Selective impairment of phonation: A case study

A 47-year-old right-handed man underwent craniotomy for clipping of an aneurism at the trifurcation of the left middle cerebral artery. Subsequently, he suffered a left hemisphere CVA after which his speech and language resembled that of Broca's aphasia with accompanying apraxia of speech. Medical, behavioral, and acoustical data amassed over a period of several months indicated numerous contraindications to traditional diagnoses of Broca's aphasia, apraxia of speech, and dysarthria. Ultimately, it was determined that the patient had a selective impairement of phonation or laryngeal apraxia. This was illustrated dramatically when he was taught to use an electrolarynx which allowed him to bypass his disrupted phonatory system. Speaking with the electrolarynx, the patient communicated normally. Any semblance of Broca's aphasia disappeared. Supralaryngeal articulation was normal; apraxia of speech behaviors were absent. This case report indicates that dissociation of oral and laryngeal gestures due to brain injury is possible. Mechanisms underlying such a dissociation for this case are reviewed. The possibility of discrete center lesions in the frontal motor association area causing different types of apraxia of speech is discussed.     

Elaborative interrogation applied to small and large group contexts

The present study examined the application of elaborative interrogation (EI), a questioning strategy, to ecologically valid classroom contexts. Instruction was provided to individuals, small groups of five, and large groups of 20. Recall performance did not differ as a function of group size. For individuals, small and large groups, EI subjects outperformed repetition control subjects.     

Research-structured vs clinically flexible versions of social learning-based marital therapy

The purpose of this study was to compare our structured research-based version of marital therapy from a social learning perspective with a clinically flexible version of the same treatment where treatment plans were individually-based and there was no specific number of treatment sessions. Thirty distressed married couples were randomly assigned to one of these two treatments. Assessment of outcome was based on global marital satisfaction, spouse reports of functioning in specific areas, and direct observational measures of communication. At posttest there were no differences in efficacy between structured and flexible treatments, although both treatments led to significant improvements. At a 6-month follow-up couples treated with the structured format were more likely to have deteriorated and flexibly treated couples were more likely to have maintained their treatment gains.     

The "psychosomatic family" model: an empirical and theoretical analysis

Evolution of the Family Systems Paradigm has been constrained by the dichotomy between theory building and empirical research. This article integrates these two domains by presenting a theoretical analysis of the "psychosomatic family" model as it informs and is informed by an empirical research project. Forty families of children with Crohn's disease (CD), ulcerative colitis (UC), and functional recurrent abdominal pain syndrome (RAP) were rated during standard, videotaped family interaction tasks, lunch, and interview. Laboratory scores of disease activity were associated with triangulation, marital dysfunction, and total "psychosomatic family" scores. Disease activity was not significantly correlated with enmeshment, overprotection, rigidity, conflict avoidance, or poor conflict resolution. Thus, the marital/triangulation and enmeshment/overprotection/conflict clusters may be subcomplexes of the "psychosomatic family" complex. CD, UC, and RAP groups differed in the relations among particular family patterns and disease activity. A heuristic family-psycho-somatic model is presented to facilitate future research.     

The wilderness therapy program: An empirical study of its effects with adolescents in an outpatient setting

The results of a study of the Wilderness Therapy Program involving 23 adolescents in outpatient counseling are presented. Data were collected before and after four trips on measures of locus of control, behavioral symptoms, self-efficacy, self-esteem, and a number of measures designed specifically for this program. Following a one and one-half to two week backpacking trip that included daily therapy, significant change was found for locus of control, self-esteem and symptom reduction. Positive changes were noted on the other measures as well. Future directions and social work implications were discussed.     

Effects of test anxiety, tests, and sleep on children''s performance

This study examined the interrelationship between children's test anxiety, sleep, and performance. The subjects, 239 sixth and seventh graders, responded to questionnaires examining sleep behavior and test anxiety on a day when they had a major exam in school, and on a day when they did not. They also completed a vigilance task on both days. The results showed that partial sleep loss (i.e., under 3 hr) did not adversely influence subjects' performance on the vigilance task or on the actual class exam. However, the results did reveal that test anxiety was negatively related to performance on the class exam.     

The inequivalence of self-reports of Type A behavior: Differential relationships of the Jenkins Activity Survey and the Framingham cale with affect,stress, and control

The Jenkins Activity Survey (JAS) and the Framingham Type A Scale (FTAS) have been found to have different psychological correlates. The JAS is typically unrelated to anxiety, while the FTAS is consistently correlated with trait anxiety. The present study of 200 male and female college students clarifies further the psychological heterogeneity of these measures. Enhanced motivation to control the environment has been suggested as an underlying psychological component of Type A behavior (Glass, 1977). Dysphoric emotions and the perception of more environmental stresses, on the other hand, are typical of neuroticism or negative affectivity (Watson & Clark, 1984). Although the results indicate that the JAS and FTAS are highly correlated, the JAS is more closely related to control motivation than is the FTAS. Further, compared to the JAS, the FTAS is more closely correlated with dysphoric emotions and perceived daily stresses. Thus, the results indicate that the JAS is closely correlated with core psychological components of the Type A pattern, while the FTAS has a relatively unique association with general emotional distress. Such differences may account for the fact that these measures are related to different disease end points.     

Proximity and hierarchy: orthogonal dimensions of family interconnectedness

The purpose of this research was to develop logical and empirically valid conceptual tools for investigating relationships between family patterns of interconnectedness and psychosocial functioning of children in the family. The family systems concept of boundary was analyzed into two component concepts: Proximity (interpersonal boundaries) and generational Hierarchy (subsystem boundaries). These concepts were operationalized as dimensions, and eight families were assessed by means of interaction coding, interview, and Kinetic Family Drawing to yield empirical verification of these dimensions. Findings indicated that Proximity and Hierarchy are reliable, valid, and independent dimensions of family interconnectedness. Weak generational Hierarchy was associated with increased levels of psychological dysfunction for both identified patients and their siblings. High Proximity was similarly associated with psychological dysfunction, but only for identified patients. The hypothesis that enmeshment is a composite pattern of high Proximity and weak Hierarchy was disconfirmed. Suggestions for future research include systemic analysis of deviation-counteracting and -amplifying relationships between patterns of Proximity and Hierarchy, on the one hand, and psychosocial dysfunction, on the other.     

The Social Psychology of Caregiving: Physical and Psychological Costs of Providing Support to the Disabled1

The emphasis of much of the existing research on social support-health relationships has been on the availability and impact of support on the recipient, but social psychologists have paid little attention to the costs to the caregiver of providing that support. In an earlier study (Schulz & Decker, 1985), we found that the long-term coping of individuals experiencing chronic disability as a result of spinal-cord injury was facilitated by the availability of a primary support person, or caregiver. In this study we examined the determinants of well-being of the primary caregiver of the middle-aged and elderly spinal-cord-injured persons. Psychological well-being, life satisfaction, and depression were the dependent measures. The availability of social support, social contact, and feelings of control over one's life were important determinants of caregiver well-being, even after controlling for health and income. In addition, the amount of time spent each day assisting the disabled person was a strong independent correlate of depression, and the extent to which the caregiver felt burdened by the victim was significantly and negatively related to life satisfaction. These results are discussed in the context of a comprehensive stress-coping model. Since data were available from both disabled individuals and their primary support persons, we had the unique opportunity to compare the perspectives of both those giving and receiving daily care. We found no relationship in levels of psychological well-being and depression reported by the disabled person and caregiver; however, caregivers attributed to the victims affective levels similar to their own.     

Separate verbal memory and naming deficits in attention deficit disorder and reading disability

In this study, verbal memory and naming abilities were investigated in reading disabled (RD) and control children who were characterized according to the presence or absence of attention deficit disorder (ADD). Results indicate that deficits in learning and memory for recently acquired information occur as a function of ADD rather than RD while deficits in naming are specific to RD rather than ADD. We conclude that ADD is a major source of additional and separate cognitive morbidity in RD children.