Posttraumatic stress and depression: potential pathways to disease burden among heart failure patients

Background and Objectives: Posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) are associated with high disease burden. Pathways by which PTSD and MDD contribute to disease burden are not understood. Design: Path analysis was used to examine pathways between PTSD symptoms, MDD symptoms, and disease burden among 251 low-income heart failure patients. Methods: In Model 1, we explored the independent relationship between PTSD and MDD symptoms on disease burden. In Model 2, we examined the association of PTSD symptoms and disease burden on MDD symptoms. We also examined indirect associations of PTSD symptoms on MDD symptoms, mediated by disease burden, and of PTSD symptoms on disease burden mediated by MDD symptoms. Results: Disease burden correlated with PTSD symptoms (r = .41; p < .001) and MDD symptoms (r = .43; p < .001) symptoms. Both models fit the data well and displayed comparable fit. MDD symptoms did not mediate the association of PTSD symptoms with disease burden. Disease burden did mediate the relationship between PTSD symptoms and MDD symptoms. Conclusions: Results support the importance of detection of PTSD in individuals with disease. Results also provide preliminary models for testing longitudinal data in future studies.     

Making the Decision to Participate in Predictive Genetic Testing for Arrhythmogenic Right Ventricular Cardiomyopathy

This paper describes the experience of predictive genetic testing for Arrhythmogenic Right Ventricular Cardiomyopathy in the context of novel gene discovery. Two approaches to making the decision to engage in genetic testing were apparent: the decision to be tested either (a) develops gradually over time or (b) happens so quickly that it is felt as a “fait accompli.” Six key factors that influenced the particular approach taken by the participants were identified: (1) scientific process—available and relevant predictive genetic test; (2) numerous losses or deaths within the family; (3) physical signs and symptoms of disease; (4) gender; (5) sense of relational responsibility or moral obligation to other family members; and (6) family support. This study found that at risk individuals juxtapose scientific knowledge against their experiential knowledge and the six identified factors in order to make the decision to participate in genetic testing. Recommendations include the creation of a relational space within which to provide psychological counselling and assessment for the six identified factors that shape the decision to engage in predictive genetic testing.     

Dyad Practice Impacts Self-Directed Practice Behaviors and Motor Learning Outcomes in a Contextual Interference Paradigm

We studied dyad practice to determine whether and how alternating practice blocks with a partner impacts self-directed practice scheduling, learning, and perceptions of practice. Participants were assigned to be Partner 1 (P1) or 2 (P2). P1s had a blocked, random, or self-directed schedule, while all P2s self-directed practice of 3, differently-timed keystroke-sequences. P2s showed both own error-dependent practice (switching sequences following better performance) and partner-dependent practice, with the partner's schedule impacting sequence selection and switching frequency. A partner's schedule also impacted learning. Random practice resulted in better timing accuracy than blocked practice for both partners in an immediate and delayed retention test. These data give evidence that self-directed practice behaviors and learning outcomes are modulated by a partner's practice schedule.     

EVALUATION AND TRAINING OF YES‐NO RESPONDING ACROSS VERBAL OPERANTS

Topographically similar verbal responses may be functionally independent forms of operant behavior. For example, saying yes or no may have different functions based on the environmental conditions in effect. The present study extends previous research on both the assessment and acquisition of yes and no responses across contexts in children with language deficits and further examined the functional independence of topographically similar responses. All participants in the present study acquired yes and no responses within verbal operants (e.g., mands). However, generalization of the responses across novel verbal operants (e.g., tacts to intraverbals) did not occur without additional training, thus supporting Skinner's (1957) assertion of functional independence of verbal operants.     

Integrating Objective and Subjective Social Class to Advance Our Understanding of Externalizing Problem Behavior in Children and Adolescents: A Conceptual Review and Model

Clinical Child and Family Psychology Review - Extant research has identified both objective measures of socioeconomic status (SES) and subjective social class (SSC) as important predictors of...     

Relative reinforcing effects of different oral ethanol doses in rhesus monkeys

The relative reinforcing effects of different doses of orally delivered ethanol were evaluated. Mouth-contact responding by rhesus monkeys was measured under concurrent fixed-ratio fixed-ratio schedules of liquid delivery (0.67 ml/delivery) from each of two spouts during daily 3-hr sessions. Experiment 1 examined persistence of responding with ethanol (2%, 8%, and 32% wt/vol) and water available. When fixed-ratio values from 8 to 128 were tested, the number of ethanol deliveries obtained per session decreased as the response requirement increased. The decrease in deliveries was less at higher than at lower ethanol concentrations, however. Experiment 2 examined choice between two ethanol concentrations under concurrent fixed-ratio 16 schedules (4% vs. 8%, 4% vs. 16%, 8% vs. 16%, 2% vs. 8%, 2% vs. 32%, 8% vs. 32%). Higher concentrations (16%, 32%) generally maintained more responding than concurrently available concentrations of 8% or less. An exception was the observation of a preference for 8% over 32% ethanol. When the fixed-ratio value was increased, however, the relative preference for these two doses was reversed so that 32% ethanol maintained more responding than 8% ethanol. Thus, the direction of the preference depended on the size of the response requirement. These results indicate that the reinforcing effects of ethanol increase with dose.     

Gender Differences in Pain Perception: The Mediating Role of Self-Efficacy Beliefs

The purpose of this study was to assess the extent to which the gender differences in response to the cold pressor test (CPT) are mediated by self-efficacy beliefs. One hundred twelve college undergraduates (69 women and 43 men) engaged in CPT and completed self-report measures of demographic information, physical self-efficacy (i.e., expectations about one's overall physical capabilities), and task-specific self-efficacy (i.e., beliefs about one's ability to cope successfully with the upcoming CPT). In addition, participants provided subjective ratings of pain intensity every 30 s during CPT and were evaluated for tolerance during CPT (up to 4 min). Consistent with past research, men reported lower average subjective ratings of pain intensity and showed higher tolerance for CPT. Path analyses indicated that associations between gender and pain perception were fully mediated by self-efficacy beliefs. Men reported greater physical self-efficacy and task-specific self-efficacy than women did. In turn, higher task-specific self-efficacy ratings predicted increases in tolerance for pain and lower ratings of average pain intensity. Findings indicate that self-efficacy beliefs are one factor that accounts for gender differences in responses to painful stimulation. Future researchers should evaluate conditions under which heightened self-efficacy may be beneficial and harmful, and they should employ experimental designs that incorporate opportunities for use of both communal–interpersonal and individualistic coping strategies in light of possible gender differences in preferred approaches to coping with pain.