Rules for making psychiatric diagnoses in children on the basis of multiple sources of information: Preliminary strategies

Inherent in the structured diagnostic interviewing of children is the problem of how to resolve differences between the child's own report and that of the parent about the child. A related problem concerns the use of outside source of information about the child, such as information from the teacher. In this study, the authors review the decision-making process used in the assignment of summary psychiatric diagnoses based on the child and parent reports, as well as a number of other sources of information about the child. Provisional rules for making summary diagnoses of children are presented.This research was supported by NIAAA Center Grant Number AA-03539, and The John D. and Catherine T. MacArthur Foundation, Network III on Risk and Protective Factors in the Major Mental Disorders.     

Groups as social network members: Overlooked sources of social support

In a study of the link between physical disability and social relationships among the elderly, questions about social network and social support evoked a surprisingly large number of group responses. People mentioned "my grandchildren," "the people in my building," "people at the senior center," and other groups in ways that suggested that the real unit of support was extraindividual and could not be accurately understood by reference to individual people within those groups. This paper describes the frequency of such responses and the circumstances under which they emerged. Definitions of social support and of social network should not be restricted to dyadic relationships between individuals; better understanding of social support processes would derive from consideration of the kinds of social support functions best offered by groups vs. individuals and consideration of differences in the ways in which support is derived from groups and individuals.     

The post-reinforcement pause

Measurements of the post-reinforcement pause and response rate were obtained from four birds on a range of fixed ratio schedules from 25 to 150. The results indicated a consistent increase in the length of the pause as the ratio was increased. Response rate tended to decrease, but these data were less consistent and some reversals were apparent.     

Conditioned suppression and variable ratio reinforcement

Conditioned suppression is a decrease in response rate during a relatively short duration stimulus that terminates independently of the animal's behavior and coincidentally with a brief unavoidable shock. The degree of conditioned suppression was measured for each of three birds on three variable ratio schedules; that is, the number of responses required for food reinforcement was varied around a mean of 50, 100, or 200. The results indicated a slight and possibly negligible decrease in the degree of suppression as the mean number of responses required on the schedule was increased from 50, to 100, and 200. In general, it was found that all of the variable ratio schedules tested were quite insensitive to the conditioned suppression procedure, although almost complete suppression was obtained on a few occasions. Since the reinforcement was contingent upon the emission of responses, the birds typically displayed a high rate of response during the pre-shock stimulus on all schedules. In addition, the rate during the pre-shock stimulus often changed abruptly independent of the presentation of a reinforcement. As a result of the high rate of response and the abrupt changes in rate, the degree of suppression from trial to trial was quite variable. A clear analysis of an experimental variable on this baseline is thus difficult.     

Giving and Receiving Help: Interpersonal Transactions in Mutual-Help Meetings and Psychosocial Adjustment of Members

The helping transactions that occur in group meetings have been theorized to be important therapeutic mechanisms within mutual-help (or self-help) groups. Hypothesized links between giving and receiving help and psychosocial adjustment were examined in a mutual-help group for individuals with serious mental illness (GROW). Participants' adjustment was assessed at two time points and helping behaviors were measured with observational coding of weekly group interactions during the period between assessments. Frequencies of helping behaviors were used to predict Time 2 adjustment after controlling for initial adjustment. Consistent with the helper therapy principle, giving help to others predicted improvements in psychosocial adjustment; giving advice was a unique predictor. Total amount of help received was not associated with adjustment, but receiving help that provided cognitive reframing was associated with better social adjustment. A predicted interaction suggested that receiving help was related to better functioning when members experienced high levels of group integration.     

A relational theory of self-deception

The authors argue that the fragmentary model of consciousness implied in the term ‘self-deception’ has provided the chief metaphor for explaining the apparent discrepancies that can arise between the evaluation of a motivated observer and the evaluation of a less interested external observer. Though self-deception models have explained these discrepancies in terms of both a dualistic opaque consciousness and in terms of cognitive and affective processes, all of these accounts seem to rest on the same essential fragmentation of the psyche. The authors argue that a relational model of consciousness, one that claims the indissolubility of cognition and affect, object and perception, and of past, present, and future can account for the apparent discrepancies involved in the paradigmatic cases of self-deception in a more parsimonious and phenomenologically faithful way than more objectivist and fragmented accounts of self-deception.     

Social and emotional loneliness and self‐reported difficulty initiating and maintaining sleep (DIMS) in a sample of Norwegian university students

Social and emotional loneliness negatively impact several areas of health, including sleep. However, few comprehensive population‐based studies have evaluated this relationship. Over 12,000 students aged 21–35 years who participated in the student survey for higher education in Norway (the SHoT study) were assessed. Loneliness was assessed using the Social and Emotional Loneliness Scale. Difficulty initiating and maintaining sleep (DIMS) was assessed by a single‐item subjective response on the depression scale of the Hopkins Symptoms Checklist (HSCL‐25). Social loneliness was associated with more serious DIMS (unadjusted proportional odds‐ratio [OR] = 2.69, 95% CI = 2.46–2.95). This association was attenuated following adjustment for anxiety (adjusted OR = 1.92, 95% CI = 1.75–2.10) and depression (adjusted OR = 1.48, 95% CI = 1.34–1.63), however was not substantially altered when all demographics and psychological distress were accounted for (fully adjusted OR = 1.46, 95% CI = 1.30–1.63). Emotional loneliness was also associated with more serious DIMS (unadjusted proportional OR = 2.33, 95% CI = 2.12–2.57). Adjustment for anxiety (adjusted OR = 1.96, 95% CI = 1.78–2.15) and depression (adjusted OR = 1.64, 95% CI = 1.48–1.80) attenuated, but did not extinguish this relationship in the fully adjusted model (adjusted OR = 1.22, 95% CI = 1.09–1.31). Mediation analyses revealed that the social loneliness‐DIMS association was fully attributed to psychological distress, while the emotional loneliness‐DIMS association was only partially mediated, and a direct association was still observed. Associations between social and emotional loneliness and subjective DIMS were embedded in a larger pattern of psychological distress. Mitigating underlying feelings of loneliness may reduce potentially deleterious effects on sleep health and psychological wellbeing in young adults.     

Interactions between Callous Unemotional Behaviors and Executive Function in Early Childhood Predict later Aggression and Lower Peer-liking in Late-childhood

Callous unemotional (CU) behaviors are linked to aggression, behavior problems, and difficulties in peer relationships in children and adolescents. However, few studies have examined whether early childhood CU behaviors predict aggression or peer-rejection during late-childhood or potential moderation of this relationship by executive function. The current study examined whether the interaction of CU behaviors and executive function in early childhood predicted different forms of aggression in late-childhood, including proactive, reactive, and relational aggression, as well as how much children were liked by their peers. Data from cross-informant reports and multiple observational tasks were collected from a high-risk sample (N = 240; female = 118) at ages 3 and 10 years old. Parent reports of CU behaviors at age 3 predicted teacher reports of reactive, proactive, and relational aggression, as well as lower peer-liking at age 10. Moderation analysis showed that specifically at high levels of CU behaviors and low levels of observed executive function, children were reported by teachers as showing greater reactive and proactive aggression, and were less-liked by peers. Findings demonstrate that early childhood CU behaviors and executive function have unique main and interactive effects on both later aggression and lower peer-liking even when taking into account stability in behavior problems over time. By elucidating how CU behaviors and deficits in executive function potentiate each other during early childhood, we can better characterize the emergence of severe and persistent behavior and interpersonal difficulties across development.