Further experience in conjoint psychotherapy of marital pairs.

Conjoint therapy of marital partners is a technique that lends itself to the counseling efforts of health professionals. Its growing use has, however, brought with it seemingly inevitable pitfalls, such as inadequate assessment of individual needs and psychopathology, overzealous application and disregard of certain contraindications, management problems and goal definition that may be unclear to patients or more related to the therapist''s personality than to an objective view of the marriage dynamics. Despite the difficulties and pitfalls of this relatively new field, conjoint therapy can be the treatment of choice when the primary difficulties are related to the inability to cope in the marital situation, even though functioning in other social roles is adequate.     

THE PSYCHOTHERAPEUTIC APPROACH TO EMOTIONAL PROBLEMS

Physicians are confronted with more and more psychological problems in their daily practice. Not only must a physician be able to recognize the problems, he must also be prepared to treat a certain number of them. Some of the patients will improve just because of a good relationship with the physician. Others will require more definitive, yet comparatively simple, psychotherapy. On the other hand, some patients with clear-cut emotional problems are best treated by the physician''s traditional medical approach rather than by some type of “formal” psychotherapy. In some circumstances psychotherapeutic efforts may be damaging.     

Psychiatry and Psychotherapy: Is a Divorce Imminent?

Despite the long tradition of psychiatrists practicing psychotherapy, many psychiatric and medical leaders are predicting and urging a reorientation of psychiatry toward the medical model. They would leave psychotherapy to psychologists, social workers and the like. Many social, governmental and institutional factors favor such a change. The marriage of psychiatry and psychotherapy has always been an uneasy one, and the push for divorce may be irresistible. The author cautions that a divorce could be detrimental to medicine by substituting, in the name of “science,” a dehumanized, technological psychiatry for the current “moral” treatment. One alternative to divorce is a broader approach to psychiatry, combining biological, neuromedical, socioenvironmental and psychodynamic factors. The divorce, though imminent, should be resisted.     

NONVERBAL TREATMENT OF NEUROSIS—Techniques for General Practice

“Psychosomatic medicine” does not demand that the general practitioner function as a psychiatrist; rather, it is a psychiatric orientation that can increase the effectiveness of purely medical treatment for such conditions as neuroses. The general practitioner to whom the patient turns may achieve permanent results with nonverbal techniques where formal psychotherapy would be impracticable or unacceptable.The first aim is to relieve pressure so that the patient can regain his mental balance and thereby his self-confidence. Arts, hobbies, sports, and the like can be prescribed rather specifically according to the patient''s personality and needs. Nutrition can be improved simply at first by prescribing needed additions to diet rather than imposing restrictions. Vitamin deficiency may by itself be the cause of neurosis or more serious mental disease, whereas psychic stress by itself may create a need for additional vitamin intake. Hormone therapy may be extremely helpful but must be based on clear indication and limited to specific purposes.Since lack of sleep and rest quickly impairs mental function, it is important for neurotic persons to learn relaxation as a necessity for sleep. Sedatives may be used in a crisis but should be abandoned as soon as possible.With all drugs there are problems of excess and habituation. The least, the mildest, the shortest dosage is the ideal.The initial steps of psychotherapy are available to any physician: Establishing rapport, noting how complaints are stated, encouraging ventilation, winning confidence rather than immediate results.     

Joint Cognition: Thought Contagion and the Consequences of Cooperation when Sharing the Task of Random Sequence Generation

Generating random number sequences is a popular psychological task often used to measure executive functioning. We explore random generation under “joint cognition” instructions; pairs of participants take turns to compile a shared response sequence. Across three studies, we point to six key findings from this novel format. First, there are both costs and benefits from group performance. Second, repetition avoidance occurs in dyadic as well as individual production settings. Third, individuals modify their choices in a dyadic situation such that the pair becomes the unit of psychological function. Fourth, there is immediate contagion of sequence stereotypy amongst the pairs (i.e., each contributor “owns” their partner’s response). Fifth, dyad effects occur even when participants know their partner is not interacting with them (Experiment 2). Sixth, ironically, directing participants’ efforts away from their shared task responsibility can actually benefit conjoint performance (Experiment 3). These results both constrain models of random generation and illuminate processes of joint cognition.     

Money Walks: Implicit Mobility Behavior and Financial Well-Being

Traditional financial decision systems (e.g. credit) had to rely on explicit individual traits like age, gender, job type, and marital status, while being oblivious to spatio-temporal mobility or the habits of the individual involved. Emerging trends in geo-aware and mobile payment systems, and the resulting “big data,” present an opportunity to study human consumption patterns across space and time. Taking inspiration from animal behavior studies that have reported significant interconnections between animal spatio-temporal “foraging” behavior and their life outcomes, we analyzed a corpus of hundreds of thousands of human economic transactions and found that financial outcomes for individuals are intricately linked with their spatio-temporal traits like exploration, engagement, and elasticity. Such features yield models that are 30% to 49% better at predicting future financial difficulties than the comparable demographic models.     

Human Collective Intelligence under Dual Exploration-Exploitation Dilemmas

The exploration-exploitation dilemma is a recurrent adaptive problem for humans as well as non-human animals. Given a fixed time/energy budget, every individual faces a fundamental trade-off between exploring for better resources and exploiting known resources to optimize overall performance under uncertainty. Colonies of eusocial insects are known to solve this dilemma successfully via evolved coordination mechanisms that function at the collective level. For humans and other non-eusocial species, however, this dilemma operates within individuals as well as between individuals, because group members may be motivated to take excessive advantage of others'' exploratory findings through social learning. Thus, even though social learning can reduce collective exploration costs, the emergence of disproportionate “information scroungers” may severely undermine its potential benefits. We investigated experimentally whether social learning opportunities might improve the performance of human participants working on a “multi-armed bandit” problem in groups, where they could learn about each other''s past choice behaviors. Results showed that, even though information scroungers emerged frequently in groups, social learning opportunities reduced total group exploration time while increasing harvesting from better options, and consequentially improved collective performance. Surprisingly, enriching social information by allowing participants to observe others'' evaluations of chosen options (e.g., Amazon''s 5-star rating system) in addition to choice-frequency information had a detrimental impact on performance compared to the simpler situation with only the choice-frequency information. These results indicate that humans groups can handle the fundamental “dual exploration-exploitation dilemmas” successfully, and that social learning about simple choice-frequencies can help produce collective intelligence.     

MARRIAGE PROBLEMS—Dealing with Them in Private Practice

Marriages and divorces in Los Angeles County almost equal each other. Marriage per se is not the cause of neurosis. When two neurotic persons marry, the resulting neurotic interaction too often ends in conflict, broken homes and a new generation of neurotic children.Psychotherapy must be related to the diagnosis of family psychopathology, should include all the involved members and should be directed toward the realistic goal of integrating them into family living.Of 100 cases taken from the author''s experience, 64 involved married couples and the majority of these had serious interspouse conflicts. In 37 cases both spouses were treated and substantial psychotherapy was given to one or both of the partners. It included one or more modalities varying from electroshock therapy, tranquilizers, and such psychotherapy as supportive, dynamic interpretive, individual, spouses together, group and hypnotherapy. Thirteen achieved clinical recovery, nine improved, twelve were still in therapy. In three cases therapy failed.     

Developmentally Regulated Expression of the Gene Family for Cytosolic Glutamine Synthetase in Pisum sativum

In Pisum sativum, two classes of genes encode distinct isoforms of cytosolic glutamine synthetase (GS). The first class comprises two nearly identical or “twin” GS genes (GS341 and GS132), while the second comprises a single GS gene (GS299) distinct in both coding and noncoding regions from the “twin” GS genes. Gene-specific analyses were used to monitor the individual contribution of each gene for cytosolic GS during root nodule development and in cotyledons during germination, two contexts where large amounts of ammonia must be assimilated by GS for nitrogen transport. mRNAs corresponding to all three genes for cytosolic GS were shown to accumulate coordinately during a time course of nodule development. All the GS mRNAs also accumulate to wild-type levels in mutant nodules formed by a nifD⁻ strain of Rhizobium leguminosarum indicating that induced GS expression in pea root nodules does not depend on the production of ammonia. Distinct patterns of expression for the two classes of GS genes were observed in certain mutant root nodules and most dramatically in cotyledons of germinating seedlings. The different patterns of expression between the two classes of genes for cytosolic GS suggests that their distinct gene products may serve nonoverlapping functions during pea development.     

Body Composition and Body Weight: Criteria of Overnutrition

The terms “body weight” and “body composition” are by no means synonymous, and attention is increasingly being focused on body composition. A measurement of relative fatness is a better criterion of caloric overnutrition than is body weight.The simple technique of skinfold measurement using established standard methods is the most practical for use in the field to obtain an estimate of fatness or caloric overnutrition. The current need is for the establishment of “norms” for skinfolds for population groups of all ages and both sexes. When these are established, excellent simple criteria for overnutrition will be available.Prior to the establishment of norms, more work is needed to indicate which skinfolds for each age group and for each sex best reflect total body fatness. Body fatness may then be studied in relation to body weight and both may be related to morbidity, mortality and longevity. Finally, the answer may be obtained to the question whether it is overweight per se or overfatness that is related to excess morbidity and mortality.     

Characterization of the Oral Fungal Microbiome (Mycobiome) in Healthy Individuals

The oral microbiome–organisms residing in the oral cavity and their collective genome–are critical components of health and disease. The fungal component of the oral microbiota has not been characterized. In this study, we used a novel multitag pyrosequencing approach to characterize fungi present in the oral cavity of 20 healthy individuals, using the pan-fungal internal transcribed spacer (ITS) primers. Our results revealed the “basal” oral mycobiome profile of the enrolled individuals, and showed that across all the samples studied, the oral cavity contained 74 culturable and 11 non-culturable fungal genera. Among these genera, 39 were present in only one person, 16 genera were present in two participants, and 5 genera were present in three people, while 15 genera (including non-culturable organisms) were present in ≥4 (20%) participants. Candida species were the most frequent (isolated from 75% of participants), followed by Cladosporium (65%), Aureobasidium, Saccharomycetales (50% for both), Aspergillus (35%), Fusarium (30%), and Cryptococcus (20%). Four of these predominant genera are known to be pathogenic in humans. The low-abundance genera may represent environmental fungi present in the oral cavity and could simply be spores inhaled from the air or material ingested with food. Among the culturable genera, 61 were represented by one species each, while 13 genera comprised between 2 and 6 different species; the total number of species identified were 101. The number of species in the oral cavity of each individual ranged between 9 and 23. Principal component (PCO) analysis of the obtained data set followed by sample clustering and UniFrac analysis revealed that White males and Asian males clustered differently from each other, whereas both Asian and White females clustered together. This is the first study that identified the “basal mycobiome” of healthy individuals, and provides the basis for a detailed characterization of the oral mycobiome in health and disease.     

Intention Understanding in Autism

When we observe a motor act (e.g. grasping a cup) done by another individual, we extract, according to how the motor act is performed and its context, two types of information: the goal (grasping) and the intention underlying it (e.g. grasping for drinking). Here we examined whether children with autistic spectrum disorder (ASD) are able to understand these two aspects of motor acts. Two experiments were carried out. In the first, one group of high-functioning children with ASD and one of typically developing (TD) children were presented with pictures showing hand-object interactions and asked what the individual was doing and why. In half of the “why” trials the observed grip was congruent with the function of the object (“why-use” trials), in the other half it corresponded to the grip typically used to move that object (“why-place” trials). The results showed that children with ASD have no difficulties in reporting the goals of individual motor acts. In contrast they made several errors in the why task with all errors occurring in the “why-place” trials. In the second experiment the same two groups of children saw pictures showing a hand-grip congruent with the object use, but within a context suggesting either the use of the object or its placement into a container. Here children with ASD performed as TD children, correctly indicating the agent''s intention. In conclusion, our data show that understanding others'' intentions can occur in two ways: by relying on motor information derived from the hand-object interaction, and by using functional information derived from the object''s standard use. Children with ASD have no deficit in the second type of understanding, while they have difficulties in understanding others'' intentions when they have to rely exclusively on motor cues.     

Health Hazard Appraisal Counseling—Continuing Evaluation

A program of annual health examinations was expanded to include counseling based on a computerized appraisal of individual patients'' specific health risk factors. Data obtained from a specially designed questionnaire, laboratory tests and a physical examination yielded a health hazard appraisal showing a number of weighted risk factors and their relation to ten leading causes of death as determined for that patient. From all of this information, a “risk age” was developed which could then be compared with the patient''s “true age.” The results were reviewed with each patient, and methods of correcting health hazards were stressed. The first annual retesting of a group of 107 examinees showed a net risk age reduction of 1.4 years (formerly reported in this journal). The longer term follow-up reported in this paper showed a net risk reduction of 2.38 years in a group of 26 examinees. The net risk age reduction in the two groups represented 32 and 40 percent, respectively, of the achievable risk age reduction when patients comply with suggestions made during risk reduction counseling. These findings indicate that health hazard appraisal counseling is an effective method of altering priorities of health practices.     

Knowing Right From Wrong In Mental Arithmetic Judgments: Calibration Of Confidence Predicts The Development Of Accuracy

Does knowing when mental arithmetic judgments are right—and when they are wrong—lead to more accurate judgments over time? We hypothesize that the successful detection of errors (and avoidance of false alarms) may contribute to the development of mental arithmetic performance. Insight into error detection abilities can be gained by examining the “calibration” of mental arithmetic judgments—that is, the alignment between confidence in judgments and the accuracy of those judgments. Calibration may be viewed as a measure of metacognitive monitoring ability. We conducted a developmental longitudinal investigation of the relationship between the calibration of children''s mental arithmetic judgments and their performance on a mental arithmetic task. Annually between Grades 5 and 8, children completed a problem verification task in which they rapidly judged the accuracy of arithmetic expressions (e.g., 25+50 = 75) and rated their confidence in each judgment. Results showed that calibration was strongly related to concurrent mental arithmetic performance, that calibration continued to develop even as mental arithmetic accuracy approached ceiling, that poor calibration distinguished children with mathematics learning disability from both low and typically achieving children, and that better calibration in Grade 5 predicted larger gains in mental arithmetic accuracy between Grades 5 and 8. We propose that good calibration supports the implementation of cognitive control, leading to long-term improvement in mental arithmetic accuracy. Because mental arithmetic “fluency” is critical for higher-level mathematics competence, calibration of confidence in mental arithmetic judgments may represent a novel and important developmental predictor of future mathematics performance.     

WORKMEN'S COMPENSATION ACT—Some Aspects of Interest to California Physicians

This article was prepared by Mr. William M. Whelan, Director of Special Services, California Medical Association, under the supervision of Dr. Francis J. Cox, Chairman of the Medical Services Commission of the Association, and Mr. Howard Hassard, the Association''s Legal Counsel. It is intended as a brief synopsis of the California Workmen''s Compensation Law as it applies to the physician in private practice. It is not an exhaustive treatment of the subject. A physician who desires to acquaint himself in detail with California industrial practice should consult the article entitled “The Physician''s Role in Workmen''s Compensation,” California Medicine, 82:352-362, April, 1955. Inquiries regarding industrial medicine should be addressed to Mr. William M. Whelan, California Medical Association, 450 Sutter St., San Francisco 8.     

Mating Behaviour in Laevicaudatan Clam Shrimp (Crustacea,Branchiopoda) and Functional Morphology of Male Claspers in a Phylogenetic Context: A Video-Based Analysis

Clam shrimps are freshwater branchiopod crustaceans which often present complicated breeding systems including asexual reproduction (parthenogenesis) and mixed mating systems (in androdioecious species both selfing and outcrossing occurs due to the co-presence of hermaphrodites and males). Reproductive patterns of Spinicaudata, which contains most clam shrimp species, have received much attention. Another group of clam shrimps, Laevicaudata, which holds a key position in branchiopod phylogeny, has practically not been studied. As a part of the mating process, males clasp to the carapace margin of the females with a pair (or two pairs) of anterior trunk limbs modified as claspers. Previous studies have shown that clasper morphology is important in a phylogenetic context, and that some parts of the claspers in Spinicaudata and Laevicaudata may have undergone a remarkable parallel evolution. Here we have used video microscopy to study aspects of the mating behaviour, egg extrusion, and fertilization in Lynceus brachyurus (Laevicaudata). It is shown that fertilization is likely to be external and that the peculiar tri-lobed lateral lamellae of female''s hind body assist in guiding the egg mass to the exopodal egg carriers where they are collected by their distal setation. The functional morphology of the male claspers was studied in detail by close-up video recordings. The movable “finger” of the clasper bends around the female''s carapace edge and serves to hold the female during mating. The larger palp grasps around the female carapace margin in a way very similar to the movable “finger”, possibly indirectly providing sensory input on the “finger” position. A brief comparative study of the claspers of a spinicaudatan clam shrimp showed both similarities and differences to the laevicaudatan claspers. The presence of two pairs of claspers in Spinicaudata seems to give males a better hold of the female which may play a role during extended mate guarding.