Effectiveness and safety of epilepsy surgery: what is the evidence?

Evidence from a recent randomized controlled trial of surgical versus medical therapy of temporal lobe epilepsy proves that antero-mesial resection is safe and more effective than medical therapy. The number of patients needed to treat for one patient to become free of disabling seizures is two, which is superior to most interventions in neurology. A meta-analysis of non-randomized trials gives almost identical results; about two-thirds of patients become seizure-free, compared with only 8% with medical therapy. The results are remarkably similar among studies from different parts of the world. Quality of life improves early after epilepsy surgery, the improvements are both statistically and clinically significant, and they are sustained. Surgical morbidity with clinically important permanent sequelae is 2%. Epilepsy surgery remains underutilized in developed countries and it does not exist in all but a few developing countries. Current randomized trials are underway to explore the effect of early surgery versus optimum medical therapy on the prevention of disability in patients with mesial temporal lobe epilepsy, and to examine the effectiveness of novel interventions, such as minimally invasive surgery and brain stimulation.     

Maternal regulation of infant reactivity from 2 to 6 months

Previous research has investigated the effect of maternal soothing behaviors on reducing infant reactivity but not the differential effects of specific maternal behaviors on infant stress responses. The present study investigated maternal regulation of 2- and 6-month-olds' responses to an inoculation and found a significant decline with age in both the intensity and duration of infants' crying. Maternal affection and touching decreased from 2 to 6 months, whereas maternal vocalizing and distraction behaviors increased. At both ages, the combination of maternal holding/rocking and vocalizing was associated with decreases in all levels of infant reactivity. Neither strategy alone, however, was found to be effective. Feeding/ pacifying behaviors were effective only when initial distress was at a low or moderate level, which suggests that the effectiveness of maternal regulatory behaviors may depend on the intensity of infants' crying.     

Shyness: relationship to social phobia and other psychiatric disorders

The relationship between shyness, social phobia and other psychiatric disorders was examined. The prevalence of social phobia was significantly higher among shy persons (18%) compared with non-shy persons (3%). However, the majority of shy individuals (82%) were not socially phobic. A significant and positive correlation was found between the severity of shyness and the presence of social phobia, but the data suggest that social phobia is not merely severe shyness. Social phobia was also positively and moderately correlated with introversion and neuroticism. Thus, shy persons with social phobia were shyer, more introverted, and more neurotic than other shy people, but none of these factors was sufficient to distinguish shy persons with social phobia from those without social phobia. The proportion of the shy group with psychiatric diagnoses other than social phobia was significantly higher than among the non-shy group, indicating that various diagnostic categories are prominent among the shy. The results are discussed in terms of the overlap in shyness and social phobia and the relationship of shyness to other psychiatric diagnoses and personality dimensions.     

A dog's got personality: a cross-species comparative approach to personality judgments in dogs and humans

This research offers a blueprint for how a cross-species comparative approach can be realized empirically. In a single design, parallel procedures and instruments were used in 2 species, dogs (Canis familiaris) and humans (Homo sapiens), to test whether personality differences exist and can be judged in dogs as accurately as in humans. Personality judgments of humans and dogs were compared on 3 accuracy criteria: internal consistency, consensus, and correspondence. Results showed that, on all 3 criteria, judgments of dogs were as accurate as judgments of humans. These findings are consistent with the evolutionary continuity hypothesis and suggest an important conclusion not widely considered by either personality or animal researchers: Personality differences do exist and can be measured in animals other than humans.     

The social phobia and anxiety inventory: Construct validity

The Social Phobia and Anxiety Inventory (SPAI) is a new instrument composed of social phobia and agoraphobia subscales. The latter scale is used to detect social anxiety that may result from agoraphobia. The SPAI's construct validity was assessed through several procedures. First, confirmatory factor analyses were conducted to validate the existence of the two subscales. Second, exploratory factor analyses examined the underlying structure of the social phobia subscale. Third, a Q factor procedure determined if different anxiety diagnostic groups could be differentiated by their SPAI response pattern. The results confirmed the utility of the two SPAI subscales and identified a number of dimensions contained within the social phobia subscale which differed depending upon the specific subject sample. In addition, the complaints of social phobies appeared more homogeneous than those of an agoraphobic comparison group. The results are discussed in terms of construct validity and the sensitivity of the SPAI to various dimensions of social phobia fears.This study was supported in part by NIMH Grants 41852, 30915, 18269, and 16884.     

Contextual conditioning and reinstatement of extinguished instrumental responding

In three experiments we studied the relationship between contextual conditioning and the reinstatement of extinguished lever pressing that occurs when noncontingent food is introduced following extinction. In all three experiments the non-contingent food was presented off-baseline (with the response levers not present). On subsequent tests, with the response levers present, animals that had been exposed to food showed more reinstatement of lever pressing than control animals. This finding rules out alternative mechanisms for the reinstated responding that rely on the interaction of non-contingent food and responding, such as superstitious reinforcement or the discriminative after-effects of food. In addition, in each experiment we demonstrated that manipulations known to affect contextual conditioning (signalling the food in Experiment 1, context extinction in Experiment 2, and switching contexts in Experiment 3) reduced the reinstatement. These results are consistent with the claim that contextual conditioning is important in controlling instrumental conditioning and closely parallel findings concerning the reinstatement of Pavlovian responsing following extinction.     

FEMINIST CONTRIBUTIONS TO COUNSELING PSYCHOLOGY

In this article we first identify and provide evidence for feminist contributions to counseling psychology in four broad areas. These are policy and leadership in the field, theory and research, training and practice, and recognition of feminist scholarship and contributions by women. In view of the evidence, we conclude that feminist perspectives are irrevocably changing the field of counseling psychology by stimulating the rethinking of its premises and models with regard to normal development and by developing new approaches to inquiry and practice.