The Use of Psychoendocrine Strategies in Post-Traumatic Stress Disorder1

An overview is presented of a pilot psychoendocrine study of PTSD inpatients in comparison with several subgroups of schizophrenic and affective disorder patients. Using a hormonal profile including Cortisol, norepinephrine, epinephrine, testosterone, and thyroxine, it was found that the mean values for the PTSD group were at or near the extreme end of the range for every hormone measured, i.e., relatively low for Cortisol and high for the remaining hormones. The possible clinical meaning of these findings is considered in the light of prior psychoendocrine research on chronic stress. The hormonal alterations in PTSD appear to be persistent and suggest the possibility of being linked largely to traits or character structure, perhaps particularly to cognitive variables related to defense and coping mechanisms, as reviewed in detail for each hormonal system. There appears to be a potential for a fruitful union between the traumatic stress and psychoendocrine fields and some future strategies for developing and strengthening such a union are suggested.     

HOW FAR SHOULD WE GENERALIZE?

Abstract— A conceptual model based on staffing theory was applied to previously collected survey data from a representative sample of American workers The model links organizational size, workload, work experience variables (felt responsibility and involvement, assessments of work associates), and work outcomes (job satisfaction, work self-esteem, stress symptoms) Path analyses indicated that the model fit data from all waged and salaried workers relatively well When the model was applied to subsamples of new and established employees and of employees from two contrasting occupational groups (professional-technical workers and operative workers), somewhat different patterns emerged The study illustrates the benefits of applying psychological theories across subdisciplines, as well as the limitations of generalizing research findings across different categories of workers We suggest that localized theories and fine-grained analyses of workplace events could help to make research more applicable to work settings     

A bribe, “living-bread,” and a white tablecloth

This article describes marital therapy with a Holocaust survival couple in which the wife's demands for living bread plays a highly symbolic role in the marital dynamics. The author draws interesting parallels between the experience of the couple and the meaning of the therapy experience for herself.     

MOTHERS' ALCOHOL CONSUMPTION DURING PREGNANCY:

Abstract— Fourteen-year-old adolescents' behavior on a spatial-visual reasoning task was associated with self-report of their mothers' alcohol consumption during pregnancy, IS years earlier The task was arranged so that it was possible to evaluate the examinees' tendency to respond rapidly and less accurately, or slowly and more accurately The greater the mother's reported drinking, the faster and less accurately the adolescent responded The decrement in visual-spatial reasoning related to alcohol appears to be linked to a tendency toward impulsive responding     

THE TREATMENT OF COVERT SELF-INJURY THROUGH CONTINGENCIES ON RESPONSE PRODUCTS

Assessment and treatment of covert self-injurious behavior are complicated because it is difficult to quantify and apply differential consequences to covert responses. In this study, both tangible and social reinforcers were identified using reinforcer assessment methods. These reinforcers were then provided contingent upon the absence of tissue damage identified during physical examinations, resulting in near 100% success in physical assessment checks that was maintained over 10 months.     

ASSESSMENT AND TREATMENT OF DESTRUCTIVE BEHAVIOR MAINTAINED BY STEREOTYPIC OBJECT MANIPULATION

In the current investigation, 2 participants with mental retardation displayed property destruction and stereotypy, and both responses involved the same materials (e.g., breaking and tapping plastic objects). Three experiments were conducted (a) to indirectly assess the functions of these two responses, (b) to determine their relation to one another, and (c) to develop a treatment to reduce the more serious behavior, property destruction. In Experiment 1, previously destroyed materials were either present or absent, and their presence reduced property destruction but not stereotypy. In Experiment 2, matched toys (ones that produced sensory stimulation similar to stereotypy) were either present or absent, or were replaced by unmatched toys (for 1 participant). Matched toys produced large reductions and unmatched toys produced small reductions in property destruction and stereotypy. In Experiment 3, attempts to pick up undestroyed objects were either blocked or not blocked while matched toys were continuously available. Response blocking reduced property destruction (and attempts), prevented stereotypy, and increased manipulation of matched toys. These results suggest that the two aberrant responses formed a chain (e.g., breaking and then tapping the object), which was maintained by the sensory consequences (e.g., auditory stimulation) of the terminal response, and that previously destroyed material or matched toys made the initial response (property destruction) unnecessary.     

Decisions about life and death: Assessing the Law Reform Commission and the Presidential Commission Reports

This paper compares and critically comments upon certain aspects of the Canadian Law Reform Commission Report,Euthanasia, Aiding Suicide and Cessation of Treatment, and the United States Presidential Commission Report,Deciding to Forego Life-Sustaining Treatment. It focuses on their positions on euthanasia and on the general principles, values, and procedures that ought to govern practices of foregoing life-sustaining treatment. The paper first comments on the recent debate over the moral relevance of the killing/letting die distinction, since this issue appears crucial in assessing the rationality of the current, absolute prohibitions of direct killing in medical contexts, embodied both in law and in codes of ethics. This issue bears upon a question in the closing section—whether the withdrawal of foods and fluids is ever morally permissible.