Observations on the behaviour of patients in a state mental hospital and a general hospital psychiatric unit: A comparative study

The study sought to compare the naturally occurring behaviour of psychiatric patients within a traditional mental hospital ward and a general hospital psychiatric unit. Direct behavioural observations were undertaken to determine the pattern of behaviour exhibited by patients, the amount of time spent in interaction, with whom interaction took place and the content of that interaction. Data were reliably collected by trained observers, using a 10 category behaviour scale. Within each setting 10 psychotic patients, matched for age, sex and diagnosis, were the subjects and 30 min of behaviour was recorded for each subject. Observations revealed that patients in the mental hospital exhibited more disturbed behaviour, and spent less time in interaction, than did those in the general hospital unit. However, the amount of time patients spent interacting with staff was comparable in the two settings, despite marked differences in staffing levels. Analysis of the content of interaction that did occur indicated that the manner in which staff responded to patients' behaviour was not consistent with the application of a behavioural engineering approach to the modification of abnormal behaviour. While staff in both settings were indiscriminate in the way in which they responded to appropriate and inappropriate patient behaviour, a rather more punitive style of interaction was observed in the mental hospital environment. It is concluded that, from a behavioural perspective, neither setting achieved an optimum therapeutic environment.     

The rapid-smoking technique: Therapeutic effectiveness

The study examined the effectiveness of the rapid-smoking technique in terms of two measures of outcome—post-treatment abstinence rate and reduction in smoking achieved by non-abstinent subjects. A total of 75 volunteers (40 men and 35 women) participated in treatment and were randomly allocated to one of four conditions—rapid-smoking alone; rapid-smoking and relaxation training; rapid-smoking, relaxation and contingency contracting; or contingent rapid-smoking. No significant differences between treatment conditions were obtained. For the total sample, abstinence was achieved by 64% of the subjects immediately post-treatment but the probability of remaining abstinent 12 months later was only 0.33. Immediately post-treatment the non-abstinent subjects reduced their rate of cigarette consumption to 34.2% (SD = 29.3) of baseline smoking but by 12 months average consumption had increased to 82.4% (SD = 28.3) of baseline. It is concluded that rapid-smoking gives rise to substantial short-term changes in smoking behaviour but these effects are not sustained.     

The future of public-private sector partnerships for the provision of human services: problem and possibilities.

This article examines the responses of states, localities, and the private sector to recent attempts by the federal government to realign domestic responsibilities for the provision of human services. In exploring this issue, the author conducted a study of agencies assisting the developmentally disabled in Greater Richmond, Virginia. The author finds that the nation is experiencing a fundamental paradigm shift--a reconceptualization of structure, goals, and responsibilities--with respect to social welfare, with new public-private sector partnerships emerging to meet human needs.     

Learning for Life: An Ecological Approach to Pedagogical Research

ABSTRACT— The trend to convert laboratory findings on the conditions associated with optimal memory into recommendations for teaching strategies and learning aids will harm students if findings fail to generalize to students' usual learning environments. Moreover, it is likely that pedagogies function differently for students with different degrees of background knowledge, time, and interest in the subject matter; that some support activities will prevent students from honing their ability learn from narrative material without guided learning; and that an overuse of learning aids will tax students' ability to use them effectively. We contrast two approaches to developing pedagogy—memory first and pedagogical ecology—and explain how the human factors approach of pedagogical ecology could be a more satisfying model for the scholarship of teaching and learning.     

Memory for previous recall: a comparison of free and cued recall

Case studies of individuals who claimed to have recovered previously repressed memories of abuse during situations that involved memory cueing revealed that some individuals had discussed abuse with others during an earlier time period. Termed the ‘forgot‐it‐all‐along’ effect, this phenomenon has legal implications for statutes of limitations. Two experiments provide evidence for differences between free recall and more directed (recognition or cued recall) test conditions in the accuracy of memories for previous recall. Participants more often erred by claiming they had not previously remembered recognized (Experiment 1) or cued (Experiment 2) sentences than freely recalled sentences, and this difference was obtained even when the number of remembered sentences was equivalent across conditions (Experiment 2). These studies document that memory for previous recollection is less accurate for cued memories even when remembered events do not produce feelings of shock or surprise. Copyright © 2002 John Wiley & Sons, Ltd.     

Neurodevelopmental impairment: Predictors of its impact on the families of extremely low birth weight infants at 18 months

Effects on a family of a child with chronic illness have been described. The Impact on Family Scale (IOF) was developed to measure these effects. The impact of extremely low birth weight (ELBW) infants with neurodevelopmental impairment on families is unknown. This study determined IOF scores for families of ELBW infants with increasing degree of impairment at 18 months and identified factors that increase vulnerability to impact. A total of 3,849 ELBW infant survivors born at the 16 centers of the National Institute of Child Health and Human Development Neonatal Research Network between January 1993 and February 2001 were assessed at 18 to 22 months. Infants were divided into four groups by degree of impairment. IOF scores were analyzed by impairment group. Multivariate analyses assessed effects of impairment, social/demographic factors, unmet service needs, and resource utilization on the IOF. A total of 1,624 (42.2%) infants had moderate/severe impairment. Increasing severity of impairment was associated with higher IOF scores. Severity of impairment contributed 6% of variance to the IOF scores. Twenty‐one percent of variance was contributed by additional medical needs, low socioeconomic status (SES), and lack of social support. Although increasing severity of impairment impacts families of ELBW infants, significantly more impact is contributed by additional medical needs, low SES, and lack of social support.     

Individual differences in susceptibility to false memory in the Deese-Roediger-McDermott paradigm

The authors addressed whether individual differences in the working memory capacity (WMC) of young adults influence susceptibility to false memories for nonpresented critical words in the Deese-Roediger-McDermott associative list paradigm. The results of 2 experiments indicated that individuals with greater WMC recalled fewer critical words than individuals with reduced WMC when participants were forewarned about the tendency of associative lists (e.g., bed, rest, . . .) to elicit illusory memories for critical words (e.g., sleep). In contrast, both high and low WMC participants used repeated study-test trials to reduce recall of critical words. These findings suggest that individual differences in WMC influence cognitive control and the ability to actively maintain task goals in the face of interfering information or habit.     

Stress-Induced Cardiomyopathy and Psychological Wellbeing 1 Year After an Acute Event

Stress cardiomyopathy (SCM) typically presents similar symptoms to acute myocardial infarction (AMI). However, these symptoms differ when it comes to a transient and completely reversible myocardial dysfunction, which is frequently precipitated by acute stressful events, occurring in the absence of plaque rupture and coronary thrombosis. The purpose of this study was to investigate health-related quality of life (HRQL) and emotional burden subsequent to cardiac events in SCM patients. Thirty-seven SCM patients were compared with 37 matched AMI patients. All selected patients were assessed for HRQL and psychological distress at baseline and 1-year after the acute event. After controlling for covariates, scores on the Psychological General Well Being Index indicated that depressed mood had increased in both groups, but the increase for SCM patients was greater than for AMI patients. The AMI group displayed greater decreases than the SCM in physical quality of life and in total cardiac-related health quality of life. The percentage of patients with psychological distress increased significantly more in the SCM group than in the AMI group, and it made no difference whether the triggering event was emotional or physical. Our results suggest that, despite the more favorable medical prognosis of SCM patients, their cardiac condition being transient and resolving completely in few weeks, the psychological impact associated with their condition is more negative 1 year later than in the case of AMI patients whose medical prognosis is less favorable, and this difference is independent of type of trigger event.     

The effects of exercise withdrawal on mood and inflammatory cytokine responses in humans

Mechanisms underlying the relationship between exercise and mood are not well understood. This study sought to investigate the role of pro- and anti-inflammatory cytokines and autonomic balance in determining the impact of exercise withdrawal on negative mood. Healthy men and women who regularly exercised (N?=?26, mean age?=?25.5 years, SD?=?4.5 years) were randomised to exercise withdrawal or exercise maintenance for 2 weeks. Protocol adherence was monitored using accelerometers. Inflammatory markers from plasma (interleukin-6, IL-6; tumour necrosis factor-alpha; interleukin-10; and interleukin-1 receptor antagonist), heart-rate variability (HRV) and measures of mood (General Health Questionnaire-28 (GHQ) and the Profile of Mood States (POMS)) were assessed at study entry and at 2-week follow-up. Exercise withdrawal resulted in significant increases in negative mood over time on both the GHQ (p?=?0.028) and the POMS (p?=?0.005). Following the intervention, IL-6 concentration was lower in the exercise withdrawal than exercise maintenance condition (p?=?0.05). No intervention effects were observed for other cytokines or HRV. The mood changes were significantly related to changes in IL-6 concentration (β?=?-?0.50, p?=?0.011), indicating that reduction in IL-6 was related to increased negative mood. Our results are consistent with positive effects of exercise on mental health, but further research on inflammatory pathways is warranted.     

Forensic Interviewing Aids: Do Props Help Children Answer Questions About Touching?

The belief that props help children report abuse has fostered the widespread use of anatomical dolls and body diagrams in forensic interviews. Yet studies involving alleged abuse victims, children who have experienced medical examinations, and children who have participated in staged events have failed to find consistent evidence that props improve young children's ability to report key information related to bodily contact. Because props elevate the risk of erroneous touch reports, interviewers need to reconsider the belief that props are developmentally appropriate in forensic interviews, and researchers need to explore new approaches for eliciting disclosures of inappropriate touching.