Outcome Studies in the Treatment of Panic Disorder: A Review

The authors review outcome studies in the treatment of panic disorder without agoraphobia for an adult population. Empirical evidence is presented to support the efficacy of psychopharmacological and cognitive-behavioral interventions. In addition, this article can serve as the basis for the development of emerging standards of cure for the diagnosis and treatment of panic disorder.     

A Treatment for College Women at Risk for Bulimia: A Controlled Evaluation

Twenty-nine college women evidencing low body esteem, repeated dieting efforts, and other dysfunctional eating behaviors or attitudes were randomly assigned to group treatment or control conditions. At posttest and follow-up, participants who received the intervention reported significantly improved levels of self-esteem and body satisfaction, as well as reductions in their reliance on potentially dangerous methods of weight management compared with controls. They also reported fewer fears of negative evaluation by others and endorsed fewer stereotypes about thinness and attractiveness. Finally, participants in the treatment condition showed significantly reduced levels of perfectionism at posttest, but this change was not maintained at follow-up. Clinical implications and research recommendations are discussed.     

Physiological arousal and attention in veterans with posttraumatic stress disorder

Psychophysiological reactivity has been well documented in WWII, Korean Conflict, and Vietnam veterans with posttraumatic stress disorder (PTSD). In addition, these individuals have demonstrated cognitive impairments within the domains of attention, concentration, new learning, and memory. However, there has been no research examining the impact of physiological arousal on attention in individuals with PTSD. This study documents the level of physiological arousal and associated disruption of attentional abilities in 28 Persian Gulf War veterans (18 without PTSD or other psychopathology and 10 with PTSD). This population represents a group of combat trauma victims who experienced a relatively acute onset of PTSD, thus providing a unique opportunity to compare prior psychophysiological and cognitive results with a group of veterans who manifested a recent onset of PTSD. Results indicated relatively comparable psychophysiological reactivity and arousal between Persian Gulf War veterans with PTSD and Persian Gulf War veterans without PTSD. Furthermore, attentional processes of veterans with PTSD were not more disrupted than in comparison soldiers. Results suggest that the intensity and chronicity of the disorder may impact physiological arousal and disruption of cognitive functioning. Following Persian Gulf War veterans with PTSD over time may reveal that psychophysiological arousal becomes more pronounced with chronicity, perhaps as memory networks become strengthened and/or neuroendocrine systems become increasingly disrupted.     

Controversies in counseling for mitochondrial conditions

A healthy woman sought preconceptional genetic counseling regarding a family history of a mitochondrial myopathy in her brother and retinitis pigmentosa (RP) in her two maternal aunts. Several questions were raised: (1) What is the likelihood of a familial mitochondrial condition? (2) What molecular tests or prenatal screening can we offer? (3) How would these tests help assess the likelihood of a familial mitochondrial condition? A mitochondrial mutation previously identified in the brother consisted of a heteroplasmic 2.9 kb deletion. We detected this deletion in the peripheral blood of the brother by PCR amplification of the deletion breakpoint, but not in his mother, the consultand, nor in one of the two aunts affected with RP. Although the molecular analysis was encouraging to the consultand, a familial mitochondrial disorder could not be eliminated with certainty. The pros and cons of prenatal testing for mitochondrial disorders are discussed in general, and as specifically related to this family.     

Beyond organizational entry and newcomer stress: Building a self-reliant workforce

This article extends the organizational entry and newcomer stress literature by focusing on the importance of building a self-reliant workforce. It posits that newcomer socialization now and in the future requires building a workforce of self-reliant managers and employees who can function effectively in a dynamic, global workplace. This article suggests that socializing workers to be self-reliant helps employees and organizations to thrive in the uncertain economic environment that is the determining factor in the success of today's organizations. It further contends that by reducing ambiguity and increasing employability, employees are likely to suffer less distress and organizations are less likely to pay the price for distressed employees.     

Causal Attributions, Depression, and Post-Traumatic Stress Disorder in Victims of Crime

The major purpose of this study was to investigate relationships between causal attributions and symptomatology in victims of crime. Fifty-one subjects who had not been crime victims and 120 subjects who had been crime victims participated in the study and were assessed for symptoms of post-traumatic stress disorder (PTSD) and depression. Subjects also completed two attributional questionnaires. The potential differences in symptomatology among victims of a single crime, multiple crimes, and nonvictims were investigated. Results did not indicate differences in depression and PTSD based on single vs. multiple victimization, although differences between victims and nonvictims were found. Results using the Causal Dimension Scale (CDS; Peterson et al., 1982) indicated significant differences in the causal attributions of victims and nonvictims. On the Attributional Style Questionnaire (ASQ; Russell, 1982), group comparisons among nonvictims, PTSD victims, depression victims, both depression and PTSD victims, and victims with low symptoms did not yield significant results. However, regression analyses indicated that several subscales of both the CDS and ASQ were found to be moderate predictors of symptomatology. Implications for future research are discussed.     

Effects of counsellor interpretations and client reactance on social influence and the working alliance

These two studies investigated the main and interaction effects of client reactance and counsellor interpretation discrepancy and style on counsellor social influence and the working alliance. Undergraduate students who were divided into high and low reactant pups listened to low, moderate, or high discrepancy interpretations given by counsellors who used a tentative or absolute interpretation. Contrary to the hypotheses, results showed only one interaction effect for reactance, interpretation discrepancy, and interpretation style. Low reactant participants rated the working alliance higher with tentative interpretations while high reactant participants rated it higher with absolute. High reactant participants consistently tended to perceive the counsellor less positively than low reactant participants. There were unexpected gender differences, suggesting that females saw the counselling more positively in the low discrepancy condition while males did in the moderate. The results were not supportive of an interaction among reactance, discrepancy, and style, but are in line with macro-results in the counselling and psychotherapy literature indicating the primary importance of client variables.     

The role of facial masculinity/femininity in the attribution of homosexuality

This study examined whether subjects would differentially perceive male and female faces as homosexual based upon facial masculinity/femininity, and the extent to which their attitudes toward homosexuals would influence their perceptions. Sixty-eight undergraduates indicated how likely they thought it was that 6 male and 6 female faces were homosexual; they also rated the individuals on attractiveness. The present sample also completed the Index of Homophobia, the Bem Sex Role Inventory, the Attitudes Toward Women Scale, a conservatism scale, and a demographic questionnaire. The subjects assigned higher homosexuality ratings to feminine male and masculine female faces compared to their masculine and feminine counterparts, respectively. In addition, unattractive female faces received higher attribution of homosexuality ratings compared to the attractive faces; such an effect was not observed for the male photographs. Sex of subject and attitudes toward homosexuality did not significantly affect evaluations.Portions of this paper were presented at the meetings of the American Psychological Association, New Orleans, Louisiana, August 1989.