Chronic Fatigue Syndrome: The Need for Subtypes

Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians, and researchers. This article provides information concerning the need for appropriate diagnosis of CFS subtypes. We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress. Next, research involving the case definitions of CFS is reviewed. Findings suggest that whether a broad or more conservative case definition is employed, and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected. Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic, and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS characteristically confusing heterogeneous symptom profiles. Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS. This review suggests that there is a need for greater diagnostic clarity, and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.     

Psychometric evaluation of the restructured clinical scales of the MMPI-2

Conceptual overlap and heterogeneity have long been noted as weaknesses of the Minnesota Multiphasic Personality Inventory's clinical scales. Restructured clinical (RC) scales recently were developed to address these concerns (A. Tellegen et al., 2003). The authors evaluated the psychometric properties of the RC scales in psychology clinic clients (N=285) and military veterans (N=567). The RC scales were as internally consistent as the clinical scales and correlated strongly with their original counterparts (except for RC3/Hysteria). They also were less intercorrelated, produced conceptually clearer relations with measures of personality and psychopathology, and yielded somewhat greater incremental utility than the clinical scales. Thus, the RC scales demonstrated several psychometric strengths while utilizing 60% fewer items, but the 2 sets of scales cannot be used interchangeably. Interpretive considerations are discussed.     

Linguistically mediated visual search: The critical role of speech rate

Recent studies have shown that the presentation of concurrent linguistic context can lead to highly efficient performance in a standard conjunction search task by the induction of an incremental search strategy (Spivey, Tyler, Eberhard, & Tanenhaus, 2001). However, these findings were obtained under anomalously slow speech rate conditions. Accordingly, in the present study, the effects of concurrent linguistic context on visual search performance were compared when speech was recorded at both a normal rate and a slow rate. The findings provided clear evidence that the visual search benefit afforded by concurrent linguistic context was contingent on speech rate, with normal speech producing a smaller benefit. Overall, these findings have important implications for understanding how linguistic and visual processes interact in real time and suggest a disparity in the temporal resolution of speech comprehension and visual search processes.     

Civilian PTSD scales: relationships with trait characteristics and everyday distress

Strong associations between civilian posttraumatic stress disorder (PTSD) scales and measures of general psychological distress suggest that the scales are nonspecific to PTSD. Three common PTSD scales were administered to 122 undergraduates who had experienced an emotionally salient, nontraumatic event: a college examination. Results indicated that normal levels of anxiety associated with the examination were positively correlated with scores on the Impact of Event Scale-Revised, Revised Civilian Mississippi Scale, and PTSD Checklist-Civilian Version. Multiple regression analyses indicated that substantial variance in the PTSD scales was accounted for by trait characteristics such as negative and positive affectivity and affect intensity (R2 .29 to .53). Negative affectivity correlated as highly with PTSD measures (r = .46 to .71) as those measures correlated with each other (r = .48 to .65). A high proportion of participants exceeded clinical cutoffs on these measures. The findings suggest that these PTSD scales may be overly sensitive to nontraumatic stressors such as everyday distress and trait characteristics.     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

Optimism, abstinence self-efficacy, and self-mastery: a comparative analysis of cognitive resources

The relationship between optimism, abstinence self-efficacy, and self-mastery was examined by investigating levels of these cognitive resources among two samples of recovering substance abusers: Oxford House residents who attended twelve-step groups and twelve-step members who had never lived in an Oxford House. Participants 'levels of optimism were significantly and positively related to both abstinence self-efficacy and self-mastery scores, as abstinence self-efficacy was significantly and positively related to participants' number of days abstinent. Participants who reported having more than 180 days abstinent reported significantly higher levels of abstinence self-efficacy than participants who reported having less than 180 days abstinent. In addition, among participants who reported having less than 180 days abstinent, Oxford House residents reported significantly higher levels of abstinence self-efficacy than twelve-step members. Overall, findings suggest that cognitive resources facilitate substance abusers' recovery and that the Oxford House model might provide high levels of support in their ongoing abstinence.     

Senior capstone design and ethics: A bridge to the professional world

A senior level capstone design experience has been developed and offered with a particular emphasis on many of the professional issues raised in Accreditation Board for Engineering and Technology (ABET) Engineering Criterion IV. The course has sought to develop student awareness of the ethical foundation of the engineering profession, the global and societal framework within which engineers practice, and the environmental impact on engineering. The capstone design course also focused upon improving the technical communications skills of the graduating senior class with both extensive instruction in writing and multiple workshops dealing with the art of making an effective oral presentation. The effectiveness of the design course was assessed using Kirkpatrick’s model for evaluating training programs. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Psychopathy and physiological response to emotionally evocative sounds

Despite considerable evidence that psychopathic criminals are deviant in their emotional reactions, few studies have examined responses to both pleasurable and aversive stimuli or assessed the role of different facets of psychopathy in affective deviations. This study investigated physiological reactions to emotional sounds in prisoners selected according to scores on the 2 factors of Hare's Psychopathy Checklist--Revised (PCL-R; R. D. Hare, 1991). Offenders high on the PCL-R emotional-interpersonal factor, regardless of scores on the social deviance factor, showed diminished skin conductance responses to both pleasant and unpleasant sounds, suggesting a deficit in the action mobilization component of emotional response. Offenders who scored high only on the social deviance factor showed a delay in heart rate differentiation between affective and neutral sounds. These findings indicate abnormal reactivity to both positive and negative emotional stimuli in psychopathic individuals, and suggest differing roles for the 2 facets of psychopathy in affective processing deviations.     

Perceptions of Ethical Behaviour among Business Faculty in Canada

Faculty members at Canadian business schools were surveyed regarding their ethical perceptions of behaviours related to undergraduate instruction. Fifty-five behavioural statements were listed and respondents were asked to rate the extent to which they felt each behaviour was ethical or unethical. The only item that respondents endorsed as unequivocally unethical (90% indicated it was definitely unethical) was Becoming sexually involved with an undergraduate in one of your classes. We also compared the results of our sample to those of an American sample. Overall, an interesting pattern of differences emerged between the responses obtained in Canada and the U.S. In general, the direction of the significant differences was such that Canadian professors viewed the behaviours in question as less ethical than did their American counterparts.     

Silent thoughts,spoken wishes: when candidate experience of the supervisor converges with patient fantasies

How and why a candidate's private experience of two supervisors emerged in patients' fantasies about them is explored. Four issues are examined in light of two control cases: (1) Patients divide, rather than split, the transference between supervisor and candidate, experiencing both ambivalently. (2) Even a patient with no knowledge of the supervisor's identity may have a fantasy of the supervisor that is congruent with the candidate's experience of the supervisor. (3) When new professional traits emerge in the candidate as he or she identifies with his or her mentor, the patient may attribute them to the invisible person in the room--the supervisor; the patient may intuit and be influenced by the candidate's feelings about the supervisor as well. (4) A patient's fantasies about the supervisor may reflect parallel process in reverse, whereby the patient discerns what is going on between supervisor and candidate through his or her treatment, just as the supervisor reads what is going on between patient and candidate through the candidate's reporting of the treatment. Because the trio is the truth of the training case, it seems fitting and empowering to acknowledge and analyze the role of the supervisor in the patient's mind.