The dilemma of primary prevention in mental health services: Rationalize the status quo or bite the hand that feeds you

That primary prevention has been ‘inappropriately marginalised’ is seen to be an inevitable outcome of reliance on government support. Policy makers and service providers can never be expected to give prevention a higher priority than direct service. Preventionists have developed two strategies for doing their work. One, based on the logical positivist ideal, seeks specific causal models for specific disorders. This sort of prevention research, while it will always remain less well funded than direct services, tends not to challenge the status quo belief in individual responsibility, or the acceptable methods of mainstream science, and thus will tend to be more acceptable than other forms of prevention research and services. An alternative, based on a social constructivist paradigm engages in social action research through collaboration with a variety of grass roots organizations and people outside the mainstream of power. This latter approach, brings to preventionists ideas from feminists, ethnic minority leaders, neighborhood organizers, and self and mutual help group leaders. It is a sensible way to use the resources available to those professionals interested in social change oriented prevention.     

Reviews

H. Helfrich (ed.), Time and Mind
Hans Eysenck, Genius: The Natural History of Creativity     

A developmental perspective on reading dysfunction: Accuracy and rate criteria in the subtyping of dyslexic children

Children referred with specific reading dysfunction were subtyped as accuracy disabled or rate disabled according to criteria developed from an information processing model of reading skill. Multiple measures of oral and written language development were compared for two subtyped samples matched on age, sex, and IQ. The two samples were comparable in reading fluency, reading comprehension, word knowledge, and word retrieval functions. Accuracy disabled readers demonstrated inferior decoding and spelling skills. The accuracy disabled sample proved deficient in their understanding of oral language structure and in their ability to associate unfamiliar pseudowords and novel symbols in a task designed to simulate some of the learning involved in initial reading acquisition. It was suggested that these two samples of disabled readers may be best described with respect to their relative standing along a theoretical continuum of normal reading development.     

Comparison of the performances of a fluent and a nonfluent aphasic on a pantomimic referential task

The pantomimic performances of a typical Broca's (nonfluent) and Wernicke's (fluent) aphasic were compared with each other and with four normal control subjects on a simple task of nonverbal referential communication. Both aphasic subjects demonstrated only about 50% accuracy in their pantomimic communication. Also, measures were obtained of the motoric fluency of the pantomimes of all subjects and comparisons were made between the fluent and nonfluent aphasics. These measures demonstrated distinct differences in the fluency patterns of the pantomimes of the two aphasic subjects similar to the differences in speech fluency which distinguish and characterize these two types of aphasia; that is, the fluent aphasic pantomimed fluently and like the control subjects and the nonfluent aphasic pantomimed nonfluently. The quantitative and qualitative similarities in the fluency patterns of the speech and the pantomimic behaviors of the aphasic subjects are discussed in terms of their implications for a definition of aphasia.     

Soft tissue anatomy of the tongue and floor of the mouth: An ultrasound demonstration

Ultrasound technology has not been used extensively in the study of normal and abnormal oral physiology and speech. Features such as soft tissue detail, real-time motion display, and subject safety make ultrasound ideal for imaging the tongue and the floor of the mouth. This study demonstrates visualization of the muscles of the tongue and floor of the mouth for a normal subject using ultrasound imaging. By employing submandibular transducer placement of real-time sector scanners, tongue anatomy and motion were continuously visualized in sagittal or coronal planes. In addition to the entire tongue surface, much of the intrinsic anatomy was identified including: the genioglossus, geniohyoid, mylohyoid, and digastric muscles; fascial boundaries such as the median fibrous septum, floor intermuscular septum, and paramedian septums; and the hyoid bone. A tongue excised from a human cadaver was scanned using ultrasound and dissected to confirm the anatomy seen in the live tongue. Tongue surface shape and configuration of the intrinsic tissue structures were observed and compared for the phonemes /k/, /u/, and /i/. Anatomical landmarks in the resting and speaking tongue are discussed as well as applications in the fields of speech science and speech pathology.     

The effect of context during word perception in schizophrenic patients

Hospitalized chronic and acute schizophrenics were compared with age- and social-status-matched controls on word perception tests to measure the effect of context on recognition thresholds. In Experiment 1 the method of J. Morton (1964, British Journal of Psychology, 55, 165-180) was adopted to see how related and unrelated contexts influenced word recognition thresholds when both context and stimulus word were presented visually. Experiment 2 was an auditory analog of Experiment 1 and in addition the chronic schizophrenics were selected on the basis of a presence or absence of auditory hallucinations. The influence of context on perceptual thresholds was quite normal in all schizophrenics. However, analysis of the incorrect responses elicited showed that some schizophrenic subjects do produce bizarre or irrelevant responses or perseveration to a greater extent than their controls. These results are explained in terms of automatic and strategic modes of information processing. The automatic processes responsible for the adjustment of perceptual thresholds operate normally in schizophrenics but response production which demands strategic selection and editing of responses is prone to malfunction which results in the observed deviations in the normal use of language.     

Classification of spelling errors and their relationship to reading ability, sex, grade placement, and intelligence

A simple scheme for the classification of spelling errors was applied to the errors of four groups of children, totaling 483 subjects, in grades 3 to 12. The subjects in two of the groups, Group I and Group IV, consisted of individuals who attended special schools for children with dyslexia or specific reading disability (SRD). Group II included school age siblings of subjects in Group I, and Group III included subjects drawn from regular school programs. It was shown that (a) type of spelling error is independent of sex, (b) there are no consistent effects of IQ or grade level on type of spelling error, and (c) disabled readers as a group are more likely to produce dysphonetic errors than are normal readers. Although the type of spelling error produced by children who had a spelling disability only was shown to be similar to that of normal readers and to differ from that of disabled readers as a group, disabled readers were shown to differ among themselves, lending strong support to the use of spelling error type as a characteristic for identifying subgroups.     

Variability in the initiation of articulatory movements in the speech of stutterers and normal speakers

This study was designed to investigate the differences between stutterers and normal speakers in phonatory and articulatory timing during the initiation of fluent utterances of monosyllabic words. Electromyographic recordings of four articulatory muscles and recordings of glottal vibrations were made of repetitive utterances of a series of monosyllabic words by 15 stutterers and 17 nonstutterers. These data were analyzed in terms of average interval times between voice onset and onset of EMG activity and between onset of EMG activity in each articulator and in terms of the intrasubject variability of these durational measures. Results showed that there were no significant differences between stutterers and nonstutterers in average interval times and that stutterers, in general, were significantly more variable in their speech onset timing. Findings are discussed in terms of recent hypotheses concerning the role of timing disturbances as the main source of speech disruption in stutterers.     

Comparison of metabolic rates, language, and memory in subcortical aphasias

Four patients with subcortical lesions and either aphasia or amnesia were compared to four patients with cortical lesions and aphasia. Each patient had [18F] fluorodeoxyglucose positron-emission computed tomography, language, and memory evaluations. Marked metabolic depression was found in the thalamus and caudate in all patients. The subcortical patients had only mild left-cortical changes, while the cortical patients showed marked cortical metabolic changes in the left hemisphere. Language changes were mild in the subcortical patients, while moderate to severe in the cortical patients. All patients showed severe verbal memory dysfunction. The only common abnormalities in the two groups were metabolic changes in the thalamus and severity of verbal memory dysfunction. These findings suggest a relationship between verbal memory and thalamic function.     

Algorithms for processing spatial information

Pairs of stimuli taken from a psychometric measure of spatial aptitude were shown to 9-year-olds, 13-year-olds, and adults. The stimuli in pairs were (a) either identical or mirror images, and (b) presented in orientations that differed by 0-150 degrees. Individuals judged, as rapidly as possible, if the stimuli in a pair would be identical or mirror images if presented at the same orientation. In Experiment 1, in which the stimuli were letter-like characters, at all ages most persons solved the problems using an algorithm in which an individual encodes the stimuli in working memory, mentally rotates one stimulus to the orientation of the other, compares them to determine if they are identical, and responds. In Experiment 2, the stimuli were multielement flags; here, the modal algorithm for both 9- and 13-year-olds differed from the previously described algorithm in that if the comparison process revealed that the stimuli were dissimilar, individuals did not respond immediately, but continued processing until a self-imposed deadline was reached. Among adults, the modal algorithm was the same one used in Experiment 1. Results are discussed in terms of the roles of encoding in contributing to the use of a particular algorithm.