The role of compliance in hypnotic and nonhypnotic analgesia

We modified the standard procedure for administering finger pressure pain in order to assess the extent to which subjects biased their reports of pain reduction when exposed to compliance-inducing instructions. Experiment 1 used only highly hypnotizable subjects and found that compliance-induced reductions in reported pain were about half as large as the reported reductions produced by hypnotic analgesia suggestions. Experiment 2 used low as well as high hypnotizables and administered hypnotic or nonhypnotic analgesia instructions and compliance instructions to the same subjects on separate pain trials. Reported pain reductions produced by hypnotic and nonhypnotic analgesia suggestions and those produced by compliance instructions were substantially and significantly correlated. Furthermore, hypnotizability correlated with compliance-induced reported pain reductions as highly as it correlated with the reported reductions produced by hypnotic analgesia suggestions. Among high hypnotizables (but not low hypnotizables) compliant responding was predicted by social desirability. The findings of both studies indicate that compliance strongly influences the reports of hypnotic and nonhypnotic analgesia proffered by high hypnotizables. The role of compliance in the pain reductions reported by low hypnotizables is less clear-cut.     

Bilingual language processing after a lesion in the left thalamic and temporal regions. A case report with early childhood onset.

This case study concerns an 18-year-old bilingual girl who suffered a radiation lesion in the left (dominant) thalamic and temporal region when she was 4 years old. Language and memory assessment revealed deficits in auditory short-term memory, auditory word comprehension, nonword repetition, syntactic processing, word fluency, and confrontation naming tasks. Both languages (English and Dutch) were found to be affected in a similar manner, despite the fact that one language (English) was acquired before and the other (Dutch) after the period of lesion onset. Most of the deficits appear to be related to verbal (short-term) memory dysfunction. Several hypotheses of subcortical involvement in memory processes are discussed with reference to existing theories in this area.     

Pattern of language impairment is different in Alzheimer's disease and multi-infarct dementia.

Language impairment was assessed in 33 patients with Alzheimer's disease (AD), in 52 patients with multi-infarct dementia (MID), and in 86 elderly community residents. The investigation included the D-Test Battery based on the Luria's Neuropsychological Investigation for all subjects. An extended battery of Luria's language items was used for 30 demented patients (11 AD and 19 MID patients) and 86 controls. The changes in language functions in normal subjects could be clearly differentiated from those seen in patients with mild dementia. The patients with different degrees of dementia differed also significantly from each other in regard to language impairment. Moreover, patients with AD and MID appeared to have different patterns of language impairment although the severity of dementia and the levels of orientation, mnestic, and conceptual functions were equal. AD was associated especially with a defect in understanding of grammatical structures and MID with disorders in recognition of words, naming, and repetition. The differential diagnostic capacity of 23 selected language items proved to be 97% between AD, MID, and control subjects. The results indicate that the examination of language functions is valuable in the differential diagnosis of dementia.     

Aphasia in left-handers. Comparison of aphasia profiles and language recovery in non-right-handed and matched right-handed patients.

The present retrospective analysis reports two studies. In Study 1, clinical aspects of aphasia are compared in right-handed (RH) and non-right-handed (NRH) patients; in Study 2, recovery from aphasia is compared in RH and NRH aphasic patients with a minimum of 5 months of daily language rehabilitation. From a continuous series of 1200 brain-damaged subjects, 24 NRH patients with a vascular lesion documented by computerized tomography were selected. In 19 cases the lesion was in the left hemisphere and in 5 cases in the right hemisphere. For 14 NRH patients, a RH subject with similar lesion, matched for age, education, length of illness, etiology (ischemic vs. hemorrhagic), and, when possible, sex was found. Presence and type of aphasia were compared in the two patients of the same pair and were found similar except for Pair 14; the RH subject had global aphasia and the NRH had conduction-like aphasia. Fifteen NRH patients were rehabilitated and reexamined at least 5 months after the first examination. Recovery of the 12 patients with a left-hemisphere lesion was compared with recovery of a group of RH subjects and no significant differences were found. Recovery of the three patients with right-hemisphere lesions is described. It is concluded that differences in type of aphasia and recovery between RHs and NRHs have been overemphasized in the past and must be reconsidered.     

Changes in information as a function of a culturally appropriate smoking cessation community intervention for Hispanics

Tested a 7-month, media-based, community intervention among Hispanics in San Francisco designed to change levels of information on the damaging effects of cigarette smoking and on the availability of culturally appropriate cessation services. Three community-wide surveys of Hispanics were conducted with independent random samples, two as baselines (n = 1,660 and 2,053) and one postintervention (n = 1,965). Results showed that changes in the level of awareness of cessation services had taken place after implementation of the intervention. Furthermore, those changes took place primarily among the less acculturated Spanish-speaking Hispanics who were the target of the intervention. The changes in information reported here demonstrate that a culturally appropriate information dissemination campaign that utilizes multiple channels can produce changes in a community's level of information even when the campaign is implemented for a relatively short period.     

AIDS prevention for intravenous drug users in the community: Street-based education and risk behavior

Conducted a study of behavior change associated with a street-based AIDS education project targeted to intravenous (IV) drug users in San Francisco. Two cross-sections were sampled from drug detoxification clinics and street locations in 1986 (n = 438) and 1987 (n = 623). Significant increases were reported in the percentage of IV drug users who used bleach to decontaminate syringes, who did not share needles in past year, and in condom use. A significant reduction in an index of the number of needle-sharing partners was reported. Respondents ranked treatment program as most important source of AIDS information prior to implementation of the program, and ranked outreach workers as most important after implementation. Findings suggest that this community-based outreach program had at least some impact on knowledge about AIDS and may have led to reductions in behaviors known to transmit HIV.     

The moral reasoning of juvenile delinquents: A meta-analysis

To test the hypothesized immaturity of juvenile delinquents' moral reasoning, the results of 15 studies of the moral reasoning of juvenile delinquents were integrated quantitatively using meta-analysis. Hedges and Olkin (1985) methods were used to (a) compute effect sizes, (b) test the homogeneity of the obtained effect sizes, and (c) test the statistical significance of the pooled mean effect size. The results supported the hypothesis that the moral reasoning of juvenile delinquents is immature. It was concluded that several other issues are in need of investigation.     

The predictive validity of teacher nominations: A five-year followup of at-risk youth

The purpose of this study was to examine the predictive validity of a teacher nomination procedure for identifying at- risk children. Two hundred and twenty-five children were nominated by their teachers as well- adjusted (n= 75), socially withdrawn (n=76), or socially aggressive (n=74) during the fourth grade. Five years later, 198 of these children (88%) were located and their adjustment evaluated. Significant differences among the nominated children were found on a variety of measures, including academic grades, sociometric status, and social behavior. In addition, differences in school dropout and delinquent offenses were noted. Results are discussed in terms of the validity of teacher nomination procedures and their utility in identifying at- risk youth.     

The impact of methodological factors on child psychotherapy outcome research: A meta-analysis for researchers

Two recent meta-analyses have generated evidence for child and adolescent psychotherapy effects. However, critics note that such meta-analyses often include studies with methodological shortcomings which might invalidate their results. In the present study, we explored whether the results of the most extensive child/adolescent meta-analysis might have been influenced by such methodological variables, focusing on internal validity and external validity factors. Together, these factors accounted for two-thirds as much variance as the substantive factors (e.g., type of therapy, age) in the original metaanalysis. This suggests that relative to these therapy and child-characteristic variables, methodological factors have a substantial, though smaller, impact on metaanalysis results. In general, increased experimental rigor was related to larger effect sizes; this argues against the hypothesis that methodologically weak studies have led to an overestimate of therapy effects. No significant interactive relations were found between validity factors and predictors of outcome; this suggests that the relations noted in previous metaanalyses between outcome and various variables were notdistorted by the validity factors tested here.The research described here was supported in part by grants from the North Carolina Department of Human Resources, Division of Mental Health, Mental Retardation, and Substance Abuse Services (41626), and from the National Institute of Mental Health (1 RO3 MH38450). The authors gratefully acknowledge the assistance of Todd Morton, who provided reliability coding.     

An examination of the differential relationship of marital discord to parents' discipline strategies for boys and girls

Previous research has tentatively indicated that coercive, ineffective parenting might have a mediating role in the differential impact of marital discord on boys and girls. To further explore this role, we examined the relationship between children's perceptions of marital discord and their evaluations of parental discipline techniques. Ninety-one children aged 8 to 13 years (mean age: 11 years 4 months) were split into high, moderate, and low perceived marital discord on the basis of their responses to the Children's Perceptions Questionnaire (Emery & O'Leary, 1982). The children rated how coercive they believed both mothers and fathers would and should be in three discipline situations. Children with high marital discord indicated that both mothers and fathers would and should use more coercive behavior than did children with low marital discord. The effects of marital discord were stronger for boys than for girls. All children also believed that fathers would and should be more coercive than mothers. Results are discussed in relation to the effects of marital discord on children's social development with regard to sex of the child.Thanks are due to Mike Siegal and Pat Noller for their helpful comments on previous drafts.