The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children*

This essay is based on a pilot study that examined the effects of managed care on the treatment of children and families, with special attention to community mental health. We embarked on the pilot study to test the accuracy and generalizability of our impression that family therapy and other systemic practices have been marginalized in ordinary clinics and agencies, and to understand the reasons why. We interviewed managed care providers, researchers, family therapy trainers, and clinicians in the Northeast. Our findings led to seven themes that support our impression that, even though there is a consensus about the need for coordinated family-based services, there is a disconnection between state policies, contractual requirements and what is actually occurring at the implementation level. This study suggests that our knowledge of human systems may be in danger of being disqualified and lost, with damaging consequences for the care of children. Yet, as systemic thinkers and practitioners, it is our belief that ethical and effective treatment need not be at odds with care that is cost-efficient. The direction of our future research will be to study whether the involvement of all stakeholders at all levels of planning and training leads to systemic family-based practices that consistently save costs and provide high-quality care.     

Solving the rod-and-frame test in a tachistoscopic presentation: Effects of stimulus size and perceptual style

This research was undertaken to demonstrate, with correlational evidence, that presenting the rod-and-frame test (RIT) with either limited (tachistoscopic) or unlimited (Oltman’s, 1968, portable RFT) exposure time does not significantly affect the ranking of subjects. The underlying hypothesis is that the intersubject variability of performance on the portable RFT is due essentially to differences in sensitivity to the optostatic vection that appears automatically and almost immediately. Results of the tachistoscopic test show that the effect of angular size of the stimulus is similar to that described in the literature for unlimited time situations, and that subjects’ ranking is very similar regardless of the exposure time (W = .80). However, although a difference is observed between the means of low and high achievers in both types of RFT, intraindividual intertask homogeneity (correlation coefficient) is not verified in each of these subgroups. From these results, one can distinguish two processes in the RFT: the first, vections, has to do with the subject’s postural orientation and seems to playa great role in organizing interindividual differences. The second process, a more cognitive one, has a less striking effect and has to do with the selection of reference frames in perceptual organization.     

The effect of a non-informative cueing signal in a three-choice reaction-time task

Summary Many studies have shown that in a simple reaction-time (RT) task a non-informative leading cue decreases RT to a subsequent target presented in the same region as the cue. This facilitation lasts about 150 ms; it is then replaced by a sustained inhibition. Experiment 1 tests the hypothesis that the initial facilitation is due to motor, rather than perceptual, processes by using choice RT. Facilitation is greater and lasts longer in choice than in simple tasks, thus supporting the hypothesis. Experiment 2 shows that facilitation occurs even when the subject actively orients his or her attention away from the cue.     

立体视觉的心理物理和VEP比较研究

心理物理试验是研究立体视觉的主要方法。70年代VEP开始用于体视研究,并取得许多结果。由于VEP信号复杂,这些结果不能令人满意。本文使用心理物理试验和VEP对比方法对体视加以研究。我们的结果是:VEP波形中第一个正峰与刺激图形的亮度有关;N_2峰和P_3峰的潜伏期对判断体视存在与否有重要价值;本试验确定N_2峰潜伏期在体视存在时约为240ms—280ms,无体视存在时约为290ms—310ms;P_3峰潜伏期在体视存在时约为280ms—310ms,无体视存在时约为340ms—360ms;体视存在时的VEP与无体视存在时的VEP的互相关系数小于0.1;有体视的VEP其功率谱密度在8Hz附近有一峰;心理物理试验中使用强制选择得到的结果从VEP波形比较中可以确认是可靠的;有体视的VEP其N_2和P_3的潜伏期随视差变化呈现规律性改变。     

Alternation behavior, spatial discrimination, and reversal disturbances following 6-hydroxydopamine lesions in the nucleus accumbens of the rat

The effects of dopaminergic depletion of the nucleus accumbens was tested in various behavioral tasks such as alternation, spatial discrimination, and reversal learning, and in an extinction paradigm in a T maze. Animals with lesions showed impairment of spontaneous alternation behavior, disturbances in the acquisition of spatial discrimination, and great difficulty in reversing previously learned habits. In the extinction phase, experimental animals are unable to adjust their behavior, and continue to choose the previously reinforced arm of the T maze. It is suggested that the nucleus accumbens plays an important role in the transition of motivation into action, and that dopamine has a facilitatory influence on the mediation of these processes.     

Disturbances in exploratory behavior and functional recovery in the Y and radial mazes following dopamine depletion of the lateral septum

The effects of 6-hydroxydopamine (6-OHDA) injected into the lateral septum in rats were investigated for spontaneous alternation behavior in a Y maze and for spatially oriented behavior in an 8-arm radial maze. The performance of the animals in these tests was assessed under two physiological states, food-satiated and food-deprived. The selective depletion of septal dopaminergic concentrations leads to behavioral disturbances in both the Y and the radial mazes. These deficits disappeared when the animals with 6-OHDA lesions were food-deprived. These results confirm other studies from our laboratory and support two conclusions. First, lesions of dopaminergic neurons lead to behavioral impairments which resemble those found after the total lesion of the structure they innervate. Second, these behavioral impairments are responsive to therapeutic treatments, manipulations of the internal or external environment, or the level of arousal, since under certain conditions a recovery of function can occur in the absence of dopaminergic neurons. These two points provide additional support for a nonspecific role for the dopaminergic neurons originating in the ventral tegmental area. These neurons could have a permissive role in the functioning of the forebrain structures they innervate.