Real-world inpatient programs: Shedding some light-A critique

This critique is a response to an article by Morisse, Batra, Hess, Silverman, and Corrigan (1996), in which “a token economy for the real world” is promulgated as an alternative to the comprehensive social-learning program and assessment technology presented by Paul and Lentz (1977). The article misrepresents the treatment-and-assessment procedures that have been empirically validated as the most effective and cost-efficient for inpatient programs. The article also inappropriately cites the results of prior reports as support for an oversimplified approach to the development and implementation of inpatient programs. The promoted approach is in direct opposition to the widely recognized need for empirically validated interventions and evaluations in mental health services. Not only are data lacking to support assertions of effectiveness for the resulting program but illustrative examples demonstrate technically unsound procedures as well as an ethically questionable emphasis on staff desires to the exclusion of patient needs. We attempt to correct Morisse et al.'s inaccuracies and misconceptions regarding the work of Paul and colleagues, note the major problems with their perfunctory approach, and provide recommendations for implementation and maintenance of empirically validated procedures for inpatients.     

Interventions to Empower Adults with Eating Disorders and Their Partners around the Transition to Parenthood

The transition to parenthood is perceived as a stressful life event, when parents experience an immense change of their psychological focus and a reorientation of roles and responsibilities in the family system. This process may be even more challenging in the presence of a parental eating disorder history. This paper reviews the impact of parental eating disorders on the parents, the couple relationship, and their child during the perinatal period. A parental eating disorder is associated with more negative expectations of parental efficacy as well as specific difficulties in couple communication over the child’s feeding, shape, and weight. Providers who better understand the effects of an eating disorder on parental functioning can more effectively intervene early on. We also present couple- or parent-based, empirically supported interventions for adults with eating disorders and their partners in the prenatal and postnatal periods: Uniting Couples in the treatment of Anorexia Nervosa (UCAN) and Uniting couples In the Treatment of Eating disorders (UNITE) both enhance recovery from the eating disorder through a couple-based intervention; the Maudsley Model of Treatment for Adults with Anorexia Nervosa (MANTRA) incorporates the support of partners, when appropriate; Parent-Based Prevention (PBP) focuses on improving parental functioning and reducing risk of negative parental and child outcomes. Finally, we discuss the clinical implications of addressing parental eating disorders and encourage more research on these families.     

The perception of available social support is related to reduced cardiovascular reactivity in phase II cardiac rehabilitation patients

Objective  Numerous studies have observed a relationship between social support (SS) and post coronary event survival. Laboratory research suggests one mechanism regulating this relationship may be exaggerated cardiovascular reactivity (CVR). What has not been as well explored is (1) whether the SS-CVR relationship holds up for a heart diseased sample, and (2) whether this relationship is evidenced only in supportive environments or can be found as a function of generalized perception of being socially supported. Thus, the purpose of this study was to examine the relationship of perceived SS and a locally supportive presence to CVR to a speech-induced stressor in post coronary event patients. Method  Forty-one Phase II cardiac rehabilitation patients participated in a research protocol that consisted of BP and HR measurement during two identical affective stress interviews where local support was systematically varied by presence or absence of a friendly small pet dog. Perception of SS was assessed by completion of psychosocial questionnaire packet that included measures of SS, anger expression and pet attachment. Results  Repeated measures ANCOVAs revealed that patients who believed they had greater SS available to them during difficult times exhibited significantly less CVR for MAP (p<.007) and DBP (p<.024). No significant main effects for local support (pet presence) and no interactions between local and perceived support were found. Conclusions  These findings are of interest as they: (a) demonstrate an association between reduced CVR and higher (amounts of) SS in a clinical sample; (b) demonstrate this effect in a sample medicated to dampen CV levels and surges; (c) suggest that perceived amount of SS provides an ameliorative influence on CVR independent of situational support; (d) suggest that for certain conditions pet-models of support may be ineffective at establishing an local support presence.     

The general causality orientations scale: Self-determination in personality

This paper describes the development and validation of a general causality orientations scale. Causality orientations are conceptualized as relatively enduring aspects of people that characterize the source of initiation and regulation, and thus the degree of self-determination, of their behavior. Three orientations—autonomy, control, and impersonal—are measured by the three subscales of the instrument. Individuals are given a score on each orientation, thus allowing the use of the theoretically appropriate subscale (or, in some cases, a combination of subscales) to predict affects, cognitions, and behaviors. The scale was shown to have internal consistency and temporal stability. The orientations were shown to fit appropriately into a nomological network of constructs and to relate to various behaviors that were hypothesized to be theoretically relevant.     

EEG asymmetry and sleep mentation during REM and NREM

The hypothesis that dreaming is mediated by the right hemisphere was evaluated by monitoring EEG power asymmetry during REM and NREM sleep, and obtaining mentation reports when short-term temporal shifts in the EEG indicated relative left- or right-hemispheric dominance. Content analyses provided no support for the right-hemisphere hypothesis; indeed, some scales showed higher content during relative left-hemispheric dominance. In contrast to earlier reports, no difference between REM and NREM in EEG asymmetry was observed.     

Perception of symmetry in infancy: the salience of vertical symmetry and the perception of pattern wholes

Four experiments were conducted to assess converging aspects of 4-month-old infants' perception of symmetry in visual patterns. Experiments 1 and 2 manipulated the structure and orientation of comparable patterns in order to evaluate the specialty of vertical symmetry. Infants showed no preference among vertically symmetrical, vertically repeated, and obliquely symmetrical patterns, but they processed vertically symmetrical patterns more efficiently than either vertically repeated patterns or obliquely symmetrical patterns. Experiment 3 manipulated the spatial separation of pattern components in order to determine the ability of young infants to integrate and coalesce information in visual patterns that is distributed in space. Infants processed vertically symmetrical patterns whose components were contiguous or nearly contiguous about the vertical axis (0 to 2.5 degrees separations) more efficiently than discontiguous patterns (5 and 10 degrees separations). Thus, extreme spatial separation about the vertical meridian caused infants to lose the advantage for vertical symmetry, and by inference their holistic perception of the visual pattern. Experiment 4 manipulated the organization of individual components of a vertical pattern in order to examine further infants' sensitivity to perceptual organization and synthesis of pattern form. Infants discriminated vertically symmetrical patterns from asymmetrical patterns with a vertical organization, thereby demonstrating sensitivity to the symmetrical organization of the pattern above their perception of components in the pattern. The results of these four experiments together corroborate and extend previous findings that vertical symmetry has a special status in early perceptual development and that infants can perceive pattern wholes.