Efficient pain assessment in clinical settings.

The need for efficient and practical assessment techniques of the multidimensional nature of chronic pain remains paramount in clinical settings. Visual analogue scales (VASs) and simple behavioral observation methods have been proposed as efficient, reliable, and valid measures of the subjective (sensory and affective) and overt behavioral aspects of the pain experience. The relationships among VASs and the UAB Pain Behavior Scale were examined among 48 chronic pain patients. Ratings of overt behavior were significantly related to both the VAS sensory and VAS affective ratings. Regression analysis indicated that the VAS scores accounted for significant amount of the variance (27.7%) in UAB scores. Moreover, the affective dimension of self-reported pain tended to be more strongly related to the visible manifestations of pain than were ratings of pain intensity.     

An introduction to organic brain syndromes

Organic brain syndromes are of forensic interest for several reasons. First, patients with organic brain syndromes may require judicial determination of competence in any of a number of areas, e.g., testamentary capacity, need for financial guardianship, or competence to make medical decisions. Second, any patient whose mental state is of legal interest will need evaluation for contributing organic factors; uncovering these factors may have considerable medical and legal consequence. Third, the discovery of organic factors may be decisive in the outcome of a judicial proceeding, where “hard” biological data are often accorded more weight, and are thus more persuasive, than “soft” psychological data. This article provides an introductory overview of the organic brain syndromes. For each syndrome, the clinical features are described and are illustrated with a case vignette, the more common etiologies are presented, and selected aspects to the evaluation are highlighted. In addition, since the detectian of malingered mental illness is a key component in many forensic contexts, characteristics are described which help to distinguish actual from malingered mental illness.     

Common response processing and psychological refractoriness

This experiment examined whether structural considerations, that is the functional closeness of limb control centres (Kinsbourne and Hicks 1978), have a role to play in common processing models of psychological refractoriness. A typical double stimulation paradigm was used (Kantowitz 1974). On experimental trials, subjects responded with the right hand (RT1) to an auditory signal (0.80 probability). After a varied interstimulus interval (ISI) of 100, 200, 300 or 700 msec, one of three lights corresponding to one of the other limbs provided the signal for the second response (RT2). Control trials for RT1 and RT2 involved both stimuli, but subjects were required to make only one response. Results indicated that experimental RT1 was lengthened considerably over control values. While typical double stimulation effects were found at short ISIs, that is RT2 was lengthened, RT2 at long ISIs was actually faster than double stimulation control values. Although the RT results were not in a pattern that would be predicted by functional distance (Kinsbourne and Hicks 1978), within subject correlations of RT1 and RT2 by limb condition suggest that structural considerations may have a role to play. While within subject correlations were positive at all levels of ISI, they decreased as the interval between the two signals increased. The implications of these results for common processing models are discussed.     

The influence of information redundancy upon the use of traits and persons as organizing categories

The following question is addressed: How do multiple, simultaneously present cognitive structures influence the representation and recall of social information? In an empirical study examining both free and cued recall, we found the variable information redundancy to influence both the organization and accuracy of subjects' recollections of trait-related behaviors. Redundancy was defined in terms of the degree of person/trait overlap in a social information ensemble. Some evidence indicated that this effect is attributable to an increase in the discriminability of the organizational structures during encoding. The implications of these findings for understanding the formation of integrated cognitive representations of individuals and the spontaneous use of traits in social information processing are discussed.     

Effects of decision strategy and number of openings on employment selection decisions

The purpose of this study was to explore the impact of two factors—decision strategy and the number of openings—on selection decisions. Two hundred graduate and undergraduate students participated in a human resource employment screening simulation. Decision strategy was varied by having candidates evaluate resumes and letters of application for 20 candidates one-at-a-time (sequentially) or all at once (simultaneously). The number of position openings was either one or three. Decision strategy affected the number of candidates accepted, acceptance threshold, and decision time. The number of openings affected selection decisions in the simultaneous but not the sequential context. Implications of these results for selection processes are discussed.     

Humility as a psychotherapeutic formulation

Humility training is conceptualized as an appropriate treatment for persons who occasionally describe themselves, but are most frequently described by others as overbearing, insensitive and deceitful. Procedures are outlined to identify unrecognized fears and improve interpersonal skills. Humility is presented as a counterpoint to assertiveness and aggression/anger control interventions.     

Counseling psychology and employee assistance programs: Previous obstacles and potential contributions

In the last two decades, an important new therapeutic delivery system has been emerging to serve the needs of the American workforce. Known as Employee Assistance Programs (EAPs), these company and community based programs were created to provide mental health services to workers whose job performance is impaired due to substance abuse or other difficulties. Although there are obvious similarities between the mission espoused by EAPs and traditions of the counseling psychology profession, many members of our discipline have only recently become involved in these programs. This paper discusses various reasons why counseling psychologists have not become involved with EAPs. It also presents some ways that counseling psychologists may contribute to these programs and it highlights the similarities in the philosophies and the activities of EAP and counseling psychology practitioners and scientists. Additionally, some suggestions for how to prepare counseling psychologists for entrance into the EAP profession are offered. Finally, a brief research agenda designed to guide counseling psychologists who are interested in the study of EAP related variables is presented.We are appreciative of Karen Novak's and Marilyn Bayer's editorial assistance on this paper.