The aggression-coercion cycle: Use of seclusion and restraint in a child psychiatric hospital

The widespread use of seclusion and restraint in child psychiatric hospitals to manage aggression and noncompliance is based on the assumption that coercive consequences reduce the frequency of undesirable behaviors exhibited by the patients. We report a study of the use of seclusion and restraint in a public child psychiatric hospital during a 3-year period. Twenty-eight percent of the patients had been secluded or restrained a total of 1670 times. About 25% of these patients had been secluded more than five times during their hospitalization, and 32% had been placed in restraints more than once. Behaviors that typically resulted in repeated seclusion included physical aggression toward staff, verbal aggression toward peers, non-compliant or oppositional behavior, and self-harm. Variables that predicted patients most at risk for repeated seclusion included age, gender, and psychiatric diagnosis. The predictor variables for those most at risk for repeated restraint included age, property destruction, and self-harm. The high rates of use of seclusion and restraint suggest that these methods for controlling the behavior of children and adolescents in this child psychiatric hospital may not have been therapeutic. We suggest that staff in such hospitals engage in a pattern of behavior characterized by an aggression-coercion cycle, in which increasingly aggressive and coercive behaviors are exhibited by both patients and staff.     

Rationality in Religion

Religion can be defined narrowly as belief in anthropomorphic supernatural beings. For Levy-Bruhl this meant that prelogical ‘mystic participation’ preceded true religion. For Donald Wiebe and others it means that philosophical-scientific rationality has been struggling to replace religion since the axial age. A broader definition of religion interprets rational post-axial theology as a development within religion, not a replacement of true religion. Both definitions are legitimate. The narrow definition highlights a tendency to superstition in religion. The broader definition recognizes the possibility of an evolution of religious thought.     

A transformation of self-discrimination response functions in accordance with the arbitrarily applicable relations of sameness, more than, and less than

In Experiment 1, 2 experimental subjects were given pretraining of nonarbitrary relations that brought their responses under the control of four contextual stimuli; same, opposite, more than, and less than. One control subject was not exposed to this pretraining. The 2 pretrained subjects and the 3rd nonpretrained subject then received training in six arbitrary relations, the following four relations being the most critical: same/A1-B1, same/A1-C1, less than/A1-B2, more than/A1-C2. All 3 subjects were then tested for seven derived relations, the following three relations being the most important: same/B1-C1, more than/B1-C2, less than/B1-B2. The 2 pretrained subjects, but not the nonpretrained subject, showed the derived relations. One of the stimuli (B1) from the relational network and two novel stimuli (X1 and X2) were then used to train three different self-discrimination responses on three complex schedules of reinforcement. That is, all 3 subjects were trained to pick X1 if they had not emitted a response, to pick B1 if they had emitted one response only, and to pick X2 if they had emitted two responses only. The 2 pretrained subjects, but not the nonpretrained subject, showed the predicted transformation of self-discrimination response functions in accordance with the relations of sameness, more than, and less than (i.e., no response, pick B2; one response only, pick C1; and two responses only, pick C2). In Experiment 2, 2 new subjects were employed, and the arbitrary relational training and testing phases were modified to control for a procedural artifact that may have contributed to the results of the first experiment. Experiment 2 replicated the findings of Experiment 1. The pattern of results support the utility of a relational frames approach to understanding derived stimulus relations.     

Perceptual scaling of synthesized musical timbres: Common dimensions,specificities, and latent subject classes

To study the perceptual structure of musical timbre and the effects of musical training, timbral dissimilarities of synthesized instrument sounds were rated by professional musicians, amateur musicians, and nonmusicians. The data were analyzed with an extended version of the multidimensional scaling algorithm CLASCAL (Winsberg & De Soete, 1993), which estimates the number of latent classes of subjects, the coordinates of each timbre on common Euclidean dimensions, a specificity value of unique attributes for each timbre, and a separate weight for each latent class on each of the common dimensions and the set of specificities. Five latent classes were found for a three-dimensional spatial model with specificities. Common dimensions were quantified psychophysically in terms of log-rise time, spectral centroid, and degree of spectral variation. The results further suggest that musical timbres possess specific attributes not accounted for by these shared perceptual dimensions. Weight patterns indicate that perceptual salience of dimensions and specificities varied across classes. A comparison of class structure with biographical factors associated with degree of musical training and activity was not clearly related to the class structure, though musicians gave more precise and coherent judgments than did nonmusicians or amateurs. The model with latent classes and specificities gave a better fit to the data and made the acoustic correlates of the common dimensions more interpretable.     

Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Evaluation of a Coeducational Interactive Rape Prevention Program

This article illustrates one way in which counselors can contribute to victim services on campus besides providing direct remedial services. Specifically, the authors describe a project in which they designed, implemented, and evaluated a rape prevention program. The program was coeducational and interactive and was presented to members of sororities and fraternities. Those who participated in the program endorsed fewer rape-supportive attitudes than did the control group immediately following the program, although the two groups no longer differed at the one month follow-up. Recommendations are provided for counselors interested in developing and evaluating similar programs.     

Illusions of Safety in a Risky World: A Study of College Students' Condom Use

The role that costs, benefits, and perceptions of invulnerability play in condom use was examined in a sample of students ( N = 211) at 4-year and 2-year colleges. In multiple regression analyses, past condom use was related to relative invulnerability, low present risk, and inexperience. Less intended condom use was associated with high perceptions of relative invulnerability and low perceptions of present risk. It appears that many college students feel protected from HIV because they judge their current sexual environment to be safe due to monogamy, sexual history taking, and the ability to tell a partner's HIV status. Independent of that, feelings of relative invulnerability are associated with more condom use—perhaps an accurate judgment of past risky behavior.