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The purpose of this investigation was to assess mood states that accompany asthma attacks in children. Mood has been at least indirectly implicated in asthma in a number of studies. For example, destructive underlying wishes (which patients represent in part by the “powerful expiratory breath”), fantasies in which they fear they will burst, and strong latent aggression toward mother figures have been reported [1], as well as a marked frequency of depression in subjective reports of patients during asthma [2,3]. In short, mention of negative affect states, i.e. depression, aggression and anxiety, has been prominent in reports of patients studied during asthma. These reports, however, raise a number of questions. First, do negative affects characterize asthma attacks per se, or are they characteristic of the asthmatic patient even when he is asthma free? The answer to this question could contain a clue to their precipitant value. In this connection, it is interesting to note that in a study of 38 children comprising two subgroups of asthmatics, 33% of children who retained their symptoms during hospitalization at CARIH, and 75% of those whose symptoms remitted included “negative affect” among the factors reported to precipitate their asthma [4]. Second, do these states characterize asthmatics, or will the frequency and degree with which they appear in asthmatics also be found in a random sample of normals? Third, assuming that negative affects specifically characterize asthmatics during attacks, are they specific to asthma or are they rather “illness-related”? The finding that asthmatics and cardiac patients differ from normals on some personality measures, but are not different from each other [5] makes this type of question crucial both in its own right and for the problem of adequate control groups in psychological studies of asthma. The present paper will deal with the first of these questions, and will report comparisons of mood state patterns during and between asthma attacks in a sample of 32 pre-adolescent and adolescent.

The aim of the present study was to examine more closely than has previously been done some widely accepted generalizations about the ritualistic behaviour of patients suffering from obsessional neurosis. Observation of such patients had suggested that their behaviour is less consistent and is governed by a much greater complexity of factors than is normally assumed. In addition it seemed that such over-simplification has led to the construction of inadequate theoretical models to explain ritualistic behaviour. Moreover it appeared that this over-simplification was linked to the fact that there have been very few systematic studies of the obsessional ritual itself: most descriptions of obsessionals' behaviour seem to be based on the retrospective and rather general accounts, given by the patients themselves in the relative calm and detachment of the consulting-room situation. Observation of patients actually performing rituals suggested that such accounts might well be misleading. Therefore, it seemed likely that it would be profitable to study the rituals of individual obsessional patients systematically and in some detail. In the investigation reported here, three such studies were carried out. The first two, which are reported briefly, were relatively uncontrolled and had as their aim the derivation of more specific hypotheses to be tested in a later investigation. The third study, which is reported more fully, was concerned with testing out these hypotheses by the more rigorous investigation and manipulation of the rituals of a further obsessional patient.

Summary An initial observation that insomnia, especially early morning waking, is a feature of anorexia nervosa has been confirmed. A further proposition that the insomnia is more closely related to the nutritional disturbance than to the mood state has also been confirmed using standardized measures of weight, sleep and mood. These findings are discussed in terms of the possible relevance to other illnesses involving weight change in which there is an alteration of sleep patterns.

Findings are presented, which support the evidence from previous studies of patients with disorders of weight and patients with psychiatric morbidity, that nutritional change is associated with change in sleep patterns independently of mood state. In this report, obese patients undergoing weight reduction have been investigated in respect of their sleep patterns using a sleep questionnaire, standardized measures of nocturnal motility and, in one instance, all-night EEG recordings.