Differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self-harm and personality disturbance: the POPMACT study

A total of 480 patients were treated in a large, multicenter randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behavior therapy (MACT) versus treatment as usual (TAU) for recurrent deliberate self-harm. Each patient was randomized after a self-harm episode assessed at an accident and emergency center and followed up over 1 year. The main hypothesis tested was that those allocated to MACT would have a lower proportion of self-harm episodes in the succeeding year. A total of 60% of those allocated to MACT had face-to-face treatment and 430 (90%) of all patients had self-harm data recorded after 1 year. Although the results showed no significant difference between those repeating self-harm in the MACT group (39%) compared with the TAU group (46%) (P = 0.20), the treatment was cost effective (10% cheaper than TAU) and the frequency of self-harm episodes was fewer (50%) in the MACT group. A total of nine of 10 patients had some personality disturbance (42% of these with disorder), and for those where information on parasuicide events was collected, the proportion having a repeat episode ranged from 33% to 63% for different personality disorders. Those with BPD were most likely to repeat episodes quickly (mean 89 days for 25% to repeat) with dissocial personality disorder (equivalent mean 384 days) the slowest to repeat. Total costs were significantly greater in those with personality disorder and were reduced in those allocated to MACT; this saving was reversed in those with borderline disorder. On average, MACT appeared to increase the cost of those patients with BPD (BPD) and reduce the cost of those with other personality disorders. It is concluded that MACT has value in preventing self-harm cost effectively but this appears to be confined mainly to those who do not have BPD.     

Physicians' perceptions of compliance and attitudes toward complementary care

31 surveyed physicians perceived that between one-third and two-thirds of patients do not comply with instructions, and that nearly one-third of those who comply do not show optimal treatment response. The physicians expressed concerns about the validity and cost of complementary approaches that might increase medical compliance and enhance treatment response.     

Effects of Interspersing Additional Brief Math Problems on Student Performance and Perception of Math Assignments: Getting Students to Prefer to Do More Work

Three experiments were conducted to assess the effects of the interspersing procedure on students' mathematics performance, perceptions of mathematics assignments, and preference for mathematics assignments when more work was added. In Experiment I, college students worked computation problems from two assignments. The control assignment contained 15 three-digit by two-digit problems (3 × 2) and the experimental assignments contained 18 3 × 2 problems and 6 additional interspersed one-digit by one-digit problems (1 × 1). Students then rated the assignments and chose one for homework. Results showed significantly more students preferred (i.e., chose it for homework) the experimental assignment with the additional target (i.e., 3 × 2) and interspersed problems. Furthermore, significantly more students rated this experiment as requiring less effort and being less difficult. Moreover, students' mathematics performance was not affected by the procedure. Experiment II strengthened the internal validity by showing that students did not prefer the experimental assignment because it contained more target problems. Experiment III showed that the interspersing procedure was not powerful enough to extend findings beyond the 20% level (i.e., 40 and 60% more conditions). Results showed how the interspersing procedure could be used to encourage students to choose to do more target computation tasks. Discussion focuses on the applied value of the interspersing procedure and plausible causal mechanisms that may account for current and past findings related to student choice and interspersing brief tasks.     

Eliminating the IQ-RT correlation by eliminating an experimental confound

Three experiments investigated the relation between visual scanning demands, reaction time (RT), and psychometrically defined intelligence (IQ). Prior studies have shown reliable correlations between RT and IQ in the range of −.20 to −.80. However, these studies have confounded the number of possible stimuli (stimulus uncertainty) with the size of the area in which the stimuli may appear (visual angle). Experiment 1 replicated these studies retaining this confound. As the number of stimuli increased from one to eight, the visual angle was permitted to increase as well (from 0° to 30°). The results showed that RT varied in accord with Hick's (1952) law, and a median correlation between IQ and six RT parameters (subjects' mean RTs and standard deviations at three levels of stimulus uncertainty) of −.47 was observed. Experiment 2 removed the confound, varying only stimulus uncertainty, and the median IQ-RT correlation declined to −.02. Experiment 3 held stimulus uncertainty constant at 1 bit (two stimuli) and varied visual angle; a median correlation of −.19 was observed. It was concluded that many of the previously reported correlations may not have hinged on speed of information processing alone, but at least in part on subjects' abilities to scan the display across which the stimuli appeared.     

Career Compromise and Adjustment Among Graduates in the Banking Industry

A study is reported which aimed to examine several factors associated with career compromise and adjustment among 100 graduates in a bank. Contrary to predictions derived from Gottfredson's theory, satisfaction with the sextype of their jobs did not relate to perceptions of compromise; satisfaction with prestige explained some unique variance in compromise perceptions, but satisfaction with outlets for interests and use of skills and abilities were more important. Case data were used to explore other factors involved in the perception of career compromise. Qualitative data collected in the interviews with graduates highlighted several ways in which employers, graduates and career advisers can ease the transition from university to work.     

Non-pharmacologic Interventions for CFS: A Randomized Trial

Non-pharmacological behavioral treatments for CFS have been suggested as promising. These trials have tested protocols composed of behavioral, cognitive and cognitive–behavioral interventions but there have been few efforts to differentially evaluate their outcomes. The primary purpose of the current study was to evaluate the effectiveness of nurse delivered non-pharmacologic interventions. In the present study, 114 participants diagnosed with CFS were randomly assigned to four 6-month interventions. The interventions were: cognitive–behavior therapy, cognitive therapy, anaerobic activity, and a relaxation control group. The study found that these interventions led to increases in several areas of functioning, with more consistent changes occurring among those participants in the cognitive condition. For the 25 variables in this study, significant change occurred for 28%, 20%, 16%, and 12% of the variables for the cognitive, cognitive behavior therapy, anaerobic activity, and relaxation conditions, respectively. However, the majority of participants continued to be diagnosed with CFS following the treatment trial. Implications of these findings are discussed.     

Etiology and Management of Elder Self‐Neglect

This article addresses the challenges of defining and accurately identifying elder self‐neglect and explores an interdisciplinary team model, including counselors and mental health professionals, designed to implement prevention and intervention strategies. The challenge of striking a balance between the need to respect the individual elders' autonomy and the need to attend to their health care needs is underscored.     

Interdimensional interference in the Stroop effect: uncovering the cognitive and neural anatomy of attention

In the classic Stroop effect, naming the color of an incompatible color word (e.g. the word RED printed in green ink; say, 'green') is much slower and more error-prone than is naming the color of a control item (e.g. XXX or CAT printed in green; say 'green'). This seemingly simple interference phenomenon has long provided a fertile testing ground for theories of the cognitive and neural components of selective attention. We present a sketch of the behavioral phenomenon, focusing on the idea that the relative automaticity of the two dimensions determines the direction and the degree of interdimensional interference between them. We then present an outline of current parallel processing explanations that instantiate this automaticity account, and we show how existing interference data are captured by such models. We also consider how Stroop facilitation (faster response of 'red' to RED printed in red) can be understood. Along the way, we describe research on two tasks that have emerged from the basic Stroop phenomenon - negative priming and the emotional Stroop task. Finally, we provide a survey of brain imaging research, highlighting the possible roles of the anterior cingulate in maintaining attentional set and in processing conflict or competition situations.