Chest pain without coronary artery disease: An exploratory comparison with panic disorder

Recent reports have indicated similarities between patients with persistent chest pain of nonorganic origin and patients with panic disorder. In order to explore this association further, we administered a structured interview and three self-report measures (State-Trait Inventory, Beck Depression Inventory, and SCL90-R) to three subject groups: (1) a sample with persistent chest pain (CP; n=14) who had been screened and found to have normal coronary arteries, (2) a sample of patients with panic disorder (PD; n=14), and (3) a sample of matched normals (n=14). CP patients were considered to be free of coronary artery disease (CAD) following normal cardiac catheterization and/or normal thallium stress tests and were not diagnosed initially with panic disorder. PD patients were diagnosed with a standardized psychiatric interview and were free of organic causes of panic. Using an exploratory data analytic approach, the results indicated that both CP and PD samples reported increased levels of state and trait anxiety (p <.0001), depression (p <.01), and somatization (p <.0001) compared with normals. CP patients differed from PD patients in their less frequent use of anxiolytic medication (p <.01) and lower levels of reported panic anxiety and phobic avoidance (p <.0001). These data suggest that persistent chest pain in the absence of CAD shares some features with panic disorder, yet differs from panic in key ways as well. The results are discussed in light of the role of anxiety in contributing to symptom labeling.This research was supported by Grant 86G-491 from the American Heart Association, Texas Affiliate, to J.G.B. H.T. is the recipient of USPHS Research Career Development Award K04-HL-0122246.     

Age differences in the acculturation process

Age differences were assessed in a conceptual model that seeks to explain how acculturation affects psychological well-being among Mexican Americans. The data were from a national probability sample of 859 persons of Mexican decent. It was hypothesized that low acculturation creates financial stress. Moreover, low acculturation and financial stress were in turn predicted to erode feelings of personal control and self-esteem. Finally, diminished feelings of control and low self-esteem were hypothesized to exert a negative impact on psychological well-being. When data from respondents of all ages was assessed, empirical support was found for all of the hypotheses except the linkage between acculturation and financial stress. However, few age differences emerged in the model. The authors conclude that older Mexican Americans may not be more vulnerable to the stressors associated with acculturation.     

Applying family therapy theories to Asian/Pacific Americans

This paper introduces a framework by which the structural and communicative-interactive theories of family therapy can be logically and systematically applied with Asian/Pacific American families. It begins with an introduction to Schutz's FIRO theory and model. Application and relevance to work with Asian/Pacific American families is discussed and illustrated with a case application.Paper originally presented at the 1987 annual program meeting of the Council on Social Work Education, St. Louis, Missouri, March 8, 1987.     

Developmental changes in the attribution of dispositional features

It was hypothesized (1) that with age children would rely increasingly upon information about intention, rather than overt behavior, when attributing dispositional features to others; and (2) that, developmentally, “restricted” dispositional attributions (i.e., those that assume the operation of highly specific situation-response relationships) would precede “generalized” dispositional attributions (which assume the operation of a dispositional concept between broad classes of situations and responses). An experiment is reported that provides support for the first, though not the second, of these hypotheses.     

Preschool children's comprehension and production of directive forms

Thirty preschool children, 10 each at the 3-,4-, and 5-year-old levels, participated in two structured tasks designed to assess both comprehension and production of a full range of directive forms. In contrast to previous reports, the results indicated no significant differences in directive comprehension or production as a function of age; children in all age groups demonstrated the ability to understand and verbally encode the intent of most types of directive forms. However, the two most implicit forms, Question Directives and Hints, were complied with significantly less frequently than the more explicit forms, and were uused less often in the production task. The present findings indicate the importance of analyzing directive forms along a continuum of explicitness rather than dichotomizing them as direct versus indirect. Finally, the results are interpreted as providing indirect support for the general notion that mastery of some implicit forms may be achieved later than the acquisition of more explicit forms.     

Anisomycin impairs long-term working memory in a delayed alternation task

A long-term temporal component of working memory of rats trained on the radial maze has been shown to be susceptible to disruption by the protein synthesis inhibitor, anisomycin. It is not clear whether protein synthesis played a role in working memory because accurate performance on the radial maze required the storage of a large amount of information, or because the information was to be held in store for relatively long periods of time. This experiment tested these hypotheses by assessing the effect of anisomycin on choice accuracy in a comparatively simple spatial delayed alternation task. Results indicate that under the present training conditions, protein involvement in working memory is related more to the length of the retention interval than to the amount of information retained.     

Later stages in Experiential Marital Therapy

This is the second of two papers dealing with symbolic-experiential treatment of marital issues. The first—Early Stages in Experiential Marital Therapy — discussed three early stages. This paper discusses regressive work with couples, including engagement with the family of origin.     

Wilderness family therapy: Experiential dimensions

This paper describes the process in which families participate in a wilderness experience. Metaphors such as climbing or paddling a canoe are translated into daily living patterns to deepen individual and family self-knowledge, self-esteem, and intimacy.     

“Marital trap analysis”—incompetence,complementarity, and success traps: Identifying potential future dysfunctions based on a couple's current collusive agreements

This paper describes three types of traps or collusive marital agreements-incompetence traps, complementarity traps, and success traps-in which the mates renounce or forgo competent functioning in vital areas of marital roles and experience. It is suggested that responsible clinical work with the couple should include a careful evaluation of such traps and the potential breakdown or dysfunction inherent in each one, and a decision as to whether or not to attempt therapeutic penetration into such collusive agreements even before the couple complain directly about their arrangement.