Cognitive Factors in Fibromyalgia: The Role of Self-Concept and Identity Related Conflicts

Fibromyalgia is a syndrome characterized by the presence of diffuse and chronic musculoskeletal pain of unknown etiology. Clinical diagnosis and the merely palliative treatments considerably affect the patient's experience and the chronic course of the disease. Therefore, several authors have emphasized the need to explore issues related to self in these patients. The repertory grid technique (RGT), derived from personal construct theory, is a method designed to assess the patient's construction of self and others. A group of women with fibromyalgia (n = 30) and a control group (n = 30) were assessed using RGT. Women with fibromyalgia also completed the Fibromyalgia Impact Questionnaire and a visual-analogue scale for pain, and painful tender points were explored. Results suggest that these women had a higher present self–ideal self discrepancy and a lower perceived adequacy of others, and it was more likely to find implicative dilemmas among them compared to controls. These dilemmas are a type of cognitive conflict in which the symptom is construed as “enmeshed” with positive characteristics of the self. Finally, implications of these results for the psychological treatment of fibromyalgia are suggested to give a more central role to self-identity issues and to the related cognitive conflicts.     

The pseudodiagnosticity trap: Should participants consider alternative hypotheses?

The pseudodiagnosticity task has been used as an example of the tendency on the part of participants to incorrectly assess Bayesian constraints in assessing data, and as a failure to consider alternative hypotheses in a probabilistic inference task. In the task, participants are given one value, the anchor value, corresponding to P(D1|H) and may choose one other value, either P(D1|¬!H), P(D2|H), or P(D2|not;!H). Most participants select P(D2|H), or P(D2|¬!H) which have been considered inappropriate (and called pseudodiagnostic) because only P(D1|¬!H) allows use of Bayes' theorem. We present a new analysis based on probability intervals and show that selection of either P(D2|H), or P(D2|¬!H) is in fact pseudodiagnostic, whereas choice of P(D1|¬!H) is diagnostic. Our analysis shows that choice of the pseudodiagnostic values actually increases uncertainty regarding the posterior probability of H, supporting the original interpretation of the experimental findings on the pseudodiagnosticity task. The argument illuminates the general proposition that evolutionarily adaptive heuristics for Bayesian inference can be misled in some task situations.     

The black community's reactions to the 1992 los angeles riot

This article is based on field (street) interviews with a sample of 227 black community members living and/or working in South Central Los Angeles at the time of the 1992 riot. The interview instrument comprises 20 questions designed to (1) ascertain the reactions and feelings of black community members to the riot; and (2) compare a sample of black participants in the riot with nonparticipants. The participant group was found to be more frequently younger males with less education and lower income, and they were more likely to have arrest records prior to the riot than nonparticipants. Though reactions and feelings were mixed and contradictory, both groups reported an overall acceptance of the disorders. Differentials in reactions were in degree rather than in kind. Most objected to the riot in principle but concluded that collective violence “pays off.” The preriot structural facilitators (poverty, relative deprivation, unemployment, police brutality, racial discrimination, and negative police‐community relations) were similar to those found in the riot literature. Whatever the participants’ reasons and justifications for rioting might be, they present themselves as worthy protesters and freedom fighters. Unless their message is heeded and acted upon by ameliorating their adverse social, economic, and political conditions, similar riots are likely to occur.     

RACISM AND SEXISM IN INTERRACIAL PORNOGRAPHY A Content Analysis

Racism and sexism were examined in interracial (Black/White) X-rated pornography videocassettes. Five female coders coded 476 characters in the sexually explicit scenes in 54 videos. Characters were coded on aggregate measures of physical and verbal aggression, inequality cues, racial cues, and intimacy cues, as well as other specific indices. Sexism was demonstrated in the unidirectional aggression by men toward women. Racism was demonstrated in the lower status of Black actors and the presence of racial stereotypes. Racism appeared to be expressed somewhat differently by sex, and sexism somewhat differently by race. For example, Black women were the targets of more acts of aggression than were White women, and Black men showed fewer intimate behaviors than did White men. More aggression was found in cross-race sexual interactions than in same-race sexual interactions. These findings suggest that pornography is racist as well as sexist.     

Motivational Interviewing Promotes Adherence and Improves Wellbeing in Pre-Dialysis Patients with Advanced Chronic Kidney Disease

Low rates of adherence to medical treatments and adverse emotional states are a widespread problem in advanced chronic kidney disease (ACKD). Motivational interviewing using the stages of change model is an effective combination in promoting behavior modifications. The objective of the present study was to determine the effectiveness of an individual, pre-dialysis intervention program (monthly sessions of 90 min over a 6-month period) in terms of adherence, emotional state and health-related quality of life (HRQL). Forty-two patients were evaluated for adherence, depression, anxiety and HRQL with standardized self-report questionnaires. Biochemical markers were also registered. The results show that after the intervention, patients reported significantly higher levels of adherence, lower depression and anxiety levels, and better HRQL (i.e., general health and emotional role domains). Biochemical parameters were controlled significantly better after the intervention, except for iPTH. These findings highlight the potential benefit of applying individual psycho-educational intervention programs based on motivational interviewing and using the stages of change model to promote adherence and wellbeing in ACKD patients.     

A Cross-Sectional and Longitudinal Investigation of the External Correlates of Sluggish Cognitive Tempo and ADHD-Inattention Symptoms Dimensions

The objective was to determine if the external correlates of sluggish cognitive tempo (SCT) and ADHD-inattention (IN) dimensions were the same in cross-sectional and longitudinal analyses. Teachers and aides rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), and depression along with academic impairment in 758 Spanish children (55 % boys) on three occasions (twice at the end of the first grade year [6-week separation] and then again 12-months later at the end of the second grade year). Three of eight SCT symptoms showed substantial loadings on the SCT factor and substantially higher loadings on the SCT factor than the ADHD-IN factor for teachers and aides at each assessment (seems drowsy, thinking is slow, and slow moving). Cross-sectional and longitudinal analyses yielded similar results with SCT and ADHD-IN factors having different and unique external correlates (higher scores on SCT predicted lower scores on ADHD-HI and ODD while higher scores on ADHD-IN predicted higher scores on ADHD-HI and ODD with SCT and ADHD-IN both uniquely predicting academic impairment and depression). Developmental and methodological reasons are discussed for the failure to find an inconsistent alertness SCT factor (daydreams, alertness fluctuates, absent-minded, loses train of though, and confused).