Types and correlates of blood/injury-related vasovagal syncope

This study investigated by interview, the initial syncopal episode of 103 blood/injury-related vasovagal fainters in order to examine two competing hypotheses concerning their origins. Graham (Circulation, 23, 901-906, 1961) postulated that the faint resulted when sympathetic nervous system (SNS) activity ceased on termination of a threat, leaving parasympathetic nervous system (PNS) activation unopposed. Engel [Fainting (2nd edn), 1962; Annals of Internal Medicine, 89, 901-906, 1978] proposed that when in the face of threat with SNS activation, escape is blocked, the PNS becomes activated as the conservation-withdrawal response, leading to syncope. We found cases clearly conforming to each of these formulations as well as some with characteristics of both, and some who fainted in response to blood or injury but with no perception of threat. The Graham and Engel types did not differ in terms of fear or avoidance of blood, injury, or medically-related situations nor did they differ in the frequency with which their parents reported blood/injury-related syncopal episodes. It is proposed that both may be activated by a common psychological mechanism involving cessation of a defensive posture. In contrast, the non-threat fainters showed significantly less medically-related avoidance and had a greater percentage (94%) of parents with positive faint histories.     

Effect of Persuasive Appeals in AIDS PSAs and Condom Commercials on Intentions to Use Condoms1

The study compared the effect of five persuasive appeals used in AIDS PSAs and condom commercials (fear arousal-no sex/condom theme; fear arousal-sex/condom theme; erotic; humorous; factual) on 122 male and 114 female college students' i]ntentions to use and taking of condoms. Results showed that the two fear appeals were more effective than other appeals in increasing intentions to use condoms with a new partner. The fear appeal–no sex/condom theme was more effective than other appeals for increasing intentions to use condoms with a steady partner. Compared to men, women rated commercials as more effective for increasing intentions to use condoms with a new partner. Persuasive appeals had no effect on the taking of free condoms. The best predictor of commercial effectiveness was the degree to which a commercial evoked a high fear of AIDS. Other significant predictors were subjects' a]ttitude toward condom use and commercial qualities of being humorous, romantic, credible, and factual. Implications are that all five types of appeals are potentially effective for use in AIDS PSAs. Recommendations include combining appeals (e.g. fear with erotic) and emphasizing the positive features of condom use.     

The new qualification in careers guidance in higher education: A collaborative partnership

The raison d'être for the new Certificate and Diploma in Careers Guidance in Higher Education is outlined. The different perspectives of the partners in this enterprise–the Department of Community Studies at the University of Reading and the Association of Graduate Careers Advisory Services (AGCAS)–are discussed. The initial difficulties and successes are explored and a suggested strategy is offered for other such collaborative ventures.     

ASSESSMENT AND TREATMENT OF DESTRUCTIVE BEHAVIOR MAINTAINED BY STEREOTYPIC OBJECT MANIPULATION

In the current investigation, 2 participants with mental retardation displayed property destruction and stereotypy, and both responses involved the same materials (e.g., breaking and tapping plastic objects). Three experiments were conducted (a) to indirectly assess the functions of these two responses, (b) to determine their relation to one another, and (c) to develop a treatment to reduce the more serious behavior, property destruction. In Experiment 1, previously destroyed materials were either present or absent, and their presence reduced property destruction but not stereotypy. In Experiment 2, matched toys (ones that produced sensory stimulation similar to stereotypy) were either present or absent, or were replaced by unmatched toys (for 1 participant). Matched toys produced large reductions and unmatched toys produced small reductions in property destruction and stereotypy. In Experiment 3, attempts to pick up undestroyed objects were either blocked or not blocked while matched toys were continuously available. Response blocking reduced property destruction (and attempts), prevented stereotypy, and increased manipulation of matched toys. These results suggest that the two aberrant responses formed a chain (e.g., breaking and then tapping the object), which was maintained by the sensory consequences (e.g., auditory stimulation) of the terminal response, and that previously destroyed material or matched toys made the initial response (property destruction) unnecessary.     

Cognitive processing therapy for chronic PTSD from childhood sexual abuse: A case study

This paper describes a case of chronic Post-traumatic Stress Disorder (PTSD), as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, 4th edn; American Psychiatric Association, 1994). The client has a long history of childhood sexual abuse (CSA), as well as repeated sexual victimization as an adult and addiction issues. She presented with significant avoidance symptoms, including a highly restricted range of affect and distinct feelings of detachment from others. These symptoms had been greatly reduced by the end of the 17-week therapy including both individual and group modalities. The paper elaborates on theoretical issues, the Cognitive Processing Therapy model (Resick & Schnicke, 1993) as it was adapted for use with survivors of childhood sexual abuse, the various phases of the therapeutic process, and specific examples of therapeutic change with this particularly complicated case.     

Combined group and individual treatment for the borderline patient

This article discusses the attenuating mechanisms of group psychotherapy that support and enhance analytic work with borderline patients in combined group and individual psychotherapy. A group case study is presented which addresses the manifestations and management of transference and countertransference in a combined treatment approach. Combined treatment was observed to respond effectively to both the intrapsychic and interpersonal difficulties of borderline patients. A multidimensional model for treating these patients in a community mental health setting is proposed.     

Children's strategies for controlling affective responses to aversive social experience

It was hypothesized that one mechanism of self-control that children develop is the strategic capacity to select the experiences they encounter. This hypothesis led to the prediction that children would deal with certain aversive social experiences by seeking out or taking advantage of opportunities for nurturant experiences. Young children were exposed to an aversive social experience in which they received less nurturance than a peer, a positive experience in which they received more nurturance, or a neutral experience in which nurturance was equal. Subsequently, an opportunity was provided for children to control the length of time they watched a highly nurturant television program. As predicted, boys experiencing an aversive social encounter increased the length of time they exposed themselves to the nurturant television show, and their level of reduced positive affect was related to how long they watched the nurturant content, further supporting the interpretation that they did so in response to their own affective state. Girls did not adopt the strategy of self-exposure to nurturant television but did appear to engage in self-distraction during the aversive social experience. Despite the apparent use of control strategies, there was no indication that these strategies were effective for the amelioration of reduced positive affect resulting from the aversive social experience. Discussion focuses on the sex differences observed in the adoption of strategic behavior and factors contributing to the ineffectiveness of the control strategies. A general model is proposed for personal and environmental factors requisite for the selection, employment, and effectiveness of strategies to control experiences and their affective consequences.     

Men and women's acceptance of coercive sexual strategies varied by initiator gender and couple intimacy

Seventy-two men and 86 women read vignettes describing five coercive strategies for obtaining sexual intercourse on a date. Subjects rated the acceptability of strategies used by male and female initiators for couples who were or were not sexually intimate. Subjects generally rejected all tactics. Results revealed a continuum of increasing rejection from verbal pressure and sexual stimulation, followed by mock force, followed by intoxication and physical force. Although women were more rejecting of any strategy than were men, women were slightly less opposed to verbal pressure and stimulation for “more sex” rather than for “first-time sex.” Women equally rejected most male- and female-initiated strategies, but men were more accepting of female-initiated strategies. Results are explained in terms of sex role norms prescribing that men be initiators and women be gatekeepers in sexual interaction.     

Rater information acquisition processes: Tracing the effects of prior knowledge, performance level, search constraint, and memory demand

Research on performance ratings has tended to neglect factors affecting raters' acquisition of ratee performance information. The present research examined the dynamic effects of this rater information acquisition process. Study 1 examined the effects of prior ratee knowledge (familiarity) and ratee performance level on subsequent acquisition of ratee performance information under varying levels of constraint. After exposure to prior ratee information, raters acquired additional information concerning a set of ratees using a computer controlled information board procedure. The results indicated significant effects on the amount of search for prior knowledge, search constraint, and the interaction between prior knowledge and performance level. Study 2 extended the research by including a memory component (time delay) between the exposure to prior information and subsequent search. Results were congruent with Study 1. They indicated significant main effects on the amount of search for prior knowledge, ratee performance level, search constraint, and on the interaction between prior knowledge and performance level. In addition, the results indicated a significant interaction between memory demand and prior knowledge. Implications of these results, limitations, and extensions of this research approach are discussed.