An account is given of attachment theory as a way of conceptualizing the propensity of human beings to make strong affectional bonds to particular others and of explaining the many forms of emotional distress and personality disturbance, including anxiety, anger, depression and emotional detachment, to which unwilling separation and loss give rise. Though it incorporates much psychoanalytic thinking, many of its principles derive from ethology, cognitive psychology and control theory. It conforms to the ordinary criteria of a scientific discipline.

Certain common patterns of personality development, both healthy and pathological, are described in these terms, and also some of the common patterns of parenting that contribute to them.

The Gods did not reveal, from the beginning, all things to us; but in the course of time, through seeking we may learn, and know things better.

Xenophanes

Seventeen patients were treated by group desensitization and auto-hypnotic training over a period of six weeks for flight phobia, with a highly significant, reduction of fear for the group. Expectation of benefit correlated positively with fear reduction.

Symptom and personality 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.

Seventy-eight psychiatric in-patients were allocated to personal illness classes by means of the Delusions-Symptoms-States Inventory (DSSI). Paper and pencil measures of psychomotor speed and scatter of tapping were administered with an immediate retest. It is suggested that from a social desirability position one would have to predict that the more personally ill (i.e. those endorsing the more socially undesirable items) would be slower and more diffuse on these measures. We found, however, such patients to be more constricted and slower. It is concluded that such a combination adds to the utility and validity of the hierarchy of classes of personal illness.

The coroner's records of no accidental deaths resulting from poisoning, drowning and falling were examined for evidence of mental illness. Sixty per cent were classified as mentally ill before they died, depression, drug dependence and alcoholism accounting for over three-quarters of the diagnoses. Deaths given accident verdicts should be included in the study of the mortality of the mentally ill.

From a sample of psychiatric referrals who had completed the MMPI the following three groups, matched for age and sex, were derived: 42 patients with a history of a serious suicide attempt, 42 patients with a history of a non-serious attempt, and 126 patients who had neither attempted nor contemplated suicide. Non-serious suicide attempters were shown to be the most deviant group and differed to a significant extent from each of the other two groups on the Dependency, Hostility and Unconventionality scales. Male non-serious attempters showed the most disturbed personality profile. This implies that there is, for males, a higher personality threshold for making a non-serious attempt, which may account for the fact that suicide attempts, most of which are non-serious, are commoner among females.

Evidence suggests that anomalies of functional organization in the brain may be present in some psychiatric disorders and that EEG differences between psychiatric patients and appropriate control groups may depend on them. It is therefore of practical importance to develop further ways of examining the association between the EEG and such organization. The change in inter-hemisphere coherence (a measure of EEG synchronicity) in the alpha frequency band when carrying out a task is shown to discriminate a group of 11 right from 11 left preferent normal individuals. Since right and left preference is associated with differences in cerebral functional organization, the coherence measure may be a useful way of studying this feature of psychiatric illness.

Nineteen volunteers completed a Moos Menstrual Distress Questionnaire daily for a period exceeding one menstrual cycle. The data were analysed, using a least mean square method of fitting sine waves. The fact that the results obtained on this group are essentially those found by other workers looking at the menstrual cycle suggests that this may be a useful method for assessing menstrual distress.

In a study of male addicts attending a London drug dependence unit, it was found that convicted addicts tended to score more highly on measures of hostility than non-convicted subjects. The differences in hostility between the convicted and non-convicted groups were most clearly seen on the violent crimes variable, although addicts convicted of drug-possession and of non-drug crimes were also more hostile than non-convicted subjects. It is suggested that hostility acts as a personality factor which predisposes the individual towards criminal behaviour, and that the more hostile subjects may also be more likely to be apprehended and convicted.

A group of alcoholics treated by partially reinforced electrical escape conditioning were found to have a significantly better outcome on follow-up than a selected control group, who showed a parallel level of motivation, and were treated by conventional methods. No sex differences in outcome were found for either group. In the experimental group, better prognosis was associated with higher social class and older age, and poorer prognosis with single marital status. There were no variations in outcome for age in the control group. In the age range 20–40 aversion therapy showed no better results than conventional therapies, but with subjects above this age range it was very significantly superior. The results are discussed with reference to the application of aversion therapy to alcoholism.

Although ward behaviour rating scales for use with long-stay psychiatric patients by nurses have been in existence for many years, their content tends to reflect the opinions of psychiatrists and psychologists rather than those of nurses. An analysis of five commonly used rating scales illustrates the lack of agreement on what should be included. The opinions of 76 nurses from four separate hospitals were sought, using a 34-item questionnaire, to establish what areas of content were considered important in nursing practice. Apart from agreement on general content, consideration should also be given to the presentation of individual items of ward rating scales.

The fitting of the multifactorial model of disease transmission to the familial clustering of hysteria and sociopathy by Cloninger et al (1) involved an approximation. This note reports the results of fitting the bivariate Normal model exactly and also two other distributions.

The reasons which led to the search in the brain for substances with morphine-like actions are discussed. Two pentapeptides, methionine-enkephalin and leucine-enkephalin, were isolated. The amino acid sequence of methionine-enkephalin occurs also in the pituitary prohormone β-lipotropin, of which longer fragments (endorphins) of up to 31 amino acids exhibit strong morphine-like action.

The physiological significance of these short and long opioid peptides is discussed, particularly with regard to their possible roles as neurotransmitter or neuromodulator.

With regard to the mechanisms involved in the development of tolerance to and dependence on opiates, the importance of interaction between the endogenous opioid peptides and the exogenous opiate alkaloids is stressed.

The possible therapeutic implications are discussed briefly.