Treating Hypochondriasis with Interpersonal Psychotherapy

The treatment of hypochondriacal patients can be conceptualized as taking one of three approaches. These typically address one of the following questions: 1) “Should the patient be preoccupied?” 2) “Why is the patient preoccupied?” 3) “What are the interpersonal consequences of being preoccupied?” Interpersonal Psychotherapy (IPT) is specifically designed to address the last of these questions. IPT focuses on understanding the patient’s real distress, exploring the patient’s maladaptive communications, and modifying those communications so that others are more able to meet the patient’s attachment needs. With a focus on communication in a time-limited frame, fostered by a strong collaborative relationship, IPT appears to be an effective method of reducing hypochondriacal behavior.     

Biased language use in stereotype maintenance: the role of encoding and goals

In 4 studies, the authors investigated the relative impact of biased encoding of information and communication goals on biased language use. A category label (linguistic expectancy bias, Study 1) or a group label (linguistic intergroup bias, Study 2) was presented either before or after a story that participants were asked to communicate. Biased language use only emerged when participants learned about the group membership of the actor or the category label before hearing the story. However, communication goals had an effect on language use at the retrieval stage, independent of encoding (Studies 3 and 4). Although communication goal effects seemed to overwhelm encoding effects, encoding still influenced language use under externally imposed time pressure (Study 3) and self-imposed time constraints (Study 4). This research reaffirms the importance of both cognitive and communicative processes in stereotype maintenance and highlights the conditions under which they each operate.     

Role rigidity: a problem of identity misclassification?

When nonstigmatized individuals enact certain role-violating behaviors, they risk becoming "falsely accused deviants" (H. S. Becker, 1963, p. 20). For instance, when heterosexual men perform stereotypically feminine behaviors, they are liable to get misclassified as homosexual. Findings presented here reveal that expectations of identity misclassification fuel nonstigmatized individuals' negative reactions to role violations (Studies 1-2) and that using a disclaimer--that is, informing their audience of their nonstigmatized identity--assuages people's discomfort during a role-violating behavior (Studies 3-4). Moreover, when not concerned about being misclassified, nonstigmatized individuals benefit psychologically from the enactment of a challenging role violation (Study 4). Discussion considers the nature of the threat that misclassified role violators face and compares the plight of the falsely accused deviant to that of the truly stigmatized individual.     

Individuality and social influence in groups: inductive and deductive routes to group identity

A distinction between forms of social identity formation in small interactive groups is investigated. In groups in which a common identity is available or given, norms for individual behavior may be deduced from group properties (deductive identity). In groups in which interpersonal relations are central, a group identity may also be induced from individual group members' contributions, making individuality and individual distinctiveness a defining feature of the group (inductive identity). Two studies examined the prediction that depersonalization produced by anonymity has opposite effects for groups in which social identity has been induced or deduced. Results confirmed the prediction that depersonalization increases social influence in groups whose identity was more deductive. In contrast, depersonalization decreases social influence in inductive identity groups. Implications for the role of social identity in small groups are discussed. ((c) 2005 APA, all rights reserved).     

An examination of the "hot hand" in professional golfers

A study investigated the "hot hand" among professional golfers. Hole-to-hole scores within 747 tournaments from a randomly chosen group of 35 players on the 1997 PGA Tour were analyzed. Contingency analyses gave no evidence for the "hot hand". Players were just as likely to score a birdie or better following a par or worse hole as make a birdie or better following a birdie or better hole. These results are consistent with those found for individual players in baseball and basketball.     

Affirmation of personal values buffers neuroendocrine and psychological stress responses

Stress is implicated in the development and progression of a broad array of mental and physical health disorders. Theory and research on the self suggest that self-affirming activities may buffer these adverse effects. This study experimentally investigated whether affirmations of personal values attenuate physiological and psychological stress responses. Eighty-five participants completed either a value-affirmation task or a control task prior to participating in a laboratory stress challenge. Participants who affirmed their values had significantly lower cortisol responses to stress, compared with control participants. Dispositional self-resources (e.g., trait self-esteem and optimism) moderated the relation between value affirmation and psychological stress responses, such that participants who had high self-resources and had affirmed personal values reported the least stress. These findings suggest that reflecting on personal values can keep neuroendocrine and psychological responses to stress at low levels. Implications for research on the self, stress processes, health, and interventions are discussed.     

A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/impulsive and combined subtypes

Attention-deficit/hyperactivity disorder (ADHD) is currently defined as a cognitive/behavioral developmental disorder where all clinical criteria are behavioral. Inattentiveness, overactivity, and impulsiveness are presently regarded as the main clinical symptoms. The dynamic developmental behavioral theory is based on the hypothesis that altered dopaminergic function plays a pivotal role by failing to modulate nondopaminergic (primarily glutamate and GABA) signal transmission appropriately. A hypofunctioning mesolimbic dopamine branch produces altered reinforcement of behavior and deficient extinction of previously reinforced behavior. This gives rise to delay aversion, development of hyperactivity in novel situations, impulsiveness, deficient sustained attention, increased behavioral variability, and failure to "inhibit" responses ("disinhibition"). A hypofunctioning mesocortical dopamine branch will cause attention response deficiencies (deficient orienting responses, impaired saccadic eye movements, and poorer attention responses toward a target) and poor behavioral planning (poor executive functions). A hypofunctioning nigrostriatal dopamine branch will cause impaired modulation of motor functions and deficient nondeclarative habit learning and memory. These impairments will give rise to apparent developmental delay, clumsiness, neurological "soft signs," and a "failure to inhibit" responses when quick reactions are required. Hypofunctioning dopamine branches represent the main individual predispositions in the present theory. The theory predicts that behavior and symptoms in ADHD result from the interplay between individual predispositions and the surroundings. The exact ADHD symptoms at a particular time in life will vary and be influenced by factors having positive or negative effects on symptom development. Altered or deficient learning and motor functions will produce special needs for optimal parenting and societal styles. Medication will to some degree normalize the underlying dopamine dysfunction and reduce the special needs of these children. The theory describes how individual predispositions interact with these conditions to produce behavioral, emotional, and cognitive effects that can turn into relatively stable behavioral patterns.     

Adolescent Suicidality: Who Will Ideate,Who Will Act?

Responses to the 1999 Youth Risk Behavior Survey including suicide ideation, attempt, medically treated attempt, and six problem behaviors were analysed. Youth across the spectrum ideated. Overwhelmingly, the 17% of youth with more than three problem behaviors were the youth who acted; they accounted for 60% of medically treated suicidal acts. Compared to adolescents with zero problem behaviors, the odds of a medically treated suicide attempt were 2.3 times greater among respondents with one, 8.8 with two, 18.3 with three, 30.8 with four, 50.0 with five, and 227.3 with six. A count of problem behaviors offers a reliable way to identify suicide risk.     

Chronic Fatigue Syndrome: The Need for Subtypes

Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians, and researchers. This article provides information concerning the need for appropriate diagnosis of CFS subtypes. We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress. Next, research involving the case definitions of CFS is reviewed. Findings suggest that whether a broad or more conservative case definition is employed, and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected. Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic, and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS characteristically confusing heterogeneous symptom profiles. Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS. This review suggests that there is a need for greater diagnostic clarity, and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.