Symptom Presentation and Symptom Meaning Among Traumatized Cambodian Refugees: Relevance to a Somatically Focused Cognitive-Behavior Therapy

Among psychologically distressed Cambodian refugees, somatic complaints are particularly prominent. Cambodians interpret anxiety-related somatic sensations in terms of “Wind” (khyâl), an ethnophysiology that gives rise to multiple catastrophic interpretations; and they have prominent trauma-memory associations to anxiety-related somatic symptoms. In this article, we detail some of the common sensation-related dysphoric networks of Cambodian refugees, focusing on catastrophic cognitions and trauma associations. We argue that delineating symptom-related dysphoric networks is crucial to successfully adapt cognitive-behavioral interventions to treat panic disorder and posttraumatic stress disorder among Cambodian refugees, and that such an approach may be useful for the culturally sensitive adaptation of cognitive-behavior therapy for other traumatized non-Western groups.     

Therapists’ Perspectives of the Cotherapy Experience in a Training Setting

The experience of cotherapy has been sparsely addressed in the literature. This qualitative study’s goals were to explore (a) the usefulness of cotherapy as a training model (b) the impact of cotherapy on services provided; (c) the impact of being trained in a cotherapy model; and (d) factors that both facilitated and hindered the process of cotherapy. The authors conducted a focus group interview with seven participants who graduated from a COAMFTE accredited MFT master’s program. Participants unanimously reported they believed cotherapy impacted client outcomes and training. They also expressed that cotherapists’ unwillingness to address issues within the cotherapy team negatively impacted the cotherapy relationship and client outcomes. Data analysis yielded four main themes, including cotherapy as a vehicle for personal growth, accountability in the cotherapy relationship, need for safety in the cotherapy relationship, and cotherapy team’s need for supervision.     

Parallel computations for controlling an arm

In order to control a reaching movement of the arm and body, several different computational problems must be solved. Some parallel methods that could be implemented in networks of neuron-like processors are described. Each method solves a different part of the overall task. First, a method is described for finding the torques necessary to follow a desired trajectory. The methods is more economical and more versatile than table look-up and requires very few sequential steps. Then a way of generating an internal representation of a desired trajectory is described. This method shows the trajectory one piece at a time by applying a large set of heuristic rules to a "motion blackboard" that represents the static and dynamic parameters of the state of the body at the current point in the trajectory. The computations are simplified by expressing the positions, orientations, and motions of parts of the body in terms of a single, non-accelerating, world-based frame of reference, rather than in terms of the joint-angles or an egocentric frame based on the body itself.     

Lesioning an attractor network: investigations of acquired dyslexia

A recurrent connectionist network was trained to output semantic feature vectors when presented with letter strings. When damaged, the network exhibited characteristics that resembled several of the phenomena found in deep dyslexia and semantic-access dyslexia. Damaged networks sometimes settled to the semantic vectors for semantically similar but visually dissimilar words. With severe damage, a forced-choice decision between categories was possible even when the choice of the particular semantic vector within the category was not possible. The damaged networks typically exhibited many mixed visual and semantic errors in which the output corresponded to a word that was both visually and semantically similar. Surprisingly, damage near the output sometimes caused pure visual errors. Indeed, the characteristic error pattern of deep dyslexia occurred with damage to virtually any part of the network.     

Adaptation of CBT for Traumatized Egyptians: Examples from Culturally Adapted CBT (CA-CBT)

In this article we illustrate how CBT can be adapted to a traumatized Egyptian population with Islamic beliefs, giving examples from our adaptation of Culturally Adapted–CBT (CA-CBT) for this cultural group. We discuss a culturally sensitive assessment measure of local somatic complaints and cultural syndromes that was devised based on clinical experience with traumatized Egyptians. We also demonstrate how to normalize symptoms, create positive expectancy about the treatment, and educate about trauma. We give examples of how mindfulness can be adapted for an Egyptian Islamic population, and we describe local religious strategies, such as dhikr (religious chanting), salah (ritualistic prayer), and dua (supplication), that may be used to promote attentional shift from rumination topics and to teach attentional control. We describe how “loving kindness” can be adapted for this group. We outline how to modify culturally generated catastrophic cognitions and how to conduct interoceptive exposure and to create positive re-associations in a culturally sensitive manner. We describe how worry themes are explored and addressed based on a heuristic panic attack–PTSD model; how to teach anger management in a culturally sensitive way; and how to address sleep-related problems in this population. We suggest using cultural transitional “rituals” at the end of the treatment to give patients a sense of closure and a positive feeling of transformation. A case example is presented to illustrate cultural challenges associated with delivering CA-CBT to an Egyptian population. We introduce certain concepts such as cultural grounding and explanatory model bridging, both therapeutic techniques that increase adherence, positive expectancy, and cultural consonance.     

The Nootropic Properties of Ginseng Saponin Rb1 are Linked to Effects on Anxiety

Previous studies have shown that crude ginseng extracts enhance performance on shock-motivated tasks. Whether such performance enhancements are due to memory-enhancing (nootropic) properties of ginseng, or to other non-specific effects such as an influence on anxiety has not been determined. In the present study, we evaluated both the nootropic and anxiolytic effects of the ginseng saponin Rb1. In the first experiment, 80 five-day-old male chicks received intraperitoneal injections of 0, 0.25, 2.5 or 5.0 mg/kg Rb1. Performance on a visual discrimination task was evaluated 15 minutes, 24 and 72 hours later. Acquisition of a visual discrimination task was unaffected by drug treatment, but the number of errors was significantly reduced in the 0.25 mg/kg group during retention trials completed 24 and 72 hours after injection. Animals receiving higher dosages showed trends towards enhancement initially, but demonstrated impaired performance when tested 72 hours later. Rb1 had no effect on response rates or body weight. In the second experiment, 64 five-day-old male chicks received similar injections of Rb1 (0, 0.25, 2.5 or 5.0 mg/kg) and separation distress was evaluated 15 minutes, 24 and 72 hours later. Rb1 produced a change in separation distress that depended on the dose and environmental condition under which distress was recorded. These data suggest that Rb1 can improve memory for a visual discrimination task and that the nootropic effect may be related to changes in anxiety.     

Dizziness- and Palpitations-predominant Orthostatic Panic: Physiology,Flashbacks, and Catastrophic Cognitions

In an orthostatic challenge, Cambodian patients with orthostatic panic in the last month (OP patients) sometimes panicked during orthostatic challenge, whereas those without orthostatic panic in the last month (NOP patients) did not. Also, OP patients with primarily dizziness during orthostatic challenge panic (OP_OCP-D) had a less vigorous physiological response than two other groups: (a) OP patients with primarily palpitations during orthostatic challenge panic (OP_OCP-P) and (b) NOP patients who had no symptoms during orthostatic challenge (NOP_NOCP-NS). Among the patients experiencing orthostatic challenge–induced panic (i.e., the OP_OCP-D and OP_OCP-P patients), there were prominent orthostatic challenge–induced flashbacks and catastrophic cognitions, and the severity of orthostatic challenge–induced flashbacks and catastrophic cognitions correlated with the severity of orthostatic panic in the previous month and with the severity of orthostatic challenge–induced panic.     

A Test of Contextual Theory: The Relationship Among Relational Ethics,Marital Satisfaction,Health Problems,and Depression

Few studies have examined the theoretical underpinning of contextual theory. Using structural equation modeling, the relationship among relational ethics (recognized as the most important aspect of contextual theory), marital satisfaction, depression, and illness was examined. Data came from a national sample of 632 mid-life, married individuals. Results supported Nagy’s contextual theory. The total score of the Relational Ethics Scale was a significant predictor of marital satisfaction, and marital satisfaction was significantly associated with depression and health problems. Vertical and horizontal subscales of relational ethics also were significant predictors of depression and health problems through the mediating variable of marital satisfaction.