Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease

Parkinson’s disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD. This study was conducted at the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. The first author was previously affiliated with the Houston Center for Quality of Care and Utilization Studies.     

<Emphasis Type="Italic">Ziran</Emphasis> and <Emphasis Type="Italic">Wuwei</Emphasis> in the <Emphasis Type="Italic">Daodejing</Emphasis>: An Ethical Assessment

In Daoist philosophy, the self is understood as an individual interdependent with others, and situated within a broader environment. Within this framework, the concept ziran is frequently understood in terms of naturalness or nature while wuwei is explained in terms of non-oppressive government. In many existing accounts, little is done to connect these two key Daoist concepts. Here, I suggest that wuwei and ziran are correlated, ethical, concepts. Together, they provide a unifying ethical framework for understanding the philosophy of the Daodejing. I explore the meaning of ziran as self-so-ness or, in human terms, as pertaining to an individual’s spontaneity. The appropriate response to the spontaneity of individuals is to avoid, insofar as possible, imposing or using restrictive norms and methods, that is, wuwei. According to this view, ziran and wuwei offer an account of ethics that attends to core notions of interdependent selfhood, including mutuality, relationality, interdependence, symbiosis, and responsiveness.     

"时习"的内涵及心理机制

历代教育家关于知识掌握和技能习得的“时习”思想及其方法,不仅具有丰富的内涵,而且具有很强的心理学依据。本文力图通过深入揭示其内涵和心理机制,寻求其对现代学习乃至教学理论与及其实践地发展的重要借鉴价值。     

Parametrically Dissociating Speech and Nonspeech Perception in the Brain Using fMRI

Candidate brain regions constituting a neural network for preattentive phonetic perception were identified with fMRI and multivariate multiple regression of imaging data. Stimuli contrasted along speech/nonspeech, acoustic, or phonetic complexity (three levels each) and natural/synthetic dimensions. Seven distributed brain regions' activity correlated with speech and speech complexity dimensions, including five left-sided foci [posterior superior temporal gyrus (STG), angular gyrus, ventral occipitotemporal cortex, inferior/posterior supramarginal gyrus, and middle frontal gyrus (MFG)] and two right-sided foci (posterior STG and anterior insula). Only the left MFG discriminated natural and synthetic speech. The data also supported a parallel rather than serial model of auditory speech and nonspeech perception.     

Indigenization and Beyond: Methodological Relationalism in the Study of Personality Across Cultural Traditions

A brief intellectual history of the indigenization movement in Asia leads to the thesis that the generation of psychological knowledge is culture dependent. Indigenous psychologies go further and insist on viewing a target group from the natives' own standpoint. Psychological decentering underlies conceptions of human existence rooted in Asian intellectual traditions, in particular, relatedness between persons predominates in Confucianism. These conceptions demand new approaches to knowledge generation that signify a paradigmatic shift from methodological individualism to methodological relationalism. An implication is that relationships precede situations in the study of personality and social behavior. We define personality as the sum total of common attributes manifest in, and abstracted from, a person's behavior directly or indirectly observed across interpersonal relationships and situations over time. We rely on the notion that there are identifiable levels of cognition to develop a metatheoretical framework for reconstructing selfhood. Confronting the subject-object dichotomy opens the door to investigations of transcendent consciousness; confronting the self-other demarcation underlying Western theories leads to the construction of self-in-relations.     

Dragon talk: providing pastoral care for Chinese immigrants

This article describes how cultures and pastoral care education processes can be barriers between the patient, the pastoral caregiver, and the Clinical Pastoral Education (CPE) student. By providing sketches of interviews with Chinese patients, the author tries to explain why the attempt to unveil Chinese patients' feelings and needs through conversation can be a frustrating experience. Moreover, the author argues that the pedagogy of pastoral care education ought to be more culturally sensitive in regard to the diverse cultural backgrounds of both patients and CPE students.     

The role of self-enhancing evaluations in a successful life transition

The objective of the study was to investigate how self-enhancing evaluations, obtained via positive social comparisons and reflected appraisals, were related to mental health in a later life transition. The sample consisted of 266 women who were interviewed once before and 3 times after the experience of community relocation. Results extended prior findings suggesting the dynamic impact of self-enhancing evaluative processes on psychological well-being and depressive symptoms. Additional analyses showed evidence for reverse causality, that is, that mental health also influenced self-evaluative processes. This study underscores the significance of holding a positive view of self vis-à-vis others in negotiating life challenges as well as the reciprocal influence of well-being on social self-evaluative processes.     

Information entropy analysis of discrete aiming movements

Information entropy and mutual information were investigated in discrete movement aiming tasks over a wide range of spatial (20-160 mm) and temporal (250-1250 ms) constraints. Information entropy was calculated using two distinct analyses: (1) with no assumption on the nature of the data distribution; and (2) assuming the data have a normal distribution. The two analyses showed different results in the estimate of entropy that also changed as a function of task goals, indicating that the movement trajectory data were not from a normal distribution. It was also found that the information entropy of the discrete aiming movements was lower than the task defined indices of difficulty (ID) that were selected for the congruence with Fitts' law. Mutual information between time points of the trajectory was strongly influenced by the average movement velocity and the acceleration/deceleration segments of the movement. The entropy analysis revealed structure to the variability of the movement trajectory and outcome that has been masked by the traditional distributional analyses of discrete aiming movements.     

Age differences in social preferences among Taiwanese and Mainland Chinese: the role of perceived time

Socioemotional selectivity theory holds that as people recognize the inevitable constraint of time imposed by mortality, their social goals change, motivating them to limit social contacts to those with whom they are emotionally close. This theory was tested among Taiwanese and Mainland Chinese. As predicted, results showed that older adults (aged 60-90 years) in both cultures were more likely than younger adults (aged 18-30 years) to prefer familiar social partners who were most likely to provide emotionally close social interactions. Mainland Chinese, who as a group have shorter actuarial life expectancy, were more likely to prefer familiar social partners than were Taiwanese. These age and cultural differences were eliminated when differences in perceived time were statistically controlled for.