Panic symptoms in asthma and panic disorder: a preliminary test of the dyspnea-fear theory.

Ley's (Behaviour Research and Therapy, 27, 549-554, 1989) dyspnea-fear theory was tested on three groups of subjects: 10 with panic disorder, 24 with asthma, and 12 who were nonanxious and nonasthmatic, using measures of pulmonary function, muscle tension; and self-report measures of generalized anxiety, dyspnea, and psychopathology. Results are supportive of dyspnea-fear theory for asthmatics but not for individuals with panic disorder. Differences between groups on panic/fear measures were explained by a combination of general anxiety and dyspnea. Within-group regression analyses showed that only generalized anxiety symptoms contributed significantly to scores on the Asthma Symptom Checklist scale of panic/fear within the panic disorder group; while only dyspnea contributed to panic/fear among asthmatics. Additional results show that panic disorder subjects performed normally on pulmonary function tests but reported respiratory symptoms as severe as did asthmatics. Compared with normal subjects, both patient groups displayed lower correlations between self-rated symptoms of bronchoconstriction and objective pulmonary measures. Panic disorder subjects showed a negative relationship between pulmonary function and hyperventilation symptoms, suggesting a heightened sensitivity to, and discomfort with, sensations associated with normal pulmonary function. Asthmatics displayed a significant relationship between degree of airway obstruction and both trapezius surface EMG and ratings of hyperventilation symptoms.     

REDUCTION OF SEVERE BEHAVIOR PROBLEMS IN THE COMMUNITY USING A MULTICOMPONENT TREATMENT APPROACH

Problem behavior often prevents community integration of people with developmental disabilities. Therefore, we evaluated a multicomponent approach for remediating problem behavior in public community settings (specifically, supermarkets). We selected treatments based on hypotheses about the variables controlling the problem behavior (hypothesis-driven model). The multicomponent intervention included choice making, embedding, functional communication training, building tolerance for delay of reinforcement, and presenting discriminative stimuli for nonproblem behavior. Treatment progress was monitored using measures of latency and task completion rather than traditional measures of frequency and time sampling. Results showed substantial increases in task completion and duration of time spent in supermarkets without problem behavior. Outcomes were socially validated by group-home staff and cashiers. We discuss how the intervention approach taken can resolve some of the issues involved in assessing, measuring, and treating problem behavior in the community.     

Milan systemic family therapy: a review of ten empirical investigations

Ten empirical investigations of Milan Family Therapy (MFT) are reviewed in this paper. The studies include both single and comparative group outcome trials; investigations of therapeutic process; clinical audit and consumer satisfaction surveys. Substantive findings and methodological issues are discussed in the light of family therapy and individual psychotherapy research generally. Findings indicate that MFT may lead to symptomatic change in two-thirds to three-quarters of cases and to systemic change in half the treated cases. Engagement of fathers may be important for positive outcome. Technical aspects of MFT, such as the use of screens and teams, may lead to client dissatisfaction in some cases. MFT-based consultation may be effective in resolving therapeutic impasses. Coupled with short-term residential placement, MFT may reduce the risk and complexity of cases as rated by referring social workers.     

Crowding in a Woman's Prison: Attitudinal and Behavioral Effects1

Two studies were conducted to assess the impact of crowding on female inmates. The first study, an archival analysis of the records of 561 women prisoners, showed that the average population in the institution was significantly related to the transformed rate of disciplinary infractions, even when other variables had been controlled for. The second study, which used a questionnaire, found that inmates' perceived control was positively related to liking for their room and negatively related to their reported stress and physical symptoms. In addition, the stress inmates experienced was negatively related to liking for their room and positively related to physical symptoms.     

ACQUISITION OF SIGN LANGUAGE BY AUTISTIC CHILDREN. I: EXPRESSIVE LABELLING

There has been growing interest in teaching sign language to autistic children who have failed to develop speech. However, controlled experimentation in this area is nonexistent. In the present study, four nonverbal autistic children were taught expressive sign labels for common objects, using a training procedure that consisted of prompting, fading, and stimulus rotation. The efficacy of the procedure was demonstrated in a multiple-baseline design across objects. The results were reliable, replicable across children, and generalizable across therapists. A stimulus control analysis demonstrated that, for three of the children, correct signing was controlled solely by the visual cues associated with the presentation of a given object and was independent of the auditory cues related to the same object. These latter results are discussed with respect to the known perceptual and linguistic deficits of autistic children.     

When is enough enough? We are only beginning

Sheridan (1995) presents the problem of the psychologist consulting to a medical residency program as an example of the difficulty one experiences in attempting to challenge, even from a data-based perspective, the calcification inherent in health systems and medical education in particular. This paper responds to her challenging questions, “How much should we get involved in changing health care and medical education, and at what level (local, national) should psychology intervene (if at all)?” It is suggested that psychologists pick up the challenge to bring about change, whenever possible, with the admonition—we are only beginning.     

Family therapy and clinical psychology

The results of a survey of 111 clinical psychologists in the Republic of Ireland along with some comparable data from US and UK surveys were used to address a series of questions about the link between family therapy and clinical psychology. Family therapy was not a clearly identifiable sub-specialty within clinical psychology in Ireland. Family therapy theoretical models were used by more than a quarter of the Irish sample to conceptualize their work but by less than a tenth of US and UK respondents. In all three countries about a tenth of treatment time was devoted to the practice of family therapy. In Ireland, the use of family systems models, family assessment interviews and family therapy was more common within the child and family specialty than within the mental handicap or adult mental health clinical psychology specialties. The experience of live supervision and participation in family or couples therapy were important formative factors in the development of some clinical psychologists. Further training in systemic consultation, particularly in situations where an abuse of power has occurred, was identified in the survey as a priority area for continuing professional development. The evolving relationship between family therapy and clinical psychology is discussed in the light of these findings.     

The snodgrass picture fragment completion test: Alternate-form reliability

In two studies, the alternate-form reliability of the Snodgrass picture fragment completion test of implicit memory (Snodgrass, Smith, Feenan, & Corwin, 1987) was examined. In this test, identification thresholds are established for fragmented pictures. The same fragmented pictures are then shown again, intermixed with new fragmented pictures. Implicit memory is indicated by a decrease in identification threshold from the first to second presentation. Alternate-form reliability was low to moderate, depending on the measure used, regardless of the length of the test. A third study showed that explicit memory instructions did not increase the reliability. Recommendations for use of the test in correlational and experimental research are presented.