Psychosocial and pharmacological treatment of patients following deliberate self-harm: the methodological issues involved in evaluating effectiveness.

Development of effective treatments for patients following deliberate self-harm (self-poisoning or self-injury) is a very important element in suicide prevention. The randomized controlled trial (RCT) is the mainstay of evaluation of treatments. In a systematic review of the literature, the effectiveness of treatments based on RCTs was examined and the quality of the RCTs was assessed. Twenty trials were identified, and where possible, these were grouped on the basis of similarities among the types of treatment. In this paper, we examine the methodological aspects of the trials and consider what may be learned that will assist in the design of future studies in this field. The methodological quality of the trials was reasonable, but most trials included too few participants to detect clinically important differences in rates of repeated self-harm. In planning future trials, the following major issues should be addressed: investigators should perform power calculations to determine the number of subjects necessary to detect clinically important effects, provide information on method of randomization and interventions, use standard measures of outcome, and focus on homogeneous subgroups of patients. Improving the methodology of future studies in this field will be essential if sound evidence is to be obtained which can inform effective service provision for deliberate self-harm patients.     

The strings on David’s Harp: religious ritual as a container for spirituality

ABSTRACT

Religion and spirituality have often been defined over against each other. The spontaneous, emotional and experiential nature of the spirit has been seen as preferential to the structured, fixed, and predictable nature of religious ritual. Religion education for children has moved away from the performance of ritual behaviour toward creating an environment to nurture the innate spiritual nature of children. This paper questions whether the pendulum has swung too far, neglecting rituals that have sustained religious and communal life for generations, and considers ways of reimagining traditional ritual as a way to encounter the spirit and build community.     

The representation of depth in children's drawings of a table

Willats (1977) analysed developments in the drawing of a table in terms of the projection system in which the table top was represented, and concluded that representation of depth in drawing goes through a series of discrete stages, each of which can be identified with a projection system. A partial replication of Willats' study is presented here, using a much larger sample. The relationship between age and use of projection system found by Willats was in general supported. Not all the “stages” were found to be discrete, however, and an examination of the way in which the table tops were drawn shows that whilst the majority of older children appeared to use perspective, they did not use it correctly. A method is given by which tables that are drawn as if from a central viewpoint can be formally classified. It is concluded that development in the understanding of the representation of depth is not very closely linked to development in the use of projection systems.     

Book reviews

Cutting, J. E. Perception with an eye for motion. Cambridge, Mass: The MIT Press, 1986. Pp. 321.ISBN 0-262-03119-1. £29.95.

Kimble, G. A. and Schlesinger, K. (Eds.). Topics in the history of psychology, Volume 1. Hillsdale, N.J.: Lawrence Erlbaum Associates, Inc., 1985. Pp. 409. ISBN 0-89859-312-3. £36.00.

Bruce, V. and Green, P. (1985). Visual perception :Physiology, psychology and ecology. London : Lawrence Erlbaum Associates Ltd. Pp. 369. ISBN 0-86377-012-6. Hardback £26.95; paperback £8.95.

Pylyshyn, Z. W. & Demopoulos, W. (Eds.). Meaning and cognitive structure : Issues in the computational theory of mind. Norwood, N.J.: Ablex Publishing Corporation, 1986. Pp. xi + 264. ISBN 0-89391-372-3.£36.50.

Pylyshyn, Z. W. (Ed.). The robot's dilemma: The frame problem in artificial intelligence. Norwood, N.J.: Ablex Publishing Corporation, 1987. Pp. xi +156. ISBN 0-89391-371-5. £25.50.

Beaton, A. (1985). Left side, right side : A review of laterality research. London: Batsford. Pp. 364. ISBN 0-7134-4389-8. £25.00.     

Prior visual inspection and object naming: Two factors that enhance hidden feature inclusion in young children's drawings

It is widely held that young children draw what they know rather than what they see. However, evidence is growing that they can be provoked into making visually realistic drawings. In this study two factors were found to affect the form of visual realism. In Expt 1, 5- and 6-year-olds produced visually realistic drawings of a familiar object when it was neither named nor given to the child to inspect before drawing. On the other hand, prior inspection led to significant hidden feature inclusion at 5 and 6 years, and this applied whether the object drawn was familiar or novel. Seven-year-olds' drawings were visually realistic in all presentation conditions. In Expt 2, 6-year-olds were shown to include the hidden feature if the object was named before drawing. Two conclusions are drawn. It is possible that children draw what they have seen over time rather than what they see at a particular time. Secondly, object naming may lead to drawing from a canonical model tagged by the object's name.