Efficient pain assessment in clinical settings.

The need for efficient and practical assessment techniques of the multidimensional nature of chronic pain remains paramount in clinical settings. Visual analogue scales (VASs) and simple behavioral observation methods have been proposed as efficient, reliable, and valid measures of the subjective (sensory and affective) and overt behavioral aspects of the pain experience. The relationships among VASs and the UAB Pain Behavior Scale were examined among 48 chronic pain patients. Ratings of overt behavior were significantly related to both the VAS sensory and VAS affective ratings. Regression analysis indicated that the VAS scores accounted for significant amount of the variance (27.7%) in UAB scores. Moreover, the affective dimension of self-reported pain tended to be more strongly related to the visible manifestations of pain than were ratings of pain intensity.     

The debt of neuropsychology to the epilepsies.

Both neuropsychology and psychology in general have been enhanced markedly by brain-behavior models derived from the study of the epilepsies. A significant body of neuropsychological concepts originated or were confirmed through epilepsy-based treatment and research. These concepts include the peri-Rolandic homunculus, the role of the hippocampal-temporal lobe complex in cognitive memory, hemisphere plasticity for speech in childhood, the intracarotid amytal procedure for determining hemisphere memory patency, and hemisphere-based models of cognition confirmed through human commissurotomy. Personality and social-emotional research in epilepsy are additional areas in which new conceptual models grounded in psychological science can both repay our debt to the epilepsies and provide much needed psychological research and treatment.     

Scientific rewards and conflicts of ethical choices in human subjects research.

The primary responsibility of the American Psychological Association's (APA) Committee on Standards in Research (CSR) is to advise the APA on issues and standards related to the protection of human participants in psychological research. A related goal is to enhance the use of good ethical practices by APA members. The purpose of this article is to foster the view of research ethics not as an affront to the integrity of sound research, but as opportunities for scientific rewards, including increased understanding of the meaning of data, enhanced recruitment, and the inclusion of more representative samples. Three ethical practices are discussed as examples of this general premise: respect for confidentiality, use of debriefing, and assurance that participants are noncoerced volunteers. The Committee's intent is to promote consideration of these issues, not to promulgate specific guidelines or procedures.     

Injury control. A promising field for psychologists.

Injury is the fourth leading cause of death for all Americans and the most frequent cause of death for those from age 1 to 45. Moreover, injury is associated with higher treatment costs and with greater lost life-years than the other three leading causes of death. Traffic accidents are the leading cause of severe brain injury, including most paraplegic and quadriplegic cases. Because injury control is essentially psychological, there are many opportunities for psychologists to contribute, both to scientific research on the causes of injury and to clinical interventions for injury control.     

FADING TEACHER PROMPTS PROM PEER-INITIATION INTERVENTIONS FOR YOUNG CHILDREN WITH DISABILITIES

This study examined a system for fading teacher prompts to children who served as peers in peer-initiation interventions for young children with disabilities. A teacher taught peers to direct social initiations to children with disabilities, provided verbal prompts for those initiations, and introduced a system that provided peers with visual feedback about the social interactions of the children with disabilities. She then systematically withdrew the verbal prompts to peers, and subsequently faded the visual feedback system. Peer initiations increased when the intervention began and resulted in increases in social interaction for the children with disabilities. As the teacher systematically faded the prompts and visual feedback to the peers, social interaction continued at the levels found during intervention and was maintained during a short maintenance period.     

PROMOTING LAW ENFORCEMENT FOR CHILD PROTECTION: A COMMUNITY ANALYSIS

The Colorado Occupant Protection Project (COPP) intervention provided police with brief instruction concerning the importance of citations for drivers' failure to use child safety seats and special coupons to accompany citations. Coupons were exchangeable by drivers for a safety seat and brief training in its use, plus a waiver of the $50 citation fine. Over 4.5 years of archival records were employed, using an ABA design and a comparison community to evaluate the program. Few tickets were issued for nonuse of safety seats during the 3-year baseline in either community. Citations for nonuse of safety seats increased to over 50 per month during the intervention period at the test site, whereas rates remained essentially zero at the comparison site. After the COPP intervention was removed at the intervention site, citation rates for nonuse of safety seats decreased to about 15 per month. Differences between intervention conditions and settings were statistically significant. During the intervention, officers were 44 times more likely to write citations than were controls. Results suggested that a behavioral program can increase police citation writing for child protection purposes.     

Effects of alcohol intoxication on risk taking, strategy, and error rate in visuomotor performance.

Adult men (N = 44) participated for 2 days (alcohol vs. placebo treatment) in a double-blind, crossover experiment. Performance on the Digit Symbol Substitution Task (DSST) and a visuomotor (VM) task was measured 4 times each day. On the alcohol-treatment day, data were obtained once during ascending breath alcohol levels (BALs), once during maximal BALs (0.05 or 0.10), and twice during descending BALs. Data were collected at the same time points on the placebo-treatment day. Limited evidence for acute tolerance was obtained with the DSST, but error rates on the VM task were higher during maximal and descending BALs. Error rates remained near placebo values, and participants displayed slightly greater caution, while BALs were ascending. Strategy scores on the VM task exceeded placebo scores during maximal intoxication. Data interpretation is focused on individuals in higher level (e.g., professional) positions.     

Categorical time production: evidence for discrete timing in motor control.

Subjects performed a repetitive manual tapping task, attempting to match a given rate of auditory stimulus pulses, first with the pulses audible (synchronization) and then with the pulses turned off (continuation). In different sessions, the interstimulus interval (ISI) was selected from the range 175 to 825 msec in steps of 25 msec, with different ISI values presented in a random order. Across this range of ISI conditions, interresponse intervals (IRIs) exhibited alternating positive bias (too slow) and negative bias (too fast). We interpret this pattern of bias in terms of a discrete, or categorical, timing mechanism in motor timing. Categorical time production can be viewed as extending our conception of the timekeeper in Wing's (Wing & Kristofferson, 1973a, 1973b) two-process model of motor timing and may be related to the system of multiple clocks proposed by Kristofferson (1980) to explain a categorical pattern of variability measures in duration discrimination.     

Weekends and holidays and acting-out behavior of developmentally delayed women: a reply to Dr. Mark Flynn.

A previous report on the effect of the day of the full moon on the acting-out behavior of 20 developmentally delayed, institutionalized women showed that on the day of the full moon there were significantly more misbehaviors than on any other day during the lunar period. The records were re-evaluated to assess the frequency of acting-out behaviors on weekends and holidays as contrasted with the balance of the month. This re-evaluation indicated there was no significant difference between the weekends and holidays and the balance of the month (t = 1.14). The results were taken as support of the previous findings that on the day of the full moon there were significantly more misbehaviors than on any other day of the lunar period.