Developing a treatment manual for attention management in chronic pain

This article reports the development of a protocol for the therapeutic application of "attention control" for chronic pain. Attention control is the limitation of the impact of pain by switching or retunning attention. An expert systems approach was used to develop the protocol. In the first stage an extensive literature search retrieved published and unpublished accounts of attention control strategies and a draft treatment manual was prepared. In the second stage 6 experts were recruited and they independently read and reviewed the draft manual. They were interviewed using a semi-structured protocol to elicit their views on the draft manual. The manual was then revised to accommodate the information and expertise. In addition to providing expert opinion on the manual the experts also raised issues about the process of change in psychological treatment for chronic pain. These issues were organized into a process model of change in chronic pain.     

Context-processing deficits in schizophrenia: diagnostic specificity, 4-week course,and relationships to clinical symptoms

Previous research on schizophrenia suggests that context-processing disturbances are one of the core cognitive deficits present in schizophia. However, it is not clear whether such deficits are specific to schizophrenia as compared with other psychotic disorders. To address this question, the authors administered a version of the AX Continuous Performance Test designed to assess context processing in a sample of healthy controls, patients with schizophrenia, and patients with other psychotic disorders. Participants were tested at index (when medication naive and experiencing their first contact with psychiatric services) and 4 weeks later, following medication treatment. At index, patients with schizophrenia and the psychotic comparison group demonstrated similar impairments in context processing. However, context-processing deficits improved in the psychotic comparison group at 4 weeks but did not improve in patients with schizophrenia.     

Do age of onset and course of illness define biologically distinct groups within atypical depression?

Illness course separates patients with atypical depression into tricyclic responders and nonresponders as does perceptual asymmetry. The authors therefore investigated whether the course-of-illness parameters would define groups within atypical depression differing in brain laterality. Patients with atypical depression were assessed for illness course and brain laterality. Two patient groups were defined, 1 with onset prior to age 20 plus a very chronic course, and a 2nd group having later onset or less chronic illness. Patients reporting early onset of very chronic dysphoria showed significantly less right-ear (left-hemisphere) accuracy and also differed in characteristic perceptual asymmetry when compared to patients with later onset or less chronicity. Course of illness may usefully define more homogeneous depressive subgroups within atypical depression.     

The tripartite model of anxiety and depression: symptom structure in depressive and hypertensive patient groups

The structure of self-reported symptoms representative of the tripartite model was examined using data drawn from the Medical Outcomes Study (Tarlov et al., 1989). Participants were persons who had been diagnosed 48 months previously as suffering from either depression (N = 315) or hypertension (N = 403). Results of confirmatory factor analyses were broadly consistent with the tripartite model (L. A. Clark & Watson, 1991). Factors emerged corresponding to each of the 3 posited first-order dimensions of negative affect, positive affect, and physiologic arousal. Nonetheless, some discrepancies were found between the observed data and the hypothesized tripartite model. First, the obtained physiologic arousal factor was best viewed as reflecting nonspecific somatic distress rather than physiologic arousal. Finally, although differentiable in the strictest statistical sense, all three domains were significantly correlated (.36 to.86, absolute value). In particular, contrary to the tripartite model, positive and negative affect covaried markedly (-.81 to -.86). Findings raise issues concerning the utility of the tripartite model as a heuristic framework for enhancing understanding of individual differences in normal mood as well as mood disorders.     

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.     

authors index

Authors Index

authors index     

Stress symptoms of two groups before and after the terrorist attacks of 9/11/01

This study investigated stress symptoms before and after the September 11, 2001 terrorist attack on the World Trade Center. Responses to the Smith Stress Symptoms Inventory were compared for Chicago area college students assessed 1 to 5 weeks after 9/11 (n=149) and a comparable sample tested up to 5 months prior to 9/11 (n=320). Post-9/11 participants scored higher on Attention Deficit. Contrary to prior research, post-9/11 participants did not score higher on distress, including Worry, Autonomic Arousal/Anxiety, Striated Muscle Tension, Depression, and Anger. It is suggested that those indirectly exposed to a terrorist attack may display traditional symptoms of distress and arousal (as suggested by previous research). Later symptoms of attention deficit and distancing may emerge. This work was based on independent pre- and post-9/11 samples and must be replicated longitudinally as a test-retest to draw conclusions regarding change over time.     

Masked repetition and phonological priming within and across modalities

Lexical decision latencies to word targets presented either visually or auditorily were faster when directly preceded by a briefly presented (53-ms) pattern-masked visual prime that was the same word as the target (repetition primes), compared with different word primes. Primes that were pseudohomophones of target words did not significantly influence target processing compared with unrelated primes (Experiments 1-2) but did produce robust priming effects with slightly longer prime exposures (67 ms) in Experiment 3. Like repetition priming, these pseudohomophone priming effects did not interact with target modality. Experiments 4 and 5 replicated this general pattern of effects while introducing a different measure of prime visibility and an orthographic priming condition. Results are interpreted within the framework of a bimodal interactive activation model.     

Contents of Volume 9

Volume Contents

Contents of Volume 9