An investigation of the effects of comorbid Axis II pathology on outcome of inpatient treatment for unipolar depression

DSM-based research on comorbidity has suggested thatdepression andpersonality disorder frequently occur together and that the combination of syndromes is associated with a poor response to treatment for depression. The present study was designed to explore the effect of comorbid Axis II pathology for a sample of 45 inpatients who received treatment for major depression. Both categorical and dimensional ratings of personality disorder were used in the statistical analysis. Positive categorical diagnosis of Cluster C (anxious-avoidant) disorder, as well as higher dimensional rating of Cluster A (odd-eccentric) pathology, was predictive of a poor response to treatment (p<.05), as measured by change in pre-post clinical ratings on the Montgomery-Asberg Depression Rating Scale. These results were construed as indicative of a significant Axis II comorbidity effect in the context of an inpatient, multimodal treatment setting for depression. The results also spotlight the influence of techniques of measurement in determining the outcome of statistical analysis.     

The time course of recognition of novel melodies

Seven experiments explored the time course of recognition of brief novel melodies. In a continuous-running-memory task, subjects recognized melodic transpositions following delays up to 2.0 min. The delays were either empty or filled with other melodies. Test items included exact transpositions (T), same-contour lures (SC) with altered pitch intervals, and different-contour lures (DC). DCs differed from Ts in the pattern of ups and downs of pitch. With this design, we assessed subjects’ discrimination of detailed changes in pitch intervals (T/SC discrimination) as well as their discrimination of contour changes (T/DC). We used both artificial and “real” melodies. Artificial melodies differed in conformity to a musical key, being tonal or atonal. After empty delays, T/DC discrimination was superior to T/SC discrimination. Surprisingly, after filled delays, T/SC discrimination was superior to T/DC. When only filled delays were tested, T/SC discrimination did not decline over the longest delays. T/DC performance declined more than did T/SC performance across both empty and filled delays. Tonality was an important factor only for T/SC discrimination after filled delays. T/DC performance was better with rhythmically intact folk melodies than with artificial isochronous melodies. Although T/SC performance improved over filled delays, it did not overtake T/DC performance. These results suggest that (1) contour and pitch-interval information make different contributions to recognition, with contour dominating performance after brief empty delays and pitch intervals dominating after longer filled delays; (2) a coherent tonality facilitates the encoding of pitch-interval patterns of melodies; and (3) the rich melodic—rhythmic contours of real melodies facilitate T/DC discrimination. These results are discussed in terms of automatic and controlled processing of melodic information.     

Color-based inhibition of return

The inhibition of return of visual attention based on stimulus color was examined in three experiments. In the first experiment, a discrete trial paradigm showed that subjects were slower to detect a color patch if the color matched that of a patch presented earlier in the same location. Experiment 2 showed that the inhibition only occurs if a neutral, nontarget distractor color is presented between presentation of the initial color cue and the subsequent target patch—explaining the previous failures to detect the phenomenon. Experiment 3 extended the results to a different combination of colors. Taken together, the results have important implications for the processing of stimulus attributes such as spatial location and color, and for the conditions necessary for producing inhibition of return.     

African American men's Gender Role Conflict: The significance of racial identity

This study examined the relationships between racial identity attitudes and gender role conflict in a sample of 95 African American men ages 23–80 years old. Participants completed the 1981 Black Racial Identity Attitude Scale by Parham and Helms and the 1986 Gender Role Conflict Scale by O'Neil, Helms, Gable, David, and Wrightsman. Results indicated that racial identity attitudes were differentially related to patterns of gender role conflict when racial identity is externally defined. However, an internally defined racial identity had no relationship to gender role conflict. Results are discussed in terms of the significance of racial identity for understanding African American men's conflict associated with traditional male gender role standards and expectations.     

Tokens for stuttering

Four young stutterers were observed during 10 weekly sessions. Each session was divided into pretreatment, treatment, and posttreatment segments. Redeemable tokens were administered contingent upon stuttering behaviors in the treatment segment of the Experimental condition. In a Parallel Control condition, no tokens were administered during the entire session. The differences between the pretreatment and treatment segments were compared for the two conditions. Three subjects had dramatically fewer stuttering behaviors when tokens were being administered, while the fourth had more stuttering under the same condition. The subject whose stuttering increased had a history of therapy in which voluntary, “faked” stuttering had been called for, and the behaviors that increased were judged to be of this type. The decreases were interpreted as suggesting that the contingent tokens acted to countercondition the aversiveness of the stuttering experience, which reduced the anticipation of stuttering and hence the stuttering itself. The increase was felt to be simple reinforcement. The counterconditioning interpretation was borne out in two clinical applications in which money was presented contingent on stuttering behaviors judged to be aversive to the stutterer, and in which dramatically sudden, but long-lasting, improvement was seen.     

Development of clinical tests of vision: Initial data on two hyperacuity paradigms

Many basic psychophysical functions offer promise as clinical tests of vision. Here, we discuss problems that one encounters in the clinical setting, how one identifies a psychophysical test for potential clinical development, and an orderly approach to development of suitable test paradigms. Parameters are selected which are relatively insensitive to variables encountered in the field (clinic) in a normal population, but which are sensitive to changes in the response system being studied. Initial data on two hyperacuity tests are presented. These tests are adaptations of hyperacuity paradigms (Westheimer, 1979) to a clinical environment. This particular test set offers promise because it exhibits a unique threshold which is dependent upon neural data processing and is relatively independent of retinal image degradation.     

The self-serving attributional bias: Beyond self-presentation

An experiment was conducted to provide empirical support for the notion that asymmetrical causal attributions for favorable and unfavorable outcomes result from a self-serving attributional bias that occurs independently of self-presentational concerns. Subjects did either well or poorly on an ego-involving test for which their performance, attributions, and evaluations of the test were either public or private. A pattern of self-serving responses for subjects' attributions and evaluations of the test was found in the private conditions, thus providing evidence of the influence of outcome favorability on individuals' perceptions of causality. Theoretical and practical implications of these finding are discussed and suggestions for future research are offered.     

A simple technique for lateralizing visual input that allows prolonged viewing

A simplified technique is described for obtaining lateralization of visual input with prolonged viewing. This technique is based on the presence of constant normal lateral limits for horizontal rotation of the eyes with reference to the head. With head movement prevented by use of a standard bite bar, and the eyes rotated to the left and held at their lateral limit, the temporal half of the visual field of the left eye may be used for lateralized input to the right hemisphere or vice versa for input to the left hemisphere. Any form of visual stimuli or visually monitored task can be used if confined within one of the extreme temporal hemifields. In comparison to previous methods, this technique is technically simple, inexpensive, without significant risk or discomfort to the subject, readily applicable to normal and various brain-lesioned subjects, and permits prolonged in-depth viewing. An alternative version of this technique uses a stabilized spectacle frame fitted with adjustable central occluders set to allow vision through only one or both of the extreme temporal hemifields.