The psychophsiology of aggressive drivers: comparison to non-aggressive drivers and pre- to post-treatment change following a cognitive-behavioural treatment

Twenty drivers were remanded to our treatment program by the courts following arrests related to serious aggressive driving behaviors. Ten additional drivers entered our program in response to our advertisements thus identifying themselves as aggressive drivers. Psychophysiological assessments were conducted on all 30 drivers and heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), and skin resistance level (SRL) were measured in response to exposure to a mental arithmetic neutral stressor, two idiosyncratic, audio-taped, aggressive driving vignettes (audio 1 and audio 2), and one non-driving related fearful vignette. Fourteen non-aggressive driving controls also completed the assessment. The results indicated that the aggressive drivers (ADs) showed significantly more SBP responsivity during audio 1 and audio 2 and significantly less SBP reactivity during the mental arithmetic stressor than the controls. The aggressive drivers then completed a four-week, group intervention which included relaxation techniques specifically targeting aggressive driving behaviors. The same psychophysiological assessment was conducted at post-treatment. The results showed significant pre- to post-treatment decreases in HR, p<0.003, SBP, p<0.01, and DBP, p<0.02 during audio 1. Similarly, decreases were evident in audio 2 in SBP, p<0.03 only. No decreases in reactivity occurred during the neutral stressor or fearful situation.     

Les passions de l'ame: on obsessive and harmonious passion

Passion is defined as a strong inclination toward an activity that people like, that they find important, and in which they invest time and energy. Two types of passion are proposed: obsessive and harmonious. Obsessive passion (OP) refers to a controlled internalization of an activity in one's identity that creates an internal pressure to engage in the activity that the person likes. Harmonious passion (HP) refers to an autonomous internalization that leads individuals to choose to engage in the activity that they like. HP promotes healthy adaptation whereas OP thwarts it by causing negative affect and rigid persistence. Results from four studies involving more than 900 participants from different populations supported the proposed conceptualization.     

A comparison of the PAI and MMPI-2 as predictors of faking bad in college students

Both the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 2001) and Personality Assessment Inventory (PAI; Morey, 1991) offer a large set of scales devoted to the identification of response styles. This study directly compared the effectiveness of the 2 inventories as indicators of overreporting. The 2 measures were administered to 52 college students instructed to fake bad under conditions describing either a forensic (n = 24) or psychiatric (n = 28) setting as well as to 432 psychiatric patients. Results indicated that the MMPI-2 F - K index and Fp Scale were the best single indicators of a faking bad response style and that the MMPI-2 scales were the better indicators as a set. However, the PAI scales demonstrated a significant level of incremental validity over the MMPI-2 indicators in every analysis conducted. The findings suggest that either inventory offers an effective approach to the detection of overreporting, and administering both inventories can enhance the accuracy of prediction further.     

A randomized controlled trial of an internet-based treatment for chronic headache

Chronic headache is a significant public health problem in Western nations. Although controlled trials demonstrate the efficacy and cost-effectiveness of face-to-face behavioral therapy, most headache sufferers have limited access to these treatments. Delivery of behavioral interventions using Internet technology has the potential to reach a larger number of headache sufferers and reduce the burden of disease. This randomized controlled study evaluated an Internet-delivered behavioral regimen composed of progressive relaxation, limited biofeedback with autogenic training, and stress management versus a symptom monitoring waitlist control. Treatment led to a significantly greater decrease in headache activity than symptom monitoring alone. Thirty-nine percent of treated individuals showed clinically significant improvement on self-report measures of headache symptoms at post-treatment. At two-month follow-up, 47% of participants maintained improvement. Treatment had a significant impact on general headache symptoms and headache-related disability. There was a 35% within-group reduction of medication usage among the treated subjects. The Internet program was more time-efficient than traditional clinical treatment. Treatment and follow-up dropout rates, 38.1% and 64.8%, respectively, were typical of behavioral self-help studies. This approach to self-management of headache is promising; however, several methodological and ethical challenges need to be addressed.     

The effectiveness of a brief psychological intervention on court-referred and self-referred aggressive drivers

This study tested the efficacy of a cognitive-behavioral psychological intervention (CBT) targeting aggressive driving behaviors within both a court-referred (N=20) and a self-referred community (N=8) sample as compared to a symptom monitoring (SM) only control condition. Treatment outcome was assessed through the use of daily driving diaries, standard psychological tests, and a global rating of change scale. The CBT treatment condition improved more than the SM condition as assessed through the daily driving diaries. Although the court-referred and self-referred samples showed equivalent improvement on the driving diaries, the self-referred group improved more on measures of general anger. Standardized measures of driving anger, state anxiety and measures of general anger indicated significant change in the expected direction. Aggressive drivers who met criteria for Intermittent Explosive Disorder (IED) showed a trend to improve less than non-IED aggressive drivers. Treatment gains were maintained at the 2-month follow-up point.     

A one year follow-up of relaxation response meditation as a treatment for irritable bowel syndrome

Ten of thirteen original participants with Irritable Bowel Syndrome (IBS) participated in a one year follow-up study to determine whether the effects of Relaxation Response Meditation (RRM) on IBS symptom reduction were maintained over the long-term. From pre-treatment to one-year follow-up, significant reductions were noted for the symptoms of abdominal pain (p = 0.017), diarrhea (p = 0.045), flatulence (p = 0.030), and bloating (p = 0.018). When we examined changes from the original three month follow-up point to the one year follow-up, we noted significant additional reductions in pain (p = 0.03) and bloating (p = 0.04), which tended to be the most distressing symptoms of IBS. It appears that: (1) continued use of meditation is particularly effective in reducing the symptoms of pain and bloating; and (2) RRM is a beneficial treatment for IBS in the both short- and the long-term.     

Posttraumatic stress disorder in breast cancer patients following autologous bone marrow transplantation or conventional cancer treatments

We assessed 17 women who had undergone autologous bone marrow transplants (BMT) for their breast cancer and 20 other women who had been treated for breast cancer (but not with BMT) by structured clinical interviews examining each stage of the breast cancer experience (e.g. initial diagnosis, initial treatment, recurrence of cancer (if applicable) and BMT (if applicable)) and at follow-up points; 3, 6 and 12 months (if applicable) posttreatment. The two groups did not differ on incidence of posttraumatic stress disorder (PTSD), major depressive disorder (MDD) or generalized anxiety disorder at any stage. We found a high rate of PTSD over the cancer experience, 35% for the combined sample, with cancer diagnosis being the most likely point for developing PTSD, 27% for the combined sample. None of the 17 women who had undergone BMT developed PTSD as a result of the treatment.     

Sexual orientation and handedness in men and women: a meta-analysis

Recent findings suggest that sexual orientation has an early neurodevelopmental basis. Handedness, a behavioral marker of early neurodevelopment, has been associated with sexual orientation in some studies but not in others. The authors conducted a meta-analysis of 20 studies that compared the rates of non-right-handedness in 6,987 homosexual (6,182 men and 805 women) and 16,423 heterosexual (14,808 men and 1,615 women) participants. Homosexual participants had 39% greater odds of being non-right-handed. The corresponding values for homosexual men (20 contrasts) and women (9 contrasts) were 34% and 91%, respectively. The results support the notion that sexual orientation in some men and women has an early neurodevelopmental basis, but the factors responsible for the handedness-sexual orientation association require elucidation. The authors discuss 3 possibilities: cerebral laterality and prenatal exposure to sex hormones, maternal immunological reactions to the fetus, and developmental instability.     

Expansion of Genetic Services Utilizing a General Genetic Counseling Clinic

We established a general genetic counseling clinic (GCC) to help reduce long wait times for new patient appointments and to enhance services for a subset of patients. Genetic counselors, who are licensed in Tennessee, were the primary providers and MD geneticists served as medical advisors. This article describes the clinic referral sources, reasons for referral and patient dispositions following their GCC visit(s). We obtained patients by triaging referrals made to our medical genetics division. Over 24 months, our GCC provided timely visits for 321 patients, allowing the MD geneticists to focus on patients needing a clinical exam and/or complex medical management. Following their GCC visit(s), over 80 % of patients did not need additional appointments with an MD geneticist. The GCC allowed the genetic counselor to spend more time with patients than is possible in our traditional medical genetics clinic. Patient satisfaction surveys (n?=?30) were very positive overall concerning the care provided. Added benefits for the genetic counselors were increased professional responsibility, autonomy and visibility as health care providers. We conclude that genetic counselors are accepted as health care providers by patients and referring providers for a subset of clinical genetics cases. A GCC can expand genetic services, complement more traditional genetic clinic models and utilize the strengths of the genetic counselor health care provider.