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Photoinduced charge separation in supramolecular aggregates of π-conjugated molecules is a fundamental photophysical process and a key criterion for the development of advanced organic electronics materials. Herein, the self-assembly of low-band-gap chromophores into helical one-dimensional aggregates, due to intermolecular hydrogen bonding, is reported. Chromophores confined in these supramolecular polymers show strong excitonic coupling interactions and give rise to charge-separated states with unusually long lifetimes of several hours and charge densities of up to 5 mol % after illumination with white light. Two-contact devices exhibit increased photoconductivity and can even show Ohmic behavior. These findings demonstrate that the confinement of organic semiconductors into one-dimensional aggregates results in a considerable stabilization of charge carriers for a variety of π-conjugated systems, which may have implications for the design of future organic electronic materials., (© 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The current research applies decision-making theory to the problem of increasing uptake of energy-efficient technologies, where uptake is currently slower than one might predict following rational choice models. We explore the role of alignability effects on consumers' preference for standard versus energy-efficient technologies. Previous research has found that attentional weight given to alignable or nonalignable features varies depending on the decision context, including between-alternative heterogeneity. In a hypothetical choice task, subjects were presented with a choice between similar (boiler vs. boiler) versus dissimilar (boiler vs. heat pump) home heating technologies, each described by a list of alignable and nonalignable attributes. We found a preference for alignability when options were similar; an effect mediated by an increased tendency to infer missing information is the same. No effects of alignability on preference were found when options differed. We draw theoretical and applied implications for (a) the role of alignability effects in contributing to the energy efficiency gap and (b) the type of information structure best suited for the promotion of energy-efficient technologies in future marketing campaigns. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Photocharge generation and formation of long-lived charge carriers are relevant in photosynthesis, photocatalysis, photovoltaics, and organic electronics. A better understanding of the factors that determine these processes in synthetic polymer semiconductors is crucial, but difficult due to their morphological inhomogeneity. Here, we report the formation of exceptionally long-lived photocharges in one-dimensional organic semiconductor nanostructures. These nanostructures consist of chiral oligopeptide-substituted thienothiophene-based chromophores and exhibit a well-defined helical arrangement of these chromophores at their core. The chromophores give rise to spectroscopic H-aggregates and show strong intermolecular excitonic coupling. We demonstrate that all of these parameters are the prerequisites required for the nanostructures to show the efficient formation of polaron-like photocharges upon irradiation with a low-power white light source. The observed charge carriers in the helical nanowires show an unusually long lifetime on the order of several hours and are formed at high concentrations of up to 3 mol % in the absence of any dedicated electron acceptor. They are observed in solution as well as in film and furthermore give rise to a light-induced increase of the macroscopic charge transport. By contrast, no such photocharge generation is observed either in non-aggregating reference systems of the same chromophores or in aggregated but non-helical systems that do not form one-dimensional nanostructures. Our results thus demonstrate a clear correlation between nanoscopic confinement and the generation of long-lived photocharges.

Contrary to economic theory, psychological research has demonstrated increased choice can undermine satisfaction. When and why this 'excess choice effect' (ECE) occurs remains unclear. Building on theories of counterfactual thinking we argue the ECE is more likely to occur when people experience counterfactual thought or emotion and that a key trigger is a negative versus positive task outcome. Participants either selected a drink (Experiment 1) or chocolate (Experiment 2) from a limited (6) versus extensive (24) selection (Experiment 1) or were given no choice versus extensive (24) choice (Experiment 2). In both experiments, however, the choice was illusory: Half the participants tasted a 'good' flavour, half a 'bad' flavour. As predicted, extensive choice was only detrimental to satisfaction when participants tasted the 'bad' drink or chocolate, and this was mediated by the experience of counterfactual thought (Experiment 1) or emotion (Experiment 2). When outcomes were positive, participants were similarly satisfied with limited versus extensive and no choice versus extensive choice. Implications for our theoretical understanding of the ECE and for the construction of choice architectures aimed at promoting individual satisfaction and well-being are discussed., (© 2015 The British Psychological Society.)

Fifty-five patients who met criteria for serious mental illness nominated a relative with whom they had lived for at least the previous 6 months to be sent a questionnaire that included a scale for rating patients' contribution to family life in 10 specific areas. Thirty-six relatives returned completed questionnaires. Patients rated their own contributions using the same scale. Overall, relatives rated patients' contributions as positive, and their ratings of patients when well generally agreed with patients' self-ratings. For women only, relatives rated contributions as significantly less when the patient was ill. Patients' self-rated level of psychological symptoms was the best predictor of relatives' overall satisfaction with them. Ratings of patients' contributions mirrored sex-role stereotypes.

Objective: The aims of this study were to determine the prevalence of personality disorder in a sample of patients with well-documented bipolar disorder, and to assess the effects of comorbidity., Method: The sample (n = 42) was drawn from patients currently case-managed within a community treatment program who fully met DSM-IV criteria for bipolar I disorder. The International Personality Disorder Examination, a structured interview, was used to diagnose personality disorder. The Brief Symptom Inventory assessed overall levels of psychological symptoms., Results: Seven of the 13 men (55%) in the sample had 10 personality disorder diagnoses and 12 of the 29 women (41%) had 28 diagnoses, an overall prevalence of 45%. Hospital admission rates and all measures of psychological symptoms and impairment were significantly elevated in the comorbid group, who found medication significantly less helpful., Conclusions: Comorbid personality disorder was common in the sample studied, which was representative of Australian patients treated in public community psychiatry programs. However, only three (7%) had a personality disorder diagnosis recorded in their case notes, reflecting clinicians' reluctance to apply what is widely viewed as a pejorative and therapeutically nihilistic label. New treatments for personality disorder have proven effective within both public and private psychiatric settings, so that underdiagnosis represents undertreatment. The findings suggest that clinicians should be more vigilant for comorbid personality and bipolar disorder, and less reluctant to diagnose it.

Objective: The aim of this study to determine the prevalence of anxiety disorders in publically treated psychiatric inpatients with a DSM-IV diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder., Method: Using the Structured Clinical Interview for DSM-III-R (SCID), 100 consecutive inpatients with a psychotic disorder were examined for the presence or absence of an anxiety disorder. Questionnaire measures of phobias, obsessive-compulsive and general anxiety symptoms were also applied., Results: The prevalences of social phobia (17%), obsessive-compulsive disorder (13%) and generalised anxiety disorder in schizophrenia were relatively high, as were prevalences of obsessive-compulsive (30%) and panic disorder (15%) in bipolar disorder. The proportion of subjects with an anxiety disorder (43-45%) was almost identical across the three psychoses, with some evidence of gender differences. Although self-ratings of overall psychiatric symptoms were significantly elevated in those with anxiety disorders, hospital admission rates were not., Conclusions: Almost none of those with anxiety disorders were being treated for them, primarily because the severity of the acute psychotic illness required full diagnostic and therapeutic attention. Patients were generally discharged as soon as their psychotic episode was resolved, with little recognition of the presence of an anxiety disorder. Given that anxiety disorders are relatively responsive to treatment, greater awareness of their comorbidity with psychosis should yield worthwhile clinical benefits.

The study evaluates a Brief Admission Unit for clients of an emergency service located within a comprehensive community psychiatric program. Eighty-five clients completed the Brief Symptom inventory and a structured interview. Substance abuse disorder (n = 29) and major depression (n = 24) were the most common Axis I diagnoses, of which 30 subjects had two or more. Sixty subjects had an Axis II diagnosis. Mean duration of admission was 3.9 days, compared with the average in other acute units of 11.5 days. At discharge, half the subjects were rated as moderately to greatly improved and client satisfaction was high. The unit was crucial to the psychiatric emergency service and had a key role in relieving pressure on beds elsewhere within the system.

Four case managers with a nursing background took part in a 26 week in-service programme aimed at developing basic skills in cognitive-behaviour therapy. The programme occupied about 5 hours each week and included directly supervised therapy with at least 4 patients having serious mental illness. Patients' symptoms improved significantly after an average of less than 12 one hour therapy sessions. After the programme, case managers began treating patients autonomously, although all recognised the need for some continuing supervision and the necessity of referring unusually complex or challenging cases to clinical psychologists or others highly skilled in the area.

Forty-eight residents of a therapeutic community took part in a prospective study aimed at assessing overall outcome and which components of the program were most helpful. All subjects had a DSM-III-R axis II diagnosis, usually borderline personality disorder (N = 34). As well, subjects had a mean of 1.3 axis I diagnoses, underlining the severity of their psychiatric disorders. Significant symptom reduction on the Brief Symptom Inventory occurred at discharge after a mean stay of 64 days, with further significant falls at three month follow-up. These changes were paralleled in the Hostility and Direction of Hostility Questionnaire, a measure of personality. Hospital admission rates fell significantly in the year after discharge. Clients rated group therapy as the most helpful component of the program.

Fifty-seven subjects with moderate to severe dementia (49 with Alzheimer's disease) were rated twice, 8 weeks apart, using the Mini-Mental State Examination (MMSE), the Blessed Information-Memory-Concentration Test (BIMC), and the Stockton Geriatric Rating Scale (SGRC). Only three subjects lived at home; the rest were in long-stay hospital beds or nursing homes. For 29 subjects, the first rating coincided with their referral to a comprehensive geriatric psychiatry service. The main hypothesis, that the level of behavioral disturbance would correlate positively with the level of cognitive impairment, was strongly confirmed. This finding may reflect the severity of dementia in the study sample. The correlations between MMSE and BIMC scores were .87 at entry and .92 at exit, suggesting that the two measures were broadly equivalent, although both had marked floor effects. Test-retest reliability was high for all three measures. Overall, medication was of limited effectiveness in managing severe behavioral disturbance, highlighting the need for introducing effective behavioral programs.

Objective: This study had two main aims: to determine the stability over time of the diagnosis borderline personality disorder (BPD) in a psychiatric hospital population; and to assess the quality and effectiveness of treatment offered within state mental health service., Method: The case notes of 47 psychiatric hospital patients followed up for 3 years after the index admission were analysed., Results: The mean number of previous psychiatric hospital admissions was 9.0, and at least 74% of the sample had further admissions (mean 3.7) during the 3 year follow-up. Comorbidity with schizophrenia and schizoaffective disorder was rare, and was only 13% with major depression. Longitudinal stability of diagnosis was very high., Conclusions: The study firmly supported BPD as a valid diagnosis. Its treatment within the state mental health system was generally haphazard and ineffective. Post-discharge plans were implemented for only 3 subjects. Current moves toward community psychiatric treatment represent a unique opportunity for improving treatment of BPD by using existing resources more effectively.

The study examined characteristics of patients referred by police to a psychiatric emergency unit on the campus of a 400-bed psychiatric hospital in Adelaide, South Australia. Of all police referrals (N = 634) during a 21-month period, 437 cases were admitted to the hospital. Most police referrals were young, single, unemployed men. In a subsample of 61 patients, 72 percent had previous psychiatric admissions and 39 percent had been previously referred by police. Compared with nonpsychotic subjects, psychotic subjects used more mental health resources, had a longer index admission, and after the index discharge relapsed more rapidly and spent more days in the hospital.

Fifty-three psychiatric hospital inpatients with a dual diagnosis of substance abuse and schizophrenia were given the Brief Symptom Inventory and the Schizophrenia/Substance Abuse Interview Schedule. Mean age was 29; 49 were men. Only 11% were employed. Forty percent abused mainly alcohol, 40% cannabis and 8% amphetamines; 20% abused more than one substance. Mean onset age of drug abuse was 16 years; schizophrenia was diagnosed a mean of 5 years later, and subjects had been admitted to hospital an average of 7 times since then. Most believed that drug abuse initiated or exacerbated their schizophrenia; 80% took drugs primarily to relieve dysphoria and anxiety. Amphetamines improved subjective well-being significantly more than alcohol, but choice of drugs was determined mainly by price and availability. Only cannabis increased positive symptoms of schizophrenia and only amphetamines reduced negative ones. Effectively treating this population requires an integration of psychiatric and drug treatment services, ideally in a community context.

The authors found that the different hallucinated "voices" of four schizophrenic subjects reported over 1-3 weeks expressed semantic content that was at least as persistent as clauses sampled from single 5-7-minute conversational discourses of four comparison speakers. The high degree of semantic recurrence of voices from one day to the next may contribute to the mistaken belief that these experiences derive from a particular nonself agent or speaker.

The study was carried out by the same research team in two metropolitan hospitals, one in Greece (N = 60) and one in Australia (N = 56). Subjects comprised patients consecutively admitted with a DSM-III-R diagnosis of depressive disorder, all of whom completed questionnaire measures of depression, anxiety and somatic symptoms. Clinical concepts and practices in the two hospitals were very similar. Overall levels of depression, anxiety and somatic symptoms in the two samples were almost identical, but there were differences in the pattern of somatic complaints: Greeks scored significantly higher on dizziness, paraesthesiae and masticatory spasms, and Australians scored significantly higher on drowsiness, hypersomnia and non-refreshing sleep, with the latter two items being the best discriminators of the two samples using discriminant function analysis. These findings, combined with factor analysis, suggested that symptoms associated with hyperventilation in the Greek sample, and with sleep disturbance in the Australian sample, explained most of the differences between them.

This study reviewed all patients (N = 37) treated with ECT in a psychiatric intensive care unit during 1989-91. Diagnoses were: psychotic depression (8); bipolar disorder, manic phase (13); schizoaffective disorder (14); and schizophrenia (2). All patients were very severely disturbed and had failed to respond to medication given at highest levels judged to be safe, usually over 3-4 weeks. Response to ECT was generally rapid and marked, allowing substantial reductions in medication. To achieve the same clinical outcome for each course of ECT, 50% more unilateral than bilateral treatments were required, suggesting that bilateral ECT has a more rapid effect in this highly disturbed population.

Objective: The authors examined associations between patient-related characteristics and assaultiveness on six different psychiatric wards to determine 1) the relative contributions of demographic, disorder-related, and diagnostic variables to prediction of assaultiveness and 2) how ward composition and type of victim affect prediction of assaultiveness., Method: Hospital records of 1,025 inpatients residing in psychiatric wards within a 6-month time frame were reviewed for evidence of assaultiveness. Data on all 260 assaultive patients and a sample of 136 of the nonassaultive patients were analyzed with multiple regression to predict assaultiveness scores for each ward and each victim category., Results: The findings indicated high rates of assaultive patients and assaults on fellow patients. Multiple regression results produced different predictors of assaultiveness for different wards but not for different categories of assault victim within each ward. Overall, age and sex consistently failed to predict assaultiveness, whereas greater assaultiveness was significantly associated with a greater proportion of time hospitalized since first admission. The most powerful unique predictors of assaultiveness scores were diagnostic distinctions derived from data on coexistent diagnoses. The most assaults were by acute patients whose diagnoses excluded organic mental disorder but included either bipolar disorder or personality disorder and longer-stay patients whose exclusive diagnosis was organic mental disorder., Conclusions: This identification, albeit modest, of risk factors for assaultiveness on different wards nevertheless provides information fundamental to the management policies of psychiatric institutions. The findings caution against aggregating different ward populations for research on assaultiveness and endorse the usefulness of coexistent diagnoses for predicting assaultiveness.

Four hundred and twenty-five nurses working in a 420 bed metropolitan psychiatric hospital were asked to complete a questionnaire about their experience of physical assault by patients and their attitude toward the problem. 61% returned the questionnaire. The overall mean annual rate of assault per nurse was 2.0, with student psychiatric nurses (mean 6.7) significantly more at risk than any other group. Nurses working in the psychogeriatric area reported more than double the rate of assaults reported by nurses working in rehabilitation services. 60% of respondents were female; there were very few sex differences in attitudes to assault. Overall, nurses reported a high tolerance for assault, although they recognised it as an experience that was often very traumatic psychologically. Views about managing assaultiveness differed widely, and this lack of consensus probably hinders the development of optimal strategies to deal with what is a major problem in many psychiatric units.

One year after gastric restriction surgery, 70 per cent of 118 women completed a questionnaire about lifestyle and eating behaviour changes. Mean weight loss was 35.4 kg. Patients reported a moderate reduction in appetite, and most avoided specific foods which they previously enjoyed, usually because of epigastric discomfort and/or nausea and vomiting. Patients had initiated or resumed a mean of 1.8 activities, most of which involved physical exercise. Sexual interest, enjoyment and frequency were all increased. Raised sexual satisfaction correlated strongly with overall outcome satisfaction. Seventy-two per cent of respondents rated themselves as very pleased, and 18 per cent as fairly pleased, with the overall results of the operation, and responses to the open-ended questions were often strikingly enthusiastic. However, most patients emphasized the difficulty of adjusting to radically new eating habits in the first 2-3 months after surgery, during which they experienced their greatest need for social support and encouragement.

In 1979 a Guardianship Board assumed responsibility in South Australia for the welfare of those mentally ill or handicapped people unable to look after their own health or safety, or to manage their own affairs. This study examines the attitudes to guardianship and involuntary treatment of 79 patients referred to the Board from a psychiatric hospital, all of whom were under guardianship at the time of the study. Forty-seven of their relatives took part in the project, which included measures of patients' psychiatric symptoms and relatives' punitiveness. Although almost 70% of patients objected to Guardianship in principle, they made more positive than negative statements about it. Nearly 60% rated involuntary treatment, including medication, as helpful. Patients reported a level of psychiatric symptoms less than half of that of a psychiatric outpatient sample. Relatives were strongly in favour of Guardianship, stating frequently that it allowed an improved relationship between themselves and the patient. Patients who believed that they were suffering from a mental illness were comparatively happy about being under Guardianship, and a belief that the patient was mentally ill was significantly associated with reduced extrapunitiveness in relatives.

Associations between the frequency of medical visits and psychological disturbance were explored using chronic low back pain patients from a back education class. Psychometric measures included the illness Behaviour Questionnaire (IBQ), somatic problems, and current mood. Males and females responded similarly on all psychological measures. Pain duration and IBQ disease affirmation significantly predicted visits to both general practitioners and specialists. Additional predictors for specialist visits included a self-rated pain/mood association, sex, age, and IBQ denial. Patients' expectations and attitudes about illness and treatment appeared most central to medical visits and several different forms of psychological disturbance accompanied increased visits.

Scores on self-report questionnaire measures of hostility, psychiatric symptoms, marital dissatisfaction, and assertion discomfort/behaviour were compared for male (n = 26) and female (n = 25) patients with essential hypertension and their spouses, and matched normotensive controls. Correlations and factor analysis revealed clinically meaningful associations between elevated psychiatric symptoms, hostility, and assertive behaviour. These differed for male and female patients, especially regarding assertive behaviour. The findings suggest that communication training might be helpful for a sizeable proportion of married patients with essential hypertension.

This study is based on 18 patients admitted to a psychiatric hospital with a DSM-III-R diagnosis of schizophrenia who currently were living with one or both parents. Patients and parents completed several questionnaire, including the Parental Bonding Index (PBI), the Family Environment Scale (FES), the Hostility and Direction of Hostility Questionnaire (HDHQ), and the Brief Symptoms Inventory. Observer ratings of patients' symptoms also were made. Outcome was predicted best by patients' ratings of mothers on the PBI and by mothers' scores on the HDHQ Criticism of Others scale. Other significant outcome predictors were the number of previous admissions to hospital, patients' scores on the HDHQ Projected Hostility scale and the FES Expressiveness scale, and fathers' scores on the FES Achievement-Orientation scale.

The study data were obtained from a questionnaire survey of a South Australian community support group for obsessive-compulsive disorder (OCD). The response rate was 47%, yielding 81 questionnaire sets completed by members who, on the basis of their questionnaire responses, were judged to meet DSM-III-R criteria for OCD. The clinical and demographic characteristics of the respondents were very similar to those of previously reported clinical populations. Mean age at onset of OCD was 18 years and mean duration 17 years; 55% of respondents rated their current OCD as extremely or very severe. Seventy-seven percent had received psychiatric treatment (mean 55 occasions) and 47% had attended clinical psychologists or professional counsellors (mean 20 occasions). Those who reported prominent fears of losing control of motor behaviours had received a significant excess of outpatient and inpatient psychiatric treatment. Most respondents reported the presence of all 4 identified components of OCD, of which the obsession/rumination component was central. Levels of OCD correlated strongly with levels of overall psychopathology, and fertility rates were significantly reduced in those patients who reported the most symptoms.

This study examined the personal and marital adjustment of husbands before and one year after their wives had gastric restriction surgery for morbid obesity. Seventy-five married women and their husbands were assessed by clinical interview and self-report questionnaires before surgery. Forty-three husbands (57 per cent) returned questionnaires at the 12 month follow-up, and in 36 cases both partners did so. Four couples separated in the first year after surgery. Husbands' self-reported personal adjustment before surgery was essentially normal, but their marital dissatisfaction was significantly elevated. Twelve months after surgery, their scores improved on the measure of psychoneurotic symptoms, and on assertion discomfort, extrapunitiveness and marital dissatisfaction. However, there was a significant reduction in assertion behaviour. In contrast, wives (who had lost an average of 35.4 kg) reported significant increases in extrapunitiveness and assertion behaviour, the latter increase being associate with raised marital dissatisfaction in husbands. This finding suggested that husbands' adaptation to wives' increased assertiveness is often a problem in the first year after surgery, confirming reports in the clinical literature.

Twelve patients who met DSM-III-R criteria for schizophrenia and had persistent auditory hallucinations completed a diary three times daily for 2 to 3 weeks. Using 5-point equal interval rating scales, nearly all patients were able to record consistently the nature of their hallucinations, the intensity of their delusional beliefs, and the mood and clarity of their thinking. For at least half the patients, there was a statistically significant relationship between the loudness and intrusiveness of hallucinations and the intensity of delusional beliefs; the more intrusive and distressing were the hallucinations, the more anxious and depressed were the patients. The findings suggested that more emphasis might be placed on altering patients' mood in the treatment of persistent hallucinations. The diary approach to research into auditory hallucinations appears promising.

Before gastric restriction, 118 morbidly obese women were psychiatrically assessed by clinical interview and self-report questionnaire. One year after surgery, 71 repeated the questionnaires. Weight was assessed at yearly intervals until the four year follow-up (n = 91). The maximum mean weight loss of 35 kg occurred at one year follow-up, when questionnaire respondents reported a slight overall improvement in personal and marital adjustment, and 72% rated themselves as very pleased with the results of surgery. Subsequently, 70% of patients regained weight, although the mean annual increase was only 1.9 kg. Marital dissatisfaction was a significant positive predictor of weight at one year, and generalized anxiety was a significant negative predictor of weight at four years. An increase in phobia scores at one year predicted subsequent maintenance of weight loss, whereas an increase in extrapunitiveness (mainly irritability and criticism of others) predicted subsequent weight gain.

Objective: To determine former residents' views of a therapeutic community and factors associated with a good response to therapy., Method: Retrospective, using a self-report questionnaire., Results: Of 51 contactable former residents, 32 completed the questionnaire. Responses were generally very positive, although the best outcome was reported by those who held a social-interpersonal rather than a biological view of psychiatric disorder, and who scored close to normal on a measure of intropunitiveness. Respondents emphasized the crucial role of feedback and confrontation by staff and co-residents in changing their unhelpful behaviour and attitudes, although a few thought that confrontations were too forceful. The mean duration of psychiatric disorder (mainly substance abuse and personality disorder) was more than 4.5 years. Many respondents emphasized the failure of orthodox treatments to help them, adding that their disorders would probably have continued indefinitely without treatment in a therapeutic community.

26 patients with frequency, urgency and urgency incontinence, without bladder or urethral abnormality, underwent psychiatric evaluation. They were divided into 2 groups according to the degree of neuroticism found. Treatment by group and individual psychotherapy showed that approximately one-third of the patients benefited considerably, one-third refused treatment or ceased prematurely and one-third improved slightly or not at all. The importance of excluding organic bladder or urethral disease prior to psychiatric assessment is stressed.

Symptom and personaltiy profiles of 33 agoraphobic women and their husbands are examined, revealing some evidence for assortative mating. The implications of this are discussed, and predictions are made about the changes required within a marriage in order to permit the effective symptomatic treatment of the female partner.

The treatment of a 29-year-old woman with intermittent urinary retention using biofeedback is described and discussed in the context of the pathophysiology of reflux urethral instability and related disorders of micturition. During attempts to train the patient to raise the pitch of an auditory biofeedback signal, which varied directly with intrinsic bladder pressure, evidence appeared for the involvement of sensory neuronal pathways in the disorder. This and other evidence are incorporated within an explanatory hypothesis.

Objective: To evaluate the use in a psychiatric intensive care unit of a newly introduced seclusion room for the management of acutely disturbed and/or violent patients., Method: A specially designed seclusion chart was used to document fully events immediately before, during, and immediately after seclusion. Data from the charts over a 6-month period provided the basis for the study., Results: The seclusion rate of about 2% of all admissions is less than that reported in the UK and the USA, suggesting that the facility is not used exclusively. Nursing staff welcomed seclusion as a means of reducing levels of dangerousness in the unit, but emphasized that it should be monitored carefully in order to prevent inappropriate use.

Lysis of Escherichia coli by the cloned E protein of bacteriophage phi X174 was more rapid than expected when bacteria were shifted from 30 to 42 degrees C at the time of E induction. Since such treatment also induces the heat shock response, we investigated the effect of heat shock proteins on lysis. An rpoH mutant was more sensitive to lysis by E, but a secondary suppressor mutation restored lysis resistance to parental levels, which suggests that the sigma 32 subunit itself did not directly increase lysis resistance. At 30 degrees C, mutants in five heat shock genes (dnaK, dnaJ, groEL, groES, and grpE) were more sensitive to lysis than were their wild-type parents. The magnitude of lysis sensitivity varied with mutation and strain background, with dnaK, dnaJ, and groES mutants consistently exhibiting the greatest sensitivities. Extended protection against lysis occurred when overproduction of heat shock proteins was induced artificially in cells that contained a plasmid with the rpoH+ gene under control of the tac promoter. This protective effect was completely abolished by mutations in dnaK, dnaJ, or groES but not by grpE or groEL mutations. Altered membrane behavior probably explains the contradiction whereby an actual temperature shift sensitized cells to lysis, but production of heat shock proteins exhibited protective effects. The results demonstrate that E-induced lysis can be divided into two distinct operations which may now be studied separately. They also emphasize a role for heat shock proteins under non-heat-shock conditions and suggest cautious interpretation of lysis phenomena in systems where E protein production is under control of a temperature-sensitive repressor.

This paper underlines the failure of contemporary individual and marital psychotherapies to help many married people with persisting psychological disorders. It examines the spouse's contribution to the maintenance of psychological disability, and discusses the problems of constructively involving such spouses in conjoint therapy. Spouse-aided therapy addresses this problem by inviting the patient's spouse to become a co-therapist. It is explicitly not a marriage therapy, and is conducted on a goal-orientated time-limited out-patient basis. During discussion of problems with achieving treatment goals, the focus of therapy shifts from the patient's symptoms to marital interaction. Confrontation of the spouse's contribution to the patient's continuing disability then becomes possible, and is followed by changes in marital interaction which generally facilitate the patient's improvement. Many couples choose to proceed with marital therapy after spouse-aided therapy has allowed them to reconstrue the patient's symptoms in interactional terms.

Ninety-six out of 137 consultant psychiatrists working for the majority of their time in the London area outside academic units returned questionnaires concerning attitudes to their work. Analysis of the 88 fully completed questionnaires suggested the existence of four relatively discrete but overlapping patterns of psychiatric practice in the Regions concerned, of which two largely excluded individual psychotherapy. These findings are discussed in relation to the education in psychotherapy of trainee psychiatrists working in mental hospitals.

One hundred and eighteen of 142 morbidly obese women had gastric restriction surgery after completing self-report questionnaire measures of psychosocial adjustment as part of their preoperative psychiatric assessment. Compared with an age-matched normal population, they scored significantly higher on measures of phobic anxiety, somatization, depression, hostility, and marital dissatisfaction, the last being associated mainly with later onset obesity. Factor analysis of questionnaire and weight data showed that weight was largely independent of psychological adjustment, although associations occurred when analysis was restricted to the data on married women, in which marital and self-assertion abnormalities loaded significantly on the same factor.

The author describes 4 patients in whom radically new symptoms appeared after intensive behavior therapy. He suggests that fresh symptoms are most likely to develop in a small minority of patients who are unable to learn more adaptive psychological defense mechanisms during or after behavior therapy and that psychoanalytic theory may help predict the nature of such symptoms.

Twenty male and 20 female agoraphobics, matched for age and marital status, were systematically compared using self-report questionnaire measures of symptoms and hostility, and clinical observations. The males differed significantly from the females as follows: the males were less phobic of social situations but more preoccupied with somatic symptoms and related fears. The females were more phobic of mental illness, more extrapunitive, and reported fewer obsessional symptoms. Two distinct but overlapping clinical sub-groups of males were defined. The sub-group in which separation anxiety, extreme dependence on spouse, denial of hostility and hypochondriasis were prominent, responded poorly to behavioural treatment; the sub-group in which a fear of loss of control of aggressive impulses and generalised anxiety were prominent, responded comparatively well to behaviour therapy.

The use of seclusion within a psychiatric intensive care unit in a South Australian metropolitan mental hospital was documented over a ten week period. The seclusion rate within the unit was 32% of all admissions and 34% of new admissions. The overall seclusion rate for the hospital was 5.4% of all admissions and 6.3% of new admissions, somewhat higher than in the United Kingdom but considerably lower than in the Eastern United States. A comparison was then made between consecutive new admissions (30 secluded and 30 non-secluded) to this unit and to a similar unit without a seclusion room in the other mental hospital in the State. Although seclusion offered no clear advantages in terms of duration of admission, levels of medication or relapse rates, it appeared to reduce the level of dangerousness in the unit, thereby enhancing staff morale. The overall mean daily total of neuroleptic medication was about 1,200 mg chlorpromazine equivalent, somewhat less than in comparable units in the United States and Europe.