Randomized Controlled Trial of Cognitive–Behavioral Group Therapy for Irritable Bowel Syndrome in a Medical Setting

Standard medical treatments have not been effective for irritable bowel syndrome (IBS) patients. Though individualized cognitive–behavior therapy is an empirically supported treatment option, cognitive–behavioral group therapy (CBGT) has yet to be established as an effective alternative in a randomized controlled trial. This study compared the efficacy of a 10-session CBGT with a home-based symptom monitoring with weekly telephone contact (SMTC) treatment for IBS, extending previous quasi-experimental research in this area. Twenty-eight refractory IBS patients, evaluated and referred by gastroenterologists using the Rome criteria, participated in the study. IBS symptoms, psychological functioning, and health-related quality of life were assessed pre- and posttreatment, and at 3-month follow-up. CBGT patients reported significantly more gastrointestinal (GI) symptom improvement than SMTC patients on posttreatment global measures and had significantly reduced daily diary pain scores at 3-month follow-up. Based on MANOVA, there was significant improvement in psychological distress and health-related quality of life for the CBGT patients in comparison to the SMTC patients. These improvements were also maintained at the 3-month follow-up. Reductions in GI symptoms, psychological distress, and improved health related quality of life may contribute to less behavioral avoidance, disability, and health care utilization in refractory IBS patients.     

The network perspective: an integration of attachment and family systems theories

In this article we discuss the network paradigm as a useful base from which to integrate attachment and family systems theories. The network perspective refers to the application of general systems theory to living systems, and provides a framework that conceptualizes the dyadic and family systems as simultaneously distinct and interconnected. Network thinking requires that the clinician holds multiple perspectives in mind, considers each system level as both a part and a whole, and shifts the focus of attention between levels as required. Key epistemological issues that have hindered the integration of the theories are discussed. These include inconsistencies within attachment theory itself and confusion surrounding the theoretical conceptualizations of the relationship between attachment and family systems theories. Detailed information about attachment categories is provided using the Dynamic Maturational model. Case vignettes illustrating work with young children and their families explore the clinical implications of integrating attachment data into family therapy practice.     

Childhood amnesia in children and adolescents: their earliest memories

Investigations of childhood amnesia have almost exclusively focused on the earliest memories of adults. Here we investigate the earliest memories of children of 6--19 years old. Parents confirmed the memory events and dated the memories. There were surprisingly few developmental differences between the earliest memories of children. Although 6--9-year-olds recalled earlier events than did older children, there were no differences between older age groups. Memories from all age groups were similar in structure, social orientation, and the nature of the recalled event. However, memories of older children were more likely to involve negative affect. There were also few gender differences, although girls were more likely to recall traumatic or transitional events while boys were more likely to recall play events. Overall, results deepen the paradox of early memory: 6--9-year-olds have verbally accessible memories from very early childhood that then seem to disappear as they get older.     

Schizophrenia and deliberate self-harm: a systematic review of risk factors

Deliberate self-harm (DSH) is a strong predictor of suicide in schizophrenia. The aim of this review was to identify risk factors for DSH in schizophrenia. This systematic review of the international literature examined cohort and case-control studies of patients with schizophrenia or related diagnoses that reported DSH as an outcome. Studies were identified by searching electronic databases and reference lists, and by consulting international experts. Fourteen studies met the eligibility criteria. Of the 29 variables examined by two or more studies, five (past or recent suicidal ideation, previous DSH, past depressive episode, drug abuse or dependence, and higher mean number of psychiatric admissions) were associated with an increased risk of DSH, and one (unemployment) was associated with a reduced risk. Schizophrenic patients with these risk factors need careful follow-up and monitoring, with treatment of any associated comorbid depression or drug abuse. Large, prospective studies of DSH in schizophrenia are needed to further define risk factors and to build on the findings of this review.     

Familiarity influences judgments of sex: the case of voice recognition

Two experiments are reported in which subjects made judgments about the sex or the familiarity of a voice. In experiment 1, subjects were fans of the BBC-radio soap opera, The Archers, and familiar voice clips were taken from this programme. Subjects showed a large reduction in response times when making sex judgments to familiar voices, despite the fact that sex judgments are generally much faster than familiarity judgments. In experiment 2, the same familiar clips were played to subjects unfamiliar with the soap opera, and no difference was observed in times to make sex judgments to Archers or non-Archers voices. We conclude that, unlike the case of face recognition, sex and identity processing of voices are not independent. The findings constrain models of person recognition across multiple modalities.     

ERP evidence for the time course of graphic, phonological, and semantic information in Chinese meaning and pronunciation decisions

Two words that varied in their relationship were presented sequentially to Chinese readers who made meaning and pronunciation decisions. In the meaning task, they decided whether the words had the same meaning. In the pronunciation task, they decided whether the words had the same pronunciation. In both tasks, the word pairs represented 1 of 4 relationships: graphically similar, homophonic, semantically related, or unrelated. Event related potentials (ERP) recordings made from the onset of the 2nd word suggested a temporal unfolding of graphic, phonological, and semantic effects. Specifically, graphically-related pairs produced a smaller P200 in the pronunciation task and a smaller N400 in the meaning task. Homophones produced reduced N400 component with bilateral sources in the meaning task.     

Time Course of Treatment Effect of OROS(R) Methylphenidate in Children With ADHD

Objective: The authors evaluated the time course of the treatment effect of Osmotic-Release Oral System methylphenidate (OROS(?) MPH) HCl (Concerta(?), Raritan, NJ) CII in children with ADHD. Method: Data were combined from two double-blind, randomized, placebo-controlled, cross-over, analog classroom studies in children (9-12 years) with ADHD. Participants received an individualized dose of placebo or OROS(?) MPH on two laboratory school days. Permanent Product Math Test and Swanson, Kotkin, Agler, M-Flynn, and Pelham scores were evaluated 0.5 hr before dosing and 1, 2, 4, 10, 11, and 12.5 hr post dose. Analysis used a repeated-measures mixed model. Results: Treatment effects were present at all postdose assessment points (p < .0001 for all comparisons, n = 139). Adverse events were similar to previous reports for OROS(?) MPH. Conclusion: A robust treatment effect occurred with OROS(?) MPH; onset was at 1 hr and persisted for at least 12.5 hr after dosing.     

Book reviews

Campbell, B. A., Hayne, H., & Richardson, R. (Eds.) (1992). Attention and information processing in infants and adults. Perspectives from human and animal research. Hove: Lawrence Erlbaum Associates. Pp. viii + 360. ISBN 0-8058-0782-9. £54.95 (Hbk).

McFarland, D. (1993). Animal behaviour: Psychobiology, ethology and evolution (2nd ed.). Harlow: Longrnan Scientific and Technical. Pp. xiv + 585. ISBN 0-582-06721-9. £23.99 (Pbk).

Ward, J. P., & Hopkins, W.D. (Eds.) (1993). Primate laterality: Current behavioral evidence of primate asymmetries. New York/Berlin: Springer-Verlag. Pp. xii + 356. ISBN 0-387-97961-1 13-540-97961-1. £34.50 (Pbk).

Zentall, T. R. (Ed.). (1993). Animal cognition. A tribute to Donafd A. Riley. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc. Pp. xiv + 369. ISBN 0-8058-1 184-2. £22.95 (Pbk); ISBN 0-8058-1 183-4. £53.50 (Hbk).

Roitblatt, H. L., Herman, L. M., & Nachtigall, P.E. (Eds.) (1993). Language and communication. Comparative perspectives. Hillsdale, NJ : Lawrence Erlbaum Associates, Inc. Pp. xvi + 502. ISBN 0-8058-0947-3. £26.95 (Pbk); ISBN 0-8058-0946-5. £59.95 (Hbk).

Bradshaw, J. L, & Rogers, L.J. (1993). The evolution of lateral asymmetries, language, roo1 use, and intellect. San Diego, CA: Academic Press. Pp. xiii + 463. ISBN 0-12-124560-8. £58.00 (Hbk).

Ten Cate, C., Slater, P. J. B., & Kruijt, J. P. (Eds.) (1993). Song learning and imprinting. An inquiry into mechanisms of behavioural development. Amsterdam: Netherlands Zoology Society. Pp. 234. £13.00 (Pbk).     

Stance Width Influences Postural Stability and Motion Sickness

We examined the influence of stance width (the distance between the feet) on postural sway and visually induced motion sickness. Stance width influences the magnitude of body sway, and changes in sway precede the subjective symptoms of motion sickness. Thus, manipulation of stance width may influence motion sickness incidence. Participants (healthy young adults) were exposed to complex, low-frequency oscillation of a moving room. Participants stood with their feet 5 cm, 17 cm, or 30 cm apart. During exposure to visual motion, the widest stance (30 cm) was associated with reduced incidence of motion sickness. For all stance widths, motion sickness was preceded by significant changes in motion of the head and torso. The results support the postural instability theory of motion sickness and suggest practical implications for the prevention of motion sickness. Adoption of wider stance may decrease the risk of motion sickness in operational situations.