Advances in psychiatry: medical model v. social model.
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Subjects exposed to social models dissimulating tolerance or intolerance generally exhibit matching behavior in their verbal ratings of painful stimulation. It has been unclear, however, whether these changes reflect voluntary alteration of evidence or genuine changes in distress. This study used alternative measures and controlled for methodological limitations of earlier studies by examining nonpalmar skin potential in addition to palmar skin conductance and heart rate indexes of psychophysiological response to electric shock, and by evaluating verbal expressions of pain with sensory decision theory methodology. Of 20 female volunteer subjects, half served as controls, and half were exposed to a tolerant female model. Both the subject and the model verbalized ratings of discomfort provoked by a series of electric shocks of increasing intensity. Subjects then underwent a series of preselected random shocks. Sensory decision theory analyses revealed lower discriminability of the shocks among subjects exposed to a tolerant model. Several indexes of nonpalmar skin potential and heart rate reactivity exhibited lower reactivity in the tolerant group. Tolerant modeling was also associated with decreases in subjective stress. The results were consistent with the position that changes in pain indexes associated with exposure to a tolerant model represented variations in fundamental characteristics of painful experiences as opposed to suppression of information.
Although certain social environments clearly facilitate alcohol intake in humans, the role of social factors in alcohol consumption by animals is less clear. While social housing conditions such as crowding and isolation increase alcohol consumption in animals, in both cases this is mediated by heightened stress. Increases in social tension increase alcohol consumption in social groups of animals, but the literature is extremely variable in reports of how dominance correlates with alcohol consumption. Alcohol administration has biphasic effects on social behavior of animals similar to its biphasic effects on activity levels. We report a novel, social animal model of alcoholism. Rats raised over prolonged periods in highly enriched, social colony environments develop a variety of rhythms of alcohol consumption. But in each colony, only a few animals develop into extreme overconsumers of alcohol, and the proportion of colony-housed animals that develop such excessive alcohol -consumption habits is similar to the proportion of humans with alcohol problems. These overconsumers of alcohol from a rat colony show a variety of alterations in behavior, including chronic inactivity and low dominance standing. They represent a novel, voluntary animal model of social alcoholism.
Much the most common models of HIV-related risk behaviour are those psychosocial models derived from studies of health behaviour and tested on large interview samples of American gay men. These models were not appropriate for understanding risk behaviour among 32 Glasgow male prostitutes. Whereas psycho-social models conceive of risk behaviour as volitional and individualistic, ethnographic data indicate that the male prostitutes' risk practices were constrained and emergent from the immediate circumstances of the sexual encounter. Unsafe sex was associated with client control. Safer sex was associated with countervailing prostitute strategies of influence. These data confirm the utility of self-empowerment approaches to health education.
We evaluated an 8- to 12-hour Health Belief Model-Social Learning Theory (HBM-SLT)-based sex education program against several community- and school-based interventions in a controlled field experiment. Data on sexual and contraceptive behavior were collected from 1,444 adolescents unselected for gender, race/ethnicity, or virginity status in a pretest-posttest design. Over 60% completed the one-year follow-up. Multivariate analyses were conducted separately for each preintervention virginity status by gender grouping. The results revealed differential program impacts. First, for preintervention virgins, there were no gender or intervention differences in abstinence maintenance over the follow-up year. Second, female preintervention Comparison program virgins used effective contraceptive methods more consistently than those who attended the HBM-SLT program (p less than 0.01); among males, the intervention programs were equally effective. Third, both interventions significantly increased contraceptive efficiency for teenagers who were sexually active before attending the programs. For males, the HBM-SLT program led to significantly greater follow-up contraceptive efficiency than the Comparison program with preintervention contraceptive efficiency controlled (p less than 0.05); for females, the programs produced equivalent improvement. Implications for program planning and evaluation are discussed.
It is argued that the analysis of social services in southern Appalachia benefits more from a model based on ethnicity than on more commonly used models based on lower socioeconomic status or rural residence. A theoretical model of ethnicity is generated which covers structural, cultural, and symbolic aspects. Results of an exploratory study of ethnic differences between Appalachians and non-Appalachians in a mountainous North Carolina county are presented which lend validity to the ethnicity model.
Long experience of defeat in daily social intermale confrontations and permanent living with aggressive males under sensory contact conditions [Kudryavtseva (8)] has been shown to produce changes in the patterns of submissive behavior of male mice of C57BL/6J strain. The submissive males after 20 defeats demonstrated passive defense postures instead of active defense and withdrawal which they had displayed in first encounters. Moreover, new immobile postures appeared, which were very rare in the first confrontations. Submissive animals displayed a decrease of ambulation in the open-field test and increase the immobility time in the Porsolt's test. Chronic treatment with imipramine prevented the increase of "depressiveness" estimated by means of the Porsolt's test. There was a loss of weight and some disturbances in gastrointestinal functions. The data are discussed in terms of the development of depression in submissive male C57BL/6J mice as a result of chronic unavoidable social stress.
Two experiments were conducted to assess the effect of social influence pressures on eating in individuals differing in initial hunger; we assumed that conformity to a model would decline as hunger increased. In the first experiment, subjects' eating conformed closely to the model's eating, with subjects eating very little when the model ate very little, even after 24 h of food deprivation. In a second experiment, the conformity effect again dominated the results, even after lengthy deprivation. We discuss the implications and limitations of this powerful modelling effect on eating.
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Interviewed 20 children with recurrent unexplained pain (UP) and 20 children with recurrent explained pain (EP) secondary to sickle cell anemia and their parents to determine the presence of models of pain or illness behavior in the child's environment. The location, intensity, frequency, and environmental consequences of the children's and the models' pain were also assessed. The hypothesis that UP Ss would identify more models was supported. In addition, UP Ss identified more positive consequences of the child's pain behavior while EP Ss identified more negative consequences. Children perceived the frequency and intensity of their pain to be similar to their models', while parents did not report such a relationship. Body location data suggest that children may model either general illness behavior or exact symptoms. Implications for future research are discussed.
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Social work is well-positioned to mount a major curriculum initiative focused on practice with the chronically mentally ill. The profession's historical legacy, conceptual compatibility with current service needs, and its significant contribution to practice and research are a firm base upon which to build. This paper suggests the content needed to adequately prepare future cadres of professionals and proposes a variety of curriculum strategies for organizing such content. In addition, attention is devoted to the preparation of management personnel.
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This paper reports on a project carried out by the author to assess strategies for hospital location in the Durham Health District, England. This project was set up in the context of a dispute on hospital strategy between the relevant Regional and Area Health Authorities and so the development of the dispute is outlined. This is followed by a summary of the work carried out in which some reservations about the techniques employed are put forward. The subsequent debates between the Regional and Area Health Authorities are also discussed. The paper concludes by raising more general issues concerning the role of the state and the use of knowledge in planning.
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