Family Etiology and Remission in a Case of Psychogenic Fugue

A psychogenic fugue lasting six days occurred in a 15-year-old girl living with her mother, sister, and stepfather. The fugue was of the most complete type — the patient assumed a new identity; spoke a foreign language she had studied in school; “regressed” to an earlier period in history; radically altered her dress and grooming; and showed skills, interests, and personality features she had not shown before. Although accounts of fugues are rare and often sketchy, the present case is unique in the amount of detail that was available. The argument between situational and psychodynamic interpretations of fugue is reviewed briefly, and a family systems interpretation of the present case is offered.     

Reactions to blindness: a four-year follow-up study

A previously studied group of newly blind adults was followed up after four years. There was only a slight increase in the acquisition of blind skills, while there was a surprising continuing pervasiveness of depression and poor health. A number of variables from the original study and from the follow-up data predicted outcome measures. Significant predictors of depression and distress were poor health, being married, being nonProtestant in this predominantly Protestant London population, and lacking ability to be more independent. Higher social class and an absence of a family history of blindness predicted greater distress. Earlier acceptance of blindness, early learning of blind skills, and better preillness adjustment predicted better coping and greater use of blind skills at follow-up. The extent of the depression and poor health are discussed, and recommendations are made for caregivers.     

Assessing the sustainability of goal-based changes in adjustment over a four-year period

No published data addresses the longer-term sustainability of increases in well-being and adjustment derived from successful goal-striving. Although some theories and data suggest that such gains cannot be maintained, the sustainable happiness model [Lyubomirsky, S., Sheldon, K. M., & Schkade, D. (2005). Pursuing happiness: The architecture of sustainable change. Review of General Psychology, 9, 111–131.] suggests that successful intentional activity can indeed bring about lasting gains. In the current study, the “freshman goals” sample studied by Sheldon and Houser-Marko (Study 1) [Sheldon, K. M., & Houser-Marko, L. (2001). Self-concordance, goal-attainment, and the pursuit of happiness: Can there be an upward spiral? Journal of Personality and Social Psychology, 80, 152–165.] was revisited at the end of their senior year. Students who strove successfully during their freshman year, thereby enhancing their adjustment during that year, had maintained those gains three years later. Path modeling suggested that initial adjustment predicted subsequent goal-attainment which in turn predicted enhanced adjustment, combining recent theories concerning both the functional benefits of positive affect and the causes of sustainable gains in well-being.     

Behaviorally treated irritable bowel syndrome patients: a four-year follow-up

Nineteen of 27 patients suffering from Irritable Bowel Syndrome (IBS) who had completed a multicomponent treatment involving progressive muscle relaxation, thermal biofeedback, cognitive therapy and IBS education were located and evaluated 4 yr posttreatment. Seventeen of 19 (89.5, or 63% of the total original sample) rated themselves as more than 50% improved. Six of the 12 patients (50%) who submitted symptom monitoring diaries met our criteria for clinical improvement, i.e. achieving at least a 50% reduction in primary IBS symptom scores. The means on all measures at long-term follow-up were lower than those obtained prior to treatment. When follow-up symptom means were compared with pretreatment means, significant (P less than 0.05) reductions were obtained on abdominal pain/tenderness, diarrhea, nausea, and flatulence.     

Cognitive behaviour therapy of acute stress disorder: a four-year follow-up

The aim of this study was to index the long-term benefits of early provision of cognitive behavior therapy to trauma survivors with acute stress disorder. Civilian trauma survivors (n = 80) with acute stress disorder were randomly allocated to either cognitive behavior therapy (CBT) or supportive counseling (SC) - 69 completed treatment, and 41 were assessed four years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician Administered PTSD Scale. Two CBT patients (8%) and four SC patients (25%) met PTSD criteria at four-year follow-up. Patients who received CBT reported less intense PTSD symptoms, and particularly less frequent and less avoidance symptoms, than patients who received SC. These findings suggest that early provision of CBT in the initial month after trauma has long-term benefits for people who are at risk of developing PTSD.     

Modeling relations between hassles and internalizing and externalizing symptoms in adolescents: a four-year prospective study

This study examined the relations between hassles and internalizing and externalizing symptoms across 4 years in adolescents who varied with regard to their risk for psychopathology. The sample comprised 240 adolescents assessed in 6th, 7th, 8th, and 9th grades regarding their level of peer and academic hassles and internalizing and externalizing symptoms. Structural equation modeling was used to construct latent variables of hassles and internalizing and externalizing syndromes. Results varied by informant about the teens' symptoms. For adolescent report, the stress exposure model fit the data best for internalizing syndromes; that is, higher levels of stressors predicted significantly higher levels of self-reported symptoms 1 year later. For mother report of adolescents' symptoms, the stress generation model fit the data best for both internalizing and externalizing syndromes; that is, higher levels of adolescents' internalizing and externalizing symptoms, as reported by their mothers, significantly predicted higher levels of hassles 1 year later.     

Out with the old: Inhibition of old items in a preview search is limited

If some of the distractors in a visual search task are previewed prior to the presentation of the remaining distractors and the target, search time is reduced relative to when all of the items are displayed simultaneously. Here, we tested whether the ability to preferentially search new items during such a preview search is limited. We confirmed previous studies: The proportion of fixations on old items was significantly less than chance. However, the probability of fixating old locations was negatively affected by increasing the number of previewed distractors, suggesting that inhibition is limited to a small number of old items. Furthermore, the ability to inhibit old locations was limited to the first four fixations, indicating that by the fifth fixation, the resources required to sustain inhibition had been depleted. Together, these findings suggest that inhibition of old items in a preview search is a top-down mediated process dependent on capacity-limited cognitive resources.     

Functional analysis and treatment of the delusional statements of a man with multiple disabilities: a four-year follow-up

Although delusional statements in people with intellectual disabilities and traumatic brain injury can be treated using behavioral interventions, none have demonstrated long‐term treatment effects. In the current study, a functional analysis demonstrated that delusional statements were maintained by attention. Differential reinforcement of alternative behavior and extinction of delusional statements resulted in near elimination of delusional statements and an increase in nondelusional statements. Follow‐up at 6 months, 1, 2, and 4 years indicated that treatment gains were maintained with continued staff training.     

Developmental change in attention-deficit hyperactivity disorder in boys: A four-year longitudinal study

One hundred six clinic-referred boys meeting criteria for DSM-III-R attention-deficit hyperactivity disorder (ADHD) (mean age 9.4 years) were assessed annually for 4 years using structured interviews of multiple informants. Hyperactivity—impulsivity symptoms declined with increasing age, but inattention symptoms did not. Rather, inattention declined only from the first to the second assessment and remained stable thereafter in boys of all ages. The rate of decline in hyperactivity—impulsivity symptoms was independent of the amount and type of treatment received. Boys who still met criteria for ADHD in Years 3 and 4 were significantly younger, more hyperactive—impulsive, and more likely to exhibit conduct disorder in Year 1 than boys who no longer met criteria in Years 3 and 4.This study was supported by grant 1-R01-MH42529 from the National Insitute of Mental Health to Rolf Loeber and Benjamin B. Lahey.     

Attachment styles and close relationships: A four-year prospective study

A longitudinal study of 177 adults examined the stability of adult attachment styles and of romantic relationships over a 4-year period. Findings included the following: (a) attachment styles were highly stable over time; (b) Time 1 attachment style was a significant predictor of Time 2 relationship status, but (c) this effect was mediated by concurrent attachment style at Time 2; (d) secure respondents were less likely than insecure respondents to report one or more breakups during the 4-year interval, but (e) paradoxically, ambivalent respondents were just as likely as secure respondents to be in a relationship with the same partner they had identified 4 years earlier; and (f) attachment stability was moderated to some extent by the experience of breakup or initiation of new relationships during the interim. Respondents' ability to recall their previous attachment style was also examined. Methodological and theoretical implications are discussed, particularly with respect to the conceptualization of attachment styles as traits versus reflections of current relationship status.     

Developmental associations of actual motor competence and perceived physical competence with health-related fitness in schoolchildren over a four-year follow-up

The developmental associations between actual motor competence (MC), perceived physical competence (PC), and health-related fitness (HRF) in schoolchildren were investigated over a four-year period. Participants were 1147 (girls 582, boys 565) schoolchildren aged between 11 and 13 years (M = 11.27 ± 0.33 years) in the beginning of the study. Data were collected at five time points in 2017–2021. MC was measured with three product-oriented (i.e., outcome of the movement) motor competence skill tests: side-to-side jump, five-leaps, and throw-catch. PC was assessed with the Physical Self-Perception Profile. HRF was assessed with the 20m shuttle run, curl-up, and push-up tests. The random intercept cross-lagged panel model with birth month and sex as covariates, was tested using repeated measures (within level) and PC, MC, and HRF levels (between level). The key findings were: 1) PC, MC, and HRF levels were reciprocally associated over time; 2) repeated measures of HRF at each time point were positively associated with PC and MC one year later; 3) PC decreased, MC increased, and HRF remained stable over time; and 4) MC was more important than PC in explaining the variability in HRF levels and repeated measures. The positive reciprocal associations of MC, PC, and HRF from late childhood to early adolescence found in this study are important as they indicate that to support HRF in schoolchildren, both MC and PC can be promoted through investment in MC exercises.