Case vignette: cybertherapy

Dr. Neuro Transmitter, a psychotherapist in Paramus, New Jersey, provides services through an online, real-time consultation service known as CyberShrink, Inc., of Dallas, Texas. He is paid by the hour for his consultation services to subscribers who are billed by credit card through CyberShrink. One afternoon he logs on and is connected via private "chat channel" to a new subscriber to the service. She is Ann Hedonia of Simi Valley, California. Ten minutes into the session, Dr Transmitter recognizes that Ms. Hedonia is seriously depressed with suicidal ideation and is feeling on the edge of her ability to cope. He gently suggests that perhaps she ought to think about hospitalization near her home. Ms. Hedonia replies, "Even you don't care about me! That's it. I'm going to do it!" and disconnects. Discussion questions: Is offering psychotherapy services online ethical? What are Dr. Transmitter's obligations in general and at this particular moment to Ms. Hedonia? Suppose Ms. Hedonia has a complaint about Dr. Transmitter. From whom can she seek a remedy? Which state's laws apply regarding professional practice, confidentiality, or licensing qualifications? Must Dr. Transmitter be licensed in any state to offer this service?     

A comparison of multiple versus single examples of the correct stimulus on task acquisition and generalization by persons with developmental disabilities

In teaching discriminations to persons with retardation, we often presume we will improve acquisition and generalization if we use multiple examples of boththe correct and incorrect stimuli. Two experiments were conducted to test this hypothesis. In the first experiment, 7 persons with moderate retardation learned to discriminate between functional words under two conditions. In one condition, Multiple Example of S- Only,1 example of the correct stimulus (S+) and 10 examples of the incorrect stimulus (S-) were used during acquisition. In the other condition, Multiple Examples of S+ and S-,10 examples of the S+ and 10 examples of the S- were used. Results showed that the condition which presented only a single example of S+ was superior 16 times and inferior 4 times during acquisition, generalization, and maintenance. A second experiment was conducted to (a) replicate the methodology and procedures in Experiment 1 with different participants, (b) determine whether the results were replicable, and (c) obtain efficiency data. Results replicated the findings of the first experiment. The condition which presented only a single example of S+ was superior on measures of (a) trials to criterion, (b) percent correct during acquisition, and (c) minutes to criterion. On measures of generalization, the two conditions were relatively equal. Thus, the condition which presented only a single example of the correct stimulus was more efficient and was just as effective in generalization as the condition which presented multiple examples of both the S+ and S-. These surprising results were discussed in terms of stimulus control, why students performed just as well during generalization when only one example of the S+ was used, why acquisition was also poorer for this condition, and how future studies might address these points.     

Prepulse effects on magnitude estimation of startle-eliciting stimuli and startle responses

The present studies investigated the relationship between prepulse effects on the modification of the brainstem startle reflex and magnitude estimates of startle-eliciting stimuli. In Experiment 1, startle eyeblink responses were elicited in 24 students, half of whom were instructed to estimate the loudness of the startle stimulus (actual intensities of 80, 90, and 100 dB) and half of whom were instructed to estimate the magnitude of their eyeblink. When weak acoustic prepulses preceded the startle-eliciting stimulus, eyeblink amplitude was inhibited, and estimates of response magnitude decreased, but estimates of startle stimulus magnitude decreased only when 100-dB startle stimuli were presented. In Experiment 2, the same startle stimuli were preceded on some trials by a vibrotactile prepulse to the hand. In conditions in which startle amplitude was inhibited, startle stimulus magnitude estimates were not affected. This suggests that the effect of acoustic prepulses on 100-dB startle stimuli in Experiment 1 may have been due to loudness assimilation, an effect independent of the prepulse inhibition of startle responding.     

Embedding instructive feedback into teacher-student interactions during independent seat work

The effects of embedding a constant time delay procedure into an independent seat work activity and using instructive feedback were evaluated in this study. Seven students with mild disabilities participated in the study that occurred in their special education classroom. A multiple probe design across sets of target behaviors was used, and students' responses to instructive feedback stimuli were evaluated during each probe condition. The procedures were implemented with a high degree of fidelity, and the results indicate that (a) the students acquired the target behaviors taught with the constant time delay procedure that was embedded into independent seat work, and (b) the students acquired some but not all of the responses to the instructive feedback stimuli. These findings are discussed in terms of using instructive feedback in classrooms and future research on instructive feedback.     

Homicide by juvenile girls

We investigated offense characteristics for a national sample of 38,749 homicide arrestees identified in the FBI Supplemental Homicide Reports for 1984 and 1993. Analyses indicated little change from 1984 to 1993 in the circumstances of homicides committed by adolescent girls; however, there were consistent offense differences between girls and boys, and between girls and women. Homicides by adolescent girls were more likely than those committed by boys to involve interpersonal conflict rather than a criminal motive such as robbery. Girls were more likely than boys to use a knife rather than a firearm and their victims were more likely to be under the age of 13 years. Compared to women (18 years or older), girls were more likely to act with an accomplice and their victims were more likely to be female and between 13 and 20 years of age. Results were inconsistent with a stereotypic masculinization theory of the increase in female violence, but provide indirect support for the importance of domestic stress and relational conflict experienced by adolescent girls. Overall, this study supports the need for differentiated study of violence by juvenile girls, and for preventive interventions which target domestic and interpersonal stress.     

Control across the life span: A model for understanding self-direction

A comprehensive four-factor interactive model on physical, psychological, and environmental processes related to the sense of control is presented for adult development with an emphasis on later life. The four experienced components are (1) control from within oneself, (2) control over oneself, (3) control over the environment, and (4) control from the environment. Control over oneself and over the environment measure self-directed control, while control from within oneself and from the environment measure nonself-directed control. Coping (a bidimensional control scale) measures control from powerlessness and suicide to overcontrolling. Findings confirm a significant loss of coping in an older cohort group from a white, rural sample composed primarily of single subjects with low coping representing a significant drop in self-directed behavior. A discussion of the relationship between self-direction and health in the older cohort group follows.     

Matching adolescents with foster mothers and fathers: An evaluation of the role of temperament

We tested the notion that better foster care adjustment would be observed when the temperaments of mothers and fathers were matched with those of adolescent foster children. We hypothesized that families in which foster parents and foster children had high (easy) scores on subscales of the Revised Dimensions of Temperament Scale (DOTS-R) would also report higher family functioning and higher foster care adjustment than parents and children from families in which one or both family members had low (difficult) scores on these scales. The hypotheses were supported when the mothers and fathers family assessments were used but rejected when the observations of the case managers and adolescents were tested. Methodological and substantive explanations for the findings are discussed and recommendation for foster care practice and continuing research are provided.     

Prevalence of traumatic brain injury in an inpatient psychiatric population

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.     

Monogeusia for fructose,glucose, sucrose,and maltose

We investigated the ability of subjects to discriminate sugars with a whole-mouth forced-choice paradigm, in which a standard solution was compared with a test solution of varied concentration. Discrimination probabilities were U-shaped functions of test concentration: for 6 subjects and pairwise combinations of fructose, glucose, and sucrose, discriminability always declined to chance over a narrow range of test concentrations. At concentrations ≦ 100 mM, maltose was indiscriminable from fructose but discriminable at higher concentrations for 4 subjects. By analogy with themonochromacy of night vision, whereby any two lights are indiscriminable when their relative intensities are suitably adjusted, we call the gustatory indiscriminability of these sugarsmonogeusia. The simplest account of monogeusia is that all information about the indiscriminable sugars is represented by a single neural signal that varies only in magnitude. The discriminability of maltose from the other sugars at higher concentrations is consistent with the hypothesis that maltose also activates a second gustatory code.