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     

PREVENTION OF DEPRESSIVE SYMPTOMS IN SCHOOLCHILDREN:

Abstract— After teaching cognitive and social-problem-solving techniques designed to prevent depressive symptoms, we followed 69 fifth- and sixth-grade children at risk for depression for 2 years. We compared these children with 49 children in a matched no-treatment control group The prevention group re- ported fewer depressive symptoms through the 2-year follow-up, and moderate to severe symptoms were reduced by half. Surprisingly, the effects of the prevention program grew larger after the program was over. We suggest that psychological immunization against depression can occur by leaching cognitive and social skills to children as they enter puberty     

Dissociating the generation stage in implicit and explicit memory tests: Incidental production can differ from strategic access

An assumption of the generate/recognize model of direct and indirect memory is that the generation stage is identical on explicit and implicit tests. Two experiments were conducted to examine the generation stage by requiring subjects to write down every word-stem solution they could generate on either an implicit test, a cued-recall test, or a generate/recognize test. In Experiment 1, the subjects studied words and anagrams; target generation was not significantly different on the three tests. However, in Experiment 2, the subjects studied the target words with a context word, and saw either thesame ordifferent context with the test stem. Now the generation stages dissociated, such that the context manipulation had no significant effect on the implicit test, but on the cued-recall test, more targets were generated with the same context words than were generated with different context words. The results argue against the claim that dissociations between implicit and explicit tests are due only to the addition of recognition processes on the explicit test, because the generation processes themselves can be dissociated.     

The modification of auditory hallucinations

The ABAB withdrawal design was used to document the effectiveness of a behavioral treatment package in reducing the duration of auditory hallucinations of a chronically mentally ill inpatient. Results revealed clear functional control of the treatment package over the occurrence of the subject's auditory hallucinations during a 2-hr time period.     

Mental health service utilization among Puerto Rican children ages 4 through 16

This paper examines those children receiving mental health services in Puerto Rico, their demographic and psychosocial characteristics, and describes service providers and nature of facilities. The survey was done on a probability sample of children ages 4 through 16 across the island of Puerto Rico (N=777). Need for services was clinically defined as presence of a DSM-III diagnosis and functional impairment. The overall rate of service utilization for Puerto Rican children was 6% (26.2% of definite cases and 5.1% of probable cases). In most cases services were provided by psychologists and/or social workers, and they were mainly provided in schools and general medical facilities. In over 60% of the children assessed as cases, who did not receive services, the reason, given by the parent was that they considered the problem not serious. Factors associated with service utilization were measures of psychopathology, teacher's perceived need, and parental rates of criticism and hostility. These findings suggest that there is a need for more research on the motivating factors for service use (impairment and parental criticism). Teachers could benefit from receiving special training to help them readily recognize behavioral problems in children, communicate them to parents and set up services alternatives.     

New directions for the education of clinical psychologists: The primary care setting,the VA's PRIME program,and the in-depth generalist model

As part of this special issue on psychology in primary care settings, we describe the Department of Veterans Affairs' (VA's) new approach to education for practice in the primary care setting and we concurrently address some general issues related to the education of clinical psychologists for practice in this setting. In this article we argue that the primary care psychologist, in parallel with the generalist in medicine, must have a strong generic background in clinical psychology in order to gain the broad range of clinical skills necessary to function effectively as an in-depth generalist (IDG) who is capable of addressing the variety of psychological issues that emerge in the primary care setting. The IDG model of professional practice, which we believe is best suited for primary care/managed care settings, requires extensive training in generic clinical skills and increased time devoted to its implementation at both the predoctoral and the postdoctoral levels.     

Infertility treatment for postmenopausal patients: an equity-based approach

This article examines two questions pertaining to the extension of infertility treatment to postmenopausal women. First, what concepts and principles of infertility practice apply to assisted reproduction for the postmenopausal patient? Second, what role should these concepts play in the development of an ethical justification for extending women's reproductive lives past the menopausal boundary? The argument offered here supports their claim to infertility services on the basis of the formal principle of justice, which requires that similar cases be treated similarly. The cases of many postmenopausal patients are argued to be relevantly similar to classes of patients who already receive assistance in reproduction.     

Predictive testing and oncogenes

Case vignette: sharing unanticipated genetic information. The Questor family has experienced an unusual number of malignancies in the past two generations and has been advised by an oncologist that the p53 oncogene known as Li-Fraumeni Syndrome may be present in the family genome. The option of predictive genetic testing has been raised and several branches of the family have chosen to undergo screening to determine whether they are at risk for cancer because of the gene. Roger and Liz Questor have arranged for screening of themselves and their three children, ages 12, 10, and 7. The couple has, by all appearances, been happily married for 14 years. None of the family members are found to carry the oncogene; however, the geneticist conducting the analyses has made an interesting incidental discovery. The 10-year-old child is not the biological progeny of Roger Questor. Although the 12- and 7-year-olds are clearly the biological children of the couple, it is evident that the 10-year-old born to Liz Questor was fathered by a person other than Roger. What are the ethical obligations of the geneticist with respect to any sharing or disclosure of the information that has been discovered incidentally? What course of action, if any, do you recommend?