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We previously observed 2- to 3-day-old (P2-3) rats perform maternally directed orienting behaviors (MDOBs)-locomotion, torso flexion, rotation to the supine orientation, and snout probing, accompanied by audible vocalizations (barking)-under surfaces having properties of the dam's ventrum, which result in close contact between the pup's ventrum and the surface. We now report on the development of MDOBs from birth through P2. Wistar rats (24 litters) were tested at one of four times: 1 hr after birth before the first nursing bout (P0pre), on the day of birth after the first nursing bout (P0post), on postnatal Day 1 (P1), or on postnatal Day 2 (P2). Pups were placed prone on a warmed platform inside a corral where, for 4 min, they encountered one of two motherlike surfaces at head height: (a) a soft cotton roof or (b) a patch of the pup's own anesthetized dam's ventrum. Control pups received no overhead stimulus. The behaviors we had identified as MDOBs and others, including limb behaviors, are easily recognized at P0pre, and, in aggregate, are more frequent then than at any later age. The differential responsiveness of most of the behaviors to the dam's ventrum compared to the cotton roof or open condition is relatively low at P0pre, but rises rapidly through P2. Behavioral structure develops quickly from a rudimentary principal component with two behaviors at P0pre to two principal components incorporating seven behavior classes by P2. MDOBs are discussed in relation to late-term fetal behaviors, early postnatal righting responses, and the oral nipple grasp, and as a model of the development of filial attachment in an altricial mammal.

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We observed an organized repertoire of behaviors performed by newborns of the laboratory rat when placed under suspended artificial surfaces simulating various properties of the awake dam's ventrum. Pups traveled and wriggled, turned on their sides and upside down, ventroflexed and probed into the surface while on side or upside down, and audibly barked, all in a state of heightened behavioral arousal. Within 48 to 72 hr after birth, these behaviors generally increased with the addition to the simulation of more maternal features, including the texture of the dam's ventral fur and odor, separately and in combination. In addition, the behaviors were intensified by 18 hours of maternal deprivation. The possible functional relations among the components of this repertoire, which we refer to as "maternally directed orienting and proximity-seeking behaviors," and between these behaviors and nipple attachment and suckling, are discussed.

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The developmental course and behavioral processes by which infant rats come to prefer one of two prominent natural odors within their rearing environment, those of their mother and home nest shavings, was studied. Pups as young as 4-5 days and as old as 9-10 days prefer their mother's odor that of their home nest shavings in a two-choice test chamber; pups deprived overnight prior to testing express that preference more strongly than nondeprived littermates when the mother is awake, but not when anesthetized. Encountering maternal and shavings odors in a two-choice paradigm engages a behavioral sequence that progresses from arousal and active sampling of both odors during the establishment of preference to increased mouthing after the choice has been made. A .5 degrees C thermal gradient augments the maternal preference response from 4-5 days of age on, and is necessary to it in 2-day-olds. One-day-old pups do not express a preference for their mothers in our test apparatus on the basis of odor even with the addition of a .5 degrees C thermal gradient, suggesting that preference for the odor of mother over home shavings may be acquired between 1 and 2 days of age.

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OBJECTIVE: This study investigated the hypothesis that specific types of maternal touch that might promote infant growth are reduced in cases of failure to thrive (FTT) and tested reports that maternal physical interaction and physical affection are diminished in FTT. METHODS: Frequencies of operationally defined maternal touch categories were scored by blinded raters from videotaped mother-child feeding and play interactions of 21 children, aged 9 to 19 months, with FTT and 18 normally growing comparison children. After scoring and statistical analyses were completed, investigators unblinded to group status and clinical data reviewed the videotapes of the dyads with the lowest touch scores. RESULTS: Mothers of children with FTT provided less matter-of-fact touch in feeding (p = .017) and unintentional touch in play (p = .048) than the comparison group, and there was a trend (p = .082) for them to provide less proprioceptive stimulation in play. Unblinded case reviews indicate that, among children with FTT, extremely infrequent touch signals a marked touch aversion by either the mother or child. CONCLUSIONS: Types of maternal touch that may promote growth or facilitate feeding are reduced in FTT, due, in extreme cases, to maternal or child touch aversion. Clinicians evaluating FTT should be alert to very infrequent touch in the mother-child interaction and consider whether it may represent a maternal intolerance of physical contact with her infant or a problem with the infant's feeding competence.

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Positive and negative affects were assessed in 28 6- to 36-month-old children with failure-to-thrive and 14 normally growing children in feeding and nonfeeding situations. The roles of malnutrition and severity of organic effects also were examined. Failure-to-thrive children expressed less positive affect in the feeding and nonfeeding situations and more negative affect in feeding than normally growing children. Among failure-to-thrive children, the presence of both acute and chronic malnutrition was associated with heightened negative affect during feeding, whereas the degree of organic contribution had no effect. These results, if replicated, may have implications for clinical assessment and are discussed in terms of current theories of failure-to-thrive.

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A new required psychiatry course for first-year medical students linked the urgent need for acquired immune deficiency syndrome (AIDS) education with the traditional goal of teaching the biopsychosocial model of illness. The course, "Human Behavior in Disease: AIDS as Paradigm," used HIV/AIDS to demonstrate principles of all life-threatening diseases. Formal evaluations of the course's impact indicated that it significantly reduced students' prejudices and increased positive attitudes regarding AIDS patients. The students' ratings of the course indicated that the AIDS paradigm was understood and valued. Our experience suggests that preclinical psychiatry courses can play an important role in the medical educational response to AIDS, while, at the same time, achieving their traditional curricular goals.

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As more patients with AIDS and AIDS-related syndromes are admitted to psychiatric units, staffs must meet new diagnostic and therapeutic challenges while adapting to the unique stresses of treating these patients. The authors discuss several case vignettes to illustrate how the staff of a voluntary acute-stay psychiatric unit progressed over a two-year period from having difficulty treating AIDS patients within the usual therapeutic milieu to directly confronting the issues raised by the disease both among themselves and in the patient community. The authors believe that the staff's ability to cope with AIDS patients may have strongly influenced the patient community's ability to cope, and that clinical experience and educational programs were major contributors to the staff's adaptation. They conclude with several recommendations for psychiatric staffs beginning to treat AIDS patients.

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As more individuals whose lives are affected by acquired immune deficiency syndrome (AIDS) begin to need psychiatric hospitalization, psychiatric staffs must be prepared to handle the strong feelings aroused by the disease. The authors present case vignettes of four patients with AIDS-related problems admitted to a voluntary acute-stay ward of a teaching hospital. They then discuss the largely indifferent reaction of the other ward patients to the AIDS-related patients, the tense and fearful reaction of the staff, and the subsequent interruption of the usual functioning of the therapeutic milieu. To develop an optimal management plan, the authors recommend attention to specific principles of patient and milieu assessment.

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