Cognitive-behavioral therapy for women with lifelong vaginismus: process and prognostic factors

Cognitive-behavioral therapy (CBT) seems an effective treatment of lifelong vaginismus, but mechanisms of action have not yet been established. The present study explored whether the effect of CBT for lifelong vaginismus is mediated by changes in fear of penetration and avoidance behavior, which CBT explicitly aims to alter. A second aim of this study was to predict treatment outcome on the basis of pre-treatment variables. Participants with lifelong vaginismus were allocated at random to a 3-months CBT (n=81) or a waiting-list control condition (n=36). Full vaginal penetration with the penis of the partner constituted the primary outcome measure. Change scores in successful 'non-coital penetrative-behavior' and 'fear of coitus' were used to measure the mediating variables. Treatment resulted in an increase of intercourse (outcome), a decrease in fear of coitus, and an enhancement of successful non-coital penetration behavior, compared with no treatment. Outcome (intercourse) was partly mediated by changes in fear of coitus and changes in avoidance behavior. No treatment predictors could be detected in this study sample. It is concluded that techniques such as gradual exposure, aimed at decreasing avoidance behavior and penetration fear, constitute an important avenue of change in the treatment of lifelong vaginismus.     

Interrater reliability of the DSM-III-R with preschool children

Little attention has been paid to evaluating the use of DSM-III-R with preschool children. Children (N = 510) ages 2 to 5 years who were screened at the time of a pediatric visit were selected to participate in an evaluation which included questionnaires, a semistructured interview, developmental testing, and a play observation. Following the evaluation, two clinical child psychologists independently assigned DSM-III-R diagnoses. For each diagnostic category, kappa and Ycoefficients were calculated; Ycoefficients are less sensitive to base rates of disorders. For overall agreement, the weighted mean kappa (.61), and mean Y(.66) were moderately high. Overall agreement that the child had at least one of the disruptive disorders was substantial (kappa =.64; Y =.65);agreement that there was at least one of the emotional disorders was moderate for kappa (.54), but substantial for Y(.70). Kappa coefficients were higher for major categories of disorder than for specific disorders; however, Ycoefficients did not show a decline for specific disorders. Interrater reliability of DSM-III-R appears to be similar for preschoolers and older children.This study was supported by grant MH46089 from the National Institute of Mental Health.A preliminary report was presented at the Fifth Annual NIMH International Research Conference on the Classification and Treatment of Mental Disorders in General Medical Settings, Bethesda, Maryland, September 1991. We gratefully acknowledge the members of the Pediatric Practice Research Group who participated in this study.     

An eye movement analysis system (EMAS) for the identification of cognitive processes on figural tasks

EMAS is a software system (written in VAX-11 FORTRAN) for the analysis of eye movement data recorded during the performance of figural tasks. Its main functions are: (1) Calibration of raw coordinates of eye movements to determine their actual position on the stimulus display. Different kinds of measurement distortion may be corrected. (2) Identification of eye fixations and the determination of their locations and durations. (3) Analysis of fixation sequences. The frequency of transitions of fixations among specified sectors of the stimulus display is computed. A sequential list is made of the successive fixations in which the fixated sector and the fixation duration are graphically indicated. (4) Plotting of raw or calibrated eye movement data and fixation points. The sequence of fixations in specified display sectors can also be plotted in real time. Applications of the programs to the Embedded Figures Test and the Hidden Figures Test are illustrated.     

Cross-cultural generalizability of the youth self-report and teacher's report form cross-informant syndromes

Exploratory factor analyses on 569 Youth Self-Reports and 1,221 Teacher's Report Forms of clinically referred Dutch children revealed six and eight factors respectively, very similar to the eight YSR and TRF cross-informant syndromes derived by Achenbach (1991c, 1991d). Mean cross-cultural correlations were .89 for YSR syndromes and .95 for TRF syndromes. In confirmatory factor analyses of the Dutch and American YSR and TRF factor models in cross-validation samples of 570 YSRs and 1,221 TRFs, goodness-of-fit indices were only slightly better for Dutch factor models. The American cross-informant Social Problems and Attention Problems syndromes had the poorest fit. The application of the eight American cross-informant syndromes to Dutch self-and teacher reports was supported.We wish to thank Dr. Thomas Achenbach for his comments and advice on this article.This research was supported by grants from the Sophia Foundation for Medical Research and from the Dutch National Program for Stimulation of Health Research.     

Lightness,brightness, and brightness contrast: 1. Illuminance variation

Changes of annulus luminance in traditional disk-and-annulus patterns are perceptually ambiguous; they could be either reflectance or illuminance changes. In more complicated patterns, apparent reflectances are less ambiguous, letting us place test and standard patchesjnpxsurrounds perceived to be different grays. Our subjects matched the apparent amounts of light coming from the patches (brightnesses), their apparent reflectances (lightnesses), or the brightness differences between the patches and their surrounds (brightness contrasts). The three criteria produced quantitatively different results. Brightness contrasts matched when the patch/surround luminance ratio of the test was approximately equal to that of the standard. Lightness matches were illumination invariant but were not exact reflectance matches; the different surrounda of test and standard produced a small illumination-invariant error. This constant error was negligible for increments, but, for decrements, it was approximately 1.5 Munsell value steps. Brightness matches covaried substantially with illuminance.     

Academic self-efficacy,self-esteem,and grit in higher online education: Consistency of interests predicts academic success

Social Psychology of Education - Academic self-efficacy, self-esteem, and grit (i.e., perseverance of effort and consistency of interests) have all separately shown to predict academic success...