The treatment of tension headache—I. Muscular abnormality and biofeedback

The specificity and efficacy of a short EMG biofeedback treatment were assessed in a selected group of chronic tension-headache cases—those having significantly elevated levels of muscle tension. The effects of training patients to raise/maintain EMG levels were compared to those obtained from patients who were trained to lower tension levels. The results showed little evidence of increased self-control of the muscle despite successful EMG control during six bio-feedback sessions. A progressive and significant reduction in resting level was found only in the groups trained to reduce EMG levels. The treatment proved ineffectual in reducing headache. The implications of the dissociation of muscle tension and headache are discussed both with respect to current views of tension headaches and the role of biofeedback in their treatment.     

Engaging “Resistant” Families in Treatment

Many families, when presented with the option of family therapy, are less than eager to participate. This paper comprises the second and third parts of a series on engaging “resistant” families. ¹ 1 The first paper in this series, authored by J. M. Van Deusen, M. D. Stanton, S. M. Scott, and T. C. Todd, is entitled “Engaging “Resistant” Families in Treatment: I. Getting the Drug Addict to Recruit His Family Members” and appeared in the International Journal of the Addictions 15 (7): 1069–1089, 1980. A revised and expanded version of Part II is presented in M.D. Stanton, T. C. Todd, and Associates, The Family Therapy of Drug Abuse and Addictions New York, Guilford, in press.
Part II presents 21 principles and a number of techniques and strategies that have been developed for successfuly recruiting such families. These techniques should be applicable for engaging resistant families with all types of presenting problems. Part III provides an analysis of the important variables involved, along with data on cost efficiency and administrative costs. It was found that when therapists had administrative control of their cases, serving in dual roles as both therapists and drug counselors, the recruitment effort was (a) more effective (i.e., complete families, including both parents or parent surrogates, were recruited in 77 per cent of the cases), and (b) twice as cost efficient. Two-thirds of the non-engaged families were not recruited because the index patient would not allow family members to be contacted. Black families were more difficult to recruit than whites. Data on cost efficiency and on the actual administrative costs of recruiting families are also provided. We conclude that the engagement process requires a revision in therapeutic philosophy, since such families are often desperately in need of help but are unavailable unless therapists make a special effort to reach them.     

An Assessment of the Effectiveness of Two Tactics to Reduce Arousal in Crowded Mass Transit Settings1

Studies of crowding in various settings have shown that individuals are aroused and frequently suffer from ill health. Several studies have shown that it is possible to successfully intervene in residential, shopping, and classroom settings to reduce the negative effects of crowding. The present laboratory experiment assessed the effectiveness of two tactics commonly used by passengers in crowded mass transit settings. Results indicated that the two tactics, reading a newspaper or talking to others, failed to reduce arousal. An explanation for the failure of these tactics is offered.     

THE DEVELOPMENT OF KNOWLEDGE CONCERNING WRITTEN ARITHMETIC: A CROSS-CULTURAL STUDY

This study is concerned with the manner in which Western mathematics is assimilated by children raised in traditional African cultures. It was predicted that after an initial period of difficulty in learning school arithmetic, African children (Baoulé and Dioula from the Ivory Coast) acquire basic concepts, develop invented strategies, and make errors similar to those of American children. Further, it was predicted that Dioula children, since they are members of a commercial culture, perform at a somewhat higher level than the Baoulé, members of a farming culture which does not seem to stress computational activity. To investigate these hypotheses, American, Baoulé, and Dioula children at two age levels were given a variety of arithmetic problems involving basic skills (e.g., reading numbers), number knowledge (e.g., place value), and calculational abilities (e.g., written computation). The results showed that, in general, older African and American children (fifth- and sixth-graders) were quite similar in all respects. The only large and significant differences occurred in the case of younger children (second- and third-graders). At this level American children generally performed at a higher level than Africans, as predicted, and Dioula occasionally at a higher level than Baoulé, also as predicted. At the same time, qualitative aspects of African and American children's performance were similar: for example, both groups made the same types and proportions of errors in written calculations. The results generally support the hypotheses and can be explained in terms of both educational and cognitive factors.     

Performance of dyslexic children on speech perception tests

Several researchers who have compared the performance of dyslexic and normal-reading children on a variety of different tasks have suggested that dyslexic children may have subtle deficits in the phonemic analysis of spoken as well as written language. Thus it is of interest to know how children who have extraordinary difficulty learning to read can perform explicity auditory-phonetic tasks. Seventeen dyslexic children (10 years of age) and a group of 17 controls were administered tests of identification and discrimination of synthesized voiced stop consonants differing in place of articulation. These were tests of the type used to study categorical perception in adults, adapted for use with young children. Significant differences between dyslexics and controls were found in both kinds of tasks; the pattern of identification and discrimination differences suggests an inconsistency in the dyslexics' phonetic classification of auditory cues. A significant relationship was found between reading level and speech discrimination.     

The effect of modification of expressive displays on vicarious emotional arousal

Several recent experiments have demonstrated that modulation of the facial expressive response is accompanied by changes in autonomic arousal and subjective response to painful stimuli. The present study asked whether facial self-regulation may also bring about changes in covert vicarious emotional experience. Three groups of subjects were exposed to a videotaped model displaying intermittent pain to shock in a differential vicarious autonomic conditioning paradigm. Subjects in the inhibit and amplify groups were asked, respectively, (a) to inhibit their facial muscles or (b) to pose a facial response of pain when the model was shocked. It was predicted that the inhibit group would show less autonomic arousal to the model's expressive display (empathy) and less conditioning (as measured by skin conductance and heart rate change), and the amplify group more empathy and conditioning, than a third group who was given no facial instruction. In fact, the amplify group showed more skin conductance arousal, heart rate acceleration, and activity in response to the model's expressive display of pain than did the other two groups (which were not different from each other), but no more autonomic or facial conditioning. The overall pattern of physiological data is interpreted as generally supportive of a facial feedback theory of emotion: where significant between-groups' differences were obtained in facial activity, as in vicarious instigation, autonomic arousal differences also emerged; where no expressive differences were obtained, as in vicarious conditioning, no differences in autonomic arousal were found.     

On the form and location of the Psychometric Bisection Function for time

The Psychometric Bisection Function for time relates the discriminability of intermediate duration stimuli to a short and long training duration. Bisection Functions for animals (R. M. Church & M. Z. Deluty, Journal of Experimental Psychology: Animal Behavior Processes, 1977, 3, 216–228) confirm Weber's Law and also show indifference between short and long reports at the geometric mean of the training durations. Two discrimination processes are studied which, in combination with different constructions of the subjective time scale, result in Bisection Functions which differ in form and location. The two discrimination processes use a likelihood ratio rule or a similarity rule to compare intermediate durations to the training durations. These rules in combination with two different constructions of the subjective time scale result in four models which conform to Weber's Law. For one of the scales subjective time is a power function of real time with the scalar property on variance (Scalar Timing). For the other, subjective time is a logarithmic function of real time with constant variance (Log Timing). Both Log and Scalar Timing assume normality on the subjective scale. Only three of these models also entail the geometric mean at the indifference point. The exception is Scalar Timing with the likelihood ratio discrimination rule. This model entails indifference at approximately the harmonic mean of the training stimuli. Variants of the remaining three models differ theoretically but alternatives are difficult to discriminate empirically. A contrast is provided by a Poisson Timing subjective scale in which variance increases directly with the mean. This scale results in indifference at the geometric mean for both discrimination rules but violates Weber's Law in both cases.     

The computer psychiatrist: How far have we come? Where are we heading? How far dare we go?

The use of computers in psychiatry and psychology is reviewed. It is noted that computers are already being used successfully for consultation, interviewing, and continuing education. Issues related to the usage of computers in mental health are discussed. Guidelines for future work in the area are suggested.     

Design and implementation of a microcomputer-based adaptive testing system

Adaptive testing is a relatively new form of test administration in which a test is tailored to the individual taking it by choosing items most informative about that person. Methods for determining which items are most appropriate take on a variety of forms, some requiring extensive computation, and almost all requiring administration by a computer. The increasing availability of inexpensive microcomputer systems has made adaptive testing possible when access to larger computer systems is impractical. To make implementation of a variety of adaptive testing methods feasible on a microcomputer, a system efficient from both the examinee’s and the test constructor’s perspectives is necessary. This paper begins by briefly outlining the strategies of adaptive testing developed to date and showing how, structurally, they can be grouped into three general categories. Considerations in design of a test-specification subsystem are then discussed as they relate to this categorization. Finally, a specific implementation of a subsystem for use under the CP/M microcomputer operating system is described. Techniques used to make the extensive computations required by adaptive testing feasible on a microcomputer are presented.