Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: a pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone

Cambodian refugees with posttraumatic stress disorder (PTSD) represent a cohort in severe need of treatment, but little information is available to guide treatment choices. We selected a sample of pharmacotherapy-refractory individuals to test the efficacy of combination treatment with sertraline and cognitive-behavior therapy (CBT) for treating PTSD. Participants in this pilot study were ten Khmer-speaking women who had been at a mean age of 22-26 years during the Pol Pot period (1975-1979). These patients were randomly assigned to either sertraline alone or combined treatment. We found that combined treatment offered additional benefit in the range of medium to large effect sizes for PTSD and associated symptoms. Our findings indicate that substantial gains can be achieved by adding CBT to pharmacotherapy for PTSD, and that a program of CBT emphasizing information, exposure, and cognitive-restructuring can be successfully modified for Khmer-speaking refugees.     

The use of latent trajectory models in psychopathology research

Despite the recent surge in the development of powerful modeling strategies to test questions about individual differences in stability and change over time, these methods are not currently widely used in psychopathology research. In an attempt to further the dissemination of these new methods, the authors present a pedagogical introduction to the structural equation modeling based latent trajectory model, or LTM. They review several different types of LTMs, discuss matching an optimal LTM to a given question of interest, and highlight several issues that might be particularly salient for research in psychopathology. The authors augment each section with a review of published applications of these methods in psychopathology-related research to demonstrate the implementation and interpretation of LTMs in practice.     

Using video modeling and reinforcement to teach perspective-taking skills to children with autism

We evaluated video modeling and reinforcement for teaching perspective-taking skills to 3 children with autism using a multiple baseline design. Video modeling and reinforcement were effective; however, only 2 children were able to pass an untrained task, indicating limited generalization. The findings suggest that video modeling may be an effective technology for teaching perspective taking if researchers can continue to develop strategies for enhancing the generalization of these new skills.     

Sequential evaluation of behavioral treatments and methylphenidate dosage for children with attention deficit hyperactivity disorder

We used a sequential approach to evaluate the relative and combined effects of different types of behavioral treatments, as well as dosage of methylphenidate (MPH), on the disruptive behavior of 3 students who had been diagnosed with attention deficit hyperactivity disorder. Results showed that individualized behavioral treatments produced decreases in disruptive behavior equivalent to MPH for all 3 participants and demonstrated the need to evaluate behavioral treatments and medication dosage on an individual basis.     

The effects of presession attention on problem behavior maintained by different reinforcers

The effect of presession attention on the later occurrence of problem behavior was examined with elementary-school children with a range of disabilities. Results of analogue functional analyses suggested an escape function, an attention function, or both. Following the analogue functional analyses, the effects of two antecedent conditions (10-min ignore vs. 10-min attention) were compared on problem behavior in subsequent test conditions. For participants who displayed attention-maintained problem behavior, the test condition involved contingent attention for problem behavior. For participants who displayed escape-maintained problem behavior, the test condition involved contingent escape for problem behavior. Results indicated that participants who displayed attention-maintained problem behavior displayed less problem behavior following presession exposure to attention than when ignored. No such effect was found for presession attention on escape-maintained problem behavior. We discuss matching antecedent-based interventions to the results of functional analysis.     

The dynamics of masculine-agentic and feminine-communal traits: findings from a prospective study

A reciprocal impact hypothesis posits an influence of gender-related traits (agency and communion) on role enactment and a reciprocal impact of role enactment on gender-related traits, for both men and women. Specifically, in this study it was predicted that agency influences career success and career success influences agency. In addition, the reciprocal influence of communion and family roles was examined. A prospective study with almost 2000 university graduates, who were tested after graduation and 1.5 years later, clearly supported the reciprocal impact hypothesis for agency and career success. Communion influenced family roles, but there was no reciprocal influence. Implications for theories of career success and of sex and gender are discussed.     

The time course of attentional focusing in dyslexic and normally reading children

A cue size procedure was used to evaluate the time course of visuo-spatial attention in dyslexic and normally reading children. When a stimulus target is presented inside a large cue vs a small cue the identification time is slower. In the present study two cue-target delays (100 and 500 ms) were used. Results showed a slower time course of attentional focusing in dyslexics vs normal readers. Indeed, dyslexics exhibited no cue size effect at a shorter cue-target delay (100 ms), while it was present at a longer cue-target delay (500 ms). In contrast, a cue size effect was found at both cue-target delays in normally reading children. These results further support the hypothesis of sluggish automatic focusing of visual attention in dyslexics. This impairment could be a consequence of a general magnocellular deficit demonstrated previously in dyslexics.     

Impaired processing of prosodic and musical patterns after right hemisphere damage

The distinction between the processing of musical information and segmental speech information (i.e., consonants and vowels) has been much explored. In contrast, the relationship between the processing of music and prosodic speech information (e.g., intonation) has been largely ignored. We report an assessment of prosodic perception for an amateur musician, KB, who became amusic following a right-hemisphere stroke. Relative to matched controls, KB's segmental speech perception was preserved. However, KB was unable to discriminate pitch or rhythm patterns in linguistic or musical stimuli. He was also impaired on prosodic perception tasks (e.g., discriminating statements from questions). Results are discussed in terms of common neural mechanisms that may underlie the processing of some aspects of both music and speech prosody.     

Functional neuroanatomy of altered states of consciousness: the transient hypofrontality hypothesis

It is the central hypothesis of this paper that the mental states commonly referred to as altered states of consciousness are principally due to transient prefrontal cortex deregulation. Supportive evidence from psychological and neuroscientific studies of dreaming, endurance running, meditation, daydreaming, hypnosis, and various drug-induced states is presented and integrated. It is proposed that transient hypofrontality is the unifying feature of all altered states and that the phenomenological uniqueness of each state is the result of the differential viability of various frontal circuits. Using an evolutionary approach, consciousness is conceptualized as hierarchically ordered cognitive function. Higher-order structures perform increasingly integrative functions and thus contribute more sophisticated content. Although this implies a holistic approach to consciousness, such a functional hierarchy localizes the most sophisticated layers of consciousness in the zenithal higher-order structure: the prefrontal cortex. The hallmark of altered states of consciousness is the subtle modification of behavioral and cognitive functions that are typically ascribed to the prefrontal cortex. The theoretical framework presented yields a number of testable hypotheses.     

Stress within a bicultural context for adolescents of Mexican descent

Folkman and Lazarus's theory of stress and coping was used to develop a measure assessing the perceived stress within a bicultural context. Middle school students of Mexican descent (N = 881) reported their perceived stress from intergenerational acculturation gaps, within-group discrimination, out-group discrimination, and monolingual stress. Although immigrant youths reported more total number of stressors, U.S.-born youths reported more stress from needing better Spanish and impact of parents' culture. Immigrant youths reported more stress from needing better English in school. Higher stress was associated with more depressive symptoms for both U.S.-born and immigrant youths. Although this study has identified some elements of stress, it has not identified positive coping mechanisms of the bicultural context for Latino youths.