Suicidality in African American men: the roles of southern residence, religiosity, and social support

The rise in suicide by African Americans in the United States is directly attributable to the dramatic, nearly three-fold increase in suicide rates of African American males. Gibbs (1997) hypothesized high social support, religiosity, and southern residence are protective factors against suicidality for Black people. This hypothesis was tested among 5,125 participants from the National Comorbidity Survey; 299 were African American males. In this study we hypothesized that there would be significantly lower suicidality in the South, and social support and religiosity would mediate this relationship. Our results indicate that Southern region is indeed a significant predictor of suicidal symptoms in African American men, such that suicidal symptoms were lower in the South, but religiosity and social support did not account for this effect. Other potential mediators were also examined.     

The incremental validity of the MMPI-2: when does therapist access not enhance treatment outcome?

The present study examined whether therapist access to the Minnesota Multiphasic Personality Inventory (MMPI-2) predicted favorable treatment outcome, above and beyond other assessment measures. A manipulated assessment design was used, in which patients were randomly assigned either to a group in which therapists had access to their MMPI-2 data or to a group without therapist access to such information. Illness severity, improvement ratings, number of sessions attended, and premature termination were indicators of therapy outcome. Results indicated that therapist access to the MMPI-2 data did not add to the prediction of positive treatment outcome beyond that predicted by other measures in this setting. Findings from this initial study suggest that, compared with other resources, perhaps in clinical settings with an emphasis on diagnosis-based and evidence-based treatment, the MMPI-2 may not provide incrementally valid information. However, these effects warrant replication across different settings and samples. Guidelines for future studies are discussed.     

Automatic processing in spider phobia: implicit fear associations over the course of treatment

This study evaluates the cognitive model of anxiety by investigating treatment-related changes in automatic associations to evaluate schematic processing. Spider-phobic participants (n = 31) and healthy controls (n = 30) completed fear-based Implicit Association Tests (IATs), which are reaction-time measures that tap implicit associations without requiring conscious introspection. The specific tasks involved classifying pictures of snakes and spiders along with semantic categorizations (good vs.bad, afraid vs. unafraid, danger vs. safety, and disgusting vs. appealing). Phobic individuals were assessed before and after group-based exposure treatment and 2 months later, controls were assessed at matched time points. Results supported clinical applications for implicit fear associations, including prediction of phobic avoidance, and treatment sensitivity of the fear- and disgust-specific automatic associations.     

Common features of fluency-evoking conditions studied in stuttering subjects and controls: an H(2)15O PET study

We used H(2)15O PET to characterize the common features of two successful but markedly different fluency-evoking conditions -- paced speech and singing -- in order to identify brain mechanisms that enable fluent speech in people who stutter. To do so, we compared responses under fluency-evoking conditions with responses elicited by tasks that typically elicit dysfluent speech (quantifying the degree of stuttering and using this measure as a confounding covariate in our analyses). We evaluated task-related activations in both stuttering subjects and age- and gender-matched controls. Areas that were either uniquely activated during fluency-evoking conditions, or in which the magnitude of activation was significantly greater during fluency-evoking than dysfluency-evoking tasks included auditory association areas that process speech and voice and motor regions related to control of the larynx and oral articulators. This suggests that a common fluency-evoking mechanism might relate to more effective coupling of auditory and motor systems -- that is, more efficient self-monitoring, allowing motor areas to more effectively modify speech. These effects were seen in both PWS and controls, suggesting that they are due to the sensorimotor or cognitive demands of the fluency-evoking tasks themselves. While responses seen in both groups were bilateral, however, the fluency-evoking tasks elicited more robust activation of auditory and motor regions within the left hemisphere of stuttering subjects, suggesting a role for the left hemisphere in compensatory processes that enable fluency. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (1) compare brain activation patterns under fluency- and dysfluency-evoking conditions in stuttering and control subjects; (2) appraise the common features, both central and peripheral, of fluency-evoking conditions; and (3) discuss ways in which neuroimaging methods can be used to understand the pathophysiology of stuttering.     

A Comparison of Least-to-Most Prompts and Progressive Time Delay on the Disruptive Behavior of Students with Autism

We compared the effects of two instructional strategies on the frequency of errors and episodes of disruptive behavior of 4 students with autism. In Phase I, easy and difficult tasks were presented to determine whether the tasks were associated with differential rates of disruptive behavior. Phase II compared the effects of a least-to-most prompting procedure (LTM) to a progressive time delay procedure (PTD) on errors and disruptive behavior when difficult tasks were presented. Observers sequentially recorded instructor instructions, response prompts, prompts for appropriate sitting, and feedback statements; and student disruptive, correct, error, and no responses during 1:1 sessions. Results showed PTD produced fewer errors than LTM for all 4 students, and lower rates of disruptive behavior for 2 students. When PTD was implemented as the final phase with 2 of the students, rates of disruptive behavior associated with the task previously taught with LTM immediately decreased. Conditional probability statements indicated that disruptive behavior occurred infrequently with all 4 students when effective response prompts were used.     

The effect of vowel similarity and syllable length on acoustic memory

Darwin and Baddeley (1974) argue that the presence of recency, suffix, and modality effects are not attributable to the acoustic properties of the stimuli but, rather, to the acoustic distance between the items comprising the test series. The present study is designed to determine whether stimulus duration is a significant variable in acoustic memory. Eight different blocks of synthetic stimuli were prepared; one block each of 60 msec similar and dissimilar syllables and 190 msec similar and dissimilar syllables. The other four blocks consisted of these same vocabularies, but each list in the block had an eighth syllable suffix of the same duration as the syllables in the block. Significant recency and suffix effects are seen for dissimilar syllables of both durations. No effects are demonstrated for 60-msec similar syllables, but both of the effects are seen for 190-msec similar syllables. These results indicate that whether or not a speech sound is preserved in precategorical acoustic storage (PAS) depends upon not only the acoustic distance between the stimuli, but also on other characteristics intrinsic to the stimuli, e.g., stimulus duration.     

A family-based approach to adult mental disorders

Recent research studies have provided strong support for a collaborative approach between families and mental health services in the clinical management of major mental disorders. A comprehensive approach to adult mental health care that employs cognitive-behavioural family therapy as the basis for clinical assessment and treatment is described. This model emphasizes home-based intervention, collaboration with primary care, targeted specific interventions, achievement of the personal goals of index patients and their family members, long-term rehabilitation, and assessment of benefits and costs.     

Stress,coping, and resources in mothers of adults with developmental disabilities

This study examined the relationship of various stressors, coping resources, and coping strategies on the level of stress reported by 147 mothers of adults with delayed development. A sense of mastery and the mother's health as well as financial well-being were significantly negatively related to stress. Coping behaviours of reframing of the problem and acquisition of social support were also significantly negatively related to stress. Implications of the results of this study for service providers are discussed.     

Case study: Reinforcement control of severe aggression exhibited by a child with autism in a family home

This clinical case study describes in-home treatment of severe aggression and tantrum behavior exhibited by an 11 -year-old child with autism, using methods of differential reinforcement comparable to those of a case study by Luiselli (1990). No significant reductions in problem conduct occurred when a parent implemented differential reinforcement of other behavior (DRO) in conjunction with publicly posted ‘good behavior rules,’ physical management training, and redirection to relaxation. Control was established when the child was reinforced for compliance with task demands in conjunction with extinction, implemented directly by professional support staff working in the home. Despite demonstrable parental consistency, systematic training, and fading of supports, results were not maintained at follow-up. The generality of differential reinforcement as a practical intervention for severe aggression in family homes is questioned.