A randomized trial of a representational intervention to decrease cancer pain (RIDcancerPain).

OBJECTIVE: Based on theories regarding cognitive representations of illness and processes of conceptual change, a representational intervention to decrease cancer pain (RIDcancerPain) was developed and its efficacy tested. DESIGN: A two-group RCT (RIDcancerPain versus control) with outcome and mediating variables assessed at baseline (T1) and 1 and 2 months later (T2 and T3). Subjects were 176 adults with pain related to metastatic cancer. MAIN OUTCOME MEASURES: Outcome variables were two pain severity measures (BPI and TPQM), pain interference with life, and overall quality of life. Mediating variables were attitudinal barriers to pain management and coping (medication use). RESULTS: One hundred and fifty subjects completed the study. Subjects in RIDcancerPain (T1-T2 and T1-T3) showed greater decreases in Barrier scores than those in control. Subjects in RIDcancerPain (T1-T3) showed greater decreases in pain severity than those in control. Change in Barriers scores mediated the effect of RIDcancerPain on pain severity. CONCLUSION: RIDcancerPain was efficacious with respect to some outcomes. Further work is needed to strengthen it.     

Black male client, white female counsellor: Making positive use of transference phenomena

The content and process of transference issues over a 9-month period of counselling contact between a white, female counsellor and a black, male client are examined. An attempt is made to show the positive effects that may come about through a non-ethnic- and non-gender-matched counsellor-client dyad, and to explore the benefits to the client of counsellor similarity and difference.     

Outlining semi-intensive fluency therapy

This paper describes a semi-intensive approach to fluency therapy (SIFT). SIFT's rationale and theoretical origins combine both speak-more-fluently and stutter-more-fluently concepts in a cognitive-behavioral approach where the goals of the program are individualized to the needs of each client. Procedural aspects of the program are outlined. Some very preliminary findings from a small pilot study are discussed.     

The effects on induced passive rehearsal and the von Restorff phenomenon on the free recall of normals and retardates

Noninstitutionalized retardates and normal children of equal mental age (approximately 8 years) listened to 11 orders of 20 nouns with no instructions to overtly or covertly rehearse. All subjects were in each of three list conditions: (a) when all words were at the same decibel (dB) level, (b) when the 11th item was at a higher dB level, and (c) when the items were repeated at the same dB level using the rehearsal protocol of Rundus (1971). The normals' overall recall was superior to that of the retardates' recall. Repetition of items had no effect on the performance of either group except in the recency portion of the learning curve and on the initial trial for both groups and the fifth trial for the retarded group. The normal group was more susceptible to the yon Restorff effect than was the retarded group. These results were discussed in terms of the changing and different recall strategies of the two groups.     

Sequential dependencies and response range in cross-modality matches of duration to loudness

Subjects matched durations of keypresses to loudnesses of pure tones. Resulting duration responses were found to be assimilated to the value of the immediately preceding stimulus and responses from one to at least six trials back in the sequence of loudness stimuli. Responses were contrasted with the values of stimuli two through six trials back in the sequence. These sequential dependencies and other properties of the data were predicted by a cognitive model in which cross-modality matches are mediated by category judgments of stimuli on both continua, and subjects use heuristic strategies to reduce response uncertainty.     

Use of markov-encoded sequential information in numerical signal detection

Twelve Ss made binary decisions with feedback on numbers from one of two normal distributions with equal variances and unequal means. Sequences of distribution choices corresponded to first-order two-state Markov processes with probabilities of change of state of p₁ = p₂ = .50, p₁ = p₂ = .75, and p₁ = p₂ = .25. Performance was best (in d’ terms) when p₁ = p₂ ≠ .50. First-order sequential response dependencies tended to mirror the first-order stimulus dependencies. Violations of a fixed cutoff point decision rule were concentrated in the region of the average critical point, with a bandwidth of about 1/2σ, in which violations were strikingly more frequent than would be expected if they had occurred randomly. These results imply that in this task Ss are using a criterion-band decision rule instead of a fixed cutoff point rule, and that they are basing decisions in the region of the criterion band on information extracted from the sequence of decisions presented to them. The average bandwidth is generally different from the optimum bandwidth used by an ideal O in combining the two sources of information.