Pharmacological treatment of affective disorders: A review and guide for the non-medical practitioner

Mental health professionals who lack medical training may also lack knowledge and understanding of the potential utility of medications in the treatment of emotional disturbance. They may also lack information regarding the effects and side-effects of medications which their clients may already be taking, or be uncertain when the nature of their client's situation suggests a psychiatric assessment regarding drug therapy. This paper offers an educational review in one such area: the pharmacological treatment of depression. It includes a brief review of theories regarding the aetiology of affective disorder, examines the methodes, mechanisms and efficacy of anti-depressants, and draws conclusions regarding the appropriate use of pharmacological treatment.     

Marital satisfaction and family stress as predictors of classroom behaviors

The purpose of this research was to examine the relationship between parents' perceptions of marital satisfaction and family stress and their third grade children's classroom behavior. Twenty-one married couples completed questionnaires during home visits. Behavior observations were made from videotapes of children recorded in their classroom during lunch and group academic periods on each of three days. Frequencies of peer interactions, solitary behaviors, and teacher interactions were coded. Regression analyses showed that mothers' level of marital satisfaction (but not fathers') predicted their children's frequency of peer interactions during lunch. Fathers' level of perceived family stress (but not mothers') predicted their children's frequency of peer interactions during lunch. Neither measure for either parent was related to the frequency of peer interactions, solitary behaviors, or teacher interactions observed during the academic sessions. These findings highlight the importance of assessing the potential differential relation of parent variables to children's trans-situational behaviors, and the examination of these variables in relation to different social-environmental contexts in which children participate outside the home.     

Three intensive community-based programs for children and youth with serious emotional disturbance and their families

Systems of care for children with serious emotional disturbance and their families have generally lacked intensive community-based programs. We describe three types of newly established community-based programs in New York State and present a general evaluation plan for determining which programs work for various children and their families. The three community-based programs are Intensive Case Management, Family-Based Treatment, and Family-Centered Intensive Case Management. Process and outcome evaluations are being conducted for each of these programs. These evaluations make use of common intake and termination instruments, based on a minimum data set, standardized assessment instruments, and a common logic model, thus facilitating the comparison of findings across evaluations.     

The Additive Factor Method: A differential diagnostic tool in hyperactivity and learning disability

The Additive Factor Method assumes that task performance is the sum of sequential and independent processes. We studied the duration of the central processes (memory search and decision) and the motor decision process in hyperactive and learning-disabled children under socalled divided attention and S-R compatibility conditions. It was found that the learning-disabled were impaired in memory search and decision processes whereas hyperactives were impaired in the motor decision process.The authors wish to thank L. Leertouwer for making the drawings.     

Social and life skill competence in potential early school-leavers

Competencies in social and life skills of a group of students expecting to leave school at the end of Grade 10 in Australia is compared with groups expecting to continue. Academic performance and skills were also assessed. The results of the study indicated that the potential early school-leavers were disadvantaged both socio-economically and academically. But, surprisingly, the findings indicated that they were not significantly different from the other two groups of students targeted in the study in terms of their social and life skills. The results imply that potential early leavers in school populations may be unnecessarily disadvantaged because school programmes, in concentrating on a narrow range of cognitive skills, do not build on personal competency skills already possessed by students of all levels of ability. Whilst this is the case, potential early school-leavers will be likely to continue to be disaffected and disadvantaged educationally.     

Effects of gaze manipulation on subjective evaluation of neutral and phobia-relevant stimuli. A comment on Drake's (1987) 'Effects of Gaze Manipulation on Aesthetic Judgments: Hemisphere Priming of Affect'

Using neutral stimuli (mushrooms and flowers) and phobia-relevant stimuli (snakes and spiders), the present investigation examined the effect of gaze shifts on subjective evaluation of stimuli in female subjects (N = 29). One group of subjects had to orient to the right, whereas the other group had to orient to the left in order to see the stimuli. When left-handed subjects were excluded from the analysis, the results showed that subjects in the 'orient right' group gave a significantly more positive evaluation than subjects in the 'orient left' group. The results provide a replication of the phenomenon described by Drake (1987).     

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.     

Restrained eaters are rapidly habituating sensation seekers

Several authors have pointed to similarities between eating disorders and addictive behaviors. In earlier studies, addicts were found to score high on the Sensation Seeking Scale (SSS) and to habituate rapidly to neutral stimuli. In this study, we found experimental support for an addiction model of eating disorders: restrained eaters also scored significantly higher on the Sensation Seeking Scale and also habituated significantly quicker to a series of neutral stimuli than unrestrained eaters. No clear evidence was found for the hypothesis that restrained eaters score lower on measurements of anxiety. It is hypothesized that rapid habituation promotes sensation seeking, which may be manifested in excessive consumption of either drugs or food. Restraint may be a strategy to prevent negative consequences of sensation seeking and excessive consumption. The model is related to earlier experimental findings.     

Cerebral laterality and depression: differences in perceptual asymmetry among diagnostic subtypes

Examined the influence of diagnostic subtype of depression on perceptual asymmetry for dichotic listening and visual tachistoscopic tasks. A total of 65 unmedicated patients with major depressive disorders and 30 normal controls were tested on a verbal and nonverbal task in each modality. Patients diagnosed according to the DSM-III with melancholia had abnormal perceptual asymmetry for dichotic nonsense syllable and complex tone tasks. In contrast, patients having a nonmelancholic "atypical depression" (reactivity of mood with preserved pleasure capacity and associated features) did not differ from normal controls on these tasks, but had an increased incidence of left handedness. Bipolar depression (history of hypomania) differed from unipolar depression in showing abnormal perceptual asymmetry for a tachistoscopic dot enumeration task. Alterations of perceptual asymmetry in melancholia and bipolar depression were consistent with hypothesized right hemisphere dysfunction.     

Preventive group psychotherapy for at-risk infants and their mothers

There is increased evidence that infants who receive poor quality social stimulation from their primary caregiver are at risk for later developmental difficulties. This paper describes a preventive intervention for mother-infant dyads exhibiting impaired patterns of social interaction. An impaired relationship with the primary caregiver has been found to be associated with social and emotional deficits in early childhood as well as with significant psychopathology in adulthood. The intervention consisted of group treatment of mothers and their infants. Each group session has 4 subsections which, together, were directed towards improving the mothers' ability to relate in a stimulating and nurturant manner to their children. Types of intervention included didactic instruction, modeling, and interpretation of the infant's behavior. Qualitative data suggested that the group intervention has positive effects on the mother-infant dyads.