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In this report, the authors examine the problems of specific languages in medical, psychiatric and psychologic practice. They emphasize a specific epistemological view to be able to capture the distinction between clinical tongue, common parlance and specific languages.
The subject of this paper are fundamental positions, concerning the contents, and empirical results of 15 years time, concerning the dynamic-orientated single psychotherapy for youth and young adult enuretics. It is supported by analyses of 15 years time in the medical-psychological practice. From a sample of, all in all, 250 patients, the results of a group of 55 patients at the age of 15-21 years are shown, who were treated with dynamic-orientated single-psychotherapy, and are discussed with an emphasis on the integrative, biopsychosocial character of this illness. Enuresis nocturna is being regarded consequently as a special psychomatic complex phenomenon, and the empiric results are being interpreted with orientation to theory. There have been applied several test-methods for the purpose of inter-groupal pre-post-analyses, before and after the treatment with a duration of katamnese of 6 months. Statements concerning the efficiency, as well as essential changes of parameters in the course of the psychotherapy are special subject of result-related discussions. The results certify, that contential-specific, age-differentiated emotional and social aspects of personality and reflexion are getting very significantly changed in the course of the successful or partly successful therapy, while in the cases of the non-successfully treated patients no changes in such manner could be obtained.
The ethical ground for restoration (returning a patient to healthy form and function) differs from enhancement (using medical means to improve appearance). Physicians and dentists who argue that enhancements improve self-esteem must reconcile this claim with the fact that they are not licensed to practice psychology. The extreme views are that doctors either should provide cosmetic services as requested by patients or they should not. The middle position is that doctors must retain their fiduciary position of trust based on professional judgment and advocating for patients' health interests. Patient health always outweighs patients' cosmetic desires.
A child's relationship to both parents in divorcing families is discussed on the background of attachment research. Empirical data emphasize the effects of quality of attachment to both parents on child development, which arises out of the absence or the provision of a secure base. As a consequence the child develops internal working models of attachment figures and self, which is increasingly individually organized during the preschool years and shows considerable continuity throughout early and middle childhood. Adverse effects on attachment and its internal representations are expected to the degree to which through divorce the provision of a secure base is impaired. In psychological practice, parents have to be helped not only in balancing their adult conflicts but in providing a secure base for their children, without missusing them as alies or exposing them to pathological form of parentificaiton. All those are important issues of contextual therapy, which usefullness is especially discussed with respect to its key concept "multidirected partiality".
The guiding topic of this report was "the value and importance of intracavitary therapy in uterine cervix carcinoma". This implies first of all the task to assess the importance of contact therapy within the scope of all therapeutic measures taken in case of uterine cervix carcinoma. Furthermore it was necessary to compare the importance of the different methods of contact therapy: conventional radium therapy as well as low dose rate and high dose rate afterloading techniques. As to surgical intervention, it is clear that only favorable stages can be taken into consideration for this treatment. It is shown by means of data taken from the Annual Report, Vol. 18, that a considerable number of patients with uterine cervix carcinoma I are irradiated even in hospitals whose field of activity lies preponderantly in surgery, and that by far most of the patients cured from uterine cervix cancer owe their recovery to contact therapy. The consideration of contact therapy methods shows clearly that radium should no longer be used in clinical practice. Psychological doubts often hinder the decision if long-term or short-term afterloading therapy is to be applied. It is therefore shown that the very different forms of radium therapy with their chronological and spatial dose distribution were due to the characteristics of radium (e.g. little specific activity) or to other compelling features and that they were not based on radiobiological aspects. The radium dose values obtained by empirical research and the resulting spatial and chronological dose distribution are therefore not imperative. So it is not inevitable to choose the low dose rate afterloading method. On the contrary, the high dose rate technique with an adequate fractionation is very probably the method of choice. To sum up it can be said that contact therapy is still the most important therapeutic method in uterine cervix cancer.
Affective crimes constitute a difficult and important problem in forensic psychiatry. After a short historical overview, a number of important problems are discussed and controversial notions frequently used in psychiatric-psychological practice are critically assessed in a postulate-like manner. Finally, some basic propositions are outlined in order to facilitate evaluation of affective crimes.
Preconditioning experience with the unconditional stimulus (UCS) retards subsequent excitatory conditioning. Three experiments demonstrated that this UCS retardation effect is attenuated by associative manipulations of contextual stimuli of the UCS preexposure environment. The UCS retardation effect was reduced by (a) altering contextual stimuli between preexposure and conditioning (Experiment 1), (b) latently inhibiting contextual stimuli prior to UCS preexposure (Experiment 2), and (c) extinguishing contextual stimuli subsequent to UCS preexposure (Experiment 3). Although UCS preexposure retarded excitatory conditioning, the results of Experiment 4 demonstrated that UCS preexposure facilitated inhibitory conditioning. These results indicate that an association between contextual stimuli and the preexposed UCS contributes to the effects of preconditioning UCS experience on subsequent learning.
Two experiments are reported which investigate the speed of contextual conditioning in autoshaping. In both experiments, a procedure was employed in which ring doves were magazine trained in one context prior to the manipulation of background values in a second context. In Experiment 1, subjects were exposed to 4, 8, 64, 128, or 256 US-only presentations prior to autoshaping. Acquisition speed and maintained response measures were monotonically related to the number of pretraining trials. Subjects in Group 4 acquired the key-peck response fastest, and retardation was maximal within 64 pretraining trials. In Experiment 2, subjects given 20 pretraining trials were significantly more retarded than subjects given 2 pretraining trials, but only when pretraining and testing were conducted in the same context. Overall, the results of these experiments show that in autoshaping, contextual conditioning is very rapid; this demonstrates the plausibility of theoretical accounts of Pavlovian conditioning which assert that the development of the conditioned response depends on the associative values of both the CS and background stimuli.
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Greater persistence in extinction is observed following inconsistent reward compared to that observed following consistent reward, an effect termed the partial reinforcement extinction effect (PREE). We report three experiments in which the extinction rates of random partially reinforced (PRF) or continuously reinforced (CRF) infant rat pups were compared to the extinction rate of pups trained with an alternative and regular schedule of partial reinforcement, known as patterned single alternation (PSA). In PSA, subjects learn to alternate speed of responding in anticipation of the regular alternation of reward and nonreward trials in the straight alley runway. In Experiment 1, 17-day-old PSA subjects showed CRF-like extinction rates; whereas in Experiment 2, in which extinction was initiated early in training prior to the onset of the PSA discrimination, PSA subjects showed prolonged, PRF-like extinction curves. In contrast, 12-day-old pups in Experiment 3 showed no reward-schedule-related differences in extinction, despite differences in behavior during acquisition. These results prompt a modification of Amsel's (1962) model of discrimination learning, and suggest the existence of a dissociation between different types of reward-related expectancies in the younger subjects.
BACKGROUND: The general practitioner (GP) has traditionally been the first port of call for people with psychiatric morbidity but increasingly other members of the primary care team see the patients first, particularly practice nurses. The numbers and roles of practice nurses have expanded greatly over the past decade and it is important that practice nurses are able to recognize patients with psychiatric morbidity. This paper reports a study to determine the abilities of 24 practice nurses to detect psychiatric morbidity in patients attending their clinics. METHODS: Twenty-four practices were randomly selected from 41 practices recruited from South London and Kent. One nurse per practice took part in the study. Patients were asked to complete a 12-item General Health Questionnaire (GHQ-12) while waiting for their appointment with the practice nurse. Following their consultation, the practice nurse rated the patients' level of psychological distress on a five-point rating scale. RESULTS: The response rate of patients was 97% (N= 1710). The GHQ case rate was 36%. The mean detection rate by practice nurses when identifying significant distress was 16% (between nurse variation, 0% to 61%). The mean specificity was 96% (variation 77% to 100%). A second analysis, changing the nurse criterion to recognition of distress increased the mean sensitivity rate to 58% (variation 31% to 84%) but the mean specificity rate decreased to 66% (variation 26% to 95%). CONCLUSIONS: These results demonstrate that practice nurses' caseloads include a high proportion of patients with psychiatric morbidity and that agreement with the GHQ classification of psychiatric morbidity is modest. Therefore, training in detection will be crucial for the nurses.
By 1994, Health Psychology had been established as a discipline, and defined by Marie Johnston as the scientific study of the psychological processes and behaviour in health, illness and health care. Health Psychology, so far, has mainly related to the adult population, although increasing attention is now being paid to both pediatric and broadly-based child health psychology. It is noteworthy that attention devoted to pediatric and child health psychology has increased dramatically, but the great majority of published work refers to the child and not to the preterm neonate; yet being preterm means being born early, and sometimes too small, and is a stressful life event. In the field of Medicine, Neonatology has appeared as a sub-discipline, and both investigates and cares for at-risk babies, including risk for developmental disabilities. The time is consequently opportune for psychology to make an effective contribution to both the theory and care of the preterm neonate, viewed as a unique, emergent, coactional and hierarchical human being. The formal framework for this is Neonatal Health Psychology (NNHP), which is defined in the article as 'the scientific study of biopsychosocial and behavioural processes in health, illness, and health care of the preterm (and fullterm) neonate during his/her first 28 days of life, and the relationship of such processes with later outcome.' Early work in this category has shown that NNHP has profound interdisciplinary connotations, not least because of the diverse ways in which information has to be derived from the non-verbal neonates. The pathways and scope of NNHP are identified, and many examples of work with preterm neonates are summarised in the article. In making the case for the professional formalization of NNHP, descriptions are given of Neonatal Assessments and very-early interventions; the interdisciplinary character of much of the early work is shown to have been essential. Indication of theoretical frameworks for NNHP is given.
The authors, who support in principle the important goal of integrated psychological and physical care, discuss five sources of difficulty in the practical application of such integration: 1) differences in values and, consequently, in systems of practice, 2) training influences, 3) differences in dealing with emotions, 4) conflicting patient expectations, and 5) limitations on the degree of intimacy tolerable in professional relationships. They suggest that practitioners and educators take these difficulties into account without abandoning a holistic perspective.
As a confluence of unique values and activities, the collective practice of community psychology is difficult to characterize in a simple way. Increasingly, however, professional contexts are laden with pressure to define any practice--from library work to medical interventions--in the orderly, compact language of traditional science. This trend has historically been resisted in the field by those sensing a fundamental lack of fit between the fluid, emergent aspects of community psychological practice and the fixed, precise language of classic science. In response to this "language-practice gap," some have attempted to adapt the traditional language of science to better fit the field's practice, while others have explored alternative languages of practice seemingly more indigenous to the messy "swamp" of actual communities. While the former effort leaves some theoretical contradictions intact, the latter tends to discount scientific identity entirely. This paper proposes a potential step forward by resituating questions of disciplinary language and identity within a current philosophical discourse where the nature of social science itself remains sharply contested. This suggests shifting attention away from "should we be a science?" to "what kind of science might we be after all?"; in turn, alternative languages may be re-cast as legitimate contributors to a kind of science more authentic to human communities--even a viable "science in the swamp." One such language-philosophical hermeneutics--is presented as a particularly valuable supplement to traditional science. Illustrations highlight ways that hermeneutics may advance the formal language of the field towards a closer fit of what actually happens in practice, while preserving and even bolstering the empirical rigor and scientific identity of the field.
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The aim of this paper was to describe current research practices in the study of the psychology of aging. A total of 263 articles published in the Psychological Sciences Section of the Journal of Gerontology was examined in terms of subject-selection procedures, sample characteristics, author characteristics, data analysis techniques, research design, and specific area of research. Compared with an earlier survey, it was observed that research practices have improved with regard to sample representativeness of the age variable and the appropriate use of statistics, especially use of multivariate and regression analyses. Fifty-six percent of the studies surveyed were classified as cognitive investigations, and many of these studies were conducted from an information-processing perspective. A need for more detailed description by authors of subject-selection procedures and subject characteristics was noted.