Personal Control in Chronic Pain Sufferers During Acute Interpersonal Stress

Among individuals with Rheumatoid Arthritis (RA), pain-associated stress can severely impact wellbeing. Psychological attributes, such as a sense of personal mastery, may attenuate the effects of chronic pain on life quality. We tested the hypothesis that a high sense of mastery would predict lower pain, perceived stress, fatigue, and mean arterial pressure (MAP) than would a low sense of mastery during an acute, interpersonal stressor.Seventy-four individuals with RA completed a psychophysiological laboratory session involving MAP measurements, as well as self-ratings of stress, joint pain, and fatigue. Measurements were collected before, during, and after an interpersonal stressor. To assess personal mastery, exploratory and confirmatory factor analyses were conducted on the Pearlin Mastery Scale based on recommendations by Reich and Zautra (1991)The Pearlin Mastery Scale yielded two distinct factors: fatalism and control. Both fatalism and control were significant predictors of the wellbeing variables. Individuals with a highly fatalistic style demonstrated higher general levels of mean arterial pressure (F(1) = 3.41, p<.1) and reported greater joint pain (F(1) = 4.72, p<.05) across all periods. Individuals with a high sense of control also evidenced lower MAP (F(1) = 3.73, p<.1) and reported less stress (F(1) = 7.44, p<.01) and fatigue (F(1) = 5.16, p<.05). Neither fatalism nor control were related to objective measures of disease severity (r's = -.10, p=NS and -.02, p=NS, respectively).RA patients with a high level of personal mastery, as evidenced by scores on two distinct indices, experience lower MAP, and report less pain, stress and fatigue. Although fatalism and control were not related to objective disease state, they seem to play an important role in the experience of wellbeing for people with RA.     

Effects of Cognitive Behavioral Therapy and Vocational Rehabilitation on Metacognition and Coping in Schizophrenia

The Indianapolis Vocational Intervention Program (IVIP) is a cognitive behaviorally based program of group and individual interventions that seeks to help persons with schizophrenia improve vocational function and sustain hope. In this study we compared baseline and follow-up assessments of coping and metacognition among 50 participants with schizophrenia spectrum disorders offered a six-month job placement and randomized to receive IVIP (n = 25) or standard services (n = 25). ANCOVA controlling for baseline suggest that the IVIP group gained greater ability to think about their own thinking and to cope by seeing what were previously perceived as negative stressors in more positive light. An erratum to this article can be found at     

Teaching adults new words: the role of practice and consolidation

Semantic and orthographic learning of new words was investigated with the help of the picture-word interference (PWI) task. In this version of the Stroop task, picture naming is delayed by the simultaneous presentation of a semantically related as opposed to an unrelated distractor word (a specific PWI effect), as well as by an unrelated word compared with a nonword (a general PWI effect). This interference is taken to reflect automatic orthographic and semantic processing. The authors observed that participants showed both types of PWI effects for newly learned words following a single study session. Interestingly, specific PWI effects were not obtained immediately after testing but did emerge a week later without additional practice. This suggests that a period of consolidation is involved in the establishment of word representations. In addition, identical PWI effects were obtained when the study and test words were presented in either the same or different letter case. This provides evidence that the newly acquired orthographic representations are coded in an abstract format.     

Right hemispatial neglect: frequency and characterization following acute left hemisphere stroke

The frequency of various types of unilateral spatial neglect and associated areas of neural dysfunction after left hemisphere stroke are not well characterized. Unilateral spatial neglect (USN) in distinct spatial reference frames have been identified after acute right, but not left hemisphere stroke. We studied 47 consecutive right handed patients within 48h of left hemisphere stroke to determine the frequency and distribution of types of right USN using cognitive testing and MRI imaging. The distribution of USN types was different from the previously reported distribution following acute right hemisphere stroke. In this left hemisphere stroke population, allocentric neglect was more frequent than egocentric neglect.     

Counseling Supervisors' Assessment of Race,Racial Identity,and Working Alliance in supervisory Dyads

The authors investigated the role of race, racial identity attitudes and working alliance in counseling supervision using data obtained from supervisors in supervisory dyads. Results revealed the strongest working alliance for supervisor‐supervisee pairs with high racial identity development and the weakest working alliance for pairs with low racial identity development. Los autores investigaron el papel que juegan la raza, las actitudes de identidad racial y la alianza de trabajo en la supervisión de consejería, empleando datos obtenidos de supervisores involucrados en diadas de supervisión. Los resultados revelaron que la alianza de trabajo más sólida se da en parejas de supervisor‐supervisado con un desarrollo alto de identidad racial, y la alianza de trabajo más débil en parejas con un desarrollo bajo de identidad racial.     

Characteristics and reversibility of dementia in Normal Pressure Hydrocephalus

Studies of the cognitive outcome after shunt insertion for treatment of Normal Pressure Hydrocephalus have reported widely mixed results. We prospectively studied performance of 60 patients with Normal Pressure Hydrocephalus on a comprehensive battery of neuropsychological tests before and after shunt surgery to determine which cognitive functions improve with shunt insertion. We also administered a subset of cognitive tests before and after temporary controlled drainage of cerebrospinal fluid to determine if change on this brief subset of tests after drainage could predict which patients would show cognitive improvement three to six months after shunt insertion. There was a significant improvement in learning, retention, and delayed recall of verbal memory three to six months after surgery (using paired t-tests). The majority (74%) of patients showed significant improvement (by at least one standard deviation) on at least one of the memory tests. Absence of improvement on verbal memory after temporary drainage of cerebrospinal fluid had a high negative predictive value for improvement on memory tests at 3-6 months after surgery (96%; p=0.0005). Also, the magnitude of improvement from Baseline to Post-Drainage on few specific tests of learning and recall significantly predicted the magnitude of improvement after shunt surgery on the same tests (r2=0.32-0.58; p=0.04-0.001). Results indicate that testing before and after temporary drainage may be useful in predicting which patients are less likely to improve in memory with shunting.     

'Talk to me baby, tell me what's the matter now': Semiotic and developmental perspectives on communication in psychoanalytic infant treatment

Infants suffer to a considerable degree from disturbances in nursing, sleep, mood, and attachment. Psychotherapeutic methods are increasingly used to help them. According to case reports, psychoanalytic work with infants and mothers has shown deep‐reaching and often surprisingly rapid results, both in symptom reduction and in improved relations between mother and child. The clinical urgency of the method makes it important to study its results and theoretical underpinnings. Among the theoretical issues often raised in discussions on this modifi ed form of psychoanalysis, those addressing the nature of communication between analyst, baby, and the mother are the most frequent. For example, how and what does an infant understand when the analyst interprets to her? What does the analyst understand of the infant's communication? These issues are addressed by investigating the infant's tools for understanding linguistic and emotional communication, and by providing a semiotic framework for describing the communication between the three participants in the analytic setting. The paper also investigates problems with the traditional ways of using the concept of symbolization within psychoanalytic theory. The theoretical investigation is illustrated by two brief vignettes from psychoanalytic work with an 8 month‐old girl and her mother. demand for the breast. Like the two lovers in the blues, they seemed to be slaves to     

The Influence of Affect on Goal Choice and Task Performance

The present study investigated the influence of mood on self-set goals and task performance. Results from 2 studies suggest a restricted view of mood effects in which affective state influences the level of self-set goals or task performance, but not both. Study 2 reveals asymmetrical mood effects on task performance, with positive- and negative-mood participants exceeding the baseline performance of neutral mood participants. Evidence indicates that goal-setting instructions may alter how individuals interpret motivational implications of mood. Although theory implies an inclusive view in which mood has both direct and indirect (through goal-setting) performance effects, the conflicting influences of affect infusion at different points of the goal-striving process may diminish the likelihood of observing inclusive effects.