrect orientation following the blackout. Subjects were required to indicate whether they were positioned at the correct extrapolated orientation. The presence or absence of orientation change, the type of change (changes in rotation about the depth axis [roll], horizontal axis [pitch], or forward translation), the duration of the blackout, and the consistency of change were varied. In addition, the experiments used either a compensatory or a pursuit tracking task. Active observers had greater sensitivity than did passive observers in detecting a change for both tracking tasks. Subjects in both experiments exhibited greater sensitivity in detecting inconsistent changes (relative to consistent changes), suggesting that the dynamics specified by optical flow were incorporated in extrapolated orientation. In addition, sensitivity decreased with an increase in blackout duration. The results are discussed in terms of an extrapolation model of perception that incorporates the responses executed by active observers.     

Attentional bias to threat: Roles of trait anxiety, stressful events, and awareness

Attentional biases for threat stimuli were assessed in high and low trait anxious subjects (n = 66) using a probe detection task. To examine the effects of trait anxiety and situational stressors, each subject was tested three times: Under no stress, laboratory-induced stress, and examination-induced stress. To evaluate the role of awareness, half the word stimuli were presented very briefly (14 msec) and masked, and the other half were presented for 500 msec without a mask. Results showed that high trait anxious subjects under exam stress showed an attentional bias towards unmasked threat stimuli compared with low trait subjects. This effect was not found under lab-induced stress, suggesting that the attentional bias for unmasked threat in high trait subjects may be a function of a prolonged stressor, rather than a transient increase in state anxiety. The results from the masked exposure condition were not predicted; high trait anxious subjects shifted attention towards the spatial location of threat words despite lack of awareness of their lexical content, but this bias was only apparent in the no-stress condition. The results are discussed in relation to recent cognitive theories of anxiety.     

Does stimulus correspondence account for the Simon effect? Comments on Hasbroucq and Guiard (1991)

Summary In a recent paper analysing the Simon effect, Hasbroucq and Guiard (1991) concluded that stimulus congruence, a correspondence relationship between stimulus components, accounts for the Simon effect and explains its reversal in the Hedge and Marsh experiment (1975). We contend that their definition of stimulus congruence is applied inconsistently, which invalidates their conclusion. It is argued here that the effect of display-control arrangement correspondence (Simon, Sly, & Vilapakkam, 1981) is an alternative account that fits the presented data better. In a second experiment, Hasbroucq and Guiard (1991) claimed to have invalidated the suggestion that display-control arrangement correspondence could be considered to be an alternative account of the findings in their Experiment 1. However, we assert that the type of display-control arrangement employed in their second experiment was so unpredictable that no effect of display-control arrangement correspondence could occur.