An evaluation of counselling and rehabilitation courses for Chronic Fatigue Syndrome

The aim of the current study was to evaluate the services offered by Action for ME to sufferers of Chronic Fatigue Syndrome using measures developed and validated in previous research. Preliminary studies had suggested that clients attending rehabilitation residential courses were benefiting from the service. A further, more in‐depth evaluation process with a greater number of health‐related outcome measures was warranted. In addition, assessment was widened to include other services offered to sufferers of the illness. Data relating to the usefulness and success of the services (rated by the clients) were also collected. Data from client volunteers were collected at baseline (that is, before intervention) and approximately six months later. Quantitative comparative analyses were conducted using within‐group comparisons to assess any improvements in scores at six‐month follow‐up from baseline. Fifty‐six participants completed wide‐ranging questionnaires assessing illness history, psychopathology, psychosocial factors and health and well‐being. Data relating to improvements in illness status and acceptability of treatment were also collected by means of global outcome measures. Both the counselling and residential groups showed improvements in many areas assessed at follow‐up. Most importantly, improvements were indicated in areas such as fatigue and the levels of disability suffered by patients. In addition, there were significant improvements in ratings of mood, anxiety, depression and physical symptoms. Overall, clients reported satisfaction with the care received and most found the services useful. All of the participants who completed the evaluation stated that they would recommend Action for ME services to fellow sufferers. The outcome of the current study is encouraging. The data presented provides evidence of the high level of support and advice Action for ME offers to sufferers of this illness. Furthermore, measurable improvements in scores relating to illness status were accompanied by improvements in mental health and psychosocial variables in the patient group.     

Determining risk in pediatric research with no prospect of direct benefit: time for a national consensus on the interpretation of federal regulations

United States federal regulations for pediatric research with no prospect of direct benefit restrict institutional review board (IRB) approval to procedures presenting: 1) no more than "minimal risk" ( section sign 45CFR46.404); or 2) no more than a "minor increase over minimal risk" if the research is commensurate with the subjects' previous or expected experiences and intended to gain vitally important information about the child's disorder or condition ( section sign 45CFR46.406) (DHHS 2001). During the 25 years since their adoption, these regulations have helped IRBs balance subject protections with the pursuit of scientific knowledge to advance children's welfare. At the same time, inconsistency in IRB application of these regulations to pediatric protocols has been widespread, in part because of the ambiguity of the regulatory language. During the past decade, three federally-charged committees have addressed these ambiguities: 1) the National Human Research Protections Advisory Committee (NHRPAC) (Washington, DC), 2) the Institute of Medicine (IOM) Committee on the Ethical Conduct of Clinical Research Involving Children (Washington, DC); and 3) the United States Department of Health and Human Services Secretary's Advisory Committee for Human Research Protections (SACHRP) (Washington, DC). The committees have reached similar conclusions on interpretation of language within regulations section sign section sign 45CFR46.404 and 406; these conclusions are remarkably consistent with recent international recommendations and those of the original National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1977) report from which current regulations are based. Drawing on the committees' public reports, this article identifies the ethical issues posed by ambiguities in regulatory language, summarizes the committees' deliberations, and calls for a national consensus on recommended criteria.     

Socializing Attribution: Generalization to “Real” Social Environments1

Social status variables have been shown to influence attributional judgments, but their effects have been demonstrated almost entirely in experimental settings. The influence of such statuses in experimental settings may differ from their influence in natural settings. We examined the influence on attributional judgments of the status characteristics of both subjects and actors in conjunction with variations in the degree of “real world” characteristics of both subjects and social context. These comparisons were drawn through a partial replication of earlier research investigating the effects of a social status variable, victim sex, and a situational variable—type of assault—on attributions about an assault victim. The social status characteristic, victim sex, had less influence on attributions in an adult juror sample than in a student sample and testimony-related characteristics were more influential in the adult juror sample than in the student sample. Thus, the categories of variables that influence attributions appear to depend on the context of judgment and on the breadth of subjects' life experience. These findings are discussed and we conclude with the caution that careful identification of the differences produced by context and subject characteristics is necessary to support generalization of laboratory-based research.     

Family Therapy in Trouble: Psychoeducation as Solution and as Problem

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho-therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.     

Semantic priming without awareness: Some methodological considerations and replications

Previous studies of subliminal semantic priming effects are considered. The distinction between subjective and objective detection thresholds proposed by Cheesman and Merikle (1984) is accepted, and it is concluded that no convincing evidence has been adduced to support or deny the existence of semantic priming effects at or below objective threshold. New criteria for the assessment of objective thresholds are proposed, and four experiments are reported in each of which pattern-masked primes were presented 10% below objective threshold. The first three experiments presented primes, mask, and targets binocularly; the fourth used dichoptic presentation. Data were analysed using both conventional F ratios and the quasi F ratio advocated by Clark (1973). Results showed that significant subliminal semantic priming effects occurred in each experiment when conventional F ratios were used, and significant effects occurred in all but the first experiment when quasi F was used. Binocular and dichoptic presentation of stimuli gave semantic priming effects whose magnitudes did not differ significantly. It is concluded that semantic priming effects can be obtained below objective detection threshold. It is also concluded that replication with different participants and different stimuli is preferable to the use of quasi F ratios in investigations where verbal stimuli are used.     

An evaluation of the Garren-Edwards diet and behavior modification program

This study evaluated the efficacy of the Garren-Edwards Behavior Modification Program, which uses the Garren-Edwards Gastric Bubble as an adjunct to treatment. Group therapy sessions were conducted with 23 morbidly obese subjects for 6 months on a biweekly basis. Each therapy session used a five-stage problem-solving sequence designed to facilitate adaptive behavioral alternatives. In evaluating weight change, a multivariate analysis of variance was conducted along with two preplanned orthogonal comparisons. Patients lost significant amounts of weight between initial to 3-month (p<.0001) and 3- to 6-month intervals (p<0001). A similar treatment effect was noted in an additional sample of 24 morbidly obese subjects following 3 months of treatment (p<0005). The findings support the value of longer goal-oriented programs in promoting continued weight loss. Implications for treatment process and therapist interventions prompted by this new format are discussed.     

Recent developments in non-traditional employment testing: An introduction

The purpose of this special issue of theJournal of Business and Psychology is to provide a review and update of several key types of non-traditional employment tests. Non-traditional employment tests can be divided into two categories. One category consists ofbiological/physiological tests. The second category consists ofnarrow-based personality tests. A framework for thinking about non-traditional employment tests is provided.