Psychophysiological outcome of cognitive, behavioral and psychophysiologically-based treatments of agoraphobia

Psychophysiological process and outcome phenomena were analyzed to examine differential temporal patterns within and across cognitive, behavioral and physiologically-based treatments of agoraphobia. Eighty-eight severe and chronic agoraphobics with panic attacks (DSM-III) were randomly assigned to one of three treatments: Paradoxical Intention, Graduated Exposure or Progressive Deep Muscle Relaxation Training. Protocol therapists, whose treatment integrity was objectively monitored, conducted 12 two-hour weekly sessions. All subjects received programmed practice instructions concurrent with their primary treatment. Analyses revealed numerous significant reductions on in vivo psychophysiological measures for the relaxation condition, a few improvements for the exposure treatment and no effects for the paradoxical intention modality. The mediating role of pretreatment physiological reactivity in treatment outcome and follow-up status was examined and revealed no significant associations. Synchrony-desynchrony patterns were found to vary widely according to both treatment phase and the time interval between assessments. No between-group differences were observed on the proportion of synchronizers. However, synchronizers exhibited superior outcome and follow-up compared to desynchronizers on all domains except the physiological measures. Conceptual, methodological and clinical implications of these findings are discussed with recommendations for future research.     

Psychoanalytic observation

The recent focus on empathy as the essential activity in psychoanalytic data gathering has underemphasized the complexity of psychoanalytic observation and has failed to identify what truly makes it unique among modes of psychological investigation. It is a process that includes introspection and empathy. However, it also includes the analyst's observation of the patient's behavior, and particularly verbal behavior, in a way that is not necessarily empathic. The psychoanalytic use of introspection and behavioral observation together, as they are modified by the analysand's free association and the analyst's evenly hovering attention, provides a unique method of data gathering. The transient, mutually related regressions of analyst and analysand which partly constitute the analyzing instrument modify the field of observation available to both, providing better access to derivatives of the analysand's unconscious mental functioning. This more complex concept of psychoanalytic observation, as opposed to that in which empathy is predominant, has important implications for psychoanalytic training, clinical work, and theory.     

Processing distinctions between stems and affixes: evidence from a non-fluent aphasic patient

In this paper, we study the ability of a non-fluent aphasic patient, BN, to comprehend morphologically complex words when they appear in utterance contexts. We first establish that he is insensitive to the contextual appropriateness of both derived and inflected words. In a further experiment we show that he has no difficulty processing the stems of complex words and conclude that his problem is with the bound morphemes themselves. We then ask whether this problem is due to his inability to access either the phonological form of a morphologically complex word or its semantic and/or syntactic content. We find that only the access of semantic and syntactic content is impaired. We conclude from these six studies that: (a) BN presents a counter-example to the claim that non-fluent patients have particular difficulty with those aspects of morphology which have a syntactic function; (b) BN processes both derived and inflected words by mapping the sensory input onto the entire full-form of a complex word, but the semantic and syntactic content of the stem alone is accessed and integrated into the context. The semantic and syntactic implications of the suffix are never evaluated. This implies separate representation of the stems and suffixes of some types of morphologically complex words.     

Towards a theory of algorithm-determined cognitive test construction

A rationale for, and data from, a trial of a theory of item generation by algorithms whose origins are cognitive models of task performance are presented. Since Spearman (1904), intelligence has been operationally defined and assessed in human subjects by administering identical test items whose content and order have been fixed only after empirical iterations. In our approach, intelligence is ostensively defined by theoretically determined algorithms used for item construction and presentation. Knowledge of what cognitive factors limit human performance makes it possible to vary within tightly specified parameters those features of the tasks that contribute to difficulty, which we call radicals, to let those components of the tasks that do not contribute to difficulty vary randomly, and to counterbalance aspects of answer production that might induce biases of response. Empirical data are based on the generation of five different short tests demanding only functional literacy as a prerequisite for their execution. Four parallel forms of each test were administered to young male Army recruits whose scores were collated with their Army Entrance Test results, which were not previously known to us. Results show that the parallel, algorithm-generated item sets are statistically invariant, which item generation theory demands; and that the individual tests differentially predict Army Entrance Test scores. We conclude that IQ test performances are parsimoniously explained by individual differences in encoding, comparison and reconstructive memory processes.     

Why families of children with biological deficits require a systems approach.

A number of assumptions related to the systemic therapists' view of family functioning in the case of biological deficit in the child are presented and challenged. The families' behavior, it is argued, may not be primarily responsible for the difficulties of their biologically impaired offspring. Severity of handicap need not be directly linked to stress in these families, nor is avoiding an individual diagnosis helpful to them. To further clarify the relevant issues, the family's "reactions" to a dysfunctional member, along with the professionals' previously unhelpful approaches to dealing with the impairment of these children, are presented. Finally, the therapeutic implications of the position presented in this article are drawn, and specific recommendations for working with these families are offered.     

Haptic classification of common objects: Knowledge-driven exploration

In Experiment 1, haptically available object properties that would be diagnostic for constrained common object classification at the basic and subordinate levels were elicited in a questionnaire. The results are considered in terms of the nature of the haptically derived representations of common objects. Initial data are also presented regarding knowledge of the natural co-occurrence of properties in haptic object perception. In Experiment 2, the hand movements executed during haptic classification of manipulable common objects were examined. Manual exploration consisted of a two-stage sequence, an initial generalized "grasp-and -lift" routine, followed by a series of more specialized hand-movement patterns strongly driven by knowledge of the property diagnosticity for the specific object (obtained in Experiment 1). The current results may guide computational models of human haptic object classification and the development of perceptual systems for robots equipped with sensate dextrous hands, capable of intelligent exploration, recognition, and manipulation of concrete objects.     

Literalism as a marker of hypnotic "trance": disconfirming evidence

The responses given by highly hypnotizable, hypnotic subjects and those of unhypnotizable subjects who simulated hypnosis to questions of the type, "Do you mind telling me your name?" and "Do you mind standing up?" were contrasted. The purpose was to examine Erickson's (1980) assertion that literalism (answering "yes" or "no" verbally or nonverbally without any cognitive elaboration) is a marker of hypnotic "trance." Simulators exhibited a greater rate of literalism than hypnotic "virtuosos" (i.e., extreme scorers on both group and individual hypnotizability measures). Hypnotized subjects and nonhypnotized subjects approached in the campus library responded comparably. Because less than a third of hypnotic virtuosos responded literally, our results strongly refuted Erickson's assertion that literalism is a cognitive feature of hypnosis.     

PROMPTING BAR PATRONS WITH SIGNS TO TAKE FREE CONDOMS

This study was designed to determine whether signs would prompt bar patrons to avail themselves of free condoms. The intervention at three “gay bars” involved placing a large sign directly above a container of free condoms; the sign gave statistics for the number of people who have died from AIDS in the state and pointed out that condoms can reduce the spread of AIDS. Additional signs placed in the restrooms gave information about safe sex practices and reminded patrons that free condoms could be obtained at a given location in the bar. An ABAB design was used, with a 2-week baseline, 2-week treatment with signs present, 2-week reversal with no signs, and 2-week reinstatement of treatment with signs present. For all three bars combined, 748 condoms were taken with signs present and 510 condoms were taken with signs absent. Overall, when signs were present, the number of condoms taken increased by 47%.     

Ecology of depression in late childhood and early adolescence: a profile of daily states and activities

This study investigated daily states and time use patterns associated with depression. Four hundred eighty-three 5th to 9th graders reported on their experience when signalled by pagers at random times. Depressed youth reported more negative affect and social emotions, lower psychological investment, lower energy, and greater variability in affect. These differences were weaker for 5th and 6th graders, suggesting that self-reported feeling states are a poor indicator of depression prior to adolescence. No differences were found in the daily activities of depressed youths nor in the amount of time spent alone, but depressed youths experienced other people as less friendly and more often reported wanting to be alone, especially when with their families. They also spent less time in public places and more time in their bedrooms. Finally, depressed boys, but not girls, spent much less time with friends, particularly of the same sex, suggesting that social isolation is more strongly associated with depression for boys.     

The different patterns of group climate critical incidents in high and low cohesion sessions of group psychotherapy

The total data set for this study consisted of 958 critical incidents from high and low cohesion sessions in person-centered group psychotherapy. These incidents were typically noted on a group climate questionnaire at the end of each session. Altogether 211 clients and students participated in twenty-six groups. The high cohesion sessions were dominated by the following cohesion dimensions in rank order: self-disclosure and feedback (24.0%); attraction and bonding (20.2%); listening and empathy (20.0%); process performance and goal attainment (15.0%); and support and caring (10.6%). The corresponding rank order for the low cohesion sessions was strikingly different: avoidance and defensiveness (43.5%); conflict and rebellion (22.2%); and self-disclosure and feedback (8.9%). Apparently then, there are very different patterns of critical incidents in high and low cohesion sessions of group psychotherapy.