Biology of elderly suicide.

Most studies of suicide in younger patients have demonstrated significant alterations in the serotonin system. Although a high percentage of completed suicides occur in late-life, to date very few studies of the biology of suicide have focused on this age group. This chapter describes age-related changes in the central nervous system pertinent to the biology of suicide, then reviews post-mortem biological studies of the brains of suicides and suicide attempters. As suicide attempts in the elderly are characterized by the use of violent means, biologic studies of impulsive violence are discussed. Finally we describe data on the effect of degenerative diseases on the serotonin system and the possible link to increased suicidal behavior in affected patients. This review underscores the need for further study of the biology of suicide in the geriatric age group.     

Frontal cortex grafts have opposite effects at different postoperative recovery times

We studied the effect of different postoperative times on the behavioral recovery following brain implants. Adult male rats received cortical tissue grafts 2 weeks after aspiration of the medial frontal cortex. Either 2 (Immediate Group) or 28 (Delay Group) days after grafting, the performance of these rats on a behavioral battery, comprising the Morris water maze task, forepaw use, and grooming, was compared to that of rats with similar lesions and postoperative recovery times but no grafts. Rats tested immediately after receiving implants performed better on the spatial navigation task than rats with similar lesions but no grafts. This improvement, however, was less than that shown by rats with lesions but no grafts permitted to recover for 28 days before testing. In contrast, in the Delay Group, rats with grafts were more greatly impaired than were their operated controls. Neither lesions nor grafts affected grooming although the Immediate Group with grafts were significantly more impaired in using their forepaws during feeding than were any of the other groups. These results lead us to conclude that differing postoperative recovery times and task requirements may account for some of the inconsistent results of the influence of brain grafts on behavioral recovery reported in the literature. We also conclude that cortical tissue implants can have two effects with different time courses and opposite net behavioral effects.     

Prediction of early social and academic adjustment of children from the inner city

Investigated predictors of five measures of early school adjustment for an ethnically diverse cohort of 683 inner-city kindergartners and first graders. Data from 2 consecutive years were collected from teachers, school records, and children. A multiple-regression preduction model significantly explained children's competence behavior, problem behavior, reading achievement, mathematics achievement, and school absences. Prior adjustment and sociodemographic factors explained a majority of the variance in adjustment. Perceived quality of parent involvement was signifcantly related (in the expected direction) to all five outcomes. Exposure to life events was significantly associated in the expected direction with competence behavior, problem behavior, and school absences but not with reading and mathematics achievement. Together, parent involvement and life-event variables explained as much as 12% of the variance in adjustment independent of sociodemographic and prior adjustment factors. The role of family and school factors in the adjustment of children at risk is discussed [corrected].     

Chronic stress, leukocyte subpopulations, and humoral response to latent viruses

Psychological stress has been shown to affect immune system status and function, but most studies of this relationship have focused on acute stress and/or laboratory situations. The present study compared total numbers of leukocytes and lymphocyte subpopulations (determined by flow cytometry) and antibody titers to latent and nonlatent viruses among a group of chronically stressed individuals living near the damaged Three Mile Island (TMI) nuclear power plant with those of a demographically comparable control group. Urinary catecholamine and cortisol levels were also examined. Residents of the TMI area exhibited greater numbers of neutrophils, which were positively correlated with epinephrine levels. The TMI group also exhibited fewer B lymphocytes, T-suppressor/cytotoxic lymphocytes, and natural killer cells. Antibody titers to herpes simplex were significantly different across groups as well, whereas titers to nonlatent rubella virus as well as IgG and IgM levels were comparable.     

Profile analysis of standardized intelligence test performance of very low functioning individuals

Practitioners are frequently faced with the need to evaluate the intellectual skills of individuals with very low levels of functioning. Owing to the statistical rarity of these persons, few tests have sufficient range of scores for a detailed analysis of intraindividual differences in performance. This paper describes a method that uses are equivalents and standard scores to recreate the full range of variability in the scores of low-functioning individuals. The method allows for a more complete interpretation of performance that can lead to better educational and therapeutic programming.     

A comparison of the relative efficacy of self-control therapy and a behavioral problem-solving therapy for depression in children

Twenty-nine children 9 to 12 years old who were identified as moderately to severely depressed using the Children's Depression Inventory were randomly assigned to either a self-control, behavioral problem-solving, or waiting list condition. The self-control treatment focused on teaching children self-management skills. The behavioral problem-solving therapy consisted of education, self-monitoring of pleasant events, and group problem solving directed toward improving social behavior. Subjects were assessed pre-and posttreatment and at 8-week follow-up with multiple assessment procedures and from multiple perspectives. At posttreatment, subjects in both active treatments reported significant improvement on self-report and interview measures of depression while subjects in the waiting list condition reported minimal change. Results were maintained at follow-up. The general success of the experimental treatments was discussed and recommendations for further treatment components were provided.Second authorship on this article is shared by Drs. Reynolds and Kaslow. The authors would like to thank Mr. Ed Guzwieski, Principal, and the teachers of Oregon Middle School for their cooperation with this study. The authors also would like to thank Mary Wysopal for conducting the posttreatment and follow-up interviews, and Carol Fairbanks for rating the audiotapes.     

Adjustment to hemodialysis treatment through behavioral controls

The present study was conducted to examine the hypothesis that compliant chronically ill patients, typically described as adjusted, reinforce more positive social environments using behavioral controls than noncompliant patients, typically described as maladjusted. Specifically, it is hypothesized that diet-compliant chronic hemodialysis patients emit significnatly more active involvement-in-treatment behaviors and more social behaviors than diet-noncompliant chronic hemodialysis patients. Subjects, who ranged in age from 30 to 77 years, were outpatients at a kidney center. Behavioral observations were conducted to assess the occurrence or frequency of (1) four involvement-in-treatment behaviors that are routinely taught to all patients and (2) two social behaviors, which were patient verbalizations and smiles. The results showed that compliant patients emitted significantly more involvement-in-treatment behaviors and smiles than noncompliant patients. Results support the proposed control framework that compliant, in contrast to non-compliant, chronically ill patients have recourse through positive behavioral controls when adjusting to the stresses of illness. It was proposed that through these controls, compliant patients reinforce positive environments rather than simply respond to life circumstances as given.     

Referrals to school psychologists: A national survey

School psychologists serving a national, systematic sample of public elementary and secondary schools were surveyed regarding recent referrals. Most referrals were initiated by school staff members (75% of referrals), and the majority occured initially through formal mechanisms (55% of referrals). Most informal requests for assistance or information eventually became, or were thought likely to become, formal referrals. In 92% of cases, the referral agent's initial communication with the psychologist included some designation of what the pupil was doing or not doing that was viewed as problematic. Poor academic performance was of primary concern in 52% of referrals and social/emotional problems in 31%. More boys were referred than girls, and one-half of referrals from the elementary grades involved pupils in grades K-2. Frequency of referral and reason for referral were not independent of pupil's grade or sex. Reason for referral was independent of time of year (October vs. May) and geographical region.     

PRIMARY ENCOPRESIS: EVALUATION AND TREATMENT

Cathartic and behavioral treatment procedures for eliminating diurnal and nocturnal primary encopresis were investigated using a multiple-baseline design across four children. The dependent and independent variables measured were appropriate bowel movements, soiling accidents, independent toiletings, and cathartic use. Over 177 reliability observations (home visits) were conducted. For two of the children, treatment with cathartics and child-time remedied their soiling accidents and increased their independent toiletings in 8 to 11 weeks. While the cathartics and child-time increased the rate of appropriate bowel movements, they did not eliminate the soiling accidents with the other two children. Independent toiletings for these two children were achieved after 32 to 39 weeks of treatment when punishment procedures (positive practice, time-out, and hourly toilet sits) were incorporated and the suppositories were faded systematically.     

Factor analysis of the Wechsler adult intelligence scale-revised (WAIS-R): An examination of the standardization sample

Orthogonal and oblique factor analyses were performed using the Wechsler Adult Intelligence Scale-Revised (WAIS-R) standardization sample (Wechsler, 1981). Using objective criteria, it was decided to retain two factors. Evidence for a strong general intelligence (g) factor was found from both the orthogonal and oblique rotations. Whereas the verbal IQ provided an acceptable estimate of the Verbal Comprehension factor, a purer measure was found in the form of a Verbal Comprehension Deviation Quotient containing only the Information, Vocabulary, Comprehension, and Similarities subtests. The performance IQ was found to be an inadequate measure of the Perceptual Organization factor. A Perceptual Organization Deviation Quotient, containing only the Block Design and Object Assembly subtests, was recommended as an effective alternative. Analysis of the variance components for each subtest at every age level revealed that a substantial proportion of subtests at a wide range of age levels evidence either high or intermediate levels of specific variance. These results are discussed in terms of interpreting individual subtest scores and patterns. Each of the study's major findings are compared with prior work done with the Wechsler Adult Intelligence Scale (WAIS) (Wechsler, 1955).