The gestural repertoire and its evolution over the second year

The entire repertoire of communicative gestures was documented in a longitudinal, observational study of 10 infants, whose combined ages covered the range from 9 to 22 months. Early in the second year, giving as a request to do something with the object increased, while emotive gestures decreased. Later in the second year, pointing gestures increased, while protest gestures tended to decrease. Combining gestures with vocalization tended to increase only for protest gestures later in the second year. Eye contact showed a small but continuous increase in coordination with gestures over the second year, particularly with comment, request, and emotive gestures. These findings indicate an increasing use of the parent as an agent and of the informative function in non-verbal communication during this period of transition to verbal communication.     

Physicians and clergy in dialogue

The goals and ends of contemporary medicine are often unclear. An explicit inquiry into the religious dimensions of healing offers an important perspective from which to evaluate the potential capabilities of the medical profession. This paper describes a course in which medical students joined divinity students to explore areas of mutual intellectual, professional, and personal interest. Students and faculty examined in depth three broad areas in which medicine and religion share common ground: concepts of health and illness from the religious perspective, approaches to the understanding of suffering and meaning, and the shared professional stresses of physician and clergy.This paper comes from the Department of Medicine, Beth Israel Hospital, and the Division on Aging and the Program for the Analysis of Clinical Strategies, Harvard Medical School, and the West Roxbury-Brockton Veterans Administration Geriatric Research, Education and Clinical Center, Boston.     

Grouping and short-term memory: Different means and patterns of grouping

Two experiments, concerned with the improving effects of grouping on auditory short-term memory, are described. In the first, temporal grouping was found to improve recall considerably, but non-temporal grouping had a much smaller effect. Temporal grouping reduced the order errors more than other errors; it also changed the pattern of the order errors. Further, it altered the shape of the serial position curve of all errors. In the second experiment, irregular patterns of temporal grouping were found to be inferior to a regular pattern. The results are discussed in terms of the time available for processing previous items during the presentation of a sequence, and the form that this processing may take.     

Dispositional Optimism/Pessimism and Coping Strategies: Predictors of Psychosocial Adjustment of Rheumatoid and Osteoarthritis Patients1

Because rheumatoid arthritis (RA) has a more unpredictable course than osteoarthritis (OA), we hypothesized that generalized expectancies (optimistic/ pessimistic) influence the psychosocial adjustment of RA patients, whereas disease severity influences the adjustment of OA patients. Path analysis (LISREL VI) revealed that pessimistic RA patients (N= 107) and the more physically disabled OA patients (N= 108) reported poorer adjustment. The hypothesized mediating role of coping was supported for the RA but not the OA sample; that is, pessimism was associated with poor adjustment through greater use of wishful thinking coping. Unexpectedly, problem-solving coping was not found to mediate the optimism adjustment relationship.     

Being skeptical about the medical humanities

In this paper the author challenges the prevailing view that contemporary writing in the medical humanities is serving the needs of the various health care disciplines. The current medical humanities literature assumes that physicians are the appropriate target group. This is most notably the case within health care ethics literature. There appears to be an unexamined assumption that physician-centric approaches to clinical ethical decision-making are the standard by which appropriate ethical practice is judged. The author challenges this assumption and addresses the problems that this approach engenders. The medical humanities literature appears to reinforce hierarchical, patriarchal arrangements which are themselves not morally neutral.     

Prevalence of traumatic brain injury in an inpatient psychiatric population

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.     

Personality, stress, smoking, and genetic predisposition as synergistic risk factors for cancer and coronary heart disease.

Risk factors for cancer have been found in the past to act synergistically in a number of studies. However, these studies were not always designed to test the hypothesis of synergism, and have sometimes failed to equate for important variables, which might influence the results. The present study tests the hypothesis that psychosocial variables and physical ones (personality/stress, smoking, and genetic predisposition) interact in a synergistic fashion in the causation of lung cancer and coronary heart disease (CHD).     

Personality,stress, smoking,and genetic predisposition as synergistic risk factors for cancer and coronary heart disease

Risk factors for cancer have been found in the past to act synergistically in a number of studies. However, these studies were not always designed to test the hypothesis of synergism, and have sometimes failed to equate for important variables, which might influence the results. The present study tests the hypothesis that psychosocial variables and physical ones (personality/stress, smoking, and genetic predisposition) interact in a synergistic fashion in the causation of lung cancer and coronary heart disease (CHD).     

Who drops-out? Do measures of risk to self and to others predict unplanned endings in primary care counselling?

Aims: Unplanned endings, where clients unilaterally end therapy, are of concern for psychological therapy services generally as they raise questions about the appropriateness of the treatment and it's delivery for some clients. Limited available data indicates that those who drop-out often have more severe symptoms at entry, and have poorer clinical outcomes. This raises further questions about risk to self and others for those clients who leave therapy prematurely and how these clients might be identified and kept engaged. Method: This paper uses a large dataset of CORE data collected routinely in a primary care counselling service between 2000 and 2003. Logistic regression was utilised to consider different measures of risk and other client characteristics recorded at assessment to predict drop-out from the service. Results: These indicate that younger age, greater psychological distress at assessment, an addiction problem and greater risk to others, are associated with an unplanned ending. However, no reliable logistic regression model could be produced. This may be partly due to data quality issues or important characteristics not being available in the data. Implications for practice: The paper concludes that counsellors should actively seek to minimise unplanned endings, as amongst them may be represented the more distressed and risky clients referred to primary care counselling.     

A Safety and Coping Planning Intervention for Suicidal Adolescents in Acute Psychiatric Care

Transitioning from an acute psychiatric care setting to a less restrictive environment after a suicidal event is arguably the most critical period of suicide risk for adolescents, making comprehensive safety and coping plans for this population ever more critical. In this paper we provide theoretical and empirical rationale for the need for developmental adaptations to current safety planning procedures for suicidal adolescents, as well as the standardization of pediatric safety plans for broader use across settings that provide acute psychiatric care to adolescents. We describe how we developed the Adolescent Safety and Coping Plan (ASCP) using qualitative in-depth interviews with 20 adolescents and their parents, explain the specific components of the ASCP, and give a case example of the ASCP being used with a young adolescent and her parents. Finally, we conclude with a discussion of the barriers and facilitators of the use of the ASCP in settings that provide acute psychiatric care, as well as the need for future research to test the ASCP with diverse adolescent and family populations and settings.