Meta-analysis of cognitive-behavioral treatments for generalized anxiety disorder: a comparison with pharmacotherapy

The efficacy of (cognitive) behavioral therapy ([C]BT) for generalized anxiety disorder was investigated and compared with the efficacy of pharmacological therapy using meta-analytic techniques. A total of 65 (C)BT studies and pharmacological studies were included. (C)BT was more effective than control conditions. The results of the comparison between (C)BT and pharmacotherapy varied according to the meta-analytic methods used. Conclusions about differences in efficacy between therapy approaches are limited when all available studies are included owing to a number of factors that influence effect sizes. When only those studies that directly compared both therapies were included in the analysis, there were no significant differences in efficacy. Attrition rates were lower for (C)BT, indicating that it is better tolerated by patients.     

Conceptions of perfectionism and interpersonal problems: evaluating groups using the structural summary method for circumplex data

This study examined two conceptions of perfectionism in relation to interpersonal problems. Two hundred and seventy-nine undergraduate participants completed the Almost Perfect Scale-Revised (APS-R) and the Dyadic Almost Perfect Scale (DAPS). The authors used empirically derived discriminant functions (APS-R) and cluster analysis (DAPS) to identify three groups for both measures: adaptive and maladaptive perfectionists and nonperfectionists. Analyses of group profiles were performed on the Inventory of Interpersonal Problems Circumplex (IIP-C) scales using the structural summary method for circumplex data. APS-R and DAPS groups were compared on interpersonal problems endorsement and IIP-C profile characteristics. For both measures, results supported the hypotheses that maladaptive perfectionists would exhibit elevated profiles reflecting hostile-dominant and friendly-submissive interpersonal problems, whereas the adaptive perfectionists would exhibit low profile elevation indicative of interpersonal adjustment. Overall, results supported Slaney and colleagues' (2001) model of perfectionism and provided evidence for the validity of the APS-R and DAPS.     

Health Care Providers Inventory: a method for evaluating nursing aides

The Health Care Providers Inventory (HCPI) is a 70-item questionnaire containing five primary scales and a validity scale. It is a pre-employment instrument designed to evaluate American nursing aides. In this study, I determined that the HCPI is a reliable, non-discriminatory test. Concurrent, construct, and predictive validity data are reported, which indicate that the HCPI measures significant personality characteristics, and is of value to administrators in their hiring of suitable applicants and in the reduction of employee turnover in nursing homes.     

Synthesized clustering: A method for amalgamating alternative clustering bases with differential weighting of variables

In the application of clustering methods to real world data sets, two problems frequently arise: (a) how can the various contributory variables in a specific battery be weighted so as to enhance some cluster structure that may be present, and (b) how can various alternative batteries be combined to produce a single clustering that best incorporates each contributory set. A new method is proposed (SYNCLUS, SYNthesizedCLUStering) for dealing with these two problems.We wish to thank Anne Freeny and Deborah Art for their computer assistance, and Ed Fowlkes for his helpful technical discussion. We would also like to acknowledge the insightful and helpful comments from the editor and reviewers.     

Multivariate multiple regression analyses: a permutation method for linear models

A multivariate extension of a univariate procedure for the analysis of experimental designs is presented. A Euclidean-distance permutation procedure is used to evaluate multivariate residuals obtained from a regression algorithm, also based on Euclidean distances. Applications include various completely randomized and randomized block experimental designs such as one-way, Latin square, factorial, nested, and split-plot designs, with and without covariates. Unlike parametric procedures, the only required assumption is the randomization of subjects to treatments.     

Combining computerized home-based treatments for generalized anxiety disorder: an attention modification program and cognitive behavioral therapy

Generalized anxiety disorder (GAD) is a common and disabling condition associated with significant personal and societal costs. Although efficacious treatments exist for GAD, the majority of these individuals fail to access our most effective treatments. In the current paper, we report the results of an open trial that examined the efficacy of a computer-delivered home-based treatment program for GAD. Twenty-one individuals seeking treatment for GAD received a self-administered program over 6 weeks that comprised two components: (1) an Attention Modification Program (AMP) designed to facilitate attentional disengagement from threat-relevant stimuli and (2) brief computer-delivered cognitive and behavioral treatment modules (CCBT). Fourteen of the 21 enrolled participants (67%) completed the treatment program. Intent-to-treat and completer analyses revealed that AMP+CCBT resulted in significant reductions in clinician- and self-rated symptoms of anxiety, worry, depression, and functional impairment. Moreover, treatment completers displayed significant reductions in attentional bias for threat from pre- to postassessment. Change in attentional bias for threat from pre- to postassessment was associated with change in worry symptoms. Finally, 79% of participants no longer met DSM-IV criteria for GAD at postassessment and 36% were classified as remitted (Hamilton Rating Scale for Anxiety ≤7; Rickels et al., 2006). These results suggest that computer-delivered AMP+CCBT may serve as an effective and easily accessible treatment option for individuals with GAD.     

The formation of a generalized categorization repertoire: effect of training with multiple domains,samples, and comparisons

The present experiment explored the effects of three variables on the spontaneous categorization of stimuli in perceptually distinct and novel domains. Each of six stimulus domains was created by morphing two images that were the domain endpoints. The endpoints of the domains were male and female faces, two abstract drawings, a car and a truck, two banded-elevation satellite land images, a tree and a cat, and two false-color satellite images. The stimulus variants at each end of a domain defined two potential perceptual classes. Training was conducted in a matching-to-sample format and used stimuli from one or two domains, one or three variants per class as samples, and one or three variants per class as comparisons. The spontaneous categorization of stimuli in the untrained stimulus domains showed the emergence of a generalized categorization repertoire. The proportion of spontaneously categorized stimuli in the new domains was positively related to the number of domains and samples used in training, and was inversely related to the number of comparisons used in training. Differential reaction times demonstrated the discriminability of the stimuli in the emergent classes. This study is among the first to provide an empirical basis for a behavior-analytic model of the development of generalized categorization repertoires in natural settings.     

iMap: a novel method for statistical fixation mapping of eye movement data

Eye movement data analyses are commonly based on the probability of occurrence of saccades and fixations (and their characteristics) in given regions of interest (ROIs). In this article, we introduce an alternative method for computing statistical fixation maps of eye movements—iMap—based on an approach inspired by methods used in functional magnetic resonance imaging. Importantly, iMap does not require the a priori segmentation of the experimental images into ROIs. With iMap, fixation data are first smoothed by convolving Gaussian kernels to generate three-dimensional fixation maps. This procedure embodies eyetracker accuracy, but the Gaussian kernel can also be flexibly set to represent acuity or attentional constraints. In addition, the smoothed fixation data generated by iMap conform to the assumptions of the robust statistical random field theory (RFT) approach, which is applied thereafter to assess significant fixation spots and differences across the three-dimensional fixation maps. The RFT corrects for the multiple statistical comparisons generated by the numerous pixels constituting the digital images. To illustrate the processing steps of iMap, we provide sample analyses of real eye movement data from face, visual scene, and memory processing. The iMap MATLAB toolbox is editable and freely available for download online ().     

Cognitive and cognate-based treatments for bilingual aphasia: a case study

Two consecutive treatments were conducted to investigate skill learning and generalization within and across cognitive-linguistic domains in a 62-year-old Spanish-English bilingual man with severe non-fluent aphasia. Treatment 1 was a cognitive-based treatment that emphasized non-linguistic skills, such as visual scanning, categorization, and simple arithmetic. Treatment 2 was a lexically based treatment that trained cognates (cross-linguistic word pairs that are similar in meaning and form, such as rosa/rose) and non-cognates (cross-linguistic word pairs with shared meaning but different forms, such as mesa/table). Treatment 1 resulted in modest gains in both Spanish and English. Treatment 2 resulted in improved naming for non-cognates as well as cognates within each language. However, the generalization of gains from Spanish to English was apparent only for cognate stimuli.     

Promoting step responses of children with multiple disabilities through a walker device and microswitches with contingent stimuli

Children with severe or profound intellectual and motor disabilities often present problems of balance and locomotion and spend much of their time sitting or lying, with negative consequences for their development and social image. This study provides a replication of recent (pilot) studies using a walker (support) device and microswitches with preferred stimuli to promote locomotion in two children with multiple disabilities. One child used an ABAB design; the other only an AB sequence. Both succeeded in increasing their frequencies of step responses during the B (intervention) phase(s). These findings support the positive evidence already available on the effectiveness of this intervention in motivating and promoting children's locomotion.     

Facilitating ambulation and activity in persons with profound multiple disabilities through a visual orientation system

A visual orientation system was employed to help two adults with profound multiple disabilities ambulate to programmed activity destinations and carry out familiar activities. The system consisted of a portable control device and light sources. The person participating in experiment 1 was to operate the control device for activating the programmed destinations (and turning on light sources showing the way to them). The person participating in experiment 2 did not need to operate the control device; this activated each programmed destination automatically. A new destination was activated after a preset time had elapsed from the person reaching the previous destination. Results indicated that both persons used the visual orientation system successfully and thus could reach the destinations and carry out activities on their own. General implications of the findings are discussed. © 1998 John Wiley & Sons, Ltd.     

Caregiving for children through conflict and displacement: a pilot study testing the feasibility of delivering and evaluating a light touch parenting intervention for caregivers in the West Bank

A child's adjustment to wartime stress is reliant not only on individual responses and qualities, but very significantly on the availability of support that they may receive from their parent or caregivers and quality of relationships. Strengthening parental support has the potential to be valuable. A pilot two-arm randomised controlled trial investigated the feasibility of delivering and evaluating the “Caring for Children Through Conflict and Displacement” intervention with caregivers in the West Bank. Feasibility to recruit and train non-specialist staff on-the-ground to screen families for eligibility, collect outcome data, deliver the intervention and to recruit and retain families in the study were examined. Research staff and intervention facilitators were successfully appointed in the field, screened participants and delivered the intervention to 120 caregivers, collecting outcome measures pre-and post-delivery. All families completed the outcome measures, with very little missing data. This indicated that the intervention can be delivered feasibly and evaluated with families in this humanitarian context. Preliminary outcome data showed promise that the intervention may have the potential to both improve family functioning and reduce children's problem behaviour. Implications of family-focused initiatives, particularly within a conflict/post-conflict context for the prevention of several negative health and social outcomes directions, are discussed.     

A note on data smoothing for movement analysis: the relevance of a nonlinear method

The goal of this experiment was to test a potentially useful nonlinear method for smoothing noisy position data, which often is encountered in the analysis of data. This algorithm (7RY) uses a nonlinear smoothing function and behaves like a low-pass filter, automatically removing aberrant points; it is used prior to differentiation of time series so that usable acceleration information can be obtained. The experimental procedure comprises position data collection along with direct accelerometric data recording. From the position-time data, (a) 7RY and (b) Butterworth algorithms have been used to compute twice-differentiated acceleration curves. The directly recorded acceleration measurements were then compared with the acceleration computed from the original position data. Although the results indicated an overall good fit between the recorded and the calculated acceleration curves, only the nonlinear method led to reliable acceleration curves when aberrant points were present in the position data.     

Interresponse time as a function of continuous variables: a new method and some data

A cathode-ray oscilloscope and a Polaroid camera record interresponse times as a function of time, stimulus wavelength, and similar variables. Each response flashes a point of light on the oscilloscope screen; the vertical position of the point gives IRT, the horizontal position gives the value of the other variable. Several thousand such points may be recorded on a single frame of film, and the density of the points indicates the relative frequency of various IRTs. The method has the advantages of a two-dimensional display of continuous variables, flexibility, speed, and relatively low cost. It lacks the advantage of a digital output. Figures show IRTs of pigeons on VI, FR, DRL and extinction, and transitions among these, and also the results of stimulus generalization tests. The results have some provocative features that require much further exploration. Among other things, they suggest that "response rate" as a measure usually includes a response-dependent component that is insensitive to changes in other variables.     

Writing program with word prediction for a young man with multiple disabilities: a preliminary assessment

This study assessed a writing program with word prediction, which completed the writing of a word and spoke it out only when there was certainty that such a word was the correct one. The assessment was carried out with a young man with multiple disabilities, who typically used a word-processing program without word prediction. The two programs were compared on the time required by the participant for writing general sentences, through a social validation assessment, and eventually a check on the participant's preference. Analysis showed the program with word prediction was significantly more effective in terms of the writing time, which was halved, and was deemed preferable by 40 raters (psychology students) involved in the social validation assessment and by the participant himself. Implications of the findings are discussed.