Cognitive Behavior Therapy for Fear of Cancer Recurrence: A Case Study

This case study describes the course and content of cognitive behavior therapy (CBT) for clinical fear of cancer recurrence (FCR) in a breast cancer survivor. The CBT for clinical FCR consisted of seven face-to-face therapy sessions and one telephone session. The primary treatment goal was to reduce FCR severity by modifying cognitive processes and dysfunctional behavior. Assessments of FCR and quality of life were completed by the breast cancer survivor pre-therapy, post-therapy, and at 6 and 12 months of post-therapy. In each treatment session, perceived control over FCR was assessed. A clinical nurse specialist participated in evaluation interviews. The patient’s perceived control over FCR increased during the therapy, and FCR severity declined to a non-clinical level. This improvement was still evident at the 6- and 12-month follow-up assessments and was supported by results for secondary and exploratory outcomes measures. FCR offers a great challenge for health care professionals due to the lack of effective treatment options. This case study shows how clinical FCR can be addressed with CBT and can contribute to the improvement of care for cancer survivors.     

Virtual reality goes to war: a brief review of the future of military behavioral healthcare

Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in returning OEF/OIF military personnel is creating a significant healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. Virtual Reality delivered exposure therapy for PTSD has been previously used with reports of positive outcomes. This article details how virtual reality applications are being designed and implemented across various points in the military deployment cycle to prevent, identify and treat combat-related PTSD in OIF/OEF Service Members and Veterans. The summarized projects in these areas have been developed at the University of Southern California Institute for Creative Technologies, a U.S. Army University Affiliated Research Center, and this paper will detail efforts to use virtual reality to deliver exposure therapy, assess PTSD and cognitive function and provide stress resilience training prior to deployment.     

Comparison of fundus autofluorescence and minimum-motion measurements of macular pigment distribution profiles derived from identical retinal areas

The optical density of macular pigment was measured at twelve retinal locations in ten subjects by minimum motion photometry, comparing 460 nm with 580 nm or 550 nm. Fundus autofluorescence images were obtained for the same subjects with a scanning laser ophthalmoscope. Optical density was computed from mean calibrated grey-scale values for a central circular field and for annular segments, identical to areas tested psychophysically, and for complete annuli. Psychophysical assessments of optical density were similar irrespective of whether 550 nm or 580 nm was used. Optical density values derived psychophysically showed a linear correlation with assessments based on identical sampled areas of annular segments (slope = 0.98, r2 = 0.97) or complete annuli (slope = 0.89, r2 = 0.96) in autofluorescence images.     

Intimacy and computer communication

The relationship between intimacy and communication which uses computer technology is addressed. Definitions of intimacy are considered, and the nature of intimate conversations which use computers as a communications medium are discussed. Implications for counselling are examined.     

A double-blind,sham-controlled,trial of home-administered rhythmic 10-Hz median nerve stimulation for the reduction of tics,and suppression of the urge-to-tic,in individuals with Tourette syndrome and chronic tic disorder

Tourette syndrome (TS) and chronic tic disorder (CTD) are neurological disorders of childhood onset characterized by the occurrence of tics; repetitive, purposeless, movements or vocalizations of short duration which can occur many times throughout a day. Currently, effective treatment for tic disorders is an area of considerable unmet clinical need. We aimed to evaluate the efficacy of a home-administered neuromodulation treatment for tics involving the delivery of rhythmic pulse trains of median nerve stimulation (MNS) delivered via a wearable ‘watch-like’ device worn at the wrist. We conducted a UK-wide parallel double-blind sham-controlled trial for the reduction of tics in individuals with tic disorder. The device was programmed to deliver rhythmic (10 Hz) trains of low-intensity (1–19 mA) electrical stimulation to the median nerve for a pre-determined duration each day, and was intended to be used by each participant in their home once each day, 5 days each week, for a period of 4 weeks. Between 18th March 2022 and 26th September 2022, 135 participants (45 per group) were initially allocated, using stratified randomization, to one of the following groups; active stimulation; sham stimulation or to a waitlist (i.e. treatment as usual) control group. Recruited participants were individuals with confirmed or suspected TS/CTD aged 12 years of age or upward with moderate to severe tics. Researchers involved in the collection or processing of measurement outcomes and assessing the outcomes, as well as participants in the active and sham groups and their legal guardians were all blind to the group allocation. The primary outcome measure used to assess the ‘offline’ or treatment effect of stimulation was the Yale Global Tic Severity Scale–Total Tic Severity Score (YGTSS–TTSS) assessed at the conclusion of 4 weeks of stimulation. The primary outcome measure used to assess the ‘online’ effects of stimulation was tic frequency, measured as the number of tics per minute (TPM) observed, based upon blind analysis of daily video recordings obtained while stimulation was delivered. The results demonstrated that after 4-week stimulation, tic severity (YGTSS-TTSS) had reduced by 7.1 points (35 percentile reduction) for the active stimulation group compared to 2.13/2.11 points for the sham stimulation and waitlist control groups. The reduction in YGTSS–TTSS for the active stimulation group was substantially larger, clinically meaningful (effect size = .5) and statistically significant (p = .02) compared to both the sham stimulation and waitlist control groups, which did not differ from one another (effect size = −.03). Furthermore, blind analyses of video recordings demonstrated that tic frequency (tics per minute) reduced substantially (−15.6 TPM) during active stimulation compared to sham stimulation (−7.7 TPM). This difference represents a statistically significant (p < .03) and clinically meaningful reduction in tic frequency (>25 percentile reduction: effect size = .3). These findings indicate that home-administered rhythmic MNS delivered through a wearable wrist-worn device has the potential to be an effective community-based treatment for tic disorders.     

An own-age bias in mixed- and pure-list presentations: No evidence for the social-cognitive account

The own-age bias (OAB) is suggested to be caused by perceptual-expertise and/or social-cognitive mechanisms. Bryce and Dodson (2013, Psychology and Aging, 28, 87, Exp 2) provided support for the social-cognitive account, demonstrating an OAB for participants who encountered a mixed-list of own- and other-age faces, but not for participants who encountered a pure-list of only own- or other-age faces. They proposed that own-age/other-age categorization, and the resulting OAB, only emerge when age is made salient in the mixed-list condition. Our study aimed to replicate this finding using methods typically used to investigate the OAB to examine their robustness and contribution to our understanding of how the OAB forms. Across three experiments that removed theoretically unimportant components of the original paradigm, varied face sex, and included background scenes, the OAB emerged under both mixed-list and pure-list conditions. These results are more consistent with a perceptual-expertise than social-cognitive account of the OAB, but may suggest that manipulating age salience using mixed-list and pure-list presentations is not sufficient to alter categorization processes.     

A closer look at the role of social influence in the development of attitudes to eating

The relationship between social influence and the development of attitudes to eating was explored in an experimental study. Schoolgirls (n=59, median age=15 years) listened to an interview in which the interviewee (identified as a radical feminist, a sportswoman or a women's magazine journalist) gave either a pro-diet or an anti-diet message. Following the interview, participants completed a questionnaire which examine their attitudes to eating and their judgements of the interviewee. The results supported predictions that influence would vary as an interactive function of the message and the normative ingroup–outgroup status of the message source. However, different patterns of influence were observed on two factors that emerged from an analysis of the eating disorder items, suggesting that there were important differences in the shaping of subjects' beliefs about appropriate eating behaviour, (a) for themselves personally and (b) for the community in general. The findings suggest that social influence has a significant but complex impact upon the development of potentially harmful attitudes to eating. It also appears that, for a variety of reasons, certain anti-diet messages may actually be a counter-productive means of improving female body satisfaction. © 1998 John Wiley & Sons, Ltd.     

Adults' beliefs about children and mathematics: how important is it and how do children learn about it?

A series of studies was conducted which focused on US adults' beliefs about the relative importance of acquiring mathematical skills for preschool children and about how children acquire these skills. In Study 1, adults rated general information, reading and social skills as all being more important than mathematical skills. They also claimed that parents have the most influence on preschool children's learning regardless of content area. In Study 2, the parents of kindergarten children also rated reading, general information and social skills as all being more important than mathematics in preparing children for the first grade. The more important parents felt mathematics were, the more they reported engaging in a variety of mathematical-related activities with their children. However, the importance they placed on mathematics was not related to their child's actual mathematical performance. In summary, adults seem to value mathematics less than other skills in preparing young children to enter elementary school. © 1998 John Wiley & Sons, Ltd.