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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.
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.
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.
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.
Anxiety, Depression, and Sleep Disorders: Their Relationship and Reduction with Neurotherapy
This study investigated the relationship among anxiety, depression, and sleep disturbances and the treatment of these three disorders through neurotherapy. Research suggests that these conditions commonly co-occur in the general population and that central nervous system (CNS) arousal may play a primary role in the development and maintenance of these disorders. Several recent studies suggested that neurotherapy, a biofeedback-based treatment for CNS dysregulation, might be an effective treatment for comorbid conditions, particularly the ones of interest here, depression, anxiety, and sleep disturbances. This investigation used a clinical case-series design to assess pre/post neurotherapy changes on objective measures of anxiety, depression, and sleep and to determine whether changes in anxiety and depression then predict improvements in sleep quality. Data for 23 participants (10 males) were obtained from files of adults (Mage = 40.22 years, SD = 16.20) who received at least 15 neurotherapy sessions (M = 47.83 sessions, SD = 22.23) the University of North Texas Neurotherapy Lab. Matched pair t-tests revealed that symptoms of sleep disturbance, depression, and anxiety showed significant improvements following neurotherapy. Neurotherapy treatment effect sizes generally ranged from moderate to large (d = .414 - .849). Multiple regression analysis found that changes in self-reported anxiety symptoms, but not depressive symptoms, predicted observed improvements in sleep quality (adjusted R2 = .26). Last, the implications and limitations were discussed in relation to neurotherapy practice and the associated research.
Predicting Weight Loss in Post Surgical Laparoscopic Banding Patients
The present study was a retrospective chart review (N=128) that investigated the efficacy of profiles derived from the three factors of the Eating Inventory® test (EI) - cognitive restraint, disinhibition, and hunger - to predict successful weight loss in post surgical laparoscopic banding patients at 6 and 9 months post surgery. Although the EI is commonly used in bariatric presurgical assessment, few studies have found consistent relationships between presurgical factor scores and subsequent weight loss in this population. Based on restraint theory, 7 profiles (high CR, super high CR, high D, super high D, high H, super high H, and null) were derived from the raw scores on the subscales of the EI and tested for weight loss predictive ability using direct logistic regression. Results were mixed with high CR, super high CR, and null profiles accurately predicting successful weight loss. Raw scores on the three factors (cognitive restraint, disinhibition, and hunger) were tested individually for predictive ability using direct logistic regression. Overall results indicated that the profile model accurately predicted more cases than the general factor model. This study significantly contributes to both the bariatric presurgical assessment literature and the restraint theory literature. Suggestions for future research are offered.
The Relationship Between Sleep Variables and Headache
Headache pain impacts most of the population at some point in life, at an enormous cost to day-to-day functioning. Determination of the variables that are associated with prevalence and severity of headaches has been inconsistent. One area that deserves more attention is the relationship between headaches and sleep. For instance, several sleep parameters may precipitate or exacerbate headaches, but previous research often used inconsistent and limited assessments of both headaches and sleep, making results difficult to interpret and compare. The current study seeks to extend previous research by using more comprehensive and empirically validated assessment techniques to study the relationship between sleep and headaches in a healthy sample. Greater self-reported sleep quality is related to lower headache frequency and severity, and lower self-reported sleep quality is characteristic of individuals having migraine-type headaches. Greater sleep efficiency is related to lower headache severity and shorter headache duration. Greater sleep onset latency is related to longer headache duration and greater headache severity. Greater number of nighttime awakenings is related to greater headache severity and is characteristic of individuals having a diagnosable headache disorder (either tension-type or migraine-type). Stress appeared to be a partial mediator between self-reported sleep quality and headache severity. Further experimental studies may clarify causality between sleep and headache.
Boston Naming Test with Latencies (BNT-L)
Although most people have experienced word-finding difficulty at one time or another, there are no clinical instruments able to reliably distinguish normal age-related effects from pathology in word-finding impairment. Two experiments were conducted to establish a modified version of the Boston Naming Test (BNT) that includes latency times, the Boston Naming Test of Latencies (BNT-L), in order to improve the instrument's sensitivity to mild to moderate word-finding impairment. Experiment 1: Latency times on the 60-item BNT (Goodglass et al., 2001) for 235 healthy adults' ages 18-89 years were collected on a representative sample. Qualitative features of the BNT items, statistical analyses, IRT, and demographic considerations of age, gender, education, vocabulary, race and culture, helped create a reduced BNT-L version with 15 of the most discriminating items. Statistically sound and sophisticated normative tables are provided that adjust for unseen covariates. Response latencies did not indicate earlier age-related decline in an optimally healthy sample. Experiment 2: Twenty-three patients referred for neuropsychological testing were administered the BNT-L. Patients referred for evaluation of mild cognitive impairment or possible dementia produced significantly different response BNT-L latencies from the healthy sample whereas patients referred for mild brain injury evaluation did not. Normal word-finding problems were discussed in terms of serial stage models of lexical access, as well as in terms of automatic and controlled cognitive processes in younger and older adults. Statistical process for creating a psychometric instrument using latencies is illustrated.
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 …
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.
Pediatric Feeding Disorders: A Controlled Comparison of Multidisciplinary Inpatient and Outpatient Treatment of Gastrostomy Tube Dependent Children
The efficacy of multidisciplinary inpatient and outpatient treatment for transitioning children with severe pediatric feeding disorders from gastrostomy tube dependency to oral nutrition was investigated utilizing caloric and fluid intakes as an outcome measure. The study involved 29 children ages 12 months to 5 years of age with gastrostomy tube dependency. Treatments were provided by speech therapists, occupational therapist, dietician and psychologist for a 30 day period. Four treatment groups were evaluated and average intakes compared at 4 observation periods including pretreatment, initiation of treatment, completion of treatment at 30 days and 4 month follow-up. Children receiving inpatient treatment for feeding disorders evidenced significant differences in oral caloric intake from pretreatment to discharge than outpatient treatment (p < .01) and wait list control group (p = .04). Oral caloric intake from discharge to 4 month follow up yielded no significant differences indicating treatment gains were maintained. Change in environment and caretaker showed a significant effect for the inpatient group (d = 1.89). Effects of treatment by age and weight at 4 month follow up were also analyzed.
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 …
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 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 …
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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 …
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 …
The Role of Acculturation in the Health Belief Model for Mexican-Americans with Type II Diabetes
Diabetes has alarming prevalence rates not only in the U.S., but also worldwide. Ethnicity plays a large role with Hispanic-Americans having one of the highest prevalence rates. Diabetes is a complicated disease that requires significant lifestyle modifications. The health belief model (HBM) has been investigated as a theory to explain behavior change. However, little research has been done to determine its utility to Mexican-Americans. In the current study, participants were Mexican-American adults (N = 66) with type II diabetes who were recruited from family medicine clinics. Self-report questionnaires included the General Acculturation Index (GAI) and the Multidimensional Diabetes Questionnaire (MDQ). Participants had the option to complete them in either Spanish or English. Laboratory values were collected from medical charts. A MANCOVA indicated that two variables were significant, perceived severity (PS) and misguided support behaviors (MSB), p < .05. With respect to the HBM, PS was identified as a component of an individual's perception, acculturation was a modifying factor, and MSB was a component of the likelihood to change factors. These three affected glycemic control. Odds ratios determined that individuals with better glycemic control had less perceived severity and less misguided supportive behavior. Individuals with the least acculturation were more likely to have best glycemic control. Significant results were found for each of the three main columns of the model suggesting that the HBM has utility for the Hispanic-American population with type II diabetes. Results suggest that health care personnel should be aware of the ramifications of patients' perceived severity of their illness as well as the amount the "nagging" type support they receive from friends and family on glycemic control. This awareness can lead to the development of interventions aimed at improving glycemic control and the quality of life in Mexican-Americans with diabetes. Specifically, programs focused on incorporating the family …
Transportation trauma and psychological morbidity: Anxiety, depression, PTSD and perceived control in a hospitalized sample.
Transportation-related collisions are ubiquitous and often traumatic. Identifying post-collision psychological distress and the characteristics of the collision survivor that lead to distress are vital to the development of early and appropriate interventions. The goals of this study were: 1) to use a questionnaire as opposed to a typical diagnostic interview, 2) to confirm that psychological distress is present in currently hospitalized transportation-related collision survivors, 3) to confirm that different types of distress co-occur, 4) to determine if distress is more likely to occur in those who have had prior distress, and 5) to explore the relationship between symptoms of distress and perception of control by self, others, and God/Higher Power of past, present, and future collision-related events. Subjects were 100 English speaking adult inpatients, 16 years and older, who were less than 3 weeks post-injury, and receiving some rehabilitation. Participants completed a questionnaire which included the Center for Epidemiologic Studies Depression Scale (CES-D), Beck Anxiety Inventory (BAI), and Davidson Trauma Scale (DTS) as well as questions regarding demographics, details of the collision/injury, alcohol/drug use, pain, past and present stressors, social support, and perceptions of life change. Information about head injury and collision-concurrent alcohol and/or drug use was collected from the patient's medical chart. Compared to other traumatic experiences (e.g., physical/sexual abuse, war combat), transportation-related collisions share the characteristics of being sudden, unexpected, relatively brief in duration, and potentially lethal. Prior studies used diagnostic interviews to identify psychological distress in post hospitalized collision survivors. This study used questionnaire-based depression, anxiety, and trauma symptom inventories in a currently hospitalized sample and included head injured patients. As hypothesized there was a significant correlation between the CES-D total score and the BAI total score [Hypothesis 1], the DTS total score [Hypothesis 2], and collision concurrent alcohol and/or drug use (as indicated by medical chart …
Personality Factors and Trust in Placebo Medical Trials
Prior research has reported that individual differences influence both placebo and nocebo responses. The present study examined how individual personality, as well as trust, influence placebo/nocebo belief and symptom reporting after receiving an inert capsule that for some was described as an active “cognitively-enhancing” trial medication. Individuals (N = 104) were randomly assigned to one of three conditions: condition A participants were told they’d received the medication, condition B participants were told they’d received a placebo, and condition C participants were told, via random assignment, each would receive either the medication or placebo (after the experiment this condition listed the group – medication or placebo - each believed s/he was in). The study was completed in the UNT Student Health and Wellness Center to provide context in a medical setting. Of the 104 participants, 46 (44.2%) were either placed by experimental design or self-report in the medication group. Participants with a belief in medication ingestion, regardless of condition (i.e., A or C), reported significantly more symptoms (M = 16.65, SD = 3.178), than participants who believed they had ingested a placebo (M = 14.21, SD = 2.58), t (102) = 4.32, p = .001. Aspects of Neuroticism and Extroversion, as well as trust were correlated with symptom reporting and/or placebo/nocebo responses. It appears that that personality is part of a combination including trust, context and expectations. It is recommended that future research on personality and placebo effects consider the role of individual factors, context and communication of expectations.
Development of a Differential Neurocognitive Profile for Alzheimer’s Dementia and Vascular Dementia
Alzheimer’s Dementia (AD) is among the most common diseases in the Geriatric population, and its prevalence is expected to quadruple by 2047.Vascular Dementia (VaD) is the second most frequent cause of dementia, with studies indicating VaD accounts for 10-20% of dementia cases across the globe. A diagnostic model differentiating AD and VaD would be clinically and scientifically valuable, considering the treatment approaches for these conditions are different. Although there are differences between AD and VaD on their neuropsychological profiles, a diagnostic model that successfully differentiates AD and VaD on neuropsychological testing has not been developed, despite previous attempts. Our study addresses this gap in the literature by examining two diagnostic models used to predict the conversion of AD from mild cognitive impairment, and a third model was proposed to differentiate AD from VaD. We conducted ROC Analyses using the variables LM II Standard Score, Animals Total, and CDRS Sum based on a previous diagnostic model. The sensitivity and specificity for the diagnosis of mild VaD were calculated for all possible scores of each test measure. The Animals Total cutoff score of 7 achieved excellent sensitivity and specificity, receiving 96% and 92%, respectively. In this sample, patients who could name at least seven animals under 60 seconds were highly likely to be diagnosed with VaD. LM II Scaled Score also achieved statistical significance (p <0.001) and a cutoff score of 4 received 96% sensitivity and 77% specificity. Patients who achieved an LM II Scaled Score of 4 or higher were highly likely to be diagnosed with VaD.
Neurocognitive implications of diabetes on dementia as measured by an extensive neuropsychological battery.
Diabetes is a disease with a deleterious pathology that currently impacts 4.5 million individuals within the United States. This study examined the ability of a specific neuropsychological battery to identify and classify dementia type, investigated the impact of diabetes on cognition and analyzed the ability of the memory measures of the 7 Minute Screen (7MS) and the Rey-Osterrieth Recall to correctly categorize dementia type when not used in combination with a full battery. The battery in addition to exhaustive patient history, medical chart review and pertinent tests were used in initial diagnosis. Results indicated the battery was sufficient in the identification and classification of dementia type. Within the sample, diabetes did not appear to significantly impact overall battery results whereby only two measures were minimally affected by diabetes. Finally, the memory measures of the 7MS and the Rey-Osterrieth Recall were sufficient to predict membership into the Alzheimer's (AD) and vascular dementia (VD) groups with 86.4% accuracy. The classification percentage dropped to 68.3% with addition of the mild cognitive impairment category. The full battery correctly classified AD and VD dementia 87.5% and appeared to be the most robust.
An item response theory analysis of the Rey Osterrieth Complex Figure Task.
The Rey-Osterrieth Complex Figure Task (ROCFT) has been a standard in neuropsychological assessment for six decades. Many researchers have contributed administration procedures, additional scoring systems and normative data to improve its utility. Despite the abundance of research, the original 36-point scoring system still reigns among clinicians despite documented problems with ceiling and floor effects and poor discrimination between levels of impairment. This study is an attempt to provide a new method based upon item response theory that will allow clinicians to better describe the impairment levels of their patients. Through estimation of item characteristic curves, underlying traits can be estimated while taking into account varying levels of difficulty and discrimination within the set of individual items. The ultimate goal of the current research is identification of a subset of ROCFT items that can be examined in addition to total scores to provide an extra level of information for clinicians, particularly when they are faced with a need to discriminate severely and mildly impaired patients.
Role of Parental Anxiety on Pediatric Feeding Disorders
The proposed study examined the relationship between parental anxiety, measured both subjectively (via self-report questionnaires) and objectively (via salivary cortisol) and the child's feeding progress. Children diagnosed with a feeding disorder were recruited with their parents at Our Children's House at Baylor (n=19; 11 females, 8 males). The patients and their parents were housed in the clinic for an eight-week intensive multidisciplinary pediatric feeding disorder treatment program. Calorie intake was recorded daily as outcome measures of treatment progression. Parental anxiety was measured by the Pediatric Inventory for Parents (PIP), state anxiety on the State Trait Anxiety Inventory (STAI), and by salivary cortisol at three different time points. The present study attempted to examine whether parental feeding (phase three of treatment program) would continue to cause a decrease in the child's caloric intake. In averaging ten meals prior to parental feeding in comparison to the average of ten meals following parental feeding, there was no significant difference as measured by a t-test. Paired t-tests examined parental anxiety from time one to time two and found that salivary cortisol increased significantly t(15) = -6.07, p = .000 from Time 1 (M = 2.30, SD = 1.64) to Time 2 (M = 5.24, SD = 2.58). This demonstrated that while parental anxiety increased as measured by salivary cortisol, the children continued to make improvements. This may be the result of the multidisciplinary feeding program which encompassed a strong behavioral component and parent training. Even though the current results did not demonstrate a direct relationship between parental stress and caloric intake, parental stress as measured by salivary cortisol did increase.
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 …
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.
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.
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 …
The Effect of a Brief Acceptance-Based Protocol on Health Related Relational Framing
Behavior analysts who study verbal behavior theorize that people derive relationships between stimuli - forming stimulus classes such that psychological functions transfer among stimuli and therefore affect behavior. Verbal processes are thought to play a role in cancer patients' behavioral flexibility. The current study examined if an analogue intervention produced changes in relations between health-relevant stimuli from pre- to post-test in patient and student samples. A matching-to-sample (MTS) task required participants to form three 4-member classes that included health, treatment, or neutral terms. Participants next listened to either an acceptance-based or a control-based rationale and therapy exercise, or a distracter task. Then, they were re-exposed to the MTS task. Latencies and accuracies for learning each class as well as between condition differences were examined. Finally, changes in ratings of stimuli from pre to post analogues were measured. Differences in stimuli ratings were seen in the student sample, reflecting transfer of function and some reduction in responsiveness to stimuli following intervention, but overall no learning performances are found. Discussion explores the consistency of the findings with acceptance and commitment therapy (ACT) theory in light of the seemingly lack of findings.
Natural Course of Adolescent Insomnia: Patterns and Consequences
Approximately 2-11% of adolescents report chronic insomnia. The study used an archival data set from ADDHealth that assessed adolescent health and health-related behaviors. Adolescents (N = 4102) provided data at baseline (Time 1) and at 1-year follow-up (Time 2). Participants were excluded if no ethnicity, gender, or insomnia data were given at Time 1 or 2. Females were more likely to report insomnia than males at Times 1 and 2. In addition, adolescents with remitted insomnia were significantly younger than adolescents without insomnia at Times 1 and 2. Analyses found a prevalence of 9.6%, a remittance of 6.2%, an incidence of 4.4%, and a chronicity of 2.9%. At Time 1 and 2, AWI were significantly more likely to have depression, suicidal behaviors, and behavioral problems in school than AWOI. At Time 2, incidence and chronic insomnia increased the risk of depression, suicidal behaviors and behavioral problems in school. Risk and protective factors analyses indicated psychological counseling was associated with both remitted and chronic insomnia and depression was associated with incidence insomnia.
The Effects of Positive Emotion, Negative Emotion, Flourishing, and Languishing on Cardiovascular Risk
Positive psychology has led a movement that concentrates on positive characteristics. The current study examined the relationship between positive emotions, negative emotions, flourishing, languishing, and cardiovascular functioning. The study uses guided imagery to help participants recall a negative emotional event and positive emotional event in a counterbalanced order. The reverse order allowed us to examine the differential contributions of stress buffering versus facilitated recovery effects to higher levels of heart rate variability (HRV). The study also examined the relationship between mental health categories and known cardiovascular disease risk. Univariate analysis of variance revealed that positive emotions can serve as a stress buffer and dampen cardiovascular responses to a negative event. Also, analysis revealed a trend for the prediction that positive emotions can facilitate cardiovascular recovery following a negative event. Exploratory analysis did not reveal differences between a facilitated recovery group and a buffering group for cardiovascular measures. Future studies should include tighter control to help compare the differential influences of stress facilitation and stress buffering on cardiovascular functioning. The results from the study indicate that it is still too early to tell whether mental health buffers those individuals from developing CVD, and to answer whether languishing increases the risk of CVD. Longitudinal studies of young individuals without a prior history of any risk of CVD and who are flourishing or languishing might help provide answers to these questions.
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.
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.
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