Predicting who benefits from psychoeducation and self help for panic attacks

Self-help and psychoeducation have been identified as effective methods for delivering treatment, yet not everyone benefits from these brief interventions. Therefore it is clinically and economically useful to identify who is likely to require more intensive assistance. This paper develops a prognostic scale which predicts who will recover from panic attacks and who will require more assistance. Method: Random regression models were used to evaluate the relationship between predictive variables, baseline severity, and the rate of improvement in 117 people with DSMIV panic attacks who participated in a trial of a psycho-educational booklet, a self-help workbook, and brief group CBT over a 9-month period. ROC analysis was used to choose cut-off points on a scale made up of significant predictors. Results: Panic disorder and agoraphobia symptom measures were predicted by baseline social anxiety, and general mental health. There was no significant effect on the outcome for baseline depression or anxiety sensitivity. While general mental health (SF12 Mental Component scores) was predicted by the age at first panic attack, neuroticism, panic disorder and/or agoraphobia symptoms and a positive screen for alcohol use disorders. A prognostic scale based on simple additive scoring was equivalent to standard scores and significantly better than chance at predicting who would recover and who required face-to-face therapy. Conclusions: The prognostic scale may be used to guide the choice of psychoeducation, self-help or face-to-face therapy as the first step in stepped care.     

Tactile selective attention and body posture: assessing the multisensory contributions of vision and proprioception

This study addressed the role of proprioceptive and visual cues to body posture during the deployment of tactile spatial attention. Participants made speeded elevation judgments (up vs. down) to vibrotactile targets presented to the finger or thumb of either hand, while attempting to ignore vibrotactile distractors presented to the opposite hand. The first two experiments established the validity of this paradigm and showed that congruency effects were stronger when the target hand was uncertain (Experiment 1) than when it was certain (Experiment 2). Varying the orientation of the hands revealed that these congruency effects were determined by the position of the target and distractor in external space, and not by the particular skin sites stimulated (Experiment 3). Congruency effects increased as the hands were brought closer together in the dark (Experiment 4), demonstrating the role of proprioceptive input in modulating tactile selective attention. This spatial modulation was also demonstrated when a mirror was used to alter the visually perceived separation between the hands (Experiment 5). These results suggest that tactile, spatially selective attention can operate according to an abstract spatial frame of reference, which is significantly modulated by multisensory contributions from both proprioception and vision.     

Effects of the periodic administration of odor or vibration on a 3-hr. vigilance task

The present study examined performance during 3 hr. of simulated sentry duty with and without the intermittent administration of low-level sensory stimuli (odor or vibration). For odor and control conditions, target-detection latency increased steadily over the course of the 3-hr. session. Administration of a tactile stimulus reduced the increase in detection latency compared to that found in odor and control conditions. For all conditions, there were no significant differences in target-detection frequency, shot accuracy, or friend-foe discrimination. Across all conditions, restlessness (motor activity) increased significantly the first hour and remained elevated for the rest of the session. Subjective measures of workload (NASA-TLX) indicated that the 3-hr. task rated high on physical demand, mental demand, frustration, and overall workload. These findings suggest that the intermittent delivery of a clearly detectable tactile stimulus can reduce reaction-time decrements that occur as time on task increases.     

The original MMPI and Colligan Norms revisited

Norms developed by Colligan, Osborne, Swenson, and Offord (1983) and others at the Mayo Clinic for the MMPI overcome criticisms that the MMPI is not useful in 2003 and representative. This study ascertained the classification of MMPI profiles of clinicians. Mayo Clinic norms are warranted in view of the similar classifications made using both methods based on the same MMPI data.     

Familial handedness and spatial ability: a study with Chinese students aged 14-24

This study tested Annett's right-shift theory on spatial ability with two samples from China. The Vandenberg Mental Rotation Test (MRT), Edinburgh Handedness Inventory, and Family Handedness Questionnaire were administered to 266 high school students and 297 undergraduates. We found very few r++ or r-- among Chinese students. Most Chinese are either moderately right-handed or ambidextrous. Consistent with Casey's finding, we found using different methods to classify handedness leads to different conclusions. However, we did not find the effect of familial handedness that Casey found. Visual strategy is related to success on the MRT but handedness is not.     

Emotional risk factors and postconcussional disorder

Emotional risk factors were examined in 129 litigant and nonlitigant patients diagnosed with Postconcussional Disorder (PCD) following Mild Traumatic Brain Injury (MTBI). According to Millon Clinical Multiaxial Inventory (MCMI) criteria, four subgroups emerged: (a) 14.7% met criteria for an Axis I disorder, (b) 24.8% for an Axis II disorder, (c) 24.0% for bout Axis I and II disorders, and (d) 36.4% fell below threshold for psychopathology. Thus, 63.5% endorsed emotional pathology. Of the four groups, those with both Axis I and II psychopathology presented the greatest number of emotional complaints in a clinical interview and manifested the lowest neurocognitive test scores. Motor skills, verbal abilities, memory functioning, and IQ were primarily affected. With the exception of post-morbid emotional complaints, no significant differences were identified between litigants and nonlitigants. Our analysis suggests that the combination of both Axis I and II psychopathology is associated with greater impairment following MTBI.     

Next Steps in Research on Children Exposed to Domestic Violence

The papers in this special issue of Clinical Child and Family Psychology Review provided an overview of what is known about children's exposure to domestic violence, and include indications of gaps in extant research. These gaps and research needs are summarized in this conclusion. Specifically, there is need for further research in several broad areas: definition and measurement of children's exposure to domestic violence; development of research methods and statistical designs that provide detailed information and provide for evidence of intervention effectiveness; impact of domestic violence on parenting and family functioning; the role of child factors and exposure to violence factors in predicting developmental risk and resilience; medical and health consequences of exposure to violence; and the nature of child-system interaction in response to domestic violence. Research needs in these areas are discussed in greater detail, and specific questions are raised for further development.     

Next Steps in Research on Children Exposed to Community Violence or War/Terrorism

The articles in this special issue of Clinical Child and Family Psychology Review provide an overview of what is known about children's exposure to community violence and war/ terrorism, and indicate significant gaps in extant research. These gaps and research needs are summarized in this conclusion.