Medicine as a trade

The doctor-patient relationship is usually seen and accepted as a giving-taking association, in which the doctor is a giver and the patient is a taker. The paper challenges such a one-way relationship, and stresses the patient as a giver and the doctor as a receiver. The patient is described as a source for the emotional development of the doctor, and as a source of knowledge. He is also a source for what could be called ‘life experience’. By serving as a source for these three elements, the patient is also seen as a source for reward. There is a danger of under-utilisation of this reward by the doctor, when (1) he is engaged only in giving, (2) he wilfully obstructs the channel of information, and (3) he feels ‘saturation’ called by the doctor ‘experience’. This under-utilisation will ultimately lead to ‘medical parasitism’. This parasitism is seldom recognised by the patient, because the arrest of development of a doctor is usually hardly noticed, and this will lead to neglect of the patient, so that the ‘trade’ between doctor and patient becomes unfair, as the long-term investment which the patient has placed in the doctor, does not pay off any longer.     

Accommodation fatigue and dark focus: The effects of accommodation-free visual work as assessed by two psychophysical methods

Past studies of accommodation fatigue have yielded inconsistent results, partly because they have not used direct measures of accommodation, and partly because they may have been based on a misleading conception of the nature of accommodation. The dual-innervation theory of accommodation suggests that the resting position of accommodation may be neuromuscular rather than just muscular, and that it lies not at optical infinity, as assumed by older conceptions, but at some intermediate position (dark focus). Among the predictions that may be deduced from this theory is that long-term visual work not requiring active accommodation will not induce fatigue. The present study involved continuous measurements of dark focus for 10 young adults over a 3-h period, using the laser optometer with two psychophysical procedures Ibracketing and staircase. Consistent with the prediction, no changes in dark focus were found, in spite of the demanding visual task. Furthermore, it was found that both psychophysical methods yielded essentially identical results. The practical and theoretical implications of these results are discussed, and recommendations are given regarding situations in which each of the psychophysical methods is likely to be most useful.     

Depth separation and the Ponzo illusion

The Ponzo illusion refers to an apparent change in length of objectively equal parallel lines induced by enclosure within an acute angle. The present study investigated this illusory change in stimulus extent as a function of the relative depth positions of the parallel lines and the inducing angle. To permit facile and unconfounded manipulation of apparent depth, the stimuli comprising the Ponzo configuration were stereoscopic contours formed from dynamic random-element stereograms. The main results were: (1) apparent depth separation exerted a strong influence on illusion magnitude; (2) this influence was asymmetrical in that illusion magnitude decreased when the inducing angle appeared in depth behind the parallel lines and increased when the inducing angle appeared in depth in front of the lines. These data are consistent with a general theory of space perception that assumes that information about depth position is processed prior to information about stimulus characteristics.     

On the meaning of indexicals

The approach adopted in the paper is based on the theory known as Montague grammar. Accepting, in general, that theory — especially in its modified version, which is due to Thomason and Kaplan — the author points out certain inadequacy in its treatment of the meaning of some indexical expressions and suggests some modification of its theoretical framework in order to avoid that shortcoming. It is claimed that to do justice to the meaning of so-called indefinite indexicals (such as “we”, “you”, “now”) two kinds of dependence of their semantic values upon the context of use must be taken into account — a semantic (or lexical) and a pragmatic (or extralexical) one.     

Childhood peer rejection,aggression, withdrawal,and perceived competence as predictors of self-reported behavior problems in preadolescence

Childhood peer rejection, aggression, withdrawal, and perceived competence were compared as predictors of self-reported behavior problems. Peer sociometric status (Coie, Dodge, and Coppotelli, 1982), teacher ratings of behavior problems (Lorion, Cowen, & Caldwell, 1975), and perceived competence ratings (Harter, 1982) were obtained for 613 second-through fourth-grade children. Two years later, these students completed a modified version of the Youth Self-Report form (Achenbach & Edelbrock, 1987). Rejected children and neglected girls were more likely to have a self-reported nonspecific negative outcome than others. Neglected girls were at heightened risk for depression. A varied set of predictors obtained from different informants emerged for each sex for each of the specific self-reported outcomes of depression, unpopularity, delinquency, aggression, and self-destructive/identity problems. Results are discussed in terms of future directions for longitudinal research on the consequences of poor peer relationships in childhood.This research was supported in part by a grant from the W. Alton Jones Foundation and in part from Cooperative Agreement (G0087C3033) between the U.S. Department of Education, Office of Special Education and Rehabilitative Services, and the University of Virginia. However, the opinions expressed herein do not necessarily represent the opinions of the funding agencies. Portions of this paper were presented at the First Annual Meeting of the Society for Research in Child and Adolescent Psychopathology, Miami, Florida. The authors would like to thank Robert Terry, Ruth Axman, Pamela Griesler, Melissa DeRosier, Nancy Vaden, Charlene Eickholt, Amy Young, Emily Burhans, Eric Johnson, Renee Lorio, and Karen Welke for their assistance in conducting this research project.     

A comparative evaluation of parent-training interventions for families of chronic delinquents

Fifty-five families of chronically offending delinquents were randomly assigned to parent-training treatment or to service traditionally provided by the juvenile court and community. The families in the parent-training group received an average of 44.8 hours of professional contact (23.3 hours of which were phone contacts), and each control group family received treatment estimated at more than 50 hours on the average. Comparisons of police contact data at baseline and subsequent years for the two groups showed that subjects in both groups demonstrated reduced rates of offending during the followup years. The finding most relevant was significant treatment-by-time effect for offense rates, with most of this effect accounted for by a greater reduction in serious crimes for the experimental group during the treatment year, and a similar reduction of the community control group occurring in the first of three followup years. These early decrements in offense rates persisted during followup for both groups. Throughout the study, boys in the experimental group spent significantly less time in institutional settings than did boys in the control group. Parent training had a significant impact, but the reduction in offending was produced at very high emotional cost to staff. Although it is clear that this population requires substantial treatment resources, this study underscores the need for more work on prevention.Research for this paper was supported by grant MH 37938 from the Center for Studies of Antisocial and Violent Behavior, National Institute of Mental Health (NIMH), U.S. Public Health Service (PHS). The writing was supported in part by grants MH 17126 and MH 37940 from the same Center, grant DA 05304 from the National Institute of Drug Abuse, U.S. PHS., and grant MH 38730 from the Child and Adolescent Disorders Research Branch, NIMH, U.S. PHS. The authors gratefully acknowledge the enduring commitment of the treatment staff that made this study possible: Patricia Chamberlain, Marion Forgatch, and Kate Kavanagh.     

What is right with “deep” dyslexic patients?

Two aphasic adults with a specific acquired dyslexia were given tests requiring the processing of written words and sentences. Despite the general severity of the patients' deficits, some aspects of such processing appear to be relatively well preserved. The patients have particular difficulty reading aloud function words and abstract words; yet in word/nonword discrimination tests, both patients showed normal recognition of function words and one showed normal performance with abstract words. The patients do have a deficit in comprehension of visually presented words and sentences; yet their performance on comprehension tests was considerable and, moreover, showed meaningful relationships with their ability to read aloud.     

The Mexican American in Higher Education: Implications for Educators

From a review of literature and an examination of data from the Counseling Services at the University of Texas - El Paso, the authors conclude that Mexican-American students place more emphasis on cooperation and group achievement than on individual achievement, and that the education of Mexican Americans may be enhanced when teachers properly reinforce “successful behavior.” In addition, it seems that problems may arise in using U.S.-based theories of “democratic” leadership styles because the Mexican-American culture places more emphasis on traditional leadership roles.     

New approaches in counselling: Healthy diversity or anti-therapeutic?

Concern is expressed about the proliferation of new or 'innovative' approaches in counselling or psychotherapy. Most of these approaches appear to be regressive in that they ignore what we have learned about the importance of certain conditions for the therapeutic relationship. They place the counsellor or therapist in the position of a charismatic expert controlling and directing the lives of his clients. The potential dangers of these methods are noted. Yet there seems to be no good way to protect clients either from well-intentioned but misguided professionals or from the untrained non-professional. If professionals are not successful in policing the field, injured consumers and an aroused public may succeed in imposing unnecessarily rigid restrictions on all practice of counselling and psychotherapy.