Antidepressant treatment of children: clinical relapse is unrelated to tricyclic plasma concentrations

Plasma concentrations of imipramine and amitriptyline and their desmethylated metabolites were measured in 20 children being treated for major depressive illness 2 wk. and 5 to 10 wk. after achieving drug dosages of 2.25 mg/kg body weight. At 2 wk. all children had exhibited clinical improvement, but by 10 wk. 4 of the 10 children treated with imipramine and 5 of the 10 children treated with amitriptyline had experienced clinical relapse of depressive symptoms. Tricyclic antidepressant plasma concentrations and ratios were comparable in the subgroups of children who maintained their clinical improvement and those who relapsed. There was no evidence of a systematic decline in plasma tricyclic antidepressant concentrations in those children who relapsed.     

What can it mean to know?

This paper offers a critique of the prevailing epistemological assumptions which undergird modern Pastoral Care and Counseling education. By drawing upon emerging insights in Transpersonal Psychology and Consciousness disciplines, along with the ontological perspectives of Martin Heidegger and John Macquarrie, the attempt is made to reclaim the modes of knowing of William James and Anton Boison. This paper includes practical and concrete examples of how one supervisor is attempting to put a new paradigm into practice.     

The effect of cuing after backward conditioning trials

Rats were given backward pairings of a tone (CS) and shock (US) and were then tested for response to the CS in a lick suppression test. Animals given a cuing or reminder treatment prior to the test exhibited enhanced suppression in the presence of the tone relative to a variety of control conditions. The cue-induced suppression enhancement did not appear to result from sensitization or short-term motivational changes nor did it seem to depend on second-order conditioning of the test context. The effect appeared more robust as the number of backward conditioning trials preceding the cue increased. The results were discussed in terms of current explanations of backward conditioning effects.     

Infant hypotonia, obesity, hypogenitalism and oligophrenia--new viewpoints on the etiology and symptoms of Prader-Willi syndrome

We present four cases of Prader-Willi syndrome. Two of them have an abnormality of a chromosome 15, the other both show different chromosomal abnormalities. Translocations or deletions were found recently in the bands 15q11/12 in about 60% of the cases of Prader-Willi syndrome. The consequences for diagnosis, symptomatology and genetic counselling of the syndrome are discussed.     

Nonprofessional counselors: Revisiting selection and impact issues

This study examined two issues related to the use of nonprofessional counselors (n = 159) within the context of a diversion program for juvenile offenders. First, the relationship of the nonprofessionals' personality traits and general attitudes to client outcome was examined. No statistically significant correlations were observed. Second, the differential impact of various training and supervision factors was examined in terms of nonprofessional satisfaction, attitudes, and locus of control. Results suggested that training intensity, training content, and supervision setting may influence nonprofessionals' attitudes towards various social groups and their satisfaction with the nonprofessional experience.     

Changes in self-stimulatory behaviors with treatment

For four of six autistic children who underwent intensive behavioral treatment, the nature of their self-stimulatory behavior changed from initial lowlevel motor behaviors (such as rocking, spinning, twirling) to differing kinds of higher-level behaviors (such as lining of objects, echolalic speech, and preoccupation with spelling and numerical values). The children who changed to the highest levels of self-stimulatory behavior also showed the largest gains in treatment (as determined by IQ scores, school placement, etc.). The changes in self-stimulatory behaviors were attributed to the intense teaching of appropriate social behaviors and the explicit therapeutic suppression of low-level, self-stimulatory behaviors. The long-term therapeutic effects of changing from lower-to higher-level forms of self-stimulatory behavior were discussed.This study was supported by a grant from the National Institute of Mental Health (grant MH 11440). We want to express our thanks to the parents who allowed us to study their children. We gratefully acknowledge the assistance of Maria Audero with the design of the weighted measure, and Tracee Parker with the collection of the data.     

Stuttering and the valsalva mechanism: A hypothesis in need of investigation

This note presents the hypothesis than the excessively forceful closure of the mouth of larynx associated with certain types of stuttering may involve a neurological confusion between speech and the human body's Valsalva mechanism, which is designed to increase pulmonary pressure by forceful closure of the upper airway to assist in many types of physical effort. It is suggested that such behavior may result from excessive neuromotor tuning of the Valsalva mechanism prior to speech, especially in situations where the stutterer anticipates the need to “try hard” to speak properly. Such tuning may both interfere with phonation and render the Valsalva mechanism overexcitable to triggering stimuli, such as the increase in subglottal pressure that accompanies the start of articulation.     

PSYCHOLOGY AND HEALTH: CONTRIBUTIONS OF PSYCHOLOGY TO THE IMPROVEMENT OF HEALTH AND HEALTH CARE

Psychology as both a science and a profession has been closely identified with other disciplines in the broad field of health since the turn of the century. Recent advances in health care have reinforced the growing belief that the promotion of health and the prevention and treatment of illness can be greatly enhanced by incorporating the scientific findings and modern technology of psychology into everyday practices. Outlining the contributions of psychology to health care throughout the world is the primary purpose of this report. In this brief survey, only some of the most timely and relevant issues can be mentioned, together with examples of current work in the field. The reader interested in pursuing these psychological contributions more thoroughly is encouraged to review pertinent references from the citations at the end of this report. After an introductory overview, special attention is given to each of the major areas within the broad field of health care where psychological applications have been particularly useful.