Patients' Knowledge of Cystic Fibrosis: Genetic Determinism and Implications for Treatment

This paper uses the self-regulation model of illness perceptions (Leventhal et al. , 1984) to consider the implications of different ways of thinking about the causes of illness. The relationship between anxiety/depression and knowledge or denial of illness is also considered. These issues are explored using adherence to treatment in cystic fibrosis (CF) as an example. Twenty-six CF patients took part in semistructured interviews and completed a standardized anxiety and depression scale (HAD, Zigmond and Snaith, 1983). Interview data were analyzed using Interpretative Phenomenological Analysis (Chapman and Smith, 2002). HAD data were analyzed using SPSS. The respondents displayed widely differing levels of knowledge of their condition. Some deterministic comments were also reported. Findings are discussed in relation to the information that physicians might provide to patients and families in the light of increasing knowledge about genetics in society and the genotyping of individuals with genetic conditions specifically. Any important gaps in patient knowledge could usefully be discussed at transition from pediatric to adult care and issues relating to control and genetic determinism discussed with the patients individually.     

New phenomenon of abnormal auditory perception associated with emotional and head trauma: pathological confirmation by SPECT scan

We report the case of an immigrant who suffered from death threats and head trauma while a prisoner of war in Kuwait. Two months later, he began to hear conversations that had taken place previously. These perceptions occurred spontaneously or were induced by the patient's effortful concentration. The single photon emission computerized tomography (SPECT) scan performed during this abnormal perceptual experience indicated an increase in regional cerebral blood flow in the left temporal lobe and in the brainstem.     

Impact of personality disorders on treatment outcome for female assault survivors with chronic posttraumatic stress disorder

This study examined the impact of comorbid personality disorders on the outcome of cognitive behavioral treatment for women with chronic posttraumatic stress disorder (PTSD). Seventy-five adult women with PTSD resulting from rape or nonsexual assault in adulthood or sexual abuse in childhood were treated with prolonged exposure with or without cognitive restructuring. Assessment of personality disorders found that 39% of participants met DSM-IV criteria for some personality disorder diagnosis. No difference was found between women with and without personality disorders on the prevalence of PTSD at the end of treatment. Participants with a personality disorder were less likely to attain good end-state functioning, but this may be attributable to the fact that they started off slightly worse than those without personality disorders. Finally, the comorbid patients treated by community therapists fared as well or better than those treated by cognitive behavioral treatment experts in posttreatment prevalence of PTSD and end-state functioning.     

Suicidal behavior in schizophrenia and schizoaffective disorder: examining the role of depression

Understanding the relationship between depression and suicidal behavior among individuals with schizophrenia and schizoaffective disorder can aid assessment and treatment. In this study, 86 individuals with schizophrenia and schizoaffective disorder were assessed for past and current suicidal behavior, depression, hopelessness, and reasons for living. Thirty-four percent reported a history of suicide attempts. Suicidal behavior typically occurred 4.5 years after the onset of psychosis and 7.5 years after the onset of the first major depressive episode for those who had a history of major depression. Depression was frequent among both attempters and non-attempters, but only half of the attempters reported a suicide attempt during an episode of major depression. And almost half of those with depression never made a suicide attempt despite a long history of illness. Although depression is a potential stressor for triggering suicidal behavior in a vulnerable subset of individuals with schizophrenia, schizophrenia research must identify other risk factors for suicidal behavior. Clinicians should remember that even without a depressive episode there is still a significant risk for suicidal behavior in schizophrenia.     

Ethnic group preferences for multicultural counseling competencies

Asian American (n = 155), European American (n = 200), and Hispanic (n = 152) undergraduate students were surveyed using a paired-comparison format to determine preferences for the 9 attitudes/beliefs, 11 knowledges, and 11 skills identified by D. W. Sue, P. Arredondo, and R. J. McDavis (1992) as characteristics of the competent multicultural counselor. The Bradley-Terry-Luce model, which uses a weighted least square regression to place the competencies on a continuum from least preferred to most preferred and to test for significant intergroup differences, was used to analyze the data. Results indicated that preferences for 5 of the 9 attitudes/beliefs, 5 of the 11 knowledges, and 7 of the 11 skills competencies varied as a function of race/ethnicity.     

Intentional forgetting can increase,not decrease,residual influences of to-be-forgotten information

Intentionally forgotten information remains in memory at essentially full strength, as measured by recognition and priming, but access to that information is impaired, as measured by recall. Given that pattern, it seemed plausible that intentionally forgotten information might have a greater impact on certain subsequent judgments than would intentionally remembered information. In 2 experiments, participants cued to forget nonfamous names were subsequently more likely to make false attributions of fame to those names than were participants instructed to remember them. These findings implicate retrieval inhibition as a potent factor in the interplay of recollection and priming in memory and judgment. They also point to possible unintended consequences of instructions to forget, suppress, or disregard in legal or social settings.     

Timed picture naming in seven languages

Timed picture naming was compared in seven languages that vary along dimensions known to affect lexical access. Analyses over items focused on factors that determine cross-language universals and cross-language disparities. With regard to universals, number of alternative names had large effects on reaction time within and across languages after target-name agreement was controlled, suggesting inhibitory effects from lexical competitors. For all the languages, word frequency and goodness of depiction had large effects, but objective picture complexity did not. Effects of word structure variables (length, syllable structure, compounding, and initial frication) varied markedly over languages. Strong cross-language correlations were found in naming latencies, frequency, and length. Other-language frequency effects were observed (e.g., Chinese frequencies predicting Spanish reaction times) even after within-language effects were controlled (e.g., Spanish frequencies predicting Spanish reaction times). These surprising cross-language correlations challenge widely held assumptions about the lexical locus of length and frequency effects, suggesting instead that they may (at least in part) reflect familiarity and accessibility at a conceptual level that is shared over languages.     

The construction of large number representations in adults

What is the nature of our mental representation of quantity? We find that human adults show no performance cost of comparing numerosities across vs. within visual and auditory stimulus sets, or across vs. within simultaneous and sequential sets. In addition, reaction time and performance in such tasks are determined by the ratio of the numerosities to be compared; absolute set size has no effect. These findings suggest that modality-specific stimulus properties undergo a non-iterative transformation into representations of quantity that are independent of the modality or format of the stimulus.     

Motion and edge sensitivity in perception of object unity

Although much evidence indicates that young infants perceive unitary objects by analyzing patterns of motion, infants' abilities to perceive object unity by analyzing Gestalt properties and by integrating distinct views of an object over time are in dispute. To address these controversies, four experiments investigated adults' and infants' perception of the unity of a center-occluded, moving rod with misaligned visible edges. Both alignment information and depth information affected adults' and infants' perception of object unity in similar ways, and infants perceived object unity by integrating information about object features over time. However, infants perceived a moving, misaligned, three-dimensional object as indeterminate in its connectedness, whereas adults perceived it as connected behind the occluder. These findings indicate that the effectiveness of common motion in specifying unified surfaces across an occluder is reduced by misalignment of edges. Alignment information enhances perception of object unity either by serving directly as information for unity or by optimizing the detectability of motion-carried information for unity. In addition, young infants are able to retain information about edge orientation over short intervals in determining connectedness via a process of spatiotemporal integration.