Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes

This study extends the data on the efficacy of cognitive interventions for patients with chronic medical problems and describes the case of a 37-year-old woman with an anxiety disorder related to diabetes. The effects on panic frequency, use of safety behaviour and related beliefs were investigated after the introduction of two main cognitive-behavioral interventions. The results are consistent with predictions from the cognitive model of panic. This case demonstrates the usefulness of directly challenging the 'meaning' of the feared situation in order to produce clinically significant improvements in the management of physical disease.     

Collateral effects of response blocking during the treatment of stereotypic behavior

The collateral effects of response blocking were evaluated while treating stereotypic behavior in a woman diagnosed with autism. Blocking stereotypic behavior (head and tooth capping) was associated with decreases in leisure-item interaction and increases in another stereotypic response (hand wringing). Results suggested that the reduction in item interaction was due to adventitious punishment. Prompts to access an alternative source of reinforcement attenuated the side effects somewhat, but results suggested that the undesirable effects of response blocking may be fairly durable.     

Smoking research: basic research, intervention, prevention, and new trends

Smoking is a behavior that is influenced by a variety of factors that cut across methodologies, disciplines, and content areas within health psychology. The present article is designed to show the diversity and richness of smoking research by examining smoking from four perspective: basic laboratory research, intervention, prevention and deterrence, and new directions in smoking research. Methodologies that were derived from such varied sources as psychopharmacology, behavioral pharmacology, behavior therapy, clinical psychology, public health and health promotion, and social and developmental psychology have been used to study the smoking problem. The subject populations in these investigations ranged from animal models, to the individual smoker attempting to quit, to communities involved in health promotion and public health approaches. Future research should seek to provide new and improved examples of interdisciplinary research within the field of health psychology to multidisciplinary approaches from the basic and applied sciences.     

Hemispheric predominance assessment of phonology and semantics: a divided visual field experiment

The aim of the present behavioural experiment was to evaluate the most lateralized among two phonological (phoneme vs. rhyme detection) and the most lateralized among two semantic ("living" vs. "edible" categorization) tasks, within the dominant hemisphere for language. The reason of addressing this question was a practical one: to evaluate the degree of the hemispheric lateralization for several language tasks, by using the divided visual presentation of stimuli, and then choose the most lateralized semantic and phonological for mapping language in patients by using fMRI in future studies. During the divided visual field experiment by using words (semantic tasks) and pseudo-words (phonological tasks) as stimuli, thirty-nine right-handed participants were examined. Our results have shown that all tasks were significantly left hemisphere lateralized. Furthermore, the rhyme was significantly more lateralized than phoneme detection and "living" was significantly more lateralized than "edible" categorization. The rhyme decision and "living" categorization will be used in future fMRI studies for assessing hemispheric predominance and cerebral substrate for semantics and phonology in patients. Our results also suggest that the characteristics of stimuli could influence the degree of the hemispheric lateralization (i.e., the emotional charge of stimuli for words and the position of the phoneme to be detected, for pseudo-words).     

Social influences on smoking in middle-aged and older women

The purpose of this study was to examine the role of 2 types of social influence--general social support and living with a smoker--on smoking behavior among middle-aged and older women in the Women's Health Initiative (WHI) Observational Study. Participants were postmenopausal women who reported smoking at some time in their lives (N=37,027), who were an average age of 63.3 years at baseline. Analyses used multiple logistic regression and controlled for age, educational level, and ethnicity. In cross-sectional analyses, social support was associated with a lower likelihood and living with a smoker was associated with a higher likelihood of being a current smoker and, among smokers, of being a heavier smoker. Moreover, in prospective analyses among baseline smokers, social support predicted a higher likelihood and living with a smoker predicted a lower likelihood of smoking cessation 1-year later. Further, in prospective analyses among former smokers who were not smoking at baseline, social support predicted a lower likelihood and living with a smoker predicted a higher likelihood of smoking relapse 1-year later. Overall, the present results indicate that social influences are important correlates of smoking status, smoking level, smoking cessation, and smoking relapse among middle-aged and older women.     

Elevated responding to safe conditions as a specific risk factor for anxiety versus depressive disorders: evidence from a longitudinal investigation

The current study evaluated the degree to which startle reflexes (SRs) in safe conditions versus danger conditions were predictive of the onset of anxiety disorders. Specificity of these effects to anxiety disorders was evaluated in comparison to unipolar depressive disorders and with consideration of level of neuroticism. A startle paradigm was administered at baseline to 132 nondisordered adolescents as part of a longitudinal study examining risk factors for emotional disorders. Participants underwent a repetition of eight safe-danger sequences and were told that delivery of an aversive stimulus leading to a muscle contraction of the arm would occur only in the late part of danger conditions. One aversive stimulus occurred midway in the safe-danger sequences. Participants were assessed for the onset of anxiety and unipolar depressive disorders annually over the next 3 to 4 years. Larger SR magnitude during safe conditions following delivery of the aversive stimulus predicted the subsequent first onset of anxiety disorders. Moreover, prediction of the onset of anxiety disorders remained significant above and beyond the effects of comorbid unipolar depression, neuroticism, and subjective ratings of intensity of the aversive stimulus. In sum, elevated responding to safe conditions following an aversive stimulus appears to be a specific, prospective risk factor for the first onset of anxiety disorders.     

Psychotropic Medication Management Within Residential Treatment Centers: Physician Opinions About Difficulties and Barriers

Research has shown that between 40 and 98 % of youth entering residential treatment are taking at least one psychotropic medication and that psychotropic medication management is often an integral component of treatment in residential settings. To determine physician opinion about the difficulty of managing psychotropic medications for youth in residential treatment and to determine the resources that are used in the process, a survey study was conducted. Overall, physicians indicated that youth involved in residential settings were much more complex than those in traditional outpatient settings, due to multiple mental health diagnoses, polypharmacy, and unknown treatment histories. They also reported that many existing resources are not applicable to youth, particularly those in residential settings, and that they are difficult to read and interpret.     

Habermas,Virtue Epistemology,and Religious Justifications in the Public Sphere

Jürgen Habermas's recent challenge to secular citizens calling for greater inclusivity of religious justifications in the public sphere opens new epistemological debates that could benefit from the rich insights of feminist epistemologists. Despite certain theoretical tensions, there is some common ground between Habermas and recent work in feminist epistemology. Specifically, this article explores the shared interests between Habermas and one feminist theorist in particular, Miranda Fricker. I choose Fricker because her formulation of the epistemological and ethical hybrid virtues of testimonial justice and hermeneutical justice provide efficacious theoretical and practical tools capable of deepening the epistemological basis of Habermas's challenge to secular citizens. After a detailed analysis of Habermas's and Fricker's respective epistemological positions, I argue that Fricker's analysis provides a rich framework for thinking through questions of power, identity, and credibility with respect to religious justifications in the public sphere. In conclusion, this article emphasizes the importance of fostering more robust and just epistemic communities capable of countering the social, political, and ethical injustices of epistemic disauthorization and marginalization.