Environmental factors in suicide in long-term care facilities.

One major purpose of this study was to identify environmental factors related to suicide in long-term care facilities. Questionnaires were mailed to a random sample of administrators at 1,080 facilities. Information was collected on facility characteristics, overt suicide, and intentional life-threatening behavior. Chi-square analyses revealed 4 environmental characteristics related to suicidal behavior and deaths from suicide: staff turnover, size, auspices, and per diem cost. More suicides occurred in larger facilities and facilities with higher staff turnover. Religious or "other" facilities experienced more suicidal deaths than public or private facilities; facilities charging less experienced more deaths.     

Brief report: An extension of the sequential alternating treatment design using reversals with subjects not available concurrently

This brief report proposes an extension of the traditional Alternating Treatments Design that would be acceptable to use in hospital and residential settings where subjects are often not concurrently available. Concerns about the inability of traditional designs to work in these special situations and the emergence of a “scientist–practitioner split” are discussed. An example of how the Extended Alternating Treatments Design might be used is provided.     

The naturalistic fallacy: moral inferences drawn from research with children versus adults

The naturalistic fallacy occurs when a person reads a report of scientific research and concludes that the moral implication of the research was included in the article when, in fact, it was not. For example, the fallacy is committed when a study contains the conclusion that TV advertising increases preference for sugar-based foods, but the reader later believes that the study concluded that TV advertising should be controlled. Previous research indicates that the commission of the fallacy was strong when memory for social research was tested. The present study showed that the commission of the fallacy was stronger when the research which was read involved children as subjects compared to adult subjects. Increased empathy for the subjects of a research article strengthens commission of the fallacy.     

Clinical judgment, clinical training, and professional experience

Reviews studies on training, experience, and clinical judgment. The results on the validity of judgments generally fail to support the value of on-the-job experience in mental health fields. The validity results do provide limited support for the value of training. Other results suggest that experienced clinicians are better than less experienced judges at knowing which of their judgments are likely to be correct and which are likely to be wrong. Reasons why clinicians have trouble learning from experience are given. Recommendations are made for improving training and clinical practice.     

Relationship between two nontraditional procedures for assessing speech-sound discrimination

Test of speech-sound discrimination are used by special educators, reading specialists and speech-language pathologists in assessing children's ability to differentiate between speech sounds occurring in standard English. Such tests are important in determining if speech-sound articulation errors are caused by difficulty in making such differentiations. However, during the past 10 years, these tests have been criticized on the basis of their reliability and validity. The purpose of this study was to examine the use of two alternative methods of assessing speech-sound discrimination with a school-aged population to determine if they elicited responses in a similar manner.     

H-reflexes during a motor skill acquisition task

H-reflex amplitudes were studied during the acquisition of a motor skill involving coordinated isometric plantarflexion at the ankle joints as subjects learned to trace a triangular pattern on an oscilloscope screen by controlling plantarflexion torque applied against load cells. Torque feedback was presented on a subject oscilloscope with the right foot controlling a vertical cursor and the left foot a horizontal cursor. Eleven subjects reached criterion performance. H-reflexes were recorded from the right soleus and timed to the initiation of soleus muscle activity to plantarflex the foot. Average time to complete one trial decreased from 9 sec. in the prelearning block to 4 sec. postlearning. No single learning strategy was evident as subjects varied widely in their levels of H-reflex amplitude, but during postlearning, H-reflex amplitude became consistent within subjects as tracing performance became faster and accurate.     

Secondary enuresis in institutionalized conduct-disordered children

The incidence of secondary enuresis in 16 institutionalized conduct-disordered children was examined. In contrast to a control group of 16 noninstitutionalized conduct-disordered children, the former showed significantly more enuretic behaviour. Also, enuresis began within 6 mo. of the children's separation from their families, suggesting this problem is very likely related to the emotional trauma surrounding the change in living conditions. However, the small number of subjects limits further interpretation of the findings.     

Abnormal optokinetic and perceptual span parameters in cerebellar-vestibular dysfunction and related anxiety disorders

As prior studies indicated abnormal cerebellar-vestibular-based sensorimotor mechanisms and neurological and ENG diagnostic parameters in anxiety disorders and because ocular fixation and sequential scanning are cerebellar-vestibular-modulated, it appeared reasonable to measure these and related ocular functions in matched samples of anxiety-disordered and control subjects. In this study, the optokinetically-determined fixation, sequential scanning, and perceptual span capacities obtained by means of a newly revised blurring-speed method were significantly lower or impaired in 70 anxiety-disordered patients vs 70 controls. Such data supported further the hypothesis that there may be cerebellar-vestibular predispositions to anxiety disorders and the optokinetically-based tracking method may prove useful in separating a diverse array of CV-determined or related anxiety symptoms from those of other origins. However, independent validation as well as additional studies of anxiety disorders using larger samples vs random or "normal" controls are required before conclusions are justified.     

The effects of right and left hemiparkinsonism on prosody

Recent studies show right hemisphere dominance in the mediation of emotional prosody and left hemisphere contribution to linguistic prosody in patients with cortical injury. The present study investigated emotional and linguistic functions of prosody as well as facial and musical processing in 21 patients with lateralized subcortical disease. Fourteen right hemiparkinsonians (RPD) and 7 left hemiparkinsonians (LPD) were compared to 17 normal controls (NC). Patients were impaired on receptive and expressive tests of emotional and linguistic prosody. Patients were also selectively impaired on emotional processing of facial stimuli and in the musical processing of pitch and tonal memory, though not timber. These findings suggest that monotone speech reported in PD is of multimodal origins and may involve dysfunction in neural centers involved in emotional and linguistic processing. There were no differences between RPD and LPD groups in the pattern of deficits, suggesting bilateral involvement in emotional processing at the subcortical level.