The effect of hypocapnia on extinction of conditioned fear responses

Conditioning models have been very helpful in the understanding of the etiology and maintenance of anxiety. Such laboratory models, however, leave unexplained why in many cases of naturally occurring anxiety, as in the case of agoraphobia, the fear responses do not extinguish. Literature on experimental anxiety provocation suggests that a systemic alkalosis might play a role in the maintenance of phobic fear. It was hypothesized that a subject in a state of respiratory alkalosis would show delayed extinction to classical conditioned anxiety. In a differential classical conditioning paradigm, consisting of a habituation-, an acquisition-, and an extinction-phase, slides and electric shocks were used as conditioned stimuli (CS) and unconditioned stimuli (US) respectively. The skin conductance response was taken as (U)CR. Subjects were randomly assigned to two groups: hyperventilation or control. It was shown that the extinction was not delayed when subjects were hypocapnic during the extinction. These data support the view that a respiratory alkalosis per se is not a sufficient condition for the maintenance of neurotic fears. The data of the present study are discussed in the context of existing literature on a psychological interpretation of the maintenance of anxiety.     

Home-based treatment of obsessive-compulsive patients: intersession interval and therapist involvement

In a 2 x 2 factorial design massed vs spaced and therapist vs self-controlled exposure were compared with obsessive-compulsive patients. Intersession interval was varied keeping constant the length of exposure time and number of exposure sessions. Treatment in all conditions was home based. Treatment led to highly statistical and significant improvements on all measures. Massed exposure was as effective as spaced exposure; self-controlled exposure proved to be as effective as therapist-controlled exposure.     

Nigerian Clergy and healthcare professionals’ perceptions of health-seeking behaviours among Nigerian immigrants in the UK

The diversity in patient populations due to immigration in the UK has implications for adequate understanding of a patients’ culture by the clinician as well as patient–clinician cultural matching for enhanced service use and outcome. This qualitative study investigated how Nigerian clergy and health professionals perceived health-seeking behaviours among Nigerians in the UK, while considering the impact of their own beliefs and values as care providers. Six participants were interviewed (clergy, n?=?2; health professionals, n?=?4). Data were analysed using Interpretative Phenomenological Analysis. Results showed that the clergy and health professionals themselves use religious/cultural cure and formal healthcare methods, and believed Nigerian immigrants as predominantly using religious/cultural methods which can affect healthcare utilisation, although differences between the professionals were reported. The potentials for integrating other cure methods into the formal healthcare services were considered, while highlighting the challenges that may arise from such collaborative effort.     

Overgeneral autobiographical memory predicts higher prospective levels of depressive symptoms and intrusions in borderline patients

Overgeneral memory (OGM), the tendency to retrieve categories of events from autobiographical memory instead of single events, is found to be a reliable predictor for future mood disturbances and post-traumatic symptom severity. Patients with borderline personality disorder (BPD) often report co-morbid episodes of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). Therefore, we investigated whether OGM would predict depression severity and (post-traumatic) stress symptoms in BPD patients. At admission (N?=?54) and at six-month follow-up (N?≥?31), BPD patients completed the Structured Clinical Interview for DSM-IV Disorders, the Assessment of DSM-IV Personality Disorders, the Autobiographical Memory Test, the Beck Depression Inventory—2nd edition (BDI-II), and the Impact of Event Scale. OGM at baseline predicted (a) higher levels of depressive symptoms at follow-up and (b) more intrusions related to a stressful event over and above baseline levels of borderline symptoms, depressive symptoms, and intrusions, respectively. No association was found between memory specificity and event-related avoidance at follow-up. Despite previous findings suggesting that OGM in BPD is less robust than in MDD and PTSD, our results suggest that memory specificity in BPD patients may have some relevance for the course of depressive and stress symptomatology in BPD.     

Computer Ethics and Moral Methodology

In computer ethics, as in other branches of applied ethics, the problem of the justification of moral judgment is still unresolved. I argue that the method which is referred to as "The Method of Wide Reflective Equilibrium" (WRE) offers the best solution to it. It does not fall victim to the false dilemma of having to choose either case-based particularist or principle-based universalist approaches to the problem of moral justification. I claim that WRE also provides the best model of practical moral reasoning available for computer ethics. It does not pretend to provide quasi-algorithmic procedures for moral decision-making, but neither does it abandon the regulative ideal of communicative transparency in discursive public justification.     

Relation between EMG activation patterns and kinematic properties of aimed arm movements

Aimed flexion movements of the arm of different amplitude and duration were studied. Velocity and acceleration traces of movements with equal duration but different amplitude were equal, apart from a scaling factor (ratio between movement amplitudes). After appropriate scaling, EMG activity of the first agonist burst for these movements superimposed. This was not true for EMG activity in the antagonist muscle. For movements with equal amplitude, but different duration, the time to peak acceleration was constant for all MT'. Except for this fact, traces of acceleration, velocity, and agonist activity following the time of peak acceleration were about equal after appropriate scaling in time and amplitude. The integral of EMG activity in the first agonist burst increased linearly with peak velocity. For the antagonist burst, the integrated EMG activity increased more than proportionally. During movements made as fast as possible, subjects used a different strategy by varying the duration of the accelerating phase for movements of different amplitude. Movement amplitude was achieved by adjusting the duration of the agonist burst and the onset time for the antagonist muscle. Amplitude of the antagonist burst was constant within a narrow range for movements of different amplitude. These results did not change when the inertial mass was doubled by loading the arm with an additional mass.     

PEER TRAINING OF SAFETY-RELATED SKILLS TO INSTITUTIONAL STAFF: BENEFITS FOR TRAINERS AND TRAINEES

A peer training program, in which experienced staff trained new staff, was evaluated as a method for teaching and maintaining safety-related caregiver skills in an institutional setting for the developmentally disabled. Three sets of safety-type skills were assessed in simulated emergency situations: responding to facility fires, managing aggressive attacks by residents, and assisting residents during convulsive seizures. Using a multiple-baseline research design, results indicated that the peer training program was an effective method of training the three types of emergency skills to new direct care staff. The program also appeared effective in improving the skills of the peer trainers. Perhaps most importantly, results indicated that if experienced staff functioned as peer trainers for particular emergency skills, then their proficiency in those skills maintained over time whereas their proficiency declined in emergency skills for which they did not act as peer trainers. Social validity information collected from available staff 23 months after the program was completed supported the utility of the training in terms of staff responses during actual emergencies. Also, acceptability measures indicated that staff liked participating in the program. However, some inconsistencies between staff verbal reports and performance-based measures of acceptability were noted. Results are discussed regarding the overall effectiveness of the peer training program, the importance of maintenance strategies for safety-related skills, and the need for multidimensional analyses of staff acceptability in staff training/management research.     

A PROGRAM FOR INCREASING MANUAL SIGNING BY AUTISTIC AND PROFOUNDLY RETARDED YOUTH WITHIN THE DAILY ENVIRONMENT

A program was implemented to increase the manual signing of five profoundly retarded and four autistic youth within their daily environment. Each participant was nonvocal or minimally vocal. The program was based on modified incidental teaching strategies and was implemented by direct care personnel under supervision in an institutional setting. Specific components included rearranging the physical environment to prompt signing, altering routine staff-resident interactions to prompt, manually guide and/or reinforce signing; and conducting mini-training sessions. Additionally, staff modeled signs intermittently throughout the day. The program was sequentially implemented during two staff work shifts on each of two resident living modules. Observations conducted at four separate time periods during the day indicated that significant increases in signing occurred for all participating youth and that the increases generally maintained during follow-up checks at 5 and 17 weeks. Differential effects of the increased signing on frequency of vocalizations were noted across residents. A staff acceptability survey indicated favorable staff reports on the usefulness of signing to communicate with the youth. Results are discussed regarding the significance of manual signing for seriously developmentally disabled persons and the importance of ensuring that signing skills are used in the daily environment and not exclusively in formal training sessions. Also, areas for continued research are noted in terms of more refined analyses of client skills and subsequent progress in manual communication programs.     

Two new test statistics for the rasch model

It is shown that the presently available statistical tests for the Rasch model are insensitive to violation of the unidimensionality axiom. Two new test statistics are presented. The first one,Q ₁, is sensitive to the same effects as the presently available statistics, but has some desirable properties of a nonstatistical nature. The second statistic,Q ₂, is sensitive to violation of local stochastic independence and unidimensionality and thus fills an existing gap.