The role of neuropsychology in the assessment and treatment of persons with epilepsy.

Several areas of current interest in the neuropsychology of epilepsy are briefly reviewed in this article. These include variables pertaining to seizures, seizure history, antiepileptic drugs, and methods of neuropsychological evaluation. It is apparent that epilepsy is a multifaceted area: Psychologists not only can be of great assistance to patients with this condition, but may also learn a great deal from this complex disorder.     

Reaction time to threat stimuli in panic disorder and social phobia

Two studies assessed response time among clinically anxious subjects and normal controls when presented with threat, positive and neutral stimuli under perceptual (lexical decision) and semantic (category decision) task conditions. In Study 1, panic disorder subjects' (n = 14) performance was compared to that of matched normal controls (n = 14) while in Study 2 social phobic subjects (n = 24) were compared to matched normal controls (n = 24). Relative to matched normal controls, panic disorder subjects but not social phobics tended to show greater slowing in performance on the more cognitively complex (category) task. A second finding, consistent across both studies was that, compared to the normal control groups, both panic and social phobic groups showed significantly slowed responses to threat words in both the perceptual and semantic tasks. Such findings are directly counter to the predictions of a mood congruence hypothesis. This apparent contradiction is resolved by a review of the literature which indicates that mood-related facilitation effects are obtained only in tasks which tap awareness of threat information rather than speed of response. It is suggested that while anxiety may produce enhanced awareness of threat, it may inhibit responsiveness to it. The results of these studies are seen as consistent with ethological theories of inhibited motoric responses under certain threat conditions. Furthermore, the findings suggest that caution is indicated in interpreting slowed reaction time to threat stimuli in tasks such as the Stroop color naming task as purely the result of attentional processes.     

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.     

Avoidant personality disorder and the generalized subtype of social phobia.

Social phobia and avoidant personality disorder (APD) may be given as comorbid diagnoses. However, it is not known if the labels provide independent, useful diagnostic information. We classified social phobics by social phobia subtype and presence of APD. Generalized social phobics with and without APD (ns = 10 and 10) and nongeneralized social phobics without APD (n = 10) were distinguished on measures of phobic severity. The generalized groups also showed earlier age at onset and higher scores on measures of depression, fear of negative evaluation, and social anxiety and avoidance than did the nongeneralized group. APD criteria of general timidity and risk aversion were more frequently endorsed by social phobics with APD. The data suggest that both the generalized subtype of social phobia and the presence of APD do provide useful diagnostic information but the additional diagnosis of APD may simply identify a severe subgroup of social phobics.     

AN ANALYSIS OF THE EFFECTS OF MULTIPLE SETTING EVENTS ON THE SOCIAL BEHAVIOR OF PRESCHOOL CHILDREN WITH SPECIAL NEEDS

We examined the effects of four combinations of setting events on the social interactions of 7 preschool children with social delays. In Study 1, the status of the teacher, activity materials, and peer varied across conditions. In Study 2, the status of the teacher and materials varied across conditions. Within the combinations of setting events, we also examined teacher behavior. Teacher presence and absence was varied in both studies. The type and rate of teacher prompting were varied in Study 2. The four combinations of setting events produced different rates of social behavior by the children with social delays. The optimal combination of setting events for promoting peer interaction and reducing teacher—child interaction included teacher absence from the activity, a limited number and form of materials, and children paired with a socially skilled partner.     

The meaning of occupational stress items to survey respondents.

This study tested the effect of using the word stress in the measurement of self-reported occupational stressors and strains. Employees from two organizations responded to a questionnaire that included specific occupational stressors, strains, and 16 items in which the word stress was used. Survey respondents tended to interpret the word stress to refer both to employees' strains or reactions to the work environment and to job stressors or elements of the environment itself. Implications of these findings for occupational stress research are discussed.     

PROBLEM SOLVING TO PREVENT WORK INJURIES IN SUPPORTED EMPLOYMENT

A problem-solving strategy was used to teach three groups of 3 individuals in supported employment how to prevent work-related injuries. The problem-solving strategy was taught in two training phases. The first training phase involved the use of cue cards, and the second involved the withdrawal of the cue cards. Interviews and staged generalization assessments in the participants' natural work environments were conducted before, during, and up to 12 weeks after training. In these assessments, situations were presented that were either similar or dissimilar to situations presented in training. Results of both the interviews and staged assessments indicated that the participants' newly acquired problem-solving skills generalized to similar and dissimilar situations.     

Response competition: a major source of interference in a tactile identification task.

Two experiments investigated the ability of subjects to identify a moving, tactile stimulus. In both experiments, the subjects were presented with a target to their left index fingerpad and a nontarget (also moving) to their left middle fingerpad. Subjects were instructed to attend only to the target location and to respond "1" if the stimulus moved either to the left or up the finger, and to respond "2" if the stimulus moved either right or down the finger. The results showed that accuracy was better and reaction times were faster when the target and nontarget moved in the same direction than when they moved in different directions. When the target and nontarget moved in different directions, accuracy was significantly better and reaction times were significantly faster when the two stimuli had the same assigned response than when they had different responses. The results provide support for the conclusion that movement information is processed across adjacent fingers to the level of incipient response activation, even when subjects attempt to focus their attention on one location on the skin.     

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.