Consistency and change in personality characteristics and affect from middle to late adolescence.
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Adolescents on a 16-bed token economy ward of a state hospital were subjected to four interventions in a seven-phase experiment to reduce the number of fines they received each day. Phase I was a four-week baseline period. Phases II and III were four- and five-week periods, respectively, in which residents were awarded tickets for a weekly $10 lottery each day they were at or below a changing criterion of daily fines. In Phase IV, residents received coupons, exchangeable for money, for days with zero fines. Phase V was a return to baseline. Phase VI was a one-week period in which daily lotteries for $1 were held, with the criterion for receiving a ticket being zero fines on the previous day. Phase VII was a one-week return to baseline. No significant differences in average fines per day, number of residents meeting criteria, or mean number of zero-fine days per week were found across phases. Results are discussed in terms of amount and immediacy of reinforcement, other opportunities to gain money, possible rebelliousness of the residents against the increased aversiveness of fines, and implications for further research.
Historical myths about inevitable behavioural and cognitive consequences of epileptic disorders still provide patients and their families with unfounded fears leading to self-fulfilling prophecies of psychosocial and mental deterioration. Psychomotor attacks are subjectively experienced disruptions in the continuity of life and self-perception which it will be difficult to integrate into the organization of daily life. These facts must be kept in mind when epileptic patients present psychological problems. The most common features of neuropsychological and psychosocial problems are discussed and the importance of combining optimal antiepileptic medication with psychotherapy is underlined. Coexisting epileptic and psychogenic symptoms being difficult to disentangle patients presenting both may be exposed to unfortunate alternating therapeutic strategies by ambitendent therapists. Careful observation without overt attention combined with assisting the patient in obtaining more autonomy and self management appear to be the best policy to stop psychogenic fits.
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