The effects of voluntary hyperventilation on patients with chest pain without coronary artery disease

The present investigation was designed to examine panic symptom experience in patients with chest pain of nonorganic etiology, using a hyperventilation provocation procedure. Given the recent focus on panic disorder in patients with nonorganic chest pain, we assessed three indices of physiological arousal, subjective anxiety, and endorsement of DSM-III-R panic symptomatology in response to 3 min of voluntary hyperventilation. Subjects included 23 patients with nonorganic chest pain (CP sample) and matched normal controls (NC sample). The results indicate that hyperventilation produced significant increases in skin conductance, heart rate, and upper trapezious EMG in both CP and NC samples. Despite equivalent levels of physiological arousal and subjective anxiety, the CP sample endorsed a greater number of DSM-III-R panic symptoms relative to the NC sample. Examination of post-hyperventilation symptoms indicated that a greater percentage of the CP sample reported palpitations, nausea, and chest pain when compared with normals. Comparison of CP patients with and without Panic Disorder revealed no significant differences on any measure. The results suggests that hyperventilation plays a role in symptom experience in patients with nonorganic chest pain, although anxiety does not appear central in moderating this effect.     

Interference in the perceived segregation of equal-luminance element-arrangement texture patterns

Perceived segregation in element-arrangement patterns composed of squares of equal size and luminance, but of two different hues, was investigated in two experiments. Element-arrangement patterns consist of two types of elements, arranged in alternating vertical stripes in the top and bottom regions and in a checkerboard pattern in the center region. Perceived segregation of the striped and checkerboard regions decreased with increasing luminance of the interspaces between the squares, a high-luminance surround, and the increased spacing of the squares. When the luminance of the horizontal interspaces was increased, the decrease in perceived segregation was greater than that when the luminance of the vertical interspaces was increased. Two explanations of the interference of the interspace luminance are discussed. One explanation is in terms of inhibitory interactions among cortical filters tuned to spatial frequency and orientation. A second explanation is in terms of interference with preattentive grouping processes.     

Seat belt use and stress in adolescents

This study explored the association of adolescent seat belt use with psychosocial risk factors in an urban minority population after the enactment of a mandatory seat belt law. Data on seat belt use, family support, feelings of being down, suicidal ideation, substance abuse, sexual activity, school troubles, and problems with the law were obtained from 541 self-report intake forms administered to an adolescent medicine clinic population from 1986 to 1987. Respondents were almost exclusively black and Hispanic; 315 (59%) were females and 222 (41%) males, with a mean age of 15.4. Seat belt use was reported by 249 (46%) and no or intermittent use by 292 (54%). Chi-square and Wilcoxon rank sums tests were used to examine associations between seat belt use and risk factors. Results showed that the group comprised of those reporting no and intermittent seat belt use was significantly more likely to feel down, have decreased home support, have problems with school and the law, have been on probation, and feel that life in general was not going very well. No association was found between seat belt use and cigarette, drug, or alcohol use or sexual activity without contraceptives. Taking into account the lack of observed behavioral information to validate such self-report questionnaires, these data nevertheless point to the nonuse or intermittent use of seat belts as a possible manifestation of a lack of self-care due to feeling down and/or preoccupation with family, school, or societal problems.     

Relationship of intelligence with cognitive therapy outcome

Theorists have speculated that intelligence is positively associated with the capacity to benefit from cognitive-behavioral therapies. We evaluated this notion by relating pre-treatment measures of fluid and crystallized intelligence to self-reported symptom reduction in a naturalistic study (n = 106) of cognitive therapy for outpatients with principal diagnoses of major depression, dysthymia, or generalized anxiety disorder. Intelligence measures did not significantly predict outcome, and nonsignificant relationships were in the opposite direction from the theoretical prediction. Discussion centered on possible limitations to the generalizability of these results and on the logical interpretation of prediction studies in psychotherapy research.     

Group Cognitive Behavior Therapy for Chronic Posttraumatic Stress Disorder: An Initial Randomized Pilot Study

Individuals with posttraumatic stress disorder (PTSD) related to a serious motor vehicle accident were randomly assigned to either group cognitive behavioral treatment (GCBT) or a minimum contact comparison group (MCC). Compared to the MCC participants (n = 16), individuals who completed GCBT (n = 17) showed significant reductions in PTSD symptoms, whether assessed using clinical interview or a self-report measure. Among treatment completers, 88.3% of GCBT participants did not satisfy criteria for PTSD at posttreatment assessment, relative to 31.3% of the MCC participants. Examination of anxiety, depression, and pain measures did not show a unique advantage of GCBT. Treatment-related gains were maintained over a 3-month follow-up interval. Patients reported satisfaction with GCBT, and attrition from this treatment was comparable with individually administered CBTs. Results are discussed in light of modifications necessitated by the group treatment format, with suggestions for future study of this group intervention.     

Guessing imagined and live chance events: Adults behave like children with live events

An established finding is that adults prefer to guess before rather than after a chance event has happened. This is interpreted in terms of aversion to guessing when relatively incompetent: After throwing, the fall could be known. Adults (N=71, mean age 18;11, N=28, mean age 48;0) showed this preference with imagined die‐throwing as in the published studies. With live die‐throwing, children (N=64, aged 6 and 8 years; N=50, aged 5 and 6 years) and 15‐year‐olds (N=93, 46) showed the opposite preference, as did 17 adults. Seventeen‐year‐olds (N=82) were more likely to prefer to guess after throwing with live rather than imagined die‐throwing. Reliance on imagined situations in the literature on decision‐making under uncertainty ignores the possibility that adults imagine inaccurately how they would really feel: After a real die has been thrown, adults, like children, may feel there is less ambiguity about the outcome.     

Depression and Anxiety: Integrating the Tripartite and Cognitive Content-Specificity Assessment Models

The cognitive content-specificity hypothesis proposes that depression and anxiety can be discriminated on the basis of unique cognitive profiles. Alternatively, the Tripartite model suggests that, although depression and anxiety share a general distress factor, anhedonia is a characteristic of depression with anxious arousal a characteristic of anxiety. Past research devoted to integrating these two models has been limited in a number of ways. To remedy these limitations, this study attempted to assess the complete Tripartite model and used a multidimensional cognitive assessment tool to handle the heterogeneity of anxious cognitive content. Results on data collected from 411 clients seeking services at a university counseling center suggested that a one-to-one mapping between Tripartite dimensions and cognitive content was possible. Further, variables from each model simultaneously explained unique variance in depression and anxiety ratings.