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It is difficult to determine exactly when I began this book, as such. However, the research on latent inhibition was initiated in the late 1950s while I was still a graduate student at Cornell University. The next memorable date for measurement was the publication of an article reviewing the latent inhibition literature in the Psychological Bulletin (1973), which appeared in about half of its original length. The conditioned attention theory of latent inhibition was developed later in a series of articles in the Journal of Experimental Psychology: Animal Behavior Processes in the mid-1970s, and then presented more fully in a chapter in Progress in Learning and Motivation edited by G.H. Bower (1981). The idea of developing this material into a book emerged during a sabbatical year at Yale University, 1977–1978, while much of the writing itself was postponed until another sabbatical, 1981–1982, as an Israel-Canada Fellow at Concordia Unversity. To all of these institutions, and to the individuals who were responsible for inviting me, I express my sincerest gratitude, particularly to Allan Wagner and Eugene Rothman.
In addition, throughout the years I have been fortunate to have my research supported by a number of organizations: The National Institutes of Health were particularly encouraging, especially at the early stages of my career with a Career Development Award. Other support has come from the Scottish Rite Schizophrenia Research Program and, in Israel, from the Charles Smith Psychobiology Fund, the Israel National Academy of Science, Israel Research Trustees Foundation (Ford), and Tel-Aviv Unversity.
Similarity of preexposed stimulus and test stimulus
Studies of the influence of stimulus preexposure on subsequent learning usually assume that these effects are stimulus-specific. That is, preexposure to stimulus A should not retard the subsequent acquisition of an association between stimulus B and another event. This assumption is particularly critical if one maintains the idea that the subsequent decrement in the acquisition of the association between A and another event is a result of some previous associative learning during the preexposure phase. Associative learning, by definition, presumes some degree of stimulus specificity. Indeed, the apparent absence of such specificity in the learned helplessness effect, at least in rats (Maier & Seligman, 1976) in which preexposures of a motivationally significant stimulus is administered, by itself, might raise the question whether or not one is dealing with an associative learning phenomenon. For latent inhibition, across different paradigms, the results are quite clear. The decremental effects of preexposure of the to-be-conditioned stimulus on subsequent acquisition of a new association are, without doubt, stimulus-specific.
Such stimulus specificity may be demonstrated in several ways. (1) A within-subject experimental design may be employed whereby the animal is preexposed to stimulus A and tested on both stimulus A and stimulus B. When appropriately counterbalanced, slower learning to the familiar stimulus compared with the novel stimulus serves as evidence for the stimulus specificity of latent inhibition. Such a design was employed by Lubow and Moore (1959), Reiss and Wagner (1972), and Wickens et al. (1983).
Human behaviour is a key to health, and changes in behaviour have a profound influence on patterns of morbidity, and mortality from disease.
This fact is not a new discovery. From the earliest days of human history, behaviour has been the focus of most of the action aiming to prevent and treat illness. Dietary and hygienic prescriptions are embedded in most religions and rituals of mourning are undertaken by the bereaved to help them overcome stress. Societal relations are regulated to strengthen supportive social networks. In the past, links between behavioural change and the course of disease were frequently not well understood, and behavioural action was recommended because of the correlations observed – recommended nevertheless with force and insistence.
The twentieth century brought with it clear evidence of causal links between specific forms of behaviour – including attitudes, action and comprehension – and improvement or deterioration of health states. An impressive amount of literature has been produced over the past decades in this area, and both the public and the scientific community have become acutely aware of the need to influence behaviour if progress is to be made in promoting health, preventing disease, or decreasing suffering of those in whom it has appeared. Insistence that appropriate action be taken has not only stemmed from scientists; government leaders have also addressed the question. The World Health Assembly, bringing together chief health executives from 160 member states, for example, has devoted much of its time to the discussion of this matter.
The broad scope and the seriousness of the burden of illness directly associated with behaviour have been recognized as a major problem of public health and health policy. A good way of obtaining data on and indicators of mental morbidity is to investigate the clientele of general practitioners (GPs). In the overwhelming majority of the patients diagnosed as suffering from a mental disorder or disturbance, both physical and mental symptoms are present. Case registers enable continuous investigation and documentation of changes in the utilization of psychiatric services. In depressions, illness-related behaviour becomes important in terms of how the patient reacts to the mental strain caused by physical illness and the possible threat to his life. Social status and social class are among the main factors influencing mental health and life expectancy. The frequency, severity, first onset, distribution, course, and outcome of mental illness may be subject to environmental factors.
Throughout the world there are many millions of children whose diet is grossly deficient, who live in poverty-stricken circumstances, who are inadequately clothed, and housed in cramped quarters, and who receive little or no education. The most obvious adverse results of the development of modern technology on the health of children are in the areas of physical disability. Environmental hazards affecting child mental health are less well documented. On a much more widespread basis, patterns of employment that depend on migrant workers impose a different type of stress on children. Children may be in danger not just because of the influences acting upon them, but also because of the attributes they themselves possess. In both developing and developed countries it is apparent that much greater emphasis is given to physical than to mental health problems in both the training and the practice of those involved in primary health care.
This chapter highlights research needs and opportunities in the area of health and population movements. Research is under way to assess the present health status of this migrant population and the health impact of these settlements on the new agricultural environment. The main objective of the recommended research studies is to assist in the planning and implementation of health programmes, either for primary health care or for disease control. Research projects need to be theoretically sound and, at the same time, practical in orientation, so as to yield results that can be easily incorporated into health and development programmes. An important area of research is systematic study of the relationship of short-term circulation patterns to the transmission of AIDS, with variables such as age, sex, neighbourhood, clan, class, income, and occupation being used to stratify the samples.
Mental disorders are not only very much more common in health care settings than in random samples of the population but also that they are frequently unrecognized by medical professionals. Patients who have mental illnesses that are not detected by their doctors have been termed the hidden psychiatric morbidity of general medical practice. Since mentally disordered people can become physically ill for the same reasons as mentally healthy people, we should expect to find some patients in general medical settings with two unrelated illnesses, and this certainly does happen. Somatization has been succinctly defined as the expression of personal and social distress in an idiom of bodily complaints for which medical help is sought. There is enormous variation among individual physicians both in their ability to detect mental illness and in the kind of treatment they give patients with particular disorders.
In North America, on the basis of data drawn mostly from the United States, the age range for adolescence is often put at ages 10-20 years; most of the data from Latin American nations report on ages 15-19 years. There is a pressing need for epidemiologic research on health/mental health problems of adolescents, particularly in the developing nations. Improving adolescent health and reducing adult morbidity and mortality can be achieved by greater understanding of effective ways to change adolescents' behaviour toward promoting health and preventing disease. Although adolescent pregnancy is not new to Latin America, only in the recent past has it emerged as a major concern of health personnel and policymakers. The use of tobacco and alcohol is an example of behaviour that is widely prohibited to adolescents, but socially acceptable and legal for adults. In the United States much of the drug education has been ineffective or counterproductive.
Food habits formed under particular social and economic conditions, and entirely adequate to those conditions, may be carried by individuals and groups into other settings where they may be unsuitable and even harmful to health. Human behaviour as it relates to food embraces a complex of culinary activities and patterns of consumption resulting from the interaction of ecological, economic, technological, and social factors. This chapter deals with the cultural definition and classification of foods, traditional beliefs and practices as they affect nutrition and health. It also presents the symbolic roles of food that contribute to the integration of social and political units, of nations, communities, and families. Food habits are both changeable and conservative, as they are based on deeply rooted cultural traditions. In suggesting alternatives to existing practices, one must carefully consider, in advance, the costs involved and the means of attaining the desired change.
Health problems and health practices within a community can be considered functions of the prevailing ecological conditions, which include cultural, social, and economic factors. It is significant that the introduction of Western medicine sets very complex interactions in motion in a developing country. Numerous instances of adoption of the healing practices of qualified or nonqualified practitioners of the different indigenous systems of medicine, of homeopathy, or of other, nonprofessional healers were observed in the village study. Changes in the approaches of the World Health Organization (WHO) to the health services development of its Member States during the past three decades and a half reflect changes particularly in developing countries. Western medicine is grafted onto cultural conditions in which it is essentially an alien element; it sets in motion complex interactions with the pre-existing health culture.
In the preservation of mental health, supportive social networks such as family, neighbours, and friends enjoy increasing importance. There are considerable quantitative differences in the structures of social networks of the population in general and those of persons suffering from mental disorders. Among the various benefits of membership in a social group, the social support and emotional ties it affords is of special importance for coping with stressful life events and the preservation of mental health. The few studies conducted far among elderly people have focused on the effects of the loss of close relatives. Especially in countries and areas with inadequate professional health services, lay referral systems play an important role in the counselling, care, and nursing of the sick. The influence social networks have on the decision to consult medical services suffices to illustrate their importance as normative reference groups.
Though poverty, malnutrition, and disease are responsible for developmental deficiences in many of the world's children, the psychological environment also plays an important role, and is often more manageable than the major physical problems. Though variations in behaviour due to the environment may be primarily a function of the microsystem, the influences of that system are themselves shaped by higher-level factors within the system. Across a variety of cultures, urbanization and industrialization have been implicated as causing a reduction in family interactions, increased intergenerational conflict, and inadequate socialization of children. Parental values and direct parental interaction have been noted to be important for the cognitive development of school-age children and adolescents. Our ultimate goal must be to utilize our knowledge to devise comprehensive programmes for developing maximal competence in children across a wide range of dimensions.
The heaviest burden of illness today is related to individual and group behaviour. Numerous other behaviours are also highly relevant to health and disease, both mental and physical, of the individual and those around him (for example violence and suicide). Cigarette-smoking is the single most important environmental factor contributing to early death in the more developed countries. In developing countries, as in developed ones, health and behaviour are indivisible. An important precursor for an expanded research programme is a systematic assessment of the burden of illness that is attributable to psychosocial factors. This chapter presents the editors' comments on the following three topics: the social context of health, the development of children and adolescents, and mental health in general health care. Involving general health services may not be enough: even if they are fully involved, much remains undone, as the experience of developed countries has demonstrated.