Current status of psychological research in organ transplantation

Research addressing the psychological concomitants of organ transplantation is reviewed. Specifically, cognitive, behavioral, and psychosocial correlates of kidney, heart, liver, and bone marrow transplantation in both children and adults are discussed. Despite several conceptual and methodological shortcomings of the psychologically-based research in this area, results seem to indicate that organ transplantation is associated with many psychological issues at pretransplantation, posttransplantation, and follow-up periods. Implications of these general findings for the advancing roles of the health psychologist in organ transplantation are discussed.     

Cognitive status in Down syndrome individuals with sleep disordered breathing deficits (SDB)

Twelve subjects with Down syndrome underwent polysomnographic studies during night sleep and performed the Mini-Mental state test and the Raven Progressive Matrices (RPM), sets A, B, and B(1). Sleep-disordered breathing (SDB) deficits were observed in Down syndrome individuals and their Mini-Mental and RPM scores were extremely low. Regression analysis of the results revealed that the number of apneas per hour was related with the results of the RPM, set A, which were also related with the orientation of Mini-Mental test, indicating that the more apneas an individual has the more difficulties he has in the kind of visuoperceptual skills, including orientation, associated with normal right hemisphere functioning, which are tested by set A of the RPM.     

Neurochemical knowledge in electroconvulsive therapy (ECT)

The paper is concerned with an attempt to generalize and categorize current hypotheses on the biochemical basis of ECT. The hypotheses are critically evaluated with respect to the relevance of their experimental fundamentals. Thus, certain hypotheses are valid only in a qualified sense. Particular interest is focussed on those conceptions which try to correlate ECT-induced changes in synaptic receptor sensitivities (up-/down-regulation) with super- resp. subsensitivity hypotheses of psychoses. In this connection, noradrenergic and opioid systems on the one hand, and the axis hypothalamus-hypophysis on the other hand seem to play a dominant role.     

The scientific status of psychoanalytic clinical evidence (III)

Communist ideology is evolving away from its original mould. One of the decisive factors in this process is the rate of acceptance of the ‘Classical’ doctrines by the intellectuals of East‐European countries. In determining the dynamics of the process, the original doctrines and the thinking of the intellectuals are taken as sets of sentences constituting the premisses, and the manifest actual discourse of a Communist country as the set of sentences representing the conclusion. To demonstrate the conclusion from the premisses, heuristic laws are formulated accounting for the various factors conditioning the process of the interaction of Classical Communism and the thinking of the intellectuals. A logical schema of general applicability results, demonstrating the various phases of the evolution of Marxist‐Leninist ideology in East‐European countries.     

Physiological mechanisms of flooding (implosion) therapy

Desensitization of psychological and physiological complex structures may be the most important element of flooding treatment. The jmplosive sessions are assumed to represent a supramaximal stimulation of pathologically excited and inert complex structures resulting in protective inhibition, irradiation of excitation, reduction of the excitation and inertness, and a decrease of the overshooting autonomic reactivity of the complex structures, leading to reduction of anxiety, aggression, and other pathologically increased feelings. Advantages such as stronger and improved flooding can be achieved by a flooding in hypnosis. The therapeutic indications go beyond the usual treatment of phobic states. In order to establish the psychological and physiological mechanisms in implosion there is a need for psychophysiological investigations. However, much is unknown about mechanisms. Controlled comparisons with other treatments give limited answers. Perhaps an international case history bank might establish which clinical conditions might benefit by technical modifications of flooding.     

The scientific status of psychoanalytic clinical evidence (I)

The main source of evidence for psychoanalytic theory comes from the clinical situation. Yet recent empirical studies in verbal conditioning and the social psychology of persuasion indicate that psychoanalysts and therapists of other schools are speciously validating their own theories by unwittingly influencing their patients’ behavior. In the light of this evidence it is small wonder that psychoanalysts consistently ‘validate’ psychoanalytic theory in their clinical practice while therapists of other schools ‘validate’ their own theories in their clinical practice. Although Freud was not unaware of the problems of ‘suggestion’ and the conflicting evidence of rival schools of psychotherapy, he never met these problems successfully. Contemporary psychoanalysts have added little to Freud's original position. One recent attempt, by Fritz Schmidl, to formulate new criteria for the correctness of psychoanalytic clinical interpretations, does not completely escape the problem of suggestion and has new problems of its own.     

Apparative aversive therapy in combination with verbal suggestions in special obsessional syndromes (initial investigation)

The author restricts the use of aversion therapy by means of deliberate production of pain to obsessional, especially therapy-resistant disturbances of a permanent nature, with consideration being, of course, given to ethical factors. Experiences worthy of generalization are derived from methodically varied courses of treatment, bringing out suggestive moments subliminally involved in any therapeutical situation and also specifically used by the therapist. In addition, the author emphasizes the need for simultaneously developing, besides aversion therapy, positive attitudes and behavior patterns.     

The revised ABC's of rational-emotive therapy (RET)

Although I was perceptive enough to realize, in my first paper on rational-emotive therapy (RET) in 1956, that cognitions, emotions, and behaviors almost always are not pure or disparate but significantly include each other, I have appreciably added to this concept and have stressed forceful emotive and educative, as well as strong behavioral, techniques of RET in recent years. I have also increasingly pointed out that the ABC's of RET-A standing for Activating Events, B for Beliefs about these events, and C for emotional and behavioral Consequences of these Beliefs-also influence, include, and interact with each other. The present paper gives salient details of how A's, B's, and C's, as well as cognitions, emotions, and behaviors all importantly affect one another and how they become combined into dysfunctional, demanding core Basic Philosophic Assumptions that lead to neurotic disturbances. To change and to keep changing these dysfunctional basic assumptions, RET uses a number of intellectual, affective, and action techniques that often are applied in a forceful, persistent, active-directive manner. It is more cognitive than most of the other cognitive-behavior therapies in that it tries to help many (not all) clients to make an elegant or profound philosophic change (Ellis, 1979b, 1985b). But it is also more emotive and behavioral than most other popular therapies in that it assumes that neurotic individuals' core basic philosophies assumptions are, as Muran (in press) points out, tacit cognitive-affective-motoric structures that account for emotional experiences in the face of external stimuli, and that therefore therapists had better teach their clients (and the general public) several powerful cognitive-emotive-behavioral methods of helping themselves change.Albert Ellis is President of the Institute for Rational-Emotive Therapy, 45 East 65th Street, New York, NY, 10021     

Virtual reality exposure therapy and standard (in vivo) exposure therapy in the treatment of fear of flying

This controlled clinical trial tested virtual reality exposure (VRE) therapy for the fear of flying (FOF), a relatively new and innovative way to do exposure therapy, and compared it to standard (in vivo) exposure therapy (SE) and a wait list (WL) control with a 6- and 12-month follow-up. Eighty-three participants with FOF were randomly assigned to VRE, SE, or WL. Seventy-five participants, 25 per group, completed the study. Twenty-three WL participants completed randomly assigned treatment following the waiting period. Treatment consisted of 4 sessions of anxiety management training followed either by exposure to a virtual airplane (VRE) or an actual airplane at the airport (SE) conducted over 6 weeks. Results indicate that VRE was superior to WL on all measures, including willingness to fly on the posttreatment flight (76% for VRE and SE; 20% for WL). VRE and SE were essentially equivalent on standardized questionnaires, willingness to fly, anxiety ratings during the flight, self-ratings of improvement, and patient satisfaction with treatment. Follow-up assessments at 6 and 12 months indicated that treatment gains were maintained, with more than 70% of respondents from both groups reporting continued flying at follow-up. Based on these findings, the use of VRE in the treatment of FOF was supported in this controlled study, suggesting that experiences in the virtual world can change experiences in the real world.     

Anogenital distance and dominance status in male house mice (Mus domesticus)

Factors influencing the tendency to be aggressive were investigated in male house mice using a series of paired encounters. Body size, body lenght, body temperature, age, and anogenital distance were measured on all males. Paired encounters were conducted using a standard mouse cage as an arena. Across 64 males involved in 224 encounters, the tendency to be dominant and win encounters was significantly correlated only with anogenital distance (r = 0.383). These findings suggest that there are significant behavioral effects in male mice that could parallel the intrauterine position and related prental hormone effects that have been elucidated in female house mice and other rodents. © 1995 Wiley-Liss, Inc.     

Detection of phytanic acid (3,7,11,15-tetramethylhexadecanoic acid) in serum using the gas chromatograph GCHF 18.3

A gas-chromatic method for detection of phytanic acid (3,7,11,15-tetramethylhexadecanoic acid) in serum is described. The sensitivity of the method is very high. It is easy to distinguish between patients with Refsum's disease and those with other polyneuropathies.     

Applications of rational-emotive therapy (RET) to love problems

Rational-emotive therapy (RET) can be particularly applied to individuals with serious love problems, such as people possessed by super-romantic love, limerents who are mired in obsessive-compulsive feelings, insensately jealous and possessive lovers, people who needlessly interfere with their encountering suitable partners, and those who suffer anguish and depression when they lose love. It also has important things to teach about keeping alive and enhancing normal love feelings. This paper outlines the RET theory of love and applies it to various amative difficulties.This article is to appear as a chapter inClinical applications of Rational-Emotive Therapy, edited by Albert Ellis and Michael Bernard, New York: Plenum, 1985.     

Serum testosterone determination in the antiandrogen therapy of sexual deviations with cyproterone acetate (preliminary report of experiences)

Total testosterone concentrations in the serum of patients treated with antiandrogens were measured by means of an industrially produced radioimmunological testosterone assay kit (VEB S?chsisches Serumwerk Dresden). Antiandrogen therapy using cyproterone acetate (Androcur) leads to a reduction in serum testosterone concentration which is significant at the p less than 0.01 level. The data suggest that testosterone concentrations vary inversely with increasing Androcur dosage; they are around 7 nmol/l at the doses conventionally administered. The testosterone concentrations obtained under depot-Androcur treatment suggest that intervals between injections should be less than 10 days.     

On the status of self in social prediction: comment on Karniol (2003)

A challenge to mainstream notions on the status of the self in social prediction is welcome. The self-as-distinct model (R. Karniol, 2003) is thoughtful, provocative, and parsimonious, but it is also underspecified, undertested, and selective in its treatment of the evidence. More important, the model does not provide compelling answers to issues pertaining to the origins of prototypic social knowledge, the status of self-knowledge, the content of the self-representation, whether the use of self in social prediction is a logical contradiction, and whether the self's role in social prediction is amotivated.     

Cognitive behavior therapy vs exposure in vivo in the treatment of panic disorder with agoraphobia (corrected from agrophobia)

Seventy-three psychiatric outpatients with DSM-IV diagnosis of panic disorder with agoraphobia were assessed with a battery of independent assessor, self-observation, self-report and behavioral measures before and after therapy, and at a 1-yr follow-up. They were randomly assigned to Exposure in vivo (E; n = 25), Cognitive Behavior Therapy (CBT; n = 26), or a Wait-list control (WLC; n = 22) and received 12-16 individual therapy sessions, once weekly. The treatments yielded significant improvements, both on panic/agoraphobia measures and on measures of general anxiety, depression, social adjustment and quality of life, which were maintained at follow-up. However, there were no significant differences between E and CBT. The three criteria of clinically significant improvement were achieved by 67% of the E-patients and 79% of the CBT-patients at post-treatment, and 74% and 76%, respectively, at follow-up. The conclusion that can be drawn is that adding cognitive therapy to exposure did not yield significantly better results than for exposure alone.     

A multistudy analysis of socioeconomic status (SES) and the measures and outcomes of cognitive-behavioral treatment with children

The relationship of the child's socioeconomic status (SES) to improvement and generalization from cognitive behavioral-treatment was investigated by comparing high and low SES groups on teacher ratings, performance measures, and judges' ratings of improvement and maintenance of positive change. Fifty-eight teacher referred classroom problem children (grades 2–6) who had served as treated subjects in one of three treatment outcome studies were examined. SES data were collected by administration of a questionnaire to the head of each household. The judges' ratings were performed on clusters of teacher ratings and clusters of performance measures that were present in each study. Results indicated that, despite SES group variation in level of performance, improvement, when it occurred, was evident for both high and low SES groups. In addition, there were significant differences on a number of the performance measures at pretreatment, posttreatment, and follow-up. Initial SES group differences in verbal ability as measured by the Peabody Picture Vocabulary Test (PPVT) appear to have been an important factor in these performance differences.This research was supported by grant number 441 0749 5236 02 from the Graduate School of the University of Minnesota, awarded to Philip C. Kendall. Portions of this research were presented at the Association for the Advancement of Behavior Therapy Convention, San Francisco, December 1979. Portions of the material were prepared while the second author was at the Center for Advanced Study in the Behavioral Sciences and supported by NIMH (No. 5-T32-MH 14581-05) and the MacArthur Foundation. The authors wish to thank Dorothy Raney for her valuable assistance.