Randomized Controlled Trial of Cognitive–Behavioral Group Therapy for Irritable Bowel Syndrome in a Medical Setting

Standard medical treatments have not been effective for irritable bowel syndrome (IBS) patients. Though individualized cognitive–behavior therapy is an empirically supported treatment option, cognitive–behavioral group therapy (CBGT) has yet to be established as an effective alternative in a randomized controlled trial. This study compared the efficacy of a 10-session CBGT with a home-based symptom monitoring with weekly telephone contact (SMTC) treatment for IBS, extending previous quasi-experimental research in this area. Twenty-eight refractory IBS patients, evaluated and referred by gastroenterologists using the Rome criteria, participated in the study. IBS symptoms, psychological functioning, and health-related quality of life were assessed pre- and posttreatment, and at 3-month follow-up. CBGT patients reported significantly more gastrointestinal (GI) symptom improvement than SMTC patients on posttreatment global measures and had significantly reduced daily diary pain scores at 3-month follow-up. Based on MANOVA, there was significant improvement in psychological distress and health-related quality of life for the CBGT patients in comparison to the SMTC patients. These improvements were also maintained at the 3-month follow-up. Reductions in GI symptoms, psychological distress, and improved health related quality of life may contribute to less behavioral avoidance, disability, and health care utilization in refractory IBS patients.     

Dysmorphic concern and behavioural impairment related to body image in adolescents

This study examined a moderated mediation model testing whether dysmorphic concern is related to behaviour altered to change appearance. This relationship is potentially mediated by depressive symptomatology (dysphoria and self-esteem) and ideas of reference about “laughing, commenting” and “attention, appearance,” and each mediated relationship moderated by sex. The sample was made up of 3377 adolescents from 12 to 18 years old (M_age = 14.52; SD = 1.65, 56.5% girls). The results showed that dysphoria and ideas of reference about “laughing, commenting” and “attention, appearance” partially mediated the relationship between dysmorphic concern and behavioural impairment related to body image. The relationship with dysphoria was moderated by sex, such that the mediation effect was stronger in girls than in boys. This result implies that girls who are worried about some characteristic of their appearance and show dysphoria are at greater risk of altered behaviour involving avoidance or controlling their appearance than boys. In addition, a possible risk of body dysmorphic disorder (3.45% of the sample) was found, with very prominent hiding behaviour using clothing or control behaviours, such as frequent weighing and looking at oneself in the mirror too much. Implications of these findings are discussed.     

The socialization of the gifts of tongues and healing in Mexican Pentecostalism

Mexican Pentecostalism emphasizes both speaking in tongues and faith healing as religious manifestations which believers should have. Although they are considered to be given by the Holy Spirit, these practices imply a socialization with the collective of followers. The analysis of pentecostal groups in the urban environment of Mexico City and in the rural Totonac Indian communities shows that these religious practices and beliefs are very similar in the two areas mentioned. It is necessary for the pentecostal believer to learn the ‘proper’ way to speak in tongues and to heal the sick, in order to separate followers from other religions which compete with pentecostalism by offering ritual possession and alternative forms of curing human suffering. In Mexico, popular spiritualism, the Catholic charismatic movement and traditional Indian curers all offer direct competition for pentecostalism. The religious mobility further complicates this situation. The important role of public discourse and testimony is also dealt with here.     

Sexual differences in memory in shiny cowbirds

Avian brood parasites depend on other species, the hosts, to raise their offspring. During the breeding season, parasitic cowbirds (Molothrus sp.) search for potential host nests to which they return for laying a few days after first locating them. Parasitic cowbirds have a larger hippocampus/telencephalon volume than non-parasitic species; this volume is larger in the sex involved in nest searching (females) and it is also larger in the breeding than in the non-breeding season. In nature, female shiny cowbirds Molothrus bonariensis search for nests without the male’s assistance. Here we test whether, in association with these neuroanatomical and behavioural differences, shiny cowbirds display sexual differences in a memory task in the laboratory. We used a task consisting of finding food whose location was indicated either by the appearance or the location of a covering disk. Females learnt to retrieve food faster than males when food was associated with appearance cues, but we found no sexual differences when food was associated with a specific location. Our results are consistent with the view that parasitism and its neuroanatomical correlates affect performance in memory tasks, but the effects we found were not in the expected direction, emphasising that the nature of avian hippocampal function and its sexual differences are not yet understood. Received: 30 April 1998 / Accepted after revision: 5 September 1998