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Use of cigarettes and alcohol by preschoolers while role-playing as adults: "Honey, have some smokes".

OBJECTIVE: To examine preschoolers' attitudes, expectations, and perceptions of tobacco and alcohol use. DESIGN: Structured observational study. Children used props and dolls to act out a social evening for adults. As part of the role play, each child selected items from a miniature grocery store stocked with 73 different products, including beer, wine, and cigarettes, for an evening with friends. SETTING: A behavioral laboratory at the Department of Psychological and Brain Sciences, Dartmouth College. PATIENTS: One hundred twenty children, 2 to 6 years old, participated individually in the role-playing. MAIN OUTCOME MEASURE: Whether or not a child purchased cigarettes or alcohol at the store. RESULTS: Children purchased a mean of 17 of the 73 products in the store. Thirty-four children (28.3%) bought cigarettes and 74 (61.7%) bought alcohol. Children were more likely to buy cigarettes if their parents smoked (adjusted odds ratio [OR], 3.90; 95% confidence interval [CI], 1.20-12.63). Children were more likely to buy beer or wine if their parents drank alcohol at least monthly (adjusted OR, 3.04; 95% CI, 1.02-9.10) or if they viewed PG-13- or R-rated movies (adjusted OR, 5.10; 95% CI, 1.14-22.90). Children's play behavior suggests that they are highly attentive to the use and enjoyment of alcohol and tobacco and have well-established expectations about how cigarettes and alcohol fit into social settings. CONCLUSIONS: The data suggest that observation of adult behavior, especially parental behavior, may influence preschool children to view smoking and drinking as appropriate or normative in social situations. These perceptions may relate to behaviors adopted later in life.

Adult↗

The impact of unstructured games of fantasy and role playing on an inpatient unit for adolescents.

Games of fantasy and role playing such as Dungeons and Dragons (1983) have become increasingly popular among adolescents and young adults. This article reviews the negative impact of such games on an adolescent inpatient treatment setting. The unrestricted play of such games contributed to the disruption of a treatment setting, resistances to treatment, reinforcement of character pathology, disruption of individual treatments, and to the normalization of violence. When such games begin to be played on a psychiatric inpatient unit or are prominent in discussions of individual patients, treaters should examine them in the context of their potential to reinforce and foster resistance and maladaptive patterns of relating to the environment. Treaters are also encouraged to attempt to understand the meaning and risks of such games in the context of an individual patient's psychiatric difficulties and of group dynamics, both within the patient group and between patients and treaters.

Adolescent↗

Spatial play.

More than sharpening our tools or making them sterile, our task in psychotherapy and analysis is to enliven them, find in them the organic, the animate, and the fecund. For our tools are formed of language, more like living nets than like knives, dies, taps, or templates, and our familiary with them might as well be a marriage of love as one of convenience. One's own onymy (Forrest, 1973) of words and phrases that seem to be one's property and private treasury will include, in the case of a doctor who uses words, several such verbal tools that have acquired greater frequency of use and richer and deeper meanings with experience. For me the word play in its affinity for very spatial senses has grown increasingly helpful in meeting both the practical demands of therapeutic communication and the personal need to maintain theoretical structures to support therapeutic work. I wish here to explore the concept of play--contributions to its definition, its developmental stages, applications of play, and its extended properties.

Child Development↗

That place where we live: the discovery of self through the creative play experience.

TOPIC: The origin and meaning of play in relation to D.W. Winnicott's (1971) conceptualization of the intermediate area of experience and transitional object, and transitional phenomena formation. PURPOSE: To demonstrate how the nurse therapist can enhance the child's discovery of self and healthy development through creativity and play. SOURCES: Clinical experiences with children in a school-based mental health program and literature support. CONCLUSIONS: By providing "good enough" mothering and a holding environment to enhance the development of a creative play experience, the nurse allows the child to find meaning through self-expression and, ultimately, health.

Child↗

Play therapy and children with disabilities.

Play therapy allows children with developmental and health disabilities to discover what physical and emotional strengths they have in relation to their disabilities. Play therapy may be directive or nondirective, emotionally or physically focused. Suggestions for specific activities are presented for providing play therapy for children with disabilities.

Child↗

Studies of play: implications for growth, development, and for clinical practice.

The clinical yields of studies of play conducted by graduate students in occupational therapy are identified, and the boundaries of the studies are described. The theme of change in play over time is acknowledged as prominent in all the studies. Open systems and hierarchy are helpful concepts for understanding the process of change in growth and development through play. Clinical tasks to facilitate the change process are cited.

Adolescent↗

Play intervention strategies for the Hispanic toddler with separation anxiety.

Constructive, therapeutic play is an effective nursing intervention for helping the toddler deal with separation anxiety, but, the play must transcend cultural barriers. Using Bowlby's theoretical framework to understand the response of separation anxiety in the toddler, culturally sensitive interventions of play that allow the Hispanic toddler to work through fears and express issues of separation are examined.

Adult↗

[Therapeutic play].

Atraumatic care is one of the important principles in pediatric nursing. Immature cognitive development, however, and limited coping ability exacerbate tension when children are ill and require hospitalization. Therapeutic play has been demonstrated as an effective nursing intervention. Through therapeutic play, children can acquire opportunities to express themselves and deal with stress related to health experiences. Also, nurses can gain insights into children's cognition, perception, and needs. This paper introduces concepts of therapeutic play. We hope that nurses will be able to incorporate it into pediatric nursing practice and provide care as atraumatically as possible.

Child↗

Brain evolution relating to family, play, and the separation call.

Mammals stem from the mammal-like reptiles (therapsids) that were widely prevalent in Pangaea 250 million years ago. In the evolutionary transition from reptiles to mammals, three key developments were (1) nursing, in conjunction with maternal care; (2) audiovocal communication for maintaining maternal-offspring contact; and (3) play. The separation call perhaps ranks as the earliest and most basic mammalian vocalization, while play may have functioned originally to promote harmony in the nest. How did such family related behavior develop? In its evolution, the forebrain of advanced mammals has expanded as a triune structure that anatomically and chemically reflects ancestral commonalities with reptiles, early mammals, and late mammals. Recent findings suggest that the development of the behavioral triad in question may have depended on the evolution of the thalamocingulate division of the limbic system, a derivative from early mammals. The thalamocingulate division (which has no distinctive counterpart in the reptilian brain) is, in turn, geared in with the prefrontal neocortex that, in human beings, may be inferred to play a key role in familial acculturation.

Animal Communication↗

Social play with an unfamiliar group in weanling rats (Rattus norvegicus).

Early signs of aggressive behavior toward an intruder were examined in Sprague-Dawley rats. The interactions between groups of four 24-day-old pups (2 males, 2 females) and an unfamiliar male pup from another litter were observed. Some patterns of social play were asymmetric. Compared to the playmate from the group, the unfamiliar pup was most likely to be underneath the other rats, either during play fighting or by crawling under a playmate. The single pup was most frequently involved in the following behaviors: on top (One animal climbs on top of another animal placing its forepaws on the second animal.), grooming, or crawling under a playmate. The effects of relative birth weight, ambient temperature during the lactation period, relative body weight, and relative body temperature during the observation period were studied. Results show that pups born and raised in a warm environment interacted socially more than pups raised in a colder environment. Pups lighter than the mean body weight of playmates tended to use submissive behaviors more than relatively heavier pups. Relatively heavy pups tended to use play behaviors that might be considered more aggressive during the interaction. The results suggest that under appropriate conditions, early evidence for dominance, i.e., asymmetry can be revealed.

Animals↗

Role-played and hypnotically induced simulation of psychopathology on the MMPI.

The differential effects of role-played vs. hypnotically induced simulation of a paranoid syndrome on diagnostic and validity scales of the MMPI were tested with 30 female undergraduate Ss. Hypnotized Ss given the paranoid syndrome suggestion simulated the MMPI more accurately than did role-playing Ss. The F scale and Gough F-K index of dissimulation identified the role-playing group, but not the hypnosis with simulation suggestion group. It was concluded that further refinement of the validity scales of the MMPI is needed to improve their effectiveness in detecting deception on this test.

Adolescent↗

Measurement of assertive behavior: construct and predictive validity of self-report, role-playing, and in-vivo measures.

Examined the predictive validity and construct equivalence of the three major procedures used to measure assertive behavior: Self-report, behavioral role-playing, and in-vivo assessment. Seventy-five Ss, who spanned the range of assertiveness, completed two self-report measures of assertiveness, the Rathus Assertiveness Scale (RAS) and the College Self-Expression Scale (CSES); two scales from the Endler S-R Inventory of General Trait Anxiousness, the interpersonal and general anxiety scales; eight role-playing situations that involved the expression of positive and negative assertiveness; and a telephone in-vivo task. In general, the study revealed the following: (1) assertiveness measures are task-dependent in that there was more overlap within task than between tasks; (2) there is a moderate degree of correspondence between self-report and role-playing measures, although this was true only for negative assertion; (3) positive and negative assertion do not appear to have the same topography of responding; and (4) there appears to be no consistent relationship between the in-vivo measure and any other type of assertiveness measure.

Anxiety↗

The effects of role-playing high gender identification on the California Psychological Inventory.

This study of the California Psychological Inventory (CPI) demonstrates that subjects can alter significantly their CPI profiles through role-playing high gender identification, i.e., males attempt to appear more masculine and women attempt to appear more feminine. The majority of these subjects did so without being detected by the validity scales designed to detect faking good or bad. Thirty-two volunteers, 16 male and 16 female, participated as subjects. A 2 X 2 ANOVA (subject gender by instructions to role-play vs. standard instructions) design was used. A significant main effect (p less than .01) for instructions was found on 14 of 18 scales and a significant interaction effect (p less than .01) on 4 of 18 scales. The profiles from the role-playing subjects indicate that the stereotypes of both genders, as seen by these subjects, are maladaptive. Implications for practical application of these findings are discussed.

Adaptation, Psychological↗

Role-playing techniques: locus of control and the attraction to behavior simulation interventions.

This study investigated the relationship between internal-external locus of control and preferences to enact conflict situations designed as spontaneous, mimetic-replication or a combination of these two behavior simulation (role playing) conditions. Four groups of females, high-school students (N = 10 each), indicated their portrayal preferences on a Role Playing Situation Questionnaire. Two of these, an internal and an external group, participated in a task designed to create feelings of failure (lack of success) prior to taking the questionnaire. Spontaneous portrayals were preferred by internals, and portrayals that involved mimetic-replication were favored by externals. Unsuccessful internals preferred the combined spontaneous/mimetic-replication alternative more than did the other internals. The relationship between personality and role playing, as well as the implications for clinical uses of behavior simulation conditions, is discussed.

Adolescent↗

The assessment of involvement in role playing.

Two experiments (N = 169) focused on involvement in role playing. Subjects rated their level of involvement after each enactment; in addition, a probe procedure was used with prompts, increasingly disparate from the content of the role play. In the first experiment, subjects role played an anger of sad scenario; both measures of involvement correlated with emotional response, but were not correlated with each other. In the second experiment, involvement was manipulated experimentally; both measures varied as expected with the manipulation.

Adult↗

First seizures associated with playing electronic screen games: a community-based study in Great Britain.

Active surveillance by virtually all electroencephalographic departments throughout Great Britain identified 118 patients who had a first seizure while playing an electronic screen game during two 3-month periods. Patients were divided into Group A (46 patients)--those for whom there was thought to be a definite causal relationship (type 4 photoparoxysmal response); Group B (25 patients)--those for whom there was a probable causal relationship (types 1-3 photoparoxysmal response, clinical evidence of photosensitivity, subsequent recurrent seizures on repeat exposure to electronic screen games, and/or occipital spikes in the resting electroencephalogram); and Group C (47 patients)--those for whom there was no apparent causal relationship. The number of patients in Group C did not exceed that expected by the chance occurrence of two common events (playing electronic screen games and incidence of epilepsy). Most (103/118) of the patients were in the age range of 7 to 19 years. Within this age group the annual incidence of first seizures triggered by playing electronic screen games (Groups A and B combined) was estimated to be 1.5/100,000.

Adolescent↗

Refusal assertion versus conversational skill role-play competence: relevance to prevention of tobacco use.

Conversational and refusal assertion skills of 768 seventh grade youth were assessed through ratings of global (for example, effectiveness) and non-verbal (for example, eye contact) behaviour performed in two role-play scenarios. The ratings were completed after each scenario by the subjects themselves, as well as by classmate and trained adult observers. Use of the Hays and Hayashi multitrait scaling method to interpret these data revealed two results. First, the items used to measure role-play behaviour did not achieve sufficient internal consistency to create global and non-verbal composites. Second, inter-rater agreement and discriminant validity were obtained only for ratings of the global effectiveness of each of the two social skills. Next, a series of multiple regression analyses indicated that an index of the global effectiveness of refusal assertion skill, but not of conversational skill, was predictive of intention to use tobacco. Those who were relatively unskillful at refusing offers were more likely to intend to use tobacco. Analyses exploring relations of trained observer ratings of the effectiveness of both role-play types, trained observer ratings of the other global and non-verbal items, and subjects' intention to use tobacco indicated that only a hesitant voice pattern was both negatively predictive of effective refusal assertion and positively predictive of intention to use tobacco in the future. In other words, those who are hesitant when they refuse a tobacco offer are the ones most likely to report an intention to use tobacco in the future. The consistency of this last finding in the tobacco use prevention literature is discussed.

Assertiveness↗

Mental rotation at 7 years: relations with prenatal testosterone levels and spatial play experiences.

Biological and social-experiential factors appear to play a role in the male advantage in spatial abilities. In the present study, relations among prenatal testosterone levels, spatial play experiences, and mental rotation task performance were explored in 7-year-old boys and girls. A positive correlation was observed between prenatal testosterone levels and rate of rotation in girls. The findings were less clear for boys, but suggested the opposite pattern of results. Relations between spatial play preferences and mental rotation task performance were not observed in children of either sex. These findings are consistent with the hypothesis that testosterone acts on the fetal brain to influence the development of spatial ability.

Amniocentesis↗