Dynamical concurrent schedules

Previous work on the matching law has predominantly focused on the molar effects of the contingency by examining only one reinforcer ratio for extended periods. Responses are distributed as a function of reinforcer ratios under these static conditions. But the outcome under a dynamic condition in which reinforcer ratios change continuously has not been determined. The present study implemented concurrent variable-interval schedules that changed continuously across a fixed 5-min trial. The schedules were reciprocally interlocked. The variable interval for one key changed continuously from a variable-interval 15-s to a variable-interval 480-s, while the schedule for the other key changed from a variable-interval 480-s to a variable-interval 15-s. This dynamical concurrent schedule shifted behavior in the direction of matching response ratios to reinforcer ratios. Sensitivities derived from the generalized matching law were approximately 0.62, the mean absolute bias was approximately 0.11, and r2s were approximately 0.86. It was concluded that choice behavior can come to adapt to reinforcer ratios that change continuously over a relatively short time and that this change does not require extensive experience with a fixed reinforcer ratio. The results were seen as supportive of the view that all behavior constitutes choice.     

Family Functioning and the Course of Adolescent Bipolar Disorder

The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder, using longitudinal measures of family cohesion, adaptability, and conflict. Parent- and adolescent-reported symptom and family functioning data were collected from 58 families of adolescents with bipolar disorder (mean age = 14.48 ± 1.60; 33 female, 25 male) who participated in a 2-year randomized trial of family-focused treatment for adolescents (FFT-A). Cohesion and adaptability scores did not significantly change over the course of the study. Parent-reported conflict prior to psychosocial treatment moderated the treatment responses of families, such that high-conflict families participating in FFT-A demonstrated greater reductions in conflict over time than low-conflict families. Moreover, adolescent mania symptoms improved more rapidly in low-conflict than in high-conflict families. For all respondents, cohesion, adaptability, and conflict were longitudinally correlated with adolescents’ depression scores. Finally, decreases in parent-reported conflict also predicted decreases in adolescents’ manic symptoms over the 2-year study. Findings suggest that family cohesion, adaptability, and conflict may be useful predictors of the course of adolescent mood symptoms. Family conflict may be an important target for family intervention in early onset bipolar disorder.     

Support groups for parents with an adult child suffering from bipolar disorder

Confronted with the disconcerting behaviour exhibited by their children, parents of bipolar patients are in severe distress. Research focuses on the study of the ‘burden’ that the pathology puts on caregivers, owing to their experience of depression, sometimes combined with the presence of hostile attitudes and negative affects. In France, parents of adult patients encounter an initial specific difficulty: they are not systematically included in the care management system. Thanks to the initiative of an association of psychiatrists and psychoanalysts, the authors set up a psychoanalytic support group for the parents of ‘bipolar’ adults. The diagnosis of a bipolar disorder is established by a psychiatrist within a medical structure. Support groups for parents do exist in France, but their experiences have not led to scientific publications on this specific topic. Existing publications focus on other types of pathology and other therapeutic approaches. In this article, we will highlight how this type of psychoanalytic support group, with operating rules based on the theoretical work of Anzieu, can help parents of patients with bipolar disorders. Group participants accepted the principle of a research study that maintained their anonymity. We collected and analysed qualitative data from the first year of the group, so we highlight the specific difficulties of these parents, faced with chronic disease. The relevance of our qualitative study also resides in the data collected over a period of time, enabling us to see the progress made, and encouraging us to reflect on the place of psychoanalytic groups for parents, as well as on the care management of this pathology.     

Brightening His Days: A Reflective Single Case-Study of Social Integration and Recovery

Having been persuaded to change from an older to a newer generation antipsychotic, a gentleman with bipolar depression then had the potential to “recover his life,” which he did by utilizing occupational therapy interventions offered to him by occupational therapists in the UK National Health Service (NHS). This reflective case study illustrates how the combination of medical outpatient clinic and occupational therapy intervention together made a big difference in a person's life. Eleven key ingredients were reflected on as intentional strategies for helping him achieve his life goals.     

A Program Intervention for Pediatric Bipolar Disorder: Preliminary Results

The effectiveness of a behaviorally based day treatment program for young children diagnosed with Pediatric Bipolar Disorder (PBD) was evaluated using pretreatment and posttreatment mean scores from the Child Behavior Checklist (CBCL). Data were evaluated in aggregate and using the clinically significant change method for children diagnosed with PBD, Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Adjustment Disorder, and no diagnosis/clinical and subclinical groups. Significant effects were found for all groups except the no diagnosis/subclinical group on the Internalizing scale and for all groups on the Externalizing scale. Clinically significant change was supported for the PBD, ADHD, ODD, and Adjustment Disorder groups. Implications and limitations of the study are discussed.     

Psychiatric Disorders and Childhood Parental Loss in Obesity: Relationship with the Mode of Weight Gain

We assessed the association between psychiatric disorders, childhood parental loss, and weight gain mode in 150 obese patients seeking bariatric surgery and with a history of sudden or gradual weight gain mode. Subjects with sudden weight gain mode (47%) showed significantly higher bipolar II disorder (p < .001), childhood parental death (p < .01), and separation (p < .01), but lower pure hypomania (p < .001) prevalence than subjects with gradual weight gain mode. We found preliminary evidence that lifetime bipolar spectrum disorders and childhood parental loss may influence weight gain mode in obese subjects. These findings may contribute to predict patients’ weight trajectories and implement preventive interventions.     

双相障碍及其社会-心理治疗的研究现状

双相障碍是以起伏性躁狂或抑郁为特征的慢性周期性精神疾病。近年来,社会-心理疗法作为药物治疗的辅助手段被引入到该类疾病的治疗过程中。本文基于近期关于双相障碍的病因学的研究,评述了各种不同形式的社会-心理疗法在双相障碍治疗中的应用及其疗效,指出今后的研究需要进行严格的临床设计,以保证不同研究间的可比性和可重复性;应尽可能延长追踪观察的时间,并进行大样本多变量研究,以保证研究结果的普遍性。     

积极与消极情绪关系的理论及研究

积极与消极情绪的关系一直是情绪领域中最引人注目的焦点之一。该文介绍了探讨积极与消极情绪关系的模型及相关的证据,包括以下4个方面的内容：（1）情绪的双极模型及相关证据;（2）情绪的双变量模型及相关证据;（3）情绪的混合模型及相关证据;（4）解决各种模型争论的新视角：条件决定论。文章最后分析了该领域研究的不足,并提出了未来研究的方向     

Mood and Creativity over Time in a Bipolar Participant

When depression alternates with mania, as in a bipolar affective disorder, creativity might be enhanced. To investigate this, we employed a single‐subject design, looking at both affective space and the spectral covariation of mood and creativity in a participant presenting with bipolar affective disorder. The study was conducted over a period of 54 days, and employed a standard measure of mood (the Brief Mood Introspection Scale) and a standard task of creativity (Alternative Uses Task). Both positive affect and negative affect appear to be somewhat undifferentiated for this participant, and her mood space does not conform to that described by the accepted major dimensions of Arousal and Pleasure. Conceivably, this is because of her rapid mood fluctuations. A 2.7‐day periodicity was found for Tired, Peppy, Nervous, and Calm, on the one hand, and ideational fluency, ideational flexibility, and originality, on the other. In addition, a 9‐day periodicity was common to Happy, Sad, and Gloomy—all three affects clustering in the same affective space—together with both ideational flexibility and originality. This finding brings into question the relationship between creativity and both positive and negative mood.     

Who are the comorbid adolescents? Agreement between psychiatric diagnosis,youth, parent,and teacher report

The investigators examined the rates of psychiatric comorbidity for externalizing and internalizing behavior problems, using semistructured diagnostic interview and parent, teacher, and youth report on the Achenbach checklists. The study also evaluated the effects of conjunctive, compensatory, and disjunctive data combination strategies. Using the same data and identical diagnostic thresholds, between 5 and 74% of 189 youths presenting to an outpatient clinic were identified as having comorbid internalizing and externalizing problems. Parent report and semistructured interview indicated the highest comorbidity rates. Despite good cross-source agreement (rs .29–.58), there was very little agreement about which specific youths presented with comorbid internalizing and externalizing problems (kappas .14–.40). Results also indicate that single DSM-IV disorders, such as bipolar disorder, can manifest comorbid patterns of behavior problems on checklists.