UNT Theses and Dissertations - 102 Matching Results

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Haptic Visual Sensory Integration: A Comparison Between Normal, Schizophrenic, and Brain Damaged Groups
Neuropsychological tests have been used in differentially diagnosing schizophrenic and brain damaged populations. Research indicated some subgroups of schizophrenia exhibit certain symptoms of brain damage; and that schizophrenia involves difficulty in sensory integration. The Haptic Visual Discrimination Test (HVDT) designed to test tactilevisual integration, Bender Gestalt, and Information and Digit Symbol subtests of the WAIS were used to test performance abilities of forty schizophrenic subjects, forty subjects medically diagnosed as brain damaged (10 right hemisphere, 10 left hemisphere, and 20 diffuse), and normals as defined by the standardized age norm scores.
Muscle Tension and Locus Of Pain in Subjects With and Without Chronic Backpain
The purpose of the study is to examine the relationship between the location of the initial onset of back pain as revealed by the subject's pain drawing and the site of maximum muscle tension at rest, while jaw-clenching and during a cold stressor, in men and women. Subjects were 30 males and 30 females divided into three groups of 10 males and 10 females each and designated according to back pain history as no back pain (NBP), upper back pain onset (UBP) and lower back pain onset (LBP). Six bipolar, bilateral electromyographic (EMG) recording sites were instrumented on each subject. EMG levels were recorded from the forehead, forearm, upper back, lower back, thighs and ankles under conditions of rest, jaw-clenching and a cold stressor. Seven hypotheses predicted that EMG levels would distinguish groups and gender of the subjects and that interactions would exist between site of pain onset and EMG elevations.
Neuropsychological Assessment of Brain Damage: A Validation Study of the McCarron-Dial System
The present study investigates the effect of brain damage on verbal-spatial-cognitive (VSC) and sensorimotor (SM) measures included in the McCarron-Dial System (MDS). The subjects include 141 brain damaged adults and 42 psychiatric controls. The following research questions are addressed: (a) Does the brain damaged group differ significantly from controls? (b) Are there significant differences among left, right, anterior, posterior, and diffuse brain damaged groups? (c) Do early onset, late onset, acute, and chronic damaged groups differ significantly? and (d) Does a cerebral palsy group differ significantly from a non-CP brain damaged group?
The Irritable Bowel Syndrome a Dietary and Multi-Element Psychological Approach to Its Treatment
The present study sought to determine whether a dietary and multi-element psychological treatment (DMPT) approach in combination with standard medical treatment would offer a more efficacious therapeutic package to irritable bowel syndrome (IBS) patients than would standard medical treatment (SMT) employed alone. The DMPT group (N = 19) received a stress management training package for a 2 week period consisting of relaxation training, imagery, and bowel sound biofeedback training via a stethoscope, in addition to instructions to increase their daily consumption of dietary fiber. They also were to continue the implementation of whatever standard medical treatment they were currently receiving, be it a bulking agent, or anti-anxiety, anti-cholinergic, or anti-depressant medications, etc. The SMT group (N = 19) simply received whatever conventional medical treatment they had been prescribed.
Partial Reinforcement in Frontalis Electromyographic Training
This study investigated the role of reinforcement schedule and instructional set in frontalis EMG training. The experiment consisted of four groups participating in 30 minute sessions on three consecutive days. Group conditions were intermittent feedback (alternating 100 second trials), continuous feedback, motivated control and no-treatment control. Excepting the no-treatment controls, each subject was instructed that extra credit points were available contingent on the number of seconds in criterion. An individual criterion based on each subject's initial baseline microvolt level was utilized.
The Chemically Sensitive Individual: Validation by Criterion Group Identification
The purpose of this study was to delineate those variables which are indicative of the patient whose health may be adversely affected by sensitivity to chemicals. In stage One analysis, the files of 10 chemically sensitive and 10 non-chemically sensitive patients were used to establish criterion variables as previously defined by legal proceedings prior to the study. Chemically sensitive and non-chemically sensitive patients were compared on all variables included in the study to empirically determine those variables which demonstrated significant differences by chi square analysis.
Enkephalin Hydrolysing Activity in Alcoholism and Related Changes in Mood and Ability to Perform a Biofeedback/Relaxation Task
Evidence linking the development of chronic alcoholism with endogenous opioid peptides is reviewed. Particular emphasis is placed on enkephalin metabolism with respect to its involvement in the development of addiction and stress-related psychophysiological changes. The study was concerned with enkephalin hydrolysing activity (EHA) in chronic alcoholism as well as the mood changes that reportedly accompany alcoholism. Also of interest was the relationship of enkephalin degradation to voluntary relaxation.
Relaxation Imagery to Facilitate Endogenous Control of Lymphocytic Function in Humans
Whether an individual's state of mind can influence the body's immune system has been studied for several decades. Historical notions of a homeostatic, self-contained, and self-monitored system have been discarded. Studies have explored conditioning effects and cognitive behavioral methods to affect the immune response. This study is based on the assumption that relaxation imagery can be used as an endogenous means to produce specific physiological change in the immune function. Subjects were instructed to make a directional change in the absolute number of peripheral lymphocytes using relaxation imagery.
The Role of Self-Efficacy in Predicting Adherence/Compliance to Health Behavior Regimens
The purpose of the present study was to investigate the relationship between Self-Efficacy Theory (Bandura, 19 77) and adherence to health behavior prescription. A self report Self-Efficacy Questionnaire was developed to assess levels of efficacy. Dietary adherence was determined by self report as well as body composition assay and measurement of body weight. Levels of exercise compliance were assessed by self report in addition to a treadmill test.
Mirthful Laughter and Directed Relaxation: a Comparison of Physiological Response
The differences among certain physiological changes occurring in response to mirthful laughter, directed relaxation, and verbal speech were investigated. These changes included amount of muscle tension, as measured with surface electromyography, in the forehead and in the upper body as recorded from the forearms bilaterally, peripheral surface skin temperature, heart rate, and respiration rate. The study sought to determine whether the net effect of laughter, as measured on these five variables after a three-minute refractory period, is a more relaxed state than existed before the laughter. Determination of the similarity between the changes following laughter and the changes following directed relaxation was made in comparison with the changes following verbal speech. Factors of prior anxiety, pre- and post-self-esteem levels, humor level, and laughter intensity were examined. Historical and theoretical perspectives were reviewed, as well as the known information on physiological responses to laughter.
Assessment of Brain Damage: Discriminant Validity of a Neuropsychological Key Approach with the McCarron-Dial System
The present study investigates the predictive accuracy of a key approach to interpretation of the verbal-spatialcognitive (VSC) and sensorimotor (SM) factors of the McCarron-Dial System (MDS). The subjects include 99 brain damaged and 30 normal adults. The following research questions are addressed: (a) Does the neuropsychological key classify brain damaged and non-brain damaged subjects at a level significantly above chance? (b) Among the brain damaged subjects, does the neuropsychological key identify right brain damage, left brain damage and diffuse brain damage at an accuracy level significantly above chance? (c) Is the neuropsychological key approach superior to the empirical model derived from discriminant function analysis in predictive accuracy? The neuropsychological key correctly classifies 90% of the cases as brain damaged and 90% of the cases as non-brain damaged, for a total of 89.9% predictive accuracy. The obtained Kappa coefficient of .74 is statistically significant. The key accurately classifies 71.4% of the brain damaged group as right damage, 70% as left damage, and 93.8% as diffuse damage, for a total predictive accuracy of 7 9.5%. The Kappa coefficient of .68 is statistically significant. Chi square analysis of the difference between the key approach and multiple discriminant function analysis reveals that no significant difference is present between the accuracy of the two approaches in differentiating between brain damaged and non-brain damaged, or in differentiating among left, right and diffuse brain damage. The results support the validity of a neuropsychological key approach to interpretation of the McCarron-Dial System, although cross-validation is indicated to confirm the stability of these results. Differences in sex, educational level and racial composition of the comparison groups may have affected the results obtained. Refinement of the key in future research and the addition of test instruments assessing memory, auditory processing, attention and emotional/behavioral variables are recommended.
Cognitive Coping Strategies with Chronic Back Pain Patients
Low back pain has long been estimated to be the most prevalent and debilitating source of chronic pain. The present study first reviews the literature addressing the various theories of pain, the physiological and psychological variables important in pain research, and the psychotherapeutic approaches that have been used to date to reduce pain. Thirty-seven hospitalized chronic back pain patients were administered the cold-pressor test and a medical pain stimulus procedure which was medically relevant to their back pathology. A card-sort method was utilized in order to assess the coping strategies employed by the patients during these two pain stimulus tasks. These procedures were repeated following treatment. Coping strategies used by patients during the two pain tasks were compared. Results demonstrated that there was a significant difference in the manner in which patients coped with the two types of pain. Cold-pressor measures of pain threshold and tolerance were not significantly different between pretreatment and post-treatment. These measures were also not positively correlated with treatment outcome. A multiple regression approach demonstrated that particular coping strategies were significantly predictive of treatment outcome. The medical pain stimulus procedure was found to provide more significant pedictor variables than the cold-pressor test. At pre-treatment assessment, patients who relied on dramatized coping strategies were less likely to be successful in treatment. Breathing activity and pain acknowledgement were positive coping techniques highly predictive of successful outcome in this study. The use of computers for assessment and other recommendations for future research were discussed.
A Measure of Dependency in Patients with Chronic Illness: Clinical Ecology
This study briefly reviews both historical and recent conceptualizations of dependency. In particular, it focuses on this concept's applicability to patients with chronic illnesses, especially those with allergies. Type and degree of dependency were seen as an important factor in the approach to the medical and psychological treatment of clinical ecology patients. The purpose of the study was to develop an objective measure of dependency which could quickly identify patients whose dependency conflicts interfere with the treatment process. The study was divided into three phases. In the first phase test responses by 84 inpatients to the CAQ, MMPI, and the HAT as well as historical and demographic data were analyzed by a series of stepwise discriminant analysis. The 53 resulting items were examined for those which most concisely discriminated between the two identified groups (pathologically dependent and nonpathologically dependent). These 15 items were used to test 120 additional patients in phase II. Fourteen items were retained and the coefficients obtained classified the patients in phase I and II with a 98.81 percent and 94.17 percent degree of accuracy respectively. These classification coefficients were used to classify another 30 patients in phase III with a 96.67 percent rate of accuracy. These results provide exceptionally strong support for the hypothesis that group classification can be obtained through the use of an objective screening instrument. The pathologically dependent patients tend to focus on disease, frequently are unemployed, have histories of childhood illnesses, have limited emotional controls, are depressed, ambivalent, and distrustful. Additionally, they experience difficulty establishing goals or accepting personal responsibility. Those patients identified as nonpathologically dependent exemplify the more positive aspects of these traits. The pathologically dependent patients appear to be caught in a dilemma between wellness and satisfaction of dependency needs. While all patients need an organized approach to treatment, the …
Temperature Biofeedback and Visual Imagery in the Treatment of Migraine Headaches
After an initial four week baseline period, during which headache activity and medication consumption were monitored, 28 migraineurs were randomly assigned to one of the following groups: (a) the biofeedback temperature warming group, (b) the visual imagery group, (c) the combined treatment group, or (d) the comparison group. All four groups continued to monitor their headache activity and medication consumption during the eight week treatment period and the eight week follow-up period. A two way analysis of variance computed on groups over time indicated a significant decrease in headache activity and medication consumption. During the follow-up period (a) the combined treatment group had significantly fewer headaches than the biofeedback group or the comparison group and (b) the visual imagery group and the combined treatment group had significantly fewer headache hours than the biofeedback group or the comparison group. These results do not appear to be attributable to differences between groups on the amount of time spent in home practice or subjective ratings of relaxation. There was no consistent relationship between increases in finger temperature and headache activity improvement. Decreases in powerful other scores, as measured by the Health Attribution Test, and increases in subjective ratings of internal control were consistent with a reduction in headache activity and medication consumption.
A Comparison of Imagery Relaxation and an Educational Treatment Modality for Dysmenorrhea
This study is a comparison of four treatments involving education and imagery relaxation for the amelioration of dysmenorrhea. Treatment was presented to 76 subjects by videotape during a one-hour session. A six month follow-up was performed using one of the original instruments, the Symptom Severity Scale (Cox & Meyer, 1978) and a questionnaire designed for the study. Analysis of the test instruments indicated a significant treatment effect for the educational group. The second most effective treatment was a combined treatment utilizing imagery relaxation and education, although this group did not produce significant results. The no-treatment control group was more effective in diminishing symptoms than the fourth group, imagery relaxation alone. The lack of effectiveness of the imagery relaxation treatment was hypothesized to be due to lack of reinforcement of the technique. The educational treatment modality offered the individual an opportunity to learn about many different etiological facets of dysmenorrhea, including biological, learning, and cognitive factors. The presentation also introduced the individual to several different treatment modalities in order to provide an armamentarium of effective methods for diminishing or eliminating dysmenorrhea. These results suggest that there is a need for education about dysmenorrhea before menarche, in order to prepare, prevent, treat, and cope with this syndrome.
Total Stress Load Inventory: A Validation Study
The purpose of this study was to validate a stress inventory which would differentiate between a normative group and a patient population suffering from environmental illness. The hypotheses of this study were: (1) the Total Stress Load Inventory would be predictive in discriminating between clinical ecology patients and a normative group; (2) each section or subscale of the Total Stress Load Inventory would be predictive of psychological, cognitive, nutritional, and/or medical factors.
Factor Analysis of the Clinical Scales on the Luria-Nebraska Neuropsychological Battery, Form II
The Luria-Nebraska Neuropsychological Battery (LNNB) was published in 1980 as an attempt to provide clinicians with a standardized version of the neuropsychological assessment and diagnostic procedures proposed by A. R. Luria and A, L. Christensen. Research on the LNNB included a series of factor analyses for each of eleven clinical scales. The analyses were completed on the combined scores obtained from a sample of normal, brain-damaged, and psychiatric populations. A second version of the LNNB was published in 1985 as a largely parallel version of Form I, but included changes in stimulus materials, administration procedures, and scoring procedures. The present study completed factor analyses on same eleven clinical scales using data generated with the newer LNNB Form II. The statistical procedures and criteria employed in the present investigation were identical to those used earlier on Form I to allow for comparisons between the two resulting sets of factor structures. The patient populations were different, however, in that all subjects in the current study were receiving inpatient care in a private psychiatric hospital which specializes in long-term treatment. Despite the changes in materials and procedures and the difference in subject parameters, the factors identified in the present investigation are similar to those seen in the Form I studies. However, two trends were observed when comparing the two sets of factor structures. First, in the present study several items were excluded from the statistical procedures because they were performed perfectly by almost everyone and the resulting scores lacked statistical variance. Second, more homogenous factors were obtained with the Form II analysis. That is, some of the complex LNNB Form I factors were reduced to two or more simpler factors. The results of the study lend support to Luna's conceptual model of higher cortical function and to the reliability of the LNNB as …
Aerobic Conditioning: Effects on Locus of Control, Mood States, and General Well-Being
This study was conducted to examine the sequelae of cardiovascular conditioning on locus of control, short-term mood, and psychological well-being. A pre-post test design, with control group, was used to measure the effects of a one month program of aerobic conditioning on adult volunteers. This study also sought to examine ways in which fitness changes covaried with psychological changes, and to describe patterns of change taking place during aerobic conditioning.
Anger Reduction in Closed Head Injured Individuals with Group Social Skills Training
In the present study, an anger management treatment program was compared to a pseudo-social skills training program (self-help group) and waiting list control group to determine its effectiveness in reducing irritable/angry behavior in head injured subjects. Subjects consisted of 28 adults with previous head injury trauma who had difficulty with excessive irritability and anger. Subjects averaged 35.4 years of age and had an average of 8.9 years post head injury. Treatment consisted of 10 group sessions over a five week period. Anger management training was designed to teach subjects self management skills aimed at reducing the frequency of angry acting out behavior. Training methods included role playing, relaxation training, assertiveness training and cognitive restructuring. The pseudo-social skills training group was a self-help group designed to encourage discussion of irritability problems without teaching specific coping techniques. To assure some degree of homogeneity in cognitive abilities among subjects, minimum eligibility scores were required on five subtests of the Wechsler Adult Intelligence Scale - Revised and the Peabody Picture Vocabulary Test. Dependent measures were pre and posttreatment scores obtained from five categories of the Katz Adjustment Scale - Relative form: belligerence, negativity, general psychopathology, social obstreperousness, and social role functioning. In addition, pre and posttreatment recordings of observed angry/irritable behavior in the subjects were obtained from a significant other. Results failed to reveal statistically significant differences on the dependent measures between the three study groups. In addition, analysis failed to reveal any significant variables that predicted outcome. It is evident that much more organized research is needed to further investigate the possibilities of treatment for various problems encountered by those with head injuries.
Alzheimer's Disease and Attention: An Investigation into the Initial Stage of Information Processing
This study explores the possibility that attentional deficits are an early clinical symptom of Alzheimer's disease. The three goals are to demonstrate that individuals with Alzheimer's disease are impaired on tasks of attentional processing, to compare the sensitivity of currently used measures of attention to attentional dysfunction, and to compare the behavioral response styles (errors of commission) of Alzheimer's disease subjects and non-impaired subjects. The subjects were 22 males and 46 females with a mean age of 70.76 years. Thirty-six had the presumptive diagnosis of Alzheimer's disease; 18 were identified as mildly impaired and 18 as moderately impaired on the Cognitive Capacity Screening Examination. The remaining 32 subjects comprised the non-impaired control group. Five measures of attention were administered to all participants: the Digit Span Subtest of the WAIS-R, the Seashore Rhythm Test of the Halstead-Reitan Neuropsychological Battery, the Vigilance and Distractibility tasks of the Gordon Diagnostic System, and the Concentration/Interference task. The results show a significant difference in attentional processing between normal (non-impaired) subjects and subjects diagnosed with Alzheimer's disease. All measures of attention used in this study, except the Concentration/Interference task, differentiated normal subjects from moderately impaired Alzheimer's disease subjects. The Digit Span Subtest and the Seashore Rhythm Test were unable to differentiate between normals and mildly impaired Alzheimer's disease subjects or between mildly and moderately impaired Alzheimer's disease subjects. The Gordon Diagnostic System was able to distinguish normals form mildly impaired Alzheimer's disease subjects and mildly from moderately impaired Alzheimer's disease subjects. On the Gordon Diagnostic System the Alzheimer's disease subjects made significantly more errors of commission than did the normal subjects. This investigation concludes that attentional processing dysfunction occurs in the dementing process associated with Alzheimer's disease. The findings suggest that the Gordon Diagnostic System is a more sensitive technique for assessing attentional dysfunction than the …
Mental Status, Intellectual, and Mood States Associated with Environmental Illness Patients
The purpose of the present study was to begin development of a psychological profile for environmentally ill patients. Existing psychiatric labels are unable to encompass these patients. Test scores were drawn from a pool of 89 patients whose environmental exposures were verified by the presence of toxins in the blood serum. A Mental Status Exam, a Wechsler Adult Intelligence Scale-Revised screen, and the Profile of Mood States were administered. Results indicate a primary pattern which is significantly different from test norms consisting of fatigue, reduced mental functioning, and a lack of psychotic or personality disorder indicators. The reported symptoms of environmentally ill patients were objectively verified by current psychological test instruments. The need for a new diagnostic category for people who have been poisoned by environmental toxins is discussed.
Vestibular and Electromagnetic Stimulation: Their Effects on Intellectual Performance and Mood State
In the present study, the Electromechanical Therapeutic Apparatus was examined to determine the extent to which its repeated use can influence intellectual performance and mood state. The Electromechanical Therapeutic Apparatus is a device designed to mildly stimulate the body and brain, while facilitating relaxation. Its three components include a rotating platform-bed; a weak, extremely-low-frequency, external-electric field; and music. In the present study, three groups were contrasted, a music-only group which served as a placebo; a group which combined motion-vestibular stimulation and music; and a group which combined motion-vestibular stimulation and music with an externalelectric field. The sample included 33 randomly selected men and women whose average age was 34.6 years.
Relationship of Self-esteem in Pediatric Burn Patients to other Psychological and Physiological Parameters
The purpose of this study was to evaluate post-burn adjustment in light of the self-esteem of child burn survivors. The study attempted to assess the viability of using a single, explicit self-report measure of self-esteem (Piers-Harris Children's Self-Concept Scale) as an index of post-burn adjustment. It appears that pediatric burn patients do not suffer a compromised self-concept secondary to the burn injury and, rather, are successful in incorporating their post-burn state, physically and psychologically, into a positive self-concept. It is suggested that evaluation of overall self-esteem incorporate a comprehensive picture of post-burn adjustment, based upon psychological and physiological parameters. Further research is justified and suggestions for future examinations are presented.
Does Unemployment Become a Major Stressor in the Evolution of Chronic Pain?
Pain has been described as the most complex human experience and most frequent reason patients seek medical treatment. Few people fail to experience the pain associated with disease, injury, or medical/surgical procedures. However, the impact of unemployment that results from chronic pain suffering has not been widely researched. To present a comprehensive view of the effect unemployment has upon the chronic pain experience, this study focused upon stress philosophy, chronic pain, employment, and coping effectiveness. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and a Personal Data Questionnaire (PDQ) were administered to 96 persons (four groups of 24 subjects) representing either unemployed or employed and either chronic or non-chronic (acute) pain populations.
Women Receiving Genetic Counseling for Breast Cancer Risk: Cancer Worry, Psychological Distress, and Risk Recall Accuracy
This follows an earlier study of the same data set, which, through its findings, presented new questions that are investigated in this study. Both studies used a prospective controlled design, wherein women receiving genetic counseling for breast cancer risk were randomized into two groups. Subjects receiving an audiotaped recording of their genetic consultation (tape group) were compared to subjects who also had a genetic consultation but did not receive an audiotaped recording of it (no-tape group). Participants were drawn from attendees at the genetic clinics of two London hospitals and included 115 women with a family history of breast cancer. Cancer worry and psychological distress were assessed before genetic consultation (baseline), and at one- and six-month follow-ups by post. Objective risk was estimated by the geneticist during the consultation, and subjective risk was assessed at one month follow-up. The goals of the current study were to investigate relationships between cancer worry, psychological distress, and recall of genetic risk for breast cancer in a sample of women receiving genetic counseling for breast cancer risk, and to investigate the role sociodemographic variables on cancer worry, psychological distress, or risk recall for these women. Results for this sample of women with a family history of breast cancer found that there were consistent relationships between cancer worry, psychological distress, objective risk, and subjective risk before and after genetic consultation. This suggests that women=s psychological responses are appropriate to their level of cancer risk. There were no differences found between the tape and no-tape groups for objective or subjective risk, or for nearness of recall accuracy or degree of under-/over-estimation. Provision of an audiotaped recording of the genetic consultation did not appear to enhance recall of risk information. The role of sociodemographic variables on the psychological and risk variables assessed in this study was very …
Behavior Patterns among Children with a History of Metopic Synostosis
Metopic synostosis is a condition in which the metopic suture of the human cranium fuses prematurely and may be related to poor behavioral inhibition leading to behaviors commonly associated with Attention-Deficit Hyperactivity Disorder (ADHD). The purpose of this project was to examine the behavior patterns among children with a history of metopic synostosis. It was hypothesized that children with a history of metopic synostosis would exhibit many of the same behavioral patterns associated with ADHD. It was also hypothesized that children with a history of simple synostosis not involving the metopic suture would not evidence this type of behavioral pattern. In order to test these hypotheses, the behavior of three groups of children was compared including (1) children who had a history of metopic synostosis (M= 7.63 years, SD = 1.92 years), (2) children who had a history of simple craniosynostosis not involving the metopic suture (M= 7.54 years, SD = 1.88 years), and (3) a group of children diagnosed with ADHD (M=7.78 year, SD = 1.87 years). It was found using the Home and School versions of the Attention Deficit Disorders Evaluation Scale (ADDES) that children with a history of metopic synostosis demonstrate significantly more behavioral disturbances than children with a history of simple craniosynostosis not involving the metopic suture. Using the BASC Teacher Rating Form it was found that children with a history of metopic synostosis have a behavior pattern similar to children diagnosed with ADHD and a dissimilar behavior pattern compared to children who have a history of craniosynostosis not involving the metopic suture. Using the BASC Parent Rating Form it was found that children with a history of metopic synostosis have a behavior pattern dissimilar to children diagnosed with ADHD and a dissimilar behavior pattern compared to children who have a history of craniosynostosis not involving …
A Confirmatory Factor Analysis of WRAML Scores in a Group of Academically Talented Students
The purpose of this study was to confirm the original factor structure of the Wide Range Assessment of Memory and Learning (WRAML) utilizing a non-clinical adolescent population. Additional analysis examined the relationship between SAT-M scores and spatial relations ability. Exploratory analyses were conducted to determine ethnic and gender differences on the WRAML and subtests from the DAT. Sixty-four academically talented adolescents completed the WRAML and the mechanical reasoning and spatial relations subtests from the Differential Aptitude Test (DAT). The confirmatory factor analysis found the data obtained to not be a good fit for the factor structure of the WRAML (Sheslow & Adams, 1990). Additional confirmatory analyses were conducted which examined data fit of a three factor model found by reanalyzing the standardization data (Burton et al., 1996; Wasserman & Cambias, 1991) as well as two null models. The data failed to fit any of these three models. No support was found for the second hypothesis that predicted a positive relationship between SAT-M scores and spatial relations ability. Ethnic and gender differences on the WRAML and two DAT subtests were examined and discussed. Limitations of this study were reviewed which may have accounted for the overall lack of results.
Predictors of Use and Outcomes of Youth and Family Centers
This study analyzed data from Dallas Public Schools and Dallas Youth and Family Centers (YFCs) to explore variables associated with referrals to and utilization of Youth and Family Centers. Data from students enrolled in third, eighth or tenth grade during the 1996-1997, 1997-1998 and 1998-1999 school years were analyzed to determine the reasons for YFC referral and utilization, and to compare standardized test scores and attendance. Of the 6956 students in third, eighth and tenth grades initially referred to YFCs during those three school years, 5173 (74.3%) made at least one YFC visit. The 5173 students made an average of 2.69 visits and accessed an average of 1.18 services per year. Medical visits accounted for 42.5% of YFC visits, and mental health visits accounted for 46% of YFC visits. Results of logistic regression analyses indicate a significant difference for utilization upon referral and continued use of the YFC when the constant is compared to a set of predictor variables. For both analyses, the predictor variables were Chapter I status, LEP status, reason for referral, gender, special education status, ethnicity, distance from home school to referral YFC, food stamp eligibility and referral source. While outcome data regarding attendance and scores on standardized tests was limited to records available, results suggest that mean reading scores for eighth graders were significantly higher during Year 1 for the group that accessed YFC services. School attendance was better for eighth graders who made continued use of a YFC. Use of medical services by third graders was associated with a gain in attendance rather than a slight loss for the third graders who did not access medical services upon referral. Results of this study were limited by missing data for several records. The competitive atmosphere of health care service delivery and the practical need to know …
Identifying AD/HD subtypes using the cognitive assessment system and the NEPSY
The purpose of this study was to examine the ability of the Cognitive Assessment System (CAS) and the NEPSY, A Developmental Neuropsychological Assessment, to differentiate between the subtypes of Attention Deficit/ Hyperactivity Disorder (AD/HD). The CAS and NEPSY are neuropsychological instruments which provide norms for AD/HD children in general. This study examined the performance of the two subtypes of AD/HD on the CAS and NEPSY. In addition, this study examined the performance of the two AD/HD groups on the Screening Test for Auditory Processing Disorders (SCAN). Since AD/HD children tend to have difficulty with language, the SCAN was used to determine if any of the AD/HD subjects had auditory processing difficulties that might impact their performance on the CAS and/or NEPSY subtests. The sample consisted of 118 children between the ages of 8 and 12 years of age. Using the DSM-IV criteria, the children were diagnosed as having three types of AD/HD: A Predominantly Hyperactive-Impulsive Type (AD/HD-HI), a Predominantly Inattentive Type (AD/HD-I) and a Combined Type The subtypes were also identified by the Attention Deficit Disorders Evaluation Scale-Home Version (ADDES-H). Only two subtypes, AD/HD-I and AD/HD-C, were identified by the ADDES-H. There were not enough AD/HD-HI subjects to include in the study. Therefore, this study focused on the AD/HD-I and AD/HD-C subtypes. A binomial logistic regression analysis was conducted on the AD/HD-I and AD/HD-C subtypes with selected subtests of the NEPSY and the four PASS Scales of the CAS. Results indicated a significant difference between the AD/HD-I and AD/HD-C groups on the Tower subtest of the NEPSY and the Planning Scale of the CAS. The Tower and the Planning Scale are both purported measures of executive functioning; however, results of the Planning Scale were in an unexpected direction. No significant difference was found between the two AD/HD groups on the …
Organization of Narrative Discourse in Children and Adolescents with Acute Traumatic Brain Injury
Children with a recent history of TBI often demonstrate impaired memory, which can be affected by impaired attention, processing speed or impaired verbal information processing. The purpose of this study was to determine if qualitative differences exist among the narrative recall of TBI patients that is not adequately accounted for by standard scoring methods. Sixty-six TBI subjects ranging in age from 6 to 16 were given the Wide Range and Memory and Learning (WRAML) Story Memory subtest and selected subtests from the Wechsler Intelligence Scale for Children - Third Edition (WISC-III). Mean elapsed time since injury was 53 days. Recall of the story on the WRAML subtest was hand-recorded by the examiner. A supplemental scoring method accounted for differences in length, errors, and disorganization. Comparisons were made to a randomly selected control group consisting of 16 hospitalized subjects between 7 and 15 years with no history of head injury, neurological condition or event. Findings suggest the WRAML Story Memory subtest is relatively robust in providing information regarding the quality of recall, with the exception of not accounting for the addition of erroneous details. Subjects with both cortical and subcortical injuries were more likely to add superfluous details to their stories. Results also demonstrated significant differences between the TBI subjects and control group in how well the stories were recalled, primarily in the order of details recalled and in retention after a 30 minute delay. Location was not a significant predictor of narrative organization. Although using this comprehensive supplemental scoring system a regular basis has practical limitations, hand-recording the narrative takes relatively little time and does appear to provide useful additional information concerning the nature of the child's verbal memory difficulties. Furthermore, the more knowledgeable the child, parents and teacher are about these difficulties and about remediation strategies, the more likely …
Use of the Beck Depression Inventory in Northern Brazil
The Beck Depression Inventory (BDI) is a popular screening and research instrument for measuring severity of depression. The instrument was translated to Portuguese for use in Brazil in 1979; however, it was not until recently that its psychometric properties have been tested empirically for the Brazilian population. The purpose of the present study was to explore the BDI's psychometric properties in a northern region of Brazil and to test for possible relationships between certain demographic variables and BDI outcomes. Samples used in this study were from an urban area in Roraima, the northernmost state of Brazil. The BDI showed adequate levels of internal consistency in nonclinical and clinical samples. Female respondents had significantly higher scores than male respondents. Those who had lower levels of education, income, or occupational status had significantly higher scores than those with higher levels of these variables. Adolescents had significantly higher scores than adults from all age groups except those from age 19 to 22. No significant difference was found between those who identified themselves as “indigenous” and those who identified themselves as “non-indigenous.” Regression analysis results showed that the combination of gender, education, and age best accounted for the variance in BDI scores. An ANCOVA revealed that clinically depressed adults had significantly higher BDI scores than nonclinically depressed adults. Factor analysis results showed that there were two main factors in the item structure for both female respondents and male and female respondents combined: one factor of mainly cognitive-affective items and the other factor of mainly somatic items. The results were discussed in terms of the future use of the BDI in Brazil.
The Cross-Validation of AD/HD Instruments and the Relationship to Neurocognitive and Behavioral Measures
The purpose of this study was twofold: to determine the construct validities of comparable AD/HD instruments that were developed according to our current, DSM-IV classification system for AD/HD; and to identify potential +neurocognitive and socioemotional markers for AD/HD. The sample consisted of 145 children ages 8 to 11 years of age who were diagnosed with Attention Deficit Hyperactivity Disorder (AD/HD), or Central Auditory Processing Disorder (CAPD). Children were administered a battery of neurocognitive tests and completed a self-report measure of personality. Parents completed several, AD/HD instruments pertaining to their children. The AD/HD instruments used in this study were the Attention Deficit Disorder Evaluation Scale-Home Version (ADDES), Attention Deficit Hyperactivity Disorder Test (ADHDT), and the Attention Problems and Hyperactivity scales from the BASC-Monitor (BASC-M). Of interest was how each AD/HD instrument compared to the DSM-IV, particularly in terms of the cross-consistency of AD/HD subtype classifications. The findings showed that the AD/HD instruments classified participants differently from the initial, DSM-IV entry diagnosis. Rates of agreement were better for some of the AD/HD instruments than for others yet there was little overall consistency. The neurocognitive measures used in the study were the Cognitive Assessment System-Basic Battery scales. The socioemotional measures used in the study were two parent-report scales from the BASC-M (Internalizing Problems and Adaptive Skills), and the child report scales from the BASC-Self Report of Personality. Results showed that the neurocognitive measures were relatively insensitive to AD/HD symptomatology while a nearly opposite trend was observed on the socioemotional measures. For the most part, participants classified as the ADHD-Combined Type (ADHD-CT), (regardless of which AD/HD instrument was used) had the most significant impairment in areas of social functioning and emotional symptoms across parent and self-reports.
The Effect of Web-Based Support as an Adjunct to a Self-Help Smoking Cessation Program
For the past quarter century, the public has been educated and warned about the dangers of smoking, and both smokers and health researchers have been in search of cost-effective, smoking cessation programs that will lead to long-term cessation. This study used a randomized experimental design to investigate the effectiveness of adding Web-based support materials to a nationally sponsored self-help smoking intervention. There was no significant increase in abstinence rates nor progression through the stages of change by those participants who had access to the Web site. However, there were some overall significant trends that suggested these self-help interventions were successful at decreasing daily rates of smoking and nicotine dependency, as well as tended to encourage repeated quit attempts. Although Web-based supports did not appear to increase the effectiveness of the nationally sponsored self-help intervention, this study demonstrated overall 12 week follow-up abstinence rates of 30-32%--greater than what might be expected, given average success rates of other self-help interventions. This study also supports the notion that women may face additional barriers to smoking cessation. Limitations and implications for future research are discussed.
Family Environment, Social Support, and Psychological Distress of Women Seeking BRCA1 and BRCA2 Genetic Mutation Testing
Shared characteristics and predictors of psychological distress are beginning to be identified in research on women seeking genetic testing for BRCA1 and BRCA2 gene mutations. This study further explored patterns of psychological distress for 51 community women waiting to receive such genetic test results. There was no significant relationship between psychological distress and family cancer history, personal cancer history, social support networks, and family environment. Women in this sample tended to rely more on females and relatives for support than males and friends. Social support satisfaction was not related to gender or number of relatives providing support. Thirty-four of the 36 women classified on the family environment type were from Personal Growth-Oriented families. Comparisons with normal and distressed family means revealed increased cohesion and expressiveness with decreased conflict, indicative of supportive family environments. Limitations and implications are discussed.
Improving the Definition of Exercise Maintenance: Evaluation of Concepts Related to Adherence
Physical activity has been demonstrated in the literature as an effective way to reduce the risk for development of chronic disease. The Transtheoretical Model (TTM) of behavior change has been developed as a means to predict and facilitate movement into healthier lifestyle behaviors. The model is centered on "stages of change", which describe a continuum of readiness to engage in a health behavior change. Stages contain temporal, qualitative, and quantitative characteristics. This was a six-month study that evaluated the effectiveness of stage-matched (theorized to be pertaining only to the maintenance stage of change) vs. generic (theorized to be pertaining to anyone, regardless of stage) newsletters in assisting subjects to attain the Maintenance stage of change. It also sought to identify further qualitative characteristics that can differentiate between the Action and Maintenance stages of change. Results indicated that monthly stage-matched newsletters were no more effective in helping subjects reaching Maintenance than were the generic newsletters. Exerciser self-schema was related to stages of change, but those relationships differed from baseline to six-month follow-up, indicating development of exerciser self-schema during the study period. Implications of this are discussed. Other concepts discussed included "structure" of change process, in that three new scores were developed and correlated with self-efficacy as well as intercorrelated. Motivation was also evaluated and compared across levels of success at adhering to exercise during a three-month period. Limitations of the study and implications are discussed.
Differences in Perceptual-motor Functioning Between Blind and Sighted Adults: a Neuropsychological Perspective.
The purpose of the study was to explore perceptual-motor differences between blind and sighted adults from a neuropsychological perspective, and to analyze differences within the blind group. Perceptual-motor abilities were examined using the Comprehensive Vocational Evaluation System (CVES), a vocational rehabilitation and neuropsychological battery designed for use with blind populations. The data were processed using Analysis of Covariance. Results showed that sighted persons had better motor abilities, while persons with blindness were more skilled at haptic identification of shape and texture. Analysis within the blind group showed that texture identification skills are better when blindness occurs earlier in life and to the extent that the blindness is total. Later onset blindness and the retention of some functional vision may not lead to a refocusing of attentional states necessary to develop haptic images. New neural connections may develop in persons with congenital/total blindness, a hypothesis in line with recent neuroradiological findings that occipital lobe activation occurs when congenitally blind individuals engage in tactile processing tasks. One implication of the findings is that teaching individuals who retain some functional vision to read Braille is probably counterproductive. These individuals would be better served by learning to use a CCTV and large print books. Future researchers should examine blindness from a multivariate perspective, examining subsets of blind groups based on age at onset, visual status, and other pertinent variables. Other implications are discussed and recommendations for future research are provided.
Acculturative Processes and Their Impact on Self-Reports of Psychological Distress in Mexican-American Adolescents
The current study examined the effects of acculturative processes on the self-report of behavioral problems in Hispanic children ages 11-14. Acculturation was measured by the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II) (ã Sage Publications, Thousand Oaks, CA, www.sagepub.com) (Cuellar, Arnold, and Maldonado, 1995) and the self-report of behavioral symptoms was assessed using the Youth Self-Report (ã T.M. Achenbach, Burlington, VT, www.aseba.com) (Achenbach, 1991). It was hypothesized that while both the linear and orthogonal categories of acculturation would account for a significant proportion of the variance in behavior problems in this age group, the orthogonal model would account for a larger proportion of variance due to its multidimensional nature. As well, it was hypothesized that the experimental Marginalization scales of the ARSMA-II would be predictive of behavioral problems. Multivariate analysis of variance was used to test these hypotheses and results were non-significant for the linear, orthogonal, and marginalization categories. The effects of the ethnic/cultural homogeneity of the region from which the sample was drawn, the buffering of social support, and the developmental aspects of ethnic identity are discussed as factors which may have influenced the potential impact of acculturative stress on psychological and behavioral functioning.
Autonomic Balance and Control of Stress for Participants Identified as High or Low Hostile and as Having a Positive or No Family History of Cardiovascular Disease
The influence of autonomic activation in response to controllable versus noncontrollable stress, anger imagery induction, and relaxation imagery was studied among 80 participants between the ages of 18 and 34. Participants differed in level of trait hostility as assessed by the Irritability Subscale of The Buss-Durkee Hostility Inventory (Buss & Durkee,1957) and the Ho scale of the Cook-Medley Hostility Inventory (Cook & Medley, 1954). Groups were further subdivided with regards to either having a positive family history of cardiovascular disease or having no significant history. Results were obtained through analyses of electrocardiograph R-R intervals which produced an index of autonomic nervous system activation. Findings supported hypotheses involving the relations between autonomic balance and stress and hostility for the female and male populations. Among both populations, parasympathetic regulation was diminished during anger induction for individuals with high levels of trait hostility and having a family history of cardiovascular disease. Similar results were obtained for men during relaxation imagery induction.
Clustering of Behavioral Data for Identification of Presumptive Subtypes of Attention Deficit/Hyperactivity Disorder in Children
The objective of the present study was to investigate Amen's formulations of subtypes of AD/HD initially identified by brain imaging techniques, through the use of behavioral checklist data. And in testing Amen's theory of six separate subtypes of AD/HD, to identify and differentiate the subtypes based on symptom presentation. Data was obtained through retrospective chart reviews (N=161) of children between the ages of 5 and 12 who met the criteria for the major symptoms observed in AD/HD and were referred for a previous comprehensive AD/HD evaluation. Data from behavioral checklist (CBCL and DBRS-IV) were matched to Amen's Subtype Symptom Checklist and each subject was given a percentage score for six subtype symptoms. Cluster analysis reliably found six clusters and each subject was labeled according to their symptom presentation. The clusters found were labeled as AD/HD - Combined Type, AD/HD - Predominately Inattentive Type, AD/HD - Predominately Hyperactive-Impulsive Type, Ad/HD - Combined Type with Obsessive-Compulsive features, AD/HD - Combined Type with Obsessive/Compulsive and Conduct Disorder features and Undifferentiated AD/HD. However, the present study did not find evidence of subtypes that corresponded to Amen's Temporal Lobe ADD or Limbic ADD. Discriminant function analysis of the six clusters found that the variables in the model (symptom percentage scores) significantly discriminated the subtype classification. Also, 76% of all cases were correctly classified according to their symptom presentation. Potential limitations of the sample and the data used for interpretation were discussed. Limitations of the study warrant further investigation making use of multi-modal assessment tools which relate well with brain imaging techniques, such as neuropsychological measures of attention and concentration, laboratory based measures of activity, continuous performance tests measuring inattention and impulsivity, and QEEG data measuring brain wave information. A multi-modal approach to investigating symptom subtypes of AD/HD would likely provide increased reliability and validity of …
Cognitive Differences Between Congenitally and Adventitiously Blind Individuals.
It is apparent from the historical perspective regarding the theories of cognitive development and the cognitive functioning of individuals with visual impairments, that sight plays a major role in the development of certain cognitive processes. However, the affects of visual impairment on cognitive development remain to be at issue. Since sight seems to be highly integral in cognitive development beginning in the early stages of physical development, about the sixth month of life, and then begins to diminish in importance as verbal communication develops around eighteen months, then it should stand to reason that significant visual impairment or blindness occurring prior to this time would adversely impact an individual's cognitive development. Conversely, the occurrence of visual impairment or blindness after this critical period of development would have less of an impact. Cognitive theorists have proposed that visually impaired or blind persons may have developed different cognitive pathways to acquire, process, and accommodate sensory information. As a result, visually impaired or blind (VI/B) persons may "think differently" than sighted individuals. The present study was designed to address these issues as they relate to cognitive and neuropsychological development at various stages of growth and to examine possible differences in neuropsychological functioning dependent on the level of visual functioning a person retains; e.g. both the issues of age at onset and degree of impairment. It was also designed to study the possible interaction effects of degree of impairment with the age of onset. Findings indicated that the only differences in cognitive functioning appear to be related to age of onset and not the level of visual impairment. The findings further suggested that congenitally blind individuals have indeed developed alternate methods of cognitively processing nonverbal, abstract, or complex information, especially information involving a high degree of spatial orientation. Implications of this study may influence …
The Effectiveness of an Electronic-Mail Campaign to Modify Stress Levels, Mood States, and Coping Techniques Among Employed Adults
The present study was conducted to explore the effectiveness of a worksite stress management program delivered via electronic mail (e-mail). One hundred and thirty-seven employed adults (36 males, 102 females; mean age = 29.46) from several diverse businesses consented to participate. The volunteers completed Cohen's Perceived Stress Scale, the Daily Hassles Scale, the Daily Work Hassles Scale, the TCU Self-Ratings Scales, and a demographic and opinion questionnaire. Individuals in the treatment group received e-mail messages twice weekly and had access to a website for three months about a variety of cognitive-behavioral techniques for managing worksite stress. A MANCOVA of post-intervention stress levels indicated that individuals who received the stress management messages perceived the same amount of stressors and hassles as individuals who did not receive the messages [F (5, 86) = 0.95, p = .45]. However, a MANCOVA of post-intervention perceived mood states revealed a tendency for individuals in the treatment group to be less depressed, anxious, and angry than individuals in the control group [F (3, 92) = 2.44, p = .07]. Demographic variables did not influence the outcome variables and pre- and post-test absenteeism and illness rates were similar for treatment and control groups. Coping skill usage was similar in amount and frequency, but differed in quality between the groups. The findings of the present study indicate that health promotion programs can be feasibly and effectively delivered via e-mail in the worksite.
Partner abuse: Health consequences to women.
Intimate partner violence is endemic in the United States. According to the American Medical Association (1992), one-fifth to one-third of women will sustain violence from a partner or ex-partner in their lifetime. The relevant literature was organized by ICD-9-CM categories. This study examined the health consequences of partner abuse in a sample of community women using a sample consisting of 564 women in three ethnic groups. Because prior research has failed to account for variations by type of abuse on health consequences, this study assessed psychological abuse, violence and sexual aggression by women's partners. To determine whether or not different types of abuse had an effect on women's health, hierarchical regression analyses were conducted. The regression equations were calculated for women within each ethnic group to facilitate identification of similarities and differences and to control for ethnic differences in risk for specific diseases. The results were consistent with past research on health consequences of abuse and extended the prior literature by showing that psychological abuse had a pervasive effect on health conditions, distress and use of health care resources. Additionally, ethnic differences emerged. As expected, ethnicity appeared to function as a moderator. Clinical implications and recommendations are made for future research, suggesting the development of a new assessment tool for partner abuse screening.
QEEG and MMPI-2 patterns of adults reporting childhood sexual abuse: Determining differences and predictor models.
Childhood sexual abuse (CSA) has been linked to a number of adult psychological maladies. The MMPI-2 has shown specific patterns such as an inverted V in the validity scales, a floating profile, and a 4-5-6 configuration to be present more often in adults who have experienced childhood trauma. Both children and adults who have experienced trauma have shown a number of neurophysiological differences when compared to non-traumatized individuals. However, little research has looked at differences in quantitative electroencephalography (QEEG) patterns in these individuals. The purpose of this study is to determine differences seen in the MMPI-2 and the QEEG when comparing adults who report CSA to adults who deny any history of childhood abuse. Differences between the two groups in MMPI-2 basic scales and supplementary scales PK and PS were determined. This study also examined the ability to correctly classify individuals into the two groups using three patterns seen in the MMPI-2 basic scale profiles (inverted V, floating profile, and 4-5-6 configuration). In addition, this research included exploratory analyses to develop predictor models for CSA group membership. Predictors in the models were derived from MMPI-2 scales, alpha relative power at each of the 19 sites in the International 10/20 electrode placement system, as well as alpha/delta, alpha/theta, and alpha/beta ratios at each of the 19 sites. A total of 46 participants were included in this study, 24 from archived files and 22 newly recruited individuals. Each participant received a MMPI-2 and a QEEG. Significant differences were found between the MMPI-2 scores of the two groups, but MMPI-2 patterns were unable to correctly classify individuals. Models were found which were clinically relevant and statistically significant. The models were based on depression and social maladjustment. The depression models included scales F and 2 of the MMPI-2 and alpha relative power at left …
Acculturation Level, Generational Status and Gender: Their Role in Acculturative Stress in Young Adolescent Mexican Americans
The purpose of this study was to determine relationships between acculturation level, generational status, and gender with acculturative stress. Acculturation level was determined by the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II) and acculturative stress was determined by the Societal, Attitudinal, Familial and Environmental Acculturative Stress Scale-Children's Version (SAFE-C). Subjects included 1268 Hispanic children ages 11-15. In order to validate the usefulness of the ARSMA-II with this sample, analyses were conducted between acculturation level and generational status. The Pearson product moment correlation (r=.44) and the ANOVA between the mean acculturation score and generational status were significant. However, the mean acculturation score from this study was considerably lower than the ARSMA-II score; therefore, new acculturation levels were developed to establish local adolescent norms for the ARSMA-II. All analyses involving acculturation levels were conducted using both the ARSMA-II and new acculturation levels because 300 subjects were reclassified with the new norms. Significant results were similar using both acculturation levels; however, there were more between group differences using the new acculturation levels. It was hypothesized that as acculturation level increased toward the Anglo culture, acculturative stress would decrease. The one-way ANOVA confirmed this relationship. It was also hypothesized that as generational status increased, acculturative stress would decrease. A one-way ANOVA also supported this hypothesis. In order to replicate previous findings on gender, a one-way ANOVA was conducted with acculturative stress and acculturation level. Results for both were non-significant. Overall findings indicate that generational status and acculturation level have a significant impact on acculturative stress in Hispanic children; however, gender does not seem to be a factor. Findings emphasize the importance of addressing cultural issues in the assessment, intervention, and treatment of acculturating Hispanic children. Furthermore, the ARSMA-II appears to be a useful instrument in assessing acculturation level in young adolescent Hispanics though new …
Development and Psychometric Validation of the State-Trait Spirituality Inventory
The present study contributes to the widening body of spirituality research by conceptualizing it as a state-trait construct. A new measure of spirituality, the State-Trait Spirituality Inventory (STSI), was created and validated according to psychometric methods of test construction. In its current form, the STSI contains seven state spirituality items and six trait spirituality items. A thorough review of the literature identified common themes in spirituality definitions and assisted in developing definitions of trait and state spirituality. Internal consistency for the trait scale was .88 and for the state scale, .68. Good test-retest reliability was found with coefficients of .84 for trait spirituality and .81 for state spirituality. Results from a preliminary undergraduate sample as well as from the validation sample yielded a two-factor solution. In general, items determined by expert panels as trait items loaded on one factor and items deemed to be state items loaded on the second factor. Multitrait multimethod analysis yielded mixed findings for convergent, divergent, and concurrent validity for the spirituality and religiosity traits. Methods consisted of paper-and-pencil cognitive and behavioral measures. Cognitive measures were more likely to support convergent/divergent validity than were behavioral measures. A major emphasis in the study was to determine whether state and/or trait spirituality were able to predict current health status and provide evidence for predictive validity. Positive relationships were identified between trait spirituality and the mental health measures of the Short Form-36® (SF-36). In contrast, it was negatively related to the Role-Physical scale. State spirituality was inversely related to the Physical Component scale. These findings are discussed within the context of minimal research using the SF-36 and spirituality measures. The MTMM analysis was limited by available spirituality and religiosity measures that contain only cognitive or behavioral items. Suggestions for future research are offered.
The utility of the McCarron-Dial System in determining location of brain lesion.
Among the goals of neuropsychological assessment are to detect the presence of brain damage, localize which areas of the brain may be dysfunctional, and describe subsequent functional impairments. The sensitivity of neuropsychological instruments in carrying out these functions has long been a question of debate. The purpose of the present study was to determine the utility of various performance level indictors and lateralizing indicators from the McCarron-Dial System Neuropsychological Assessment Battery (MDS) in ascertaining the presence or absence of brain damage as well as location of lesion. Models used in the present study appear to provide increased classification accuracy compared to other studies utilizing the MDS. The MDS was also shown to be comparable to other well-known neuropsychological batteries, including the Halstead-Reitan Neuropsychological Test Battery (HRB) and the Luria-Nebraska Neuropsychological Battery (LNNB) with regard to distinguishing between those with brain damage and normal controls, and also localizing brain lesion. The results of this study offer clinicians parsimonious models to evaluate for presence of lesion and its location so this information may be used to make accurate, thorough diagnoses and appropriate treatment and rehabilitation recommendations.
The Effects of Perceived Locus of Control and Dispositional Optimism on Chronic Pain Treatment Outcomes.
The financial cost for health care and lost productivity due to chronic pain has been estimated at over $70 billion per year. Researchers have attempted to discover the psychosocial and personality factors that discriminate between people who learn to cope well with chronic pain and those who have difficulty adjusting. The purpose of the present study was to examine the effects of perceived locus of control and dispositional optimism on chronic pain treatment outcomes. Subjects reported significantly lower post-treatment pain levels as compared with pre-treatment levels (M = 0.66, SD = 1.58), t(45) = 2.85, p = .007 (two-tailed), but decreased pain was not associated with scores on the internality dimension of the Pain Locus of Control Scale (PLOC) or on the Life Orientation Test-Revised (LOT-R) (a measure of dispositional optimism). Overall, participants' increased coping ability was associated with scores on the LOT-R, but not with scores on the internality dimension of the PLOC. Subjects with the lowest pre-treatment scores on the LOT-R demonstrated significantly greater increases in post-treatment coping ability than those with the highest scores (F(2,40) = 3.93, p < .03). Participants with the highest pre-treatment scores on both the PLOC internality dimension and the LOT-R demonstrated greater post-treatment coping ability (F(2,32) = 4.65, p < .02), but not less post-treatment pain than other subjects. Participants' post-treatment LOT-R scores were significantly higher than their pre-treatment scores (M = 2.09, SD = 3.96), t(46) = 3.61, p = .001 (two-tailed), but post-treatment PLOC internality scores were not significantly higher than pre-treatment scores. Implications of these results are discussed.
Treatment efficacy in a chronic pain population: Pre- to post-treatment.
The purpose of the current study was to investigate the effects of a multidisciplinary pain management program on five measures of subjective psychosocial factors. Ninety-five participants in the comprehensive multidisciplinary treatment group and the standard medical intervention control group were surveyed about various psychosocial factors using Axis II of the West Haven - Yale Multidimensional Pain Inventory (MPI), pre- to post-treatment. It was hypothesized that post-treatment levels would be significantly lower than pre-treatment levels for all five psychosocial variables. Additionally, gender and ethnicity variables were examined. Based on preliminary analyses indicating pre-treatment differences between the experimental and control group, five 2 x 2 x 3 analyses of covariances (ANCOVAs) were used to examine the above hypotheses. Results indicated significant differences between the treatment conditions on measures of control, with the comprehensive group feeling more in control than the standard group at post-treatment. No other significant main effects for treatment condition were found on the measures of pain severity, interference with daily activities, negative mood, or social support. However, a significant gender main effect was found for social support at post-treatment, with females reporting more social support than males. A significant gender x ethnicity interaction was also found for post-treatment control, with African-American females exhibiting higher levels of control than the other groups. Finally, a significant gender x treatment condition was found for negative mood, with males in the comprehensive group reporting more affective distress than those in the standard group. In this study, control appeared to be an integral factor in the chronic pain sample and greatly improved with comprehensive multidisciplinary treatment; while other areas of relative efficacy were not confirmed in this population.
Treatment Outcomes Related to EEG-Biofeedback for Chemical Dependency: Changes in MMPI-2™ (University of Minnesota) Personality Measures and Long Term Abstinence Rates
Peniston and Kulkosky (1989, 1990) demonstrated the effectiveness of alpha-theta EEG-Biofeedback (EEG-BFB) in treating inpatient alcoholics noting significant improvements in depression, psychopathology, serum β-endorphin levels, and abstinence rates. The present study is an extension of a previously unpublished replication of the Peniston EEG-BFB protocol with 20 chemically dependent outpatients (Bodenhamer-Davis, Callaway, & DeBeus, 2002). Fifteen subjects were "high risk for re-arrest" probationers. Data for the EEG-BFB group was collected from archival records. Subjects completed an average of 39 sessions (SD = 6.096), with 33 of those being EEG-BFB. Pre/post-treatment MMPI-2s™ (University of Minnesota) were collected and follow-up (4-11 years) data obtained (abstinence rates, re-arrests in some cases). Treatment effects were evaluated by comparing assessment data (pre/post) and documenting abstinence rates. Post-treatment MMPI-2 results were within normal limits, with several scales significantly reduced from baseline suggesting less psychopathology. Results were then compared to 20 subjects receiving standard addiction treatment (OT-CD group), but not EEG-BFB. OT-CD subjects completed a 2-week inpatient program followed by 18 outpatient sessions. Pre/post assessment and follow-up data was collected on the OT-CD group. The OT-CD group's post-assessment results showed three elevations (MMPI-2 scales 4/6/8), suggestive of characteriological problems. Post-MMPI-2 results of the two groups were compared via ANCOVAs. Findings indicated no significant differences between groups on targeted scales; however, there was a trend for the EEG-BFB group to have lower scores. Follow-up data was obtained on 13 EEG-BFB subjects. Results indicated 92% (n = 12) were sober, with 8% (n = 1) claiming significantly reduced alcohol intake. Probationer re-arrest and revocation rates were collected on the subset of probationers (n = 14 out of 15). The majority of the probationers (79%, n = 11) had not been re-arrested nor had their probation been revoked. Short-term follow-up information (35-131 days post-assessment), available at the time of writing, for …
Treatment Effects Related to EEG-Biofeedback for Crack Cocaine Dependency: Changes in Personality and Attentional Variables
EEG biofeedback (neurotherapy) has been demonstrated as effective in the treatment of alcoholism, as evidenced by Peniston and Kulkosky's research efforts. These neurotherapy pioneers evaluated the efficacy of alpha-theta brain wave biofeedback as a treatment for chronic alcohol abuse, citing 80% abstinence rates as measured by improvements in psychopathology, serum beta endorphin levels, and long-term alcohol abstinence. Most research with alpha-theta EEG biofeedback has addressed alcohol addiction. Cocaine is now considered to be the most common drug problem of patients entering treatment for drug abuse. To date, only one controlled study has been published that researched alpha-theta neurofeedback in the treatment of "crack" cocaine addiction. The present study was an extension of a 4-year EEG-biofeedback treatment outcome project underway at a faith-based homeless mission in Houston, Texas, with male "crack" cocaine addicts. Changes in personality, attention, and impulsivity were measured following 30 sessions of a non-individualized EEG -biofeedback protocol. Experimental subjects received a variant of the Peniston-Kulkosky alpha-theta protocol for 30 sessions while controls received all elements of the experimental protocol except the EEG biofeedback. Assessment measures included the MMPI-2 and the IVA. Although experimental subjects showed greater mean improvement on most MMPI basic scales and all IVA Attention related measures, results indicated no significant differences between control and experimental groups. The present study did not result in significant differences between control and experimental groups on attentional or personality variables in crack cocaine addicts. Implications and limitations of the study are discussed.
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