The effects of outcome expectations and satisfaction on weight loss and maintenance: correlational and experimental analyses--a randomized trial.

This study examines the hypothesis that highly favorable outcome expectations promote weight loss and hinder weight maintenance. To investigate the effects of outcome expectations and satisfaction with treatment outcomes on weight loss, 349 adults were randomly assigned to 1 of 2 weight loss programs that emphasize either (a) an "optimistic" message, focusing exclusively on the positive aspects of weight loss, or (b) a "balanced" message, giving equal time to positive and negative aspects of weight loss. Participants changed their weight loss cognitions in response to the intervention, but there was no significant difference between the intervention treatment groups in short-term or long-term (18-month) weight loss. Independent of treatment message, positive outcome expectations and satisfaction were both associated with weight loss.     

An investigation of organic factors in the neuropsychological functioning of patients with borderline personality disorder

The hypothesis to be tested in this study was that the cognitive deficits that have been documented in patients with Borderline Personality Disorder (BPD) are largely the consequence of organic insult, either developmental or acquired. Using a cross-sectional design, 80 subjects (males and females) who met the criteria for BPD participated in the study. They completed a battery of neuropsychological tests and a comprehensive interview assessing organic status as well as measures of the potentially confounding factors of current levels of depression and anxiety. It was expected that BPD-patients with a probable history of organic insult would perform significantly worse than would BPD patients without such a history. Analyses of the results provided partial support for the hypothesis. Subjects with both BPD and a history of organic insult were significantly more impaired on several measures including measures of attention than were BPD only subjects. The results suggested that the impaired cognitive performance of persons diagnosed with BPD may, in part, be attributed to organic factors.     

Chronic Fatigue Syndrome: The Need for Subtypes

Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians, and researchers. This article provides information concerning the need for appropriate diagnosis of CFS subtypes. We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress. Next, research involving the case definitions of CFS is reviewed. Findings suggest that whether a broad or more conservative case definition is employed, and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected. Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic, and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS characteristically confusing heterogeneous symptom profiles. Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS. This review suggests that there is a need for greater diagnostic clarity, and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.     

Why is discrimination stressful? The mediating role of cognitive appraisal

This study attempts to shed light on past findings that experiences of racial and gender discrimination are associated with poor psychological and physical health outcomes by investigating the role of cognitive appraisal as a mediator of the relationship between experiences of discrimination and affective stress reactions. African American female college students (N = 115) imagined themselves in an audiotaped scenario in which they overheard 2 European American male classmates make negative evaluations of them. Participants then completed measures of causal attributions, cognitive appraisal, and affective stress reactions. Multiple regression analyses supported the hypotheses that attributions to racism and to discrimination that combines racism and sexism were associated with increased stress reactions. This relationship was mediated by cognitive appraisals of centrality.     

A prospective examination of body image and smoking cessation in women

This study prospectively examined body image in a community sample of women smokers (N = 141, 89% European–American, M age = 39.5, M BMI = 25.5) participating in a 12-week randomized smoking cessation trial. Participants completed measures assessing subjective and perceptual aspects of body image. Regression analyses showed that subjective body image was predictive of smoking rate at the end of treatment. A MANCOVA revealed that perceptual body image (body size estimation) significantly predicted smoking cessation. Quitting smoking actually worsened body image, although these results were no longer significant after controlling for weight gain. Results support the theory that a negative body image may hamper cessation attempts. In addition, weight gain during smoking cessation may adversely impact body image and lead to an increased risk for relapse.     

Impact of recent findings on study design of future autism clinical trials

There are specific challenges to studying the design of pharmacologic trials in child/adolescent and adult autism, such as subject stratification and parallel versus crossover designs. This article describes how optimal study design is influenced by subject selection and outcome measures chosen. Lessons learned in study design from the Research Units on Pediatric Psychopharmacology Autism Network trial with risperidone, Seaver Center trials with fluoxetine and valproate, Dartmouth trials with amantadine, and National Institutes of Health secretin trials are highlighted. The Internet System for Assessing Autistic Children system for managing multicenter clinical trials in autism and statistical issues in autism research are also described.     

Functional connectivity during working memory maintenance

Neurophysiological experiments with monkeys have demonstrated that working memory (WM) is associated with persistent neural activity in multiple brain regions, such as the prefrontal cortex (PFC), the parietal cortex, and posterior unimodal association areas. WM maintenance is believed to require the coordination of these brain regions, which do not function in isolation but, rather, interact to maintain visual percepts that are no longer present in the environment. However, single-unit physiology studies and traditional univariate analyses of functional brain imaging data cannot evaluate interactions between distant brain regions, and so evidence of regional integration during WM maintenance is largely indirect. In this study, we utilized a recently developed multivariate analysis method that allows us to explore functional connectivity between brain regions during the distinct stages of a delayed face recognition task. To characterize the neural network mediating the on-line maintenance of faces, the fusiform face area (FFA) was defined as a seed and was then used to generate whole-brain correlation maps. A random effects analysis of the correlation data revealed a network of brain regions exhibiting significant correlations with the FFA seed during the WM delay period. This maintenance network included the dorsolateral and ventrolateral PFC, the premotor cortex, the intraparietal sulcus, the caudate nucleus, the thalamus, the hippocampus, and occipitotemporal regions. These findings support the notion that the coordinated functional interaction between nodes of a widely distributed network underlies the active maintenance of a perceptual representation.     

The developing constraints on parsing decisions: the role of lexical-biases and referential scenes in child and adult sentence processing

Two striking contrasts currently exist in the sentence processing literature. First, whereas adult readers rely heavily on lexical information in the generation of syntactic alternatives, adult listeners in world-situated eye-gaze studies appear to allow referential evidence to override strong countervailing lexical biases (Tanenhaus, Spivey-Knowlton, Eberhard, and Sedivy, 1995). Second, in contrast to adults, children in similar listening studies fail to use this referential information and appear to rely exclusively on verb biases or perhaps syntactically based parsing principles (Trueswell, Sekerina, Hill, and Logrip, 1999). We explore these contrasts by fully crossing verb bias and referential manipulations in a study using the eye-gaze listening technique with adults (Experiment 1) and five-year-olds (Experiment 2). Results indicate that adults combine lexical and referential information to determine syntactic choice. Children rely exclusively on verb bias in their ultimate interpretation. However, their eye movements reveal an emerging sensitivity to referential constraints. The observed changes in information use over ontogenetic time best support a constraint-based lexicalist account of parsing development, which posits that highly reliable cues to structure, like lexical biases, will emerge earlier during development and more robustly than less reliable cues.     

Active-imaginal exposure: examination of a new behavioral treatment for cynophobia (dog phobia)

The aims of this study were to investigate exposure-based treatments for cynophobia (dog phobia) and to test a newly developed hybrid imaginal exposure treatment that we have named active imaginal exposure. The treatment introduces an in vivo coping component to imaginal exposure whereby the patient physically performs coping responses to an imagined feared stimulus. Eighty-two participants meeting DSM-IV criteria for specific phobia (animal subtype) were randomly assigned to one of three 30-min. treatments: (a) active-imaginal exposure (AI), (b) imaginal exposure alone (IE), or (c) graduated in vivo exposure (IV). Participants completed a behavioral approach test at pre, post, and four-week follow-up. Significant pre- to posttreatment improvement was observed in all three treatment conditions. Response rates at posttreatment were 51.9, 62.1, and 73.1% for the IE, AI, and IV groups respectively. Likewise, effect sizes at posttreatment were 0.76, 1.41, and 1.55 for the IE, AI, and IV groups respectively. Although in the predicted direction, the between group differences were not significant. A similar pattern of results was observed at follow-up. Further, safety behavior utilization during treatment was associated with less improvement--particularly in the two imaginal treatment conditions. Exposure treatments of dog phobia appear feasible and effective in reducing phobic fear and avoidance associated with dog phobia. Furthermore, preliminary evidence suggests that our active-imaginal exposure treatment may be a viable alternative to in vivo exposure.     

Flanker and negative flanker effects in letter identification

In a speeded choice reaction time task, responses to centrally presented letter targets can be altered by the identity of surrounding task-irrelevant letters (flankers). In the standard flanker effect, flankers associated with the same response as the target lead to faster and more accurate responses, whereas flankers associated with a different response lead to slower and more error-prone responses. B. A. Eriksen and C. W. Eriksen (1974, pp. 143-149) have argued that these flanker effects occur through response competition. We present data from a novel version of the Eriksen task, in which some targets and flankers consist of letter forms that are morphed versions of target letters. In this paradigm, flankers induce classic flanker effects on well-formed targets. But flankers induce an opposite effect, termed a negative flanker effect on morphed letter targets. For example, targets that are morphs between the letters "A" and "H" are more likely to be identified as an "A" when flanked by an "H." The interpretation advanced here is that there are two distinct kinds of flanker effects contrast enhancement in perceptual processes and response competition in response selection processes.