The effects of violence on infants and young children: international perspectives on prevention

People become subject to political and social violence when governments fail to give priority to basic health care or education. Attempts to meet foreign obligations also produce severe economic recessions which further impede efforts to improve the general quality of life of disadvantaged populations. Since multiple factors contribute to violence, a multidisciplinary approach is best suited to address the problem. For example, poverty and its associated risks are linked to violence, but living in poverty does not necessarily engender violence. Living in poverty may, however, fuel high rates of child mortality, illiteracy, malnutrition, excessive population growth, street children, and familial disintegration. An integrated action program was developed in Brazil for at-risk individuals and their families based upon the idea of building and reinforcing family ties and intergenerational togetherness. Undernourished infants, street children, the handicapped, women subjected to violence, and neglected senior citizens received special interventions in the program described in the text.     

Group analytic therapy with schizophrenic outpatients

This paper describes a model for group analytic psychotherapy with patients who have been psychotic, namely, schizophrenics and manic depressives. The groups are run on the group centered principles of S. H. Foulkes. They are continuous, slow-open groups, in line with these patients' needs for long-term therapy. A theory is proposed which justifies treating these patients in group-centered groups despite their great dependency needs. The paper also describes the task of the therapist in building and running such a group.Acknowledgments to Geoffrey Elkan, Marcia Levene, Noa Rotem, Aya Levi-Posnanski, Yossi Ezrati, S. Littman, Tamar Sternberg, E. Danilowitz, and C. Kauffman.     

BELIEF VS. COMMITMENT, VALIDITY VS. VALUE: A RESPONSE TO WARD GOODENOUGH

Abstract. This paper is on Ward Goodenough's recent article (27: 3), suggesting that his points can be clarified by reiterating the distinction between the realms of meaning and relevance. Religion's "truth" is in the form of its ualue; the "proof" which it requires is uindication; and the resulting "faith" must be understood as commitment.     

Self-Monitoring negative statements

We examined the effects of a self-monitoring program on reducing the frequency of negative statements of a student with mild mental retardation who was enrolled in a self-contained classroom at a middle school. A changing criterion design was used within a multiple baseline design across two classroom periods. Additionally, the frequency of positive statements was reported. The results showed a decrease in the number of negative statements, and an increase in the number of positive statements. Maintenance data collected up to 8 weeks after the program ended indicated that the student continued to emit positive rather than negative statements. The use of this procedure to decelerate undesirable behavior is discussed.     

Double agency and the ethics of rationing health care: a response to Marcia Angell

The arguments against doctors as "double agents" that are presented by Marcia Angell in the preceding article do not defeat the core justification for rationing some relatively high-expense, low-benefit care, and they do not enable us to conclude that clinicians should be barred from any active, substantive role in decisions to limit that care. They do, however, reveal several important conditions that need to govern cost-conscious medial practice in order to preserve an ethic of fidelity to patients: insurers' profits and providers' incomes must be fair, providers must inform patients of any economic reasons that lead to the foregoing of care, and "direct incentive" arrangements must not be used to contain costs.     

Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders

In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

Development of knowledge bases and the reliability of a decision support system for behavioral treatment consultation for persons with mental retardation: The Mental Retardation-Expert

The development of expert and decision support systems requires the collection, organization, codification, and storage of a body of specialized knowledge. The development, using reconstructive methods, of two such knowledge bases, the first containing the current scientific literature and the second containing an expert’s knowledge, is described for an automated decision support system, the Mental Retardation-Expert. This system provides practitioners with assistance in the treatment of aggressive, self-injurious, and destructive behaviors displayed by individuals with mental retardation or developmental disabilities. The average interobserver reliability of the expert knowledge base ranged from 92.5% to 95.0% when calculated across four clinicians’ assessments of 31 abstracted cases.