The detection and management of mental health disorders in pediatric primary care

We reviewed the literature on the detection and management of mental health disorders within the context of pediatric primary care. Pediatricians have displayed a low sensitivity and high specificity in research investigating the detection of mental health impairment in children. Active management efforts characterize approaches to identified cases with more recently trained primary care pediatricians displaying a wider range of skills in managing mental health disorders. Few efforts have been made by pediatric psychologists to develop strategies for enhancing detection rates and management or to empirically evaluate the integration of pediatric psychology services into the primary care context. A conceptual model of factors influencing detection rates and ongoing management of mental health disorders within pediatric primary care is presented. Recommendations are made for more direct involvement of pediatric psychologists within the primary care context.     

Primary and secondary reflection in existential family therapy

The author uses Gabriel Marcel's topology of primary and secondary thought to clarify and outline the process of reflection in Existential Family Therapy. Clinical material is used to illustrate the differences between primary and secondary reflection during the practice of Existential Family Therapy.     

汉字阅读材料的不同排列组合对字词认知速度及准确性的影响

本研究探讨了汉字阅读材料的不同组合对字词认知速度及准确性的影响。实验材料是一篇３２０个字的短文阅读材料,分成三种不同组合形式让被试从左往右发声念读．一种是顺意排列材料形式（即文章句子符合句法及词意）,一种是逆意排列材料形式（即将文章的字词逆反排列）;一种是随机排列材料形式（即将全文字词打乱随机排列）。实验结果表明：对顺意排列材料的念读效果最好,念读速度及准确性明显高于另外两种材料组合形式;中青年组被试的结果明显优于老年组及儿童组的结果．结果提示,对字词念读的认知加工过程明显受相邻字词关系的影响及字词句子化的影响．     

Social-Cognitive and Behavioral Correlates of Aggression and Victimization in Boys' Play Groups

A contrived play group procedure was utilized to examine the behavioral and social-cognitive correlates of reactive aggression, proactive aggression, and victimization via peers. Eleven play groups, each of which consisted of six familiar African-American 8-year-old boys, met for 45-min sessions on five consecutive days. Social-cognitive interviews were conducted following the second and fourth sessions. Play group interactions were videotaped and examined by trained observers. High rates of proactive aggression were associated with positive outcome expectancies for aggression/assertion, frequent displays of assertive social behavior, and low rates of submissive behavior. Reactive aggression was associated with hostile attributional tendencies and frequent victimization by peers. Victimization was associated with submissive behavior, hostile attributional bias, reactive aggression, and negative outcome expectations for aggression/assertion. These results demonstrate that there is a theoretically coherent and empirically distinct set of correlates associated with each of the examined aggression subtypes, and with victimization by peers.     

结果预期与结果反应对儿童意图认知和道德判断的影响

考察了结果预期与结果反应对儿童意图认知和道德判断的影响。结果表明,结果预期影响幼儿园和小学儿童的意图认知,结果反应仅影响幼儿园儿童的意图认知;结果预期和结果反应显著地影响幼儿园和小学儿童的道德判断,但结果预期对小学儿童道德判断的影响要比结果反应大。     

A biopsychosocial therapeutic approach in a private outpatient clinic in Portugal

Patients with chronic stress and ambiguous symptoms are likely to be more frequent in primary care. Somatizers represent 75.8% of the patients in this study and executives 56% of the sample. Job stressors were present in 78.3% of executive men. This scenario suggests that the primary care physician has to be academically better prepared to fully understand and deal with stress problems in daily clinical practice. The physician must have skills to deal with stress at a curative and preventive level, extending those skills to the workplace.     

Psychopathy and structure of primary mental abilities

The Comprehensive Ability Battery (CAB) was used to assess 18 primary mental abilities in 53 white, male prison inmates for whom highly reliable ratings of psychopathy were available. None of the correlations between ratings of psychopathy and scores on the CAB tests was significant, and the overall pattern or structure of abilities was the same for inmates with low and high ratings of psychopathy. The possibility is raised that the personality characteristics of psychopaths make them appear to be brighter and more creative than they actually are. Compared with norms for male high school students, the inmates as a group generally performed well, falling near the 50th percentile on 11 of the tests. The inmates performed significantly better than the normative sample on tests of verbal ability, esthetic judgment, aiming, and representational drawing, and significantly worse on tests of ideational fluency, spontaneous flexibility, and word fluency.This research was supported by Grant MT-4511 from the Medical Research Council of Canada.     

Peer tutoring among elementary students: educational benefits to the tutor

To determine whether tutoring might be academically beneficial to the tutor, this study investigated the acquisition of spelling words by three elementary students in a peer tutoring program. The experimental design allowed a simultaneous comparison of each child's gain in performance on comparable word lists on which the child tutored another child, was tutored by another child, or neither gave nor received tutoring. The children's spelling improved nearly an equivalent amount on those words on which they tutored another child as on the words on which they were tutored; no such change was noted on the words on which they neither gave nor received tutoring. These findings, that peer tutoring is profitable for the tutor as well as the tutee, provide a basis for recommending peer tutoring as one method of individualizing education.     

THE EFFECTS OF A GOOD-BEHAVIOR CONTRACT ON THE CLASSROOM BEHAVIORS OF SIXTH-GRADE STUDENTS1

The effects of a good-behavior contract on the on-task behavior, disruptive behavior, daily assignment completion, and weekly grades of four sixth-grade students were examined in a public school classroom. The contract consisted of presenting the students with a list of good conduct and assignment completion goals and a list of disruptive behaviors coupled with a list of rewards and penalties that could be earned. The rewards and penalties made use of existing facilities and classroom privileges. At the beginning of each morning work period, the teacher negotiated the good-behavior contract with each experimental subject. During the negotiations, the teacher emphasized student self-management and encouraged each student to earn a reward by achieving the good-conduct goals and completing the contract assignments. An isolated work area was provided to allow students the opportunity to remove themselves from their desks for a fixed period of 15 min. At the end of the work period, the teacher determined whether each student earned a choice of reward or penalty dependent on assignment completion and whether the teacher had observed disruptive behaviors. Thus, the contract permitted the student to negotiate the goal behaviors and contingencies with the teacher. Throughout the study, the students were in agreement with the teacher on whether a choice of reward or penalty had been earned. The contract was introduced for different children at different times, constituting a multiple-baseline analysis. On-task behavior and daily assignment completion increased, weekly grades were higher, and disruptive behavior decreased when the contract was in effect. Three contrast subjects were selected from the class as model students who consistently produced acceptable assignments and who did not engage in high rates of disruptive and/or off-task behaviors. When the contract was in effect for the experimental subjects, their performance compared favorably with the contrast subjects, who never received the daily contract. The results demonstrated that the contract was effective within the confines of the facilities and contingencies readily available in a public school classroom setting.     

Synapses,Schizophrenia, and Civilization: What Made Homo Sapient?

Progress in technology has allowed dynamic research on the development of the human brain that has revolutionized concepts. Particularly, the notions of plasticity, neuronal selection, and the effects of afferent stimuli have entered into thinking about brain development. Here I focus on development from the age of four years to early adulthood, during which a 30 percent reduction in some brain synapses occurs that is out of proportion to changes in neuronal numbers. This corresponds temporally with changes in normal child behavior from the loose‐associative, almost schizoid, thinking and art of the four‐year‐old to the more trained, or disciplined, or acculturated—and restrained—personality of the young adult. I propose that the synaptic changes can best be thought of as a winnowing process likely subject to environmental influences. Acquisition of language and the ability to link linguistic cognition to the plastic development of the brain provide a potentially powerful means of explaining the evolutionally explosive development of human cognition and culture. Schizophrenia, a disease that can be envisioned as representing a derangement of synaptic maturation, may provide an entry into the search for genes controlling the processes mediating the unprecedented development of Homo sapiens over the past 40,000 to 70,000 years. The recently completed mapping of the genome of the chimpanzee provides a new frame of reference that may speed the search.