Treating PTSD in suicidal and self-injuring women with borderline personality disorder: development and preliminary evaluation of a Dialectical Behavior Therapy Prolonged Exposure Protocol

This study focused on the development and pilot testing of a protocol based on Prolonged Exposure (PE) that can be added to Dialectical Behavior Therapy (DBT) to treat PTSD in suicidal and self-injuring individuals with borderline personality disorder (BPD). Women with BPD, PTSD, and recent and/or imminent serious intentional self-injury (n = 13) received one year of DBT with the DBT PE Protocol, plus three months of follow-up assessment. The treatment was associated with significant reductions in PTSD, with the majority of patients no longer meeting criteria for PTSD at post-treatment (71.4% of DBT PE Protocol completers, 60.0% of the intent-to-treat sample). A minority of patients (27.3%) engaged in intentional self-injury during the study. Improvements were also found for suicidal ideation, dissociation, trauma-related guilt cognitions, shame, anxiety, depression, and social adjustment. There was no evidence that the DBT PE Protocol led to exacerbations of intentional self-injury urges or behaviors, PTSD, treatment dropout, or crisis service use. Overall, the results indicate that this integrated BPD and PTSD treatment is feasible to implement within one year of treatment, highly acceptable to patients and therapists, safe to administer, and shows promise as an effective intervention for PTSD in this complex and high-risk patient population.     

Resources required for processing ambiguous complex features in vision and audition are modality specific

Processing multiple complex features to create cohesive representations of objects is an essential aspect of both the visual and auditory systems. It is currently unclear whether these processes are entirely modality specific or whether there are amodal processes that contribute to complex object processing in both vision and audition. We investigated this using a dual-stream target detection task in which two concurrent streams of novel visual or auditory stimuli were presented. We manipulated the degree to which each stream taxed processing conjunctions of complex features. In two experiments, we found that concurrent visual tasks that both taxed conjunctive processing strongly interfered with each other but that concurrent auditory and visual tasks that both taxed conjunctive processing did not. These results suggest that resources for processing conjunctions of complex features within vision and audition are modality specific.     

Attentional Biases for Facial Expressions in Social Phobia: The Face-in-the-Crowd Paradigm

The present study examines the attentional bias hypothesis for individuals with generalised social phobia (GSPs). Socially phobic individuals were hypothesised to exhibit attentional bias towards threat stimuli relevant to interpersonal situations. This hypothesis was tested using the face-in-the-crowd paradigm. GSPs and nonanxious controls (NACs) detected an angry, happy, neutral, or disgust target face in a crowd of 12 distracter photographs. Results indicated that, compared to NACs, GSPs exhibited greater attentional biases for angry than for happy faces in a neutral crowd. GSPs were more slowed down in their performance by happy and angry versus neutral distracters; NACs did not exhibit such sensitivity to distracter type. Finally, GSPs were faster in detecting anger than disgust expressions; NACs detected both types of faces equally quickly. Implications of these findings for the maintenance of social phobia are discussed.     

The Startle Pattern in Infants in Response to Non-Auditory Stimuli

Abstract

Goldstein, K. Human Nature in the Light of Psychopathology. Cambridge: Harvard Univ. Press, 1940. Pp. 258 Reviewed by Frederick Wyatt. Reviewed by Frederick Wyatt

Katona, G. Organizing and Memorizing. New York: Columbia Univ. Press, 1940. Pp. 318. Reviewed by Livingston Welch     

Mental and Motor Switching in Parkinson's Disease

Switching difficulties in Parkinson's disease (PD) are expressed in both mental and motor tasks. The authors of the present study investigated whether those deficits coexist in the same patient and are positively correlated. They tested 8 nondemented PD patients and 6 age-matched control participants by using the modified Wisconsin Card Sorting Test and a motor switching paradigm that is based on the task of reaching toward visual targets, the location of which could unexpectedly be altered within the reaction time. In both mental and motor tasks, patients performed significantly worse than controls. There were no significant correlations between the two types of pathology in individual patients. Mental and motor switching deteriorate in PD patients, but the deficits are not necessarily of parallel severity.

basal ganglia     

The Attainment of Concepts: I. Terminology and Methodology

On the assumption that serial recall tasks reflect spatial memory rather than verbal rehearsal, the purpose of this experiment was to determine what effect stimulus familiarity had on the spatial primacy performance of 20 retarded and 20 normal boys and girls. Linear presentation effects of familiar and nonfamiliar pictures upon serial position curve performance when overt verbalization was suppressed were investigated. Results indicated that an interaction of stimulus familiarity and spatial memory is responsible for the primacy effect found in serial position curves. No primacy effect for either the normal or retardate group was found in the nonfamiliar stimulus condition. No overall developmental effects were found between groups of children on serial position performance. Consistent with Craik and Lockhart's memory processing model, the present results indicated stimulus familiarity provided deeper levels of processing, thereby facilitating primacy effects.     

Predictive Validity of the MMPI–2 Restructured Clinical (RC) Scales in a Batterers' Intervention Program

Summary: The test-retest reliability of the Hutt Adaptation of the Bender-Gestalt Test was explored with a population of 40 process schizophrenics over a two-week interval. The total Psychopathology Scale Score was found to have high retest reliability for both male and female patients (rho = .87 for males and .83 for females). Moreover the three major components of the Scale were found to have high reliability, and fairly high reliabilities were obtained for patients scoring high as well as low on the Scale. Interjudge reliability was also found to be very high (rho = .895), confirming previous studies in this respect. On these grounds, the Scale offers promise both for clinical and research purposes.     

Development and Validation of a Child Version of the Obsessive Compulsive Inventory

Surprisingly, only 3 self-report measures that directly assess pediatric obsessive-compulsive disorder (OCD) have been developed. In addition, these scales have typically been developed in small samples and fail to provide a quick assessment of symptoms across multiple domains. Therefore, the current paper presents initial psychometric data for a quick assessment of pediatric OCD across multiple symptom domains, a child version of the Obsessive Compulsive Inventory (the OCI-CV). Data from a sample of over 100 youth ages 7 to 17 with a primary DSM-IV diagnosis of OCD support the use of the 21-item OCI-CV. Results support the use of the OCI-CV as a general index of OCD symptom severity and in 6 symptom domains parallel to those assessed by the revised adult version of the scale (OCI-R). The OCI-CV showed strong retest reliability after approximately 1.5 weeks in a subsample of 64 participants and was significantly correlated with clinician-rated OCD symptom severity and parent and child reports of dysfunction related to OCD. Significantly stronger correlations with self-reported anxiety than with depressive symptoms provide initial support for the divergent validity of the measure. Finally, preliminary data with 88 treatment completers suggest that the OCI-CV is sensitive to change.