Assertiveness, social support, and psychological adjustment following spinal cord injury.

Tested predictions that assertiveness and social support would be significantly predictive of psychological adjustment. Furthermore, it was anticipated that assertiveness and certain types of social relationships would differentially interact to predict adjustment, since positive and negative effects of both variables have been noted in prior research. Trained raters interviewed 156 persons receiving either in-patient or out-patient care for cord injuries and administered measures of assertiveness, social support, depression and psychosocial impairment. Persons who reported a keen sense of responsibility for the welfare of another reported more depression and impairment. Persons reporting higher levels of support facilitating social integration and reassuring personal worth were less depressed. Several significant interactions between assertiveness and different social support relationships revealed beneficial and deleterious effects on depressive behavior and impairment secondary to the disability. Results are discussed as they advance theoretical understanding of the effects of assertiveness and social support. Implications for discriminate cue learning in assertion training for persons with physical disability are proposed.     

Maintaining patients' improvements in a token economy.

Eighteen long stay male patients (diagnosis chronic schizophrenia) were involved in a six month token economy prior to random assignment to one of three experimental groups to investigate the importance of social reinforcement and other token-related variables in maintaining improvements brought about by the token system. Assessment included standardised psychiatric rating scales, nurse rating scales, and behavioural measures. Analysis of variance suggests the full token economy system produced significant improvements, but that the social factors involved in token exchanges were not demonstrably important sources of reinforcement. and that none of the variables studies at the experimental phase were critical factors. Once patients returned to a complete token system, results indicate that this may have more value in the promotion of work activities rather than social responding. It is argued that the token system provides a necessary clear structure within which nurses can encourage continuous improvements with long stay patients.     

BEHAVIORAL ASSESSMENT FOR PEDIATRIC INTENSIVE CARE UNITS1

Two studies were conducted to analyze behaviors of staff and patients on a Pediatric Intensive Care Unit (PICU). In the first study, behavioral observation procedures were employed to assess patient state, physical position, affect, verbal behaviors, visual attention and activity engagement, and staff verbal behavior. On the average, one-third of the patients were judged to be conscious and alert but markedly nonengaged with their environment. In the second study, a member of the hospital staff provided alert patients with individual activities to determine whether a simple environmental manipulation could positively affect behavior of children in intensive care. Employing a reversal design, the activity intervention was found to increase attention and engagement and positive affect, and to decrease inappropriate behavior. Both studies demonstrate that behavioral assessment procedures can provide an empirical basis for designing PICU routines affecting children's psychosocial status, and, thus, complement current procedures designed to provide quality medical care.     

Assessment of human obesity: The measurement of body composition

The most common methods of assessing degree of obesity in humans are reviewed. These include anthropometry, somatotyping, bodyweight, skinfold calipering, densitometry, and several nondensitometric procedures. The evidence suggests that bodyweight may often be an unreliable and invalid index of obesity. The parameters influencing its inaccuracy are discussed. These include age, height, sex, muscularity, and degree of obesity or amount of recent weight loss. The most reliable and valid measures of human bodyfat are generally the most complicated and impractical. Compromise assessment procedures involving nonintrusive measurement of subcutaneous fat and selected anthropometric dimensions may offer an incomplete but welcome improvement over sole reliance on bodyweight as an index of obesity.     

Effects of incentive and preparatory interval on activity, heart rate, and reaction time in children.

To resolve certain empirical and theoretical difficulties concerning, primarily, the significance of phasic heart-rate deceleration prior to reaction signals, 48 children were employed to perform in simple reaction-time tasks while speed, heart rate, head movement, gross movement, and blink activity were recorded. The indeory intervals and level of incentives. Reaction time varied with incentive, with preparatory interval and mode of presentation. Phasic heart-rate deceleration varied with the intervals but not incentive or mode of presentation. There was little relation between deceleration and RT. Heart rate and somatic movement measures (especially of blinking) were roughly concordant at a group level but did not correlate.