Persistent symptoms among survivors of Hodgkin's disease: an explanatory model based on classical conditioning.

Persistent symptoms of nausea, distress, and vomiting triggered by reminders of cancer treatment were examined among 273 Hodgkin's disease survivors, 1 to 20 years posttreatment. Prevalence rates were high for distress and nausea but low for vomiting. Retrospective report of anticipatory symptoms during treatment was the strongest predictor of persistent symptoms, suggesting that treatment-induced symptoms are less likely to persist if conditioning does not occur initially. Time since treatment was also a significant predictor, with patients more recently treated more likely to experience persistent symptoms. Thus, an explanatory model based on classical conditioning theory successfully predicted presence of persistent symptoms. Symptoms also were associated with ongoing psychological distress, suggesting that quality of life is diminished among survivors with persistent symptoms. Recommendations for prevention and treatment of symptoms are discussed.     

II—Thomas E. Uebel

ABSTRACT This response considers the question whether empiricists are condemned to silence about the epistemic agency their theories attribute or presuppose. It is argued that, unlike Reichenbach or Carnap, Neurath allowed for and indeed provided specifications of the role of epistemic agency in scientific inquiry. If this is correct, it underscores once more the need to distinguish between the various strands of logical positivism which show different strengths and weaknesses.     

Sentences for use in memory research

To investigate the effects of effort toward comprehension on subsequent recall, Auble, Franks, and Soraci (1979) generated a series of 40 sentences which varied in comprehensibility. We presented these sentences along with 60 new sentences to 122 undergraduates at the University of New Orleans. Sentences were rated for comprehensibility both before and after cue presentation. Sentences which appear most useful for research are discussed.     

Role of health locus of control beliefs and expectations of treatment efficacy in adjustment to cancer

We examined the effects of health locus of control beliefs (self-, doctor, and chance control) and expectations of treatment efficacy on short-term psychological adjustment in a sample of newly diagnosed cancer patients. The role of these beliefs and expectations in moderating the relation between (perceived and actual) disease severity and depression was also examined. The data were collected within one week of diagnosis. The relation between perceptions of disease severity and depression was weaker for those who believed that they could personally control their health and for those who held positive expectations about the effects of complying with medical treatment. Similar patterns were found when disease severity was defined in terms of prognosis for survival. Strong negative correlations between self-control/treatment expectations and depression were found for those who perceived that their illness was very severe. The results for chance and doctor control were less consistent. The stability of health control beliefs and treatment expectations over the course of a serious long-term illness is discussed.     

Rhesus monkeys (Macaca mulatta), video tasks, and implications for stimulus-response spatial contiguity

Recent reports (Iwai, Yaginuma, & Mishkin, 1986; Yaginuma & Iwai, 1986) have supported the earlier conclusion by Meyer, Treichler, and Meyer (1965) and by Stollnitz (1965) that the efficiency of primate learning is compromised to the degree that there is spatial discontiguity between discriminanda and the locus of response. The research reported in this article calls for a reconsideration of this conclusion. Two rhesus monkeys (Macaca mulatta) easily mastered precise control of a joystick to respond to a variety of computer-generated targets despite the fact that the joystick was located 9 to 18 cm from the video screen. We hold that stimulus-response contiguity is a significant parameter of learning only to the degree that the monkey visually attends to the directional movements of its hand in order to displace discriminanda as in the Wisconsin General Test Apparatus. If, instead, attention is focused on the effects of the hand's movement rather than on the hand itself, stimulus-response contiguity is no longer a primary parameter of learning. The implications of this work for mirror-guided studies are discussed.     

Illness representations and matching labels with symptoms

Three studies are reported that show that health-relevant information (e.g., blood pressure [BP] or symptoms) initiates an active cognitive search process that results in the construction of an illness representation. Study 1 showed that informing subjects that their BP was elevated affected two attributes of illness representation: identity (label and symptoms), and time line or expected chronology of the health threat. Subjects given a high-BP reading reported symptoms commonly associated with high BP, especially if they attributed the high-BP reading to stress. Study 2 showed that the active search process uses causal information (a third attribute of representations) to give meaning to symptoms. Specifically, subjects used environmental cues to interpret whether familiar, unfamiliar, and ambiguous symptoms were due to illness or to stress. In Study 3 we showed that the constructive process, initiated by a high-BP reading, is directed by prior beliefs about the time line for developing high BP and by the presence of external cues about the stressfulness of the subject's daily life. Subjects who believed BP was labile and that they were under high daily stress or who believed BP was stable and that they were under low daily stress reported more symptoms. The significance of these findings for understanding how people process diagnostic labels and symptom information involved in the construction of illness representations is discussed.     

Gender-related effects in the perception of anger expression

The purpose of the study was to investigate the influence of sex of stimulus person, sex type of subject, and sex of subject on the social perception of anger expression. One hundred and sixty-six female and 100 male subjects completed a questionnaire that consisted of 10 vignettes depicting the expression of anger by either a female or a male stimulus person. For each vignette, subjects rated the psychological balance, expected frequency of behavior, perceived degree of anger, and appropriateness of behavior. Overall, female stimulus persons were rated higher on all dependent measures, but only male raters significantly differentiated between male and female stimulus persons. Generally, female subjects gave higher ratings, but viewed angry behavior as less appropriate than did male subjects. Ratings were also found to be related to subjects' scores on Extended Personal Attributes Questionnaire scales that involved socially undesirable traits. Post hoc analysis indicated that the type of anger response (“aggressive” or “nonaggressive”) was also an important variable, especially for the female subjects.