Self-observation versus flooding in the treatment of agoraphobia

The effects on agoraphobia of (1) self-observation with a minimum of therapeutic intervention. (2) flooding, (3) a combination of flooding and self-observation, and (4) no-treatment control were compared. Assessments were made at the beginning of treatment, during and at the end of treatment and at the follow-up three months later. They were carried out by the therapist (in vivo) measurement; phobic anxiety and phobic avoidance scale) by an independent observer (phobic anxiety scale and phobic avoidance scale) and by the client (phobic anxiety scale; phobic avoidance scale: FSS; social anxiety scale; SDS and I-E scale).Self-observation, flooding and flooding/self-observation resulted in significant improvement on several variables, whereas the no-treatment control group did not improve. No difference in effectiveness was found between the self-observation and flooding treatments. In addition, the results suggest that a combined flooding/self-observation treatment is more effective than each of the individual treatments.     

Why Mikey's right and my key's wrong: The significance of stress and word boundaries in a child's output system

The systematic errors children make in the course of phonological development, like adult production errors and adult phonological processes, can provide evidence of language production mechanisms. A detailed investigation of the environments in which velar stops are fronted by a phonologically delayed child reveals that fronting is dependent on both word stress and word boundaries; that it shows lexical exceptions; and that it occurs in output only. This distribution suggests that the child has output lexical representations which are independent of input lexical representations, and that the fronting error occurs in these output representations. It also suggests that prosodic features are crucial to the identification of articulatory features within these representations. Such an analysis has implications for theories of lexical access, and for the development of lexical access in children.     

Speech disturbances in presenile dementia related to local cerebral blood flow abnormalities in the dominant hemisphere

Ten female patients, age 50–70 years, suffering from presenile dementia and showing signs of defective speech function were analyzed. All patients underwent measurements of regional cerebral blood flow (rCBF) by the xenon clearance technique using a 32-detector piece of equipment, and all showed a marked reduction of the hemisphere mean blood flow level. In addition, regional decreases of blood flow of the gray matter was demonstrated. Patients with a marked reduction in the temporo-parieto-occipital regions showed signs of receptive aphasia including alexia and agraphia. Patients with a marked frontal reduction showed signs of expressive aphasia of various types including stereotyped language, voluble speech, echolalia, and mutism in later stages. The results give further support to our previous conclusion that subsymptoms of presenile dementia, apparently also speech disturbances, can be related to local degenerative changes in the brain, which in their turn are accompanied by local reductions of the blood flow of the gray matter. There is pathoanatomical evidence to support this conclusion.     

The effects of differential reinforcement on generalized imitation

The present study examines the transfer of imitative learning to other nonimitative performance conditions and compares imitative and nonimitative performance under contingencies of differential reinforcement for S⁰ behavior, differential reinforcement for nonimitative behavior, and extinction. Many authors have suggested that a child's continued imitative performance of rewarded S^D and unrewarded S^Δ behavior is a function of subtle social cues or experimental demand present in most generalized imitation procedures. The two experiments presented here support that conclusion but also provide evidence that conclusions drawn from such generalized imitation studies were generally accurate. Even though a child's trial-by-trial imitative performance appeared to be a function of procedural artifacts, the child's later performance in the role of a model indicated that a functionally interdependent generalized response class of imitative behavior had been learned while the child imitated. As such, these experiments generally supported Baer's secondary reinforcement hypothesis for imitative performance and suggest that future research employ nonimitative tasks such as reversed imitation as a measure of imitative learning.     

Clinical Frequencies Recording System: Standardizing staff observations by event recording

Certain aspects of staff performance and resident behavior are less adequately assessed by standardized time sampling procedures than by complete recording of the incidence of specified events. An approach to gathering such data through systematizing the observations of clinical staff — the Clinical Frequencies Recording System — is described. Scores from the Clinical Frequencies System reflect the rate per opportunity with which individual behaviors are performed, with computer summarization providing higher-level behavioral indexes for research and evaluation purposes. Staff training and system implementation are discussed, and reliability and validity data from a system employed on two different treatment units over a period of several years are presented.The research reported in this article was supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health.Presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979, as part of a symposium on New assessment systems for residential treatment, management, research, and evaluation.     

21世纪医药卫生发展趋势

２１世纪是知识经济时代。以信息科学和生命科学为先导的信息革命贯穿整个时代,生物技术开创医学保健新纪元。人类基因组计划即将好成,基因奥秘即将被揭开。人们在基因水平上将阐明艾滋病,心血管病的发病机制。基础医学研究的前沿学科是：生物信息学及其带动的医学分子生物学,遗传学,免疫学、内分泌学、药理学和神经科学等。在临床和预防医学领域是：取代医学,器官移植,癌基因工程,老年医学,远程会诊等。预防医学则推动第三     

Principles of good clinical practice (GCP) in clinical research

Good Clinical Practice is an international quality standard for conducting trials that involve participation of human subjects. Currently, the most widely accepted international document forming the base for GCP is the ICH Harmonised Tripartite Guideline for GCP, which defines in detail the responsibilities and obligations of parties engaged in clinical research. The purpose of this paper is to analyse how compliance with GCP provides protection of the trial subjects and assures quality and credibility of the data obtained. An earlier version of this paper was presented at a symposium, Scientific Misconduct: An International Perspective, organised by The Medical University of Warsaw, 16 November, 1998.     

Stability of the Millon Clinical Multiaxial Inventory among psychiatric inpatients

This study investigated the stability of the Millon Clinical Multiaxial Inventory (MCMI) in a sample of psychiatric inpatients over a longer time period and from different perspectives than previous reliability studies. Test-retest reliability was assessed from three perspectives: correlation/regression, equivalence of dimensional structures across testings upon different admissions, and stability of personality style across testings. Some stability from a correlational perspective was found, with higher stability estimates indicated for the basic personality scales in comparison with the clinical symptom scales which is consistent with Millon's theory. The internal structure of the MCMI was essentially identical across testings. Although source of reinforcement and instrumental or coping style were stable across testings beyond chance, the MCMI profiles of a considerable number of subjects were inconsistent across testings. Correspondingly, clinicians should be cautious in using the MCMI to make categorical decisions regarding personality style with inpatients who are tested at admission and who have had repeated hospitalizations.