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.     

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.     

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.     

Coping with loneliness in old age: a cross-cultural comparison

The present study is an examination of the influence of cultural background on the ways in which the aged cope with loneliness. Thirty-six participants from Canada and 105 from Portugal (60-83 years old) answered an 86-item questionnaire which examined thebeneficial strategies which they used to cope with loneliness. The strategies which were examined included Acceptance and Reflection, Self-Development and Understanding, Social Support Network, Distancing and Denial, Religion and Faith, and Increased Activity. Results indicated that the elderly of the two cultures differ on three subscales. Gender differences between and within cultures were also examined.     

Coping with loneliness in old age: a cross-cultural comparison

The present study is an examination of the influence of cultural background on the ways in which the aged cope with loneliness. Thirty-six participants from Canada and 105 from Portugal (60-83 years old) answered an 86-item questionnaire which examined thebeneficial strategies which they used to cope with loneliness. The strategies which were examined included Acceptance and Reflection, Self-Development and Understanding, Social Support Network, Distancing and Denial, Religion and Faith, and Increased Activity. Results indicated that the elderly of the two cultures differ on three subscales. Gender differences between and within cultures were also examined.     

Development of phonological and orthographic processing in reading aloud,in silent reading,and in spelling: a four-year longitudinal study

The development of phonological and orthographic processing was studied from the middle of Grade 1 to the end of Grade 4 (age 6; 6-10 years) using the effects of regularity and of lexicality in reading aloud and in spelling tasks, and using the effect of pseudohomophony in a silent reading task. In all the tasks, signs of reliance on phonological processing were found even when indicators of reliance on orthographic processing appeared. Multiple regression analyses were conducted to determine which early skills predict later reading achievement. Pseudoword and irregular word scores were used as measures for phonological and orthographic skills, respectively. Only middle of Grade 1 phonological reading skills accounted for independent variance in end of Grade 4 orthographic skills. Conversely, from the middle to the end of Grade 1, and from the end of Grade 1 to the end of Grade 4, both orthographic and phonological skills accounted for independent variance in later orthographic skills. In the prediction of phonological skills, only the unique contribution of earlier phonological skills was significant. Thus, phonological and orthographic processing appear to be reciprocally related, rather than independent components of written word recognition. However, very early reliance on the phonological procedure seems to be the bootstrapping mechanism for reading acquisition.     

Creativity in old age

Sixty elderly subjects (M = 72 years) were tested and interviewed to find out how they experience and come to terms with the advent of illness, aging, and death. The choice of test instruments was steered by the necessity to learn how our subjects handled their anxiety (the Meta‐Contrast Technique [MCT]); to operationally define the concept of self‐image (the Identification Test [IT]); and to illuminate the findings from the perspective of creativity (the Creative Functioning Test [CFT]). The results revealed creativity to be a key factor in aging. The attitude of creative individuals towards aging was less negative and their attitude to illness less defensive. On the whole, their self‐projections were not only more flexible but also more emotional. However, creativity is not uninfluenced by context, particularly when it is of medium strength. The results also revealed that the subliminal messages used in the IT to manipulate the projected self‐image were effective.     

Relations among mothers' expressivity, children's effortful control, and their problem behaviors: a four-year longitudinal study

Longitudinal relations between mothers' expressivity, children's effortful control, and their problem behaviors were examined when children (N = 181) were 6.5-10 years old (T2) and again 2 (T3) and 4 (T4) years later. Mothers reported on their expression of positive and negative dominant emotion. Mothers and teachers reported on children's effortful control and externalizing and internalizing problem behaviors. In structural equation models, variables exhibited consistency over time. Further, the relation between mothers' expressivity (positive minus negative dominant emotion) at T2 and children's externalizing problems at T4 was mediated by T3 effortful control. The same process of mediation was significant for teacher- but not mother-reported internalizing problems. The results provide one explanation for how emotion-related socializing behaviors influence children's problem behaviors.