Addressing Shared Vulnerability for Comorbid PTSD and Chronic Pain: A Cognitive-Behavioral Perspective

Posttraumatic stress disorder (PTSD) frequently co-occurs with other conditions and symptoms that can complicate assessment and treatment. Of these, chronic musculoskeletal pain and related avoidance behaviors are amongst the most common and, unfortunately, the most often overlooked. In this paper we discuss issues that warrant consideration in developing and implementing a treatment plan that may maximize chances of successful outcome for GH, a patient with PTSD and chronic pain. Assessment strategies used in arriving at a case formulation are presented and, based on the emerging state-of-the-art, a tentative cognitive-behavioral treatment program targeting shared vulnerability for PTSD and chronic musculoskeletal pain is presented. Issues pertinent to anticipated treatment outcome are also discussed.     

Treatment of co-occurring child maltreatment and substance abuse

Despite high prevalence and severe negative consequences of child maltreatment (e.g., Brown, G. R., & Anderson, B., (1991). Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. American Journal of Psychiatry, 148, 55–61; Jaudes, P. K., Ekwo, E., & Van Voorhis, J.V., (1995). Association of drug abuse and child abuse. Child Abuse and Neglect, 19, 1065–1075; Murphy, J. M., Jellinek, M., Quinn, D., Smith, G., & Goshkom, M., (1991). Substance abuse and serious child mistreatment: Prevalence, risk, and outcome in a court sample. Child Abuse and Neglect, 15, 197—211), the treatment of perpetrators and victims of child abuse and neglect remains grossly understudied (Behl, L. E., Conyngham, H. A., & May, P. F., (2003). Trends in child maltreatment literature. Child Abuse and Neglect, 27, 215–229). More than half of parentes founded for the abuse and neglect of their children have evidenced drug abuse, yet no treatments have been validated that concurrently address these problems. The reciprocal interaction between substance abuse and child maltreatment supports the need to concurrently treat these problems. This article illustrates the relationship between child maltreatment and parental substance abuse and proposes a behavioral model to explain the reciprocal influence of drug abuse and child maltreatment. A behavioral treatment plan that is designed to concurrently address drug abuse and child abuse is proposed and suggestions are made for future directions in this area.     

Do boys prefer daddy or his physical style of play?

Fathers typically adopt a more physically active style of play with their young sons than mothers, and boys often react more positively to play with fathers than with mothers. The current study examined whether differences in children's reactions were related to differences in parental play style or to parent per se. Eighteen 3-year-old boys were observed as they played with each parent in each of two playrooms — one conducive to the maternal style of play and one to the paternal play style. Both parents were highly flexible in adopting the play style typical of the other parent in the appropriate playroom. The boys reacted more positively to both parents when their play style was more physical and active, resembling the typical paternal style. Differences between parents were smaller than differences related to play environment, but were consistent with existing literature: fathers were more actively involved, took more initiative, and played more physically with their sons than did mothers.This research was supported by a research grant and leave fellowship from the Social Sciences and Humanities Research Council of Canada. We thank Kathleen Bloom, Anat Ninio and Michael Ross for their comments on earlier drafts of this paper.     

Use of pocket computers for self-administration of cognitive tests in the field

A pocket computer is described that can be used by subjects to self-administer cognitive tests in field situations. Two cognitive tests, a vigilance and an encoding task, were developed for this computer and used to test cognitive performance during a 30-day military field exercise.     

Compliance without pressure: Some further data on the foot-in-the-door technique

A replication of the Freedman and Fraser (1966) “foot-in-the-door” technique was attempted in which subjects were exposed to one of two prior requests and were then asked to comply with a larger request. The results showed that subjects receiving prior requests complied with the larger request significantly more often than did control subjects. The mechanism by which the technique operates was discussed.     

Pattern alternation: Effects of spatial frequency and orientation

Campbell and Howell (1972) reported an effect called “monocular pattern alternation.” They found that a pattern composed of two orthogonal sinusoidal gratings, one horizontal and the other vertical, underwent rivalry when viewed monocularly for a period of time. In the present study, it has been shown that monocular pattern alternation depends upon the orientation of the pattern and the spatial frequency of its components. Fewer reversals were found for an obliquely oriented pattern than for a pattern with components in the horizontal and vertical meridians. Alternation rate was higher when the gratings were similar in frequency but differed in orientation than when the components of the pattern differed in both dimensions. It was concluded that pattern alternation reflects an antagonistic interaction between interdependent channels in the human visual system that respond to orientation and spatial frequency.     

SUPERORDINATE IDENTIFICATION, SUBGROUP IDENTIFICATION, AND JUSTICE CONCERNS:

Abstract— The diversity of American society raises concerns about whether authorities can maintain social cohesion amid competing interests and values The group-value model of justice suggests that authorities function more effectively when they are perceived as fair (e g, benevolent, neutral, and respectful) However, such relational evaluations may be effective only if authorities represent a group with which people identify In a diverse society, subgroup memberships may assume special importance People who identify predominantly with a subgroup may focus on instrumental issues when evaluating a superordinate-group authority, and conflicts with that authority may escalate if those people do not receive favorable outcomes Results indicate that subgroup identification creates problems for authorities only when people have strong subgroup subgroup identification and weak superordinate-group identification As long as people identify strongly with the superordinate group, even if they also identify strongly with their subgroup, relational issues will dominate reactions to authorities     

Ethnocentrism in dating preferences for an American sample: The ingroup bias in social context

Heterosexual dating partner preferences were examined in a multi-ethnic context. Four groups at UCLA were studied: Asian Americans, African Americans, Latino Americans, and Euro Americans. Participants completed surveys asking them to rate a ‘typical/hypothetical’ opposite-sex member for each of the four ethnic groups on physical attractiveness, similarity, social network approval, status, and desirability as a dating/marriage partner; social identification with the ethnic ingroup was also assessed. Members of all four ethnic groups demonstrated some degree of ethnocentrism on most measures (especially partner preferences) by rating opposite-sex members of their own group higher than outgroup members rated them; however, Asians and Latinos rated opposite-sex Whites as more physically attractive than typical members of their own group, and Latinos and Blacks rated Whites and Asians as higher status. Overall, Whites received more favourable ratings than any of the three minority groups. Regression analyses indicated that social network approval (by far), similarity, and physical attractiveness were (in that order) the most powerful predictors of ethnocentrism in partner preferences. Avenues of integration and interpretation between theories of inter-personal attraction and intergroup relations were considered, including the dimensionality of ingroup favouritism, and the need for stronger consideration of social influence in theories of intergroup relations.     

A comparison of the classification capabilities of the 1-dimensional kohonen neural network with two pratitioning and three hierarchical cluster analysis algorithms

Neural Network models are commonly used for cluster analysis in engineering, computational neuroscience, and the biological sciences, although they are rarely used in the social sciences. In this study we compare the classification capabilities of the 1-dimensional Kohonen neural network with two partitioning (Hartigan and Späthk-means) and three hierarchical (Ward's, complete linkage, and average linkage) cluster methods in 2,580 data sets with known cluster structure. Overall, the performance of the Kohonen networks was similar to, or better than, the performance of the other methods.