Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Depression and unemployment: Panel findings from the Epidemiologic Catchment Area study

Studies that have found an association between unemployment and psychological depression often fail to establish the direction of causal influence. Analyses of Epidemiologic Catchment Area panel data revealed that of employed respondents not diagnosed with major depression at first interview, those who became unemployed had over twice the risk of increased depressive symptoms and of becoming clinically depressed as those who continued employed. Although the increase in symptoms was statistically significant, the effect on clinical depression was not, possibly because of the low power of the test. The reverse causal path from clinical depression at Time 1 to becoming unemployed by Time 2 was not supported. The unemployment rate in the respondent's community at time of interview was not related directly to psychological depression but appeared associated indirectly with depression via its impact on the risk of becoming unemployed. Implications for policy and further research were discussed. The research described in this paper was supported by Grant #5 RO1 AA08379-02 from the National Institute of Alcohol Abuse and Alcoholism. The authors appreciate the suggestions provided by members of the Consortium for Research Involving Stress Processes sponsored by the W. T. Grant Foundation and by two anonymous journal reviewers.     

Acceptance and commitment therapy: Altering the verbal support for experiential avoidance

Acceptance and Commitment Therapy (ACT) is a behavior-analytically-based psychotherapy approach that attempts to undermine emotional avoidance and increase the capacity for behavior change. An overview of this approach is given, followed by several specific examples of the techniques used within ACT. In each instance the behavioral rationale of these techniques is described. A contemporary view of verbal relations provides the basis for new approaches to adult outpatient psychotherapy.     

Visual slow brain potentials in children with attention deficit disorder

Using a two-stimulus reaction time paradigm, with two separate reward conditions (contingent and noncontingent), we compared slow wave brain potentials (ERPs) in 144 children with attention deficit disorder (ADD) and 30 normal control children. This article reviews the findings during the 900 msec visual warning stimulus. As we had expected, based on ERP work of Forth and Hare (1989) and Raine, Venables and Williams (1990), and on previous work from our own laboratory, the group differences were found in the negative slow wave portions of the ERP complex during the contingent reward condition but not during the noncontingent condition. Aggressive hyperactive subjects with attention deficit disorder (ADDHA) were discriminated from nonaggressive subjects (including control subjects) during the contingent reward condition in the following ways: (1) greater fronto-central negativity (640–900 msec slow wave) and (2) greater right parietal than left parietal negativity (430–750 msec slow wave). All ADD subgroups, when compared to control (CONTR) subjects, showed greater slow wave negativity (700–900 msec) at the midline occipital electrode site during the contingent reward condition. This could be explained in part as an IQ effect on ERPs reflecting the IQ difference between the ADD subgroups and the controls. These slow wave findings seem to relate to attentional problems of these children. They are discussed in terms of a psychobiological model of inhibition/disinhibition and appetitive activation.     

The effects of multi-component,assessment-based curricular modifications on the classroom behavior of children with emotional and behavioral disorders

In this study, academic task assignments were modified in an effort to improve the conduct and task performance of three students with emotional and behavioral disorders. Functional assessments, including interviews and direct observations, were conducted to identify variables that affected the performance of each student during problematic assignments. The assessments implicated several variables for each student. These variables were then used as guides to modify the problematic tasks. The modifications resulted in reduced levels of problem behaviors and increased rates of task engagement, work productivity and accuracy for each of the students. The effects were demonstrated within ongoing academic activities and replicated through the use of reversal designs. The findings are discussed in relation to the practical process of functional assessment and the relevance of curricular and instructional arrangements to the occurrence of disruptive behavior.     

Event-related brain potentials elicited by rhyming and non-rhyming pictures differentiate subgroups of reading disabled adolescents

Event-related brain potentials were recorded while disabled adolescent subjects read and judged whether two sequentially presented pictures had names that rhymed. Subjects with relatively good phonetic skills displayed an N400 priming effect, i.e., a significant reduction in the amplitude of the negative peak, occurring approximately 400 msec post-stimulus, for pictures with names that rhymed with preceding pictures as compared with pictures that had names that did not rhyme with the prime. No such effect was evident for subjects with relatively poor phonetic skills. This lack of an N400 priming effect provides evidence for a reduction in neural capacity and/or activation during phonological processing in the subjects with poor phonological skills. Demonstrating the N400 priming effect to be stronger in one group of reading disabled subjects, compared to another, supports the position that specific subtypes of reading disability exist. In addition to the stronger N400 priming effect, the phonetically stronger group also exhibited an enhanced negativity, from 700 to 1,000 msec after target stimulus onset, compared to phonetically inferior subjects. This finding replicates earlier work and possibly reflects a higher level of confidence in the group with better phonetic skills.