An investigation of organic factors in the neuropsychological functioning of patients with borderline personality disorder

The hypothesis to be tested in this study was that the cognitive deficits that have been documented in patients with Borderline Personality Disorder (BPD) are largely the consequence of organic insult, either developmental or acquired. Using a cross-sectional design, 80 subjects (males and females) who met the criteria for BPD participated in the study. They completed a battery of neuropsychological tests and a comprehensive interview assessing organic status as well as measures of the potentially confounding factors of current levels of depression and anxiety. It was expected that BPD-patients with a probable history of organic insult would perform significantly worse than would BPD patients without such a history. Analyses of the results provided partial support for the hypothesis. Subjects with both BPD and a history of organic insult were significantly more impaired on several measures including measures of attention than were BPD only subjects. The results suggested that the impaired cognitive performance of persons diagnosed with BPD may, in part, be attributed to organic factors.     

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.     

Why is discrimination stressful? The mediating role of cognitive appraisal

This study attempts to shed light on past findings that experiences of racial and gender discrimination are associated with poor psychological and physical health outcomes by investigating the role of cognitive appraisal as a mediator of the relationship between experiences of discrimination and affective stress reactions. African American female college students (N = 115) imagined themselves in an audiotaped scenario in which they overheard 2 European American male classmates make negative evaluations of them. Participants then completed measures of causal attributions, cognitive appraisal, and affective stress reactions. Multiple regression analyses supported the hypotheses that attributions to racism and to discrimination that combines racism and sexism were associated with increased stress reactions. This relationship was mediated by cognitive appraisals of centrality.     

A Web-based program for coding open-ended response protocols

A Web-based coding application was designed to improve coding efficiency and to provide a systematic means of evaluating responses to open-ended assessments. The system was developed for use by multiple raters to assign open-ended responses to predetermined categories. The application provides a software environment for efficiently supervising the work of coders and evaluating the quality of the coding by (1) systematically presenting open-ended responses to coders, (2) tracking each coder’s categorized responses, and (3) assessing interrater consistency at any time in order to identify coders in need of further training. In addition, the application can be set to automatically assign repeated responses to categories previously identified as appropriate for those responses. To evaluate the efficacy of the coding application and to determine the statistical reliability of coding open-ended data within this application, we examined data from two empirical studies. The results demonstrated substantial interrater agreement on items assigned to various categories across free and controlled association tasks. Overall, this new coding application provides a feasible method of reliably coding open-ended data and makes the task of coding these data more manageable.     

A prospective examination of body image and smoking cessation in women

This study prospectively examined body image in a community sample of women smokers (N = 141, 89% European–American, M age = 39.5, M BMI = 25.5) participating in a 12-week randomized smoking cessation trial. Participants completed measures assessing subjective and perceptual aspects of body image. Regression analyses showed that subjective body image was predictive of smoking rate at the end of treatment. A MANCOVA revealed that perceptual body image (body size estimation) significantly predicted smoking cessation. Quitting smoking actually worsened body image, although these results were no longer significant after controlling for weight gain. Results support the theory that a negative body image may hamper cessation attempts. In addition, weight gain during smoking cessation may adversely impact body image and lead to an increased risk for relapse.     

Using What Premarital Couples Already Know to Inform Marriage Education: Integration of a Gottman Model Perspective

The Marriage Preparation and Preservation Act of Florida stimulated a study of premarital couples. What are the best things that you do in your relationship was asked in a survey of persons seeking marriage licenses. The sample consisted of 962 participants. Responses were examined using Gottman's Sound Marital House (1999) as a theoretical framework. Results indicate that premarital participants view specific aspects of the Sound Marital House as the best things they contribute to their relationship. Responses can be used as a guide to the development of a Gottman-based marriage preparation curriculum.     

The Parents Matter! Program Interventions: Content and the Facilitation Process

The Parents Matter! Program (PMP) has developed three interventions for parents of 4th and 5th grade African-American children (9–12 years old). The overarching goal of all three interventions is to provide parents with knowledge, skills, and support for enhancing their efforts to raise healthy children. The interventions are: (1) Enhanced Communication and Parenting (five 2 -hour sessions), (2) Brief Communication and Parenting (single 2 -hour session), and (3) General Health (single 2 -hour session). This article discusses the development of these interventions, presents an overview of the content of each intervention, and discusses issues related to the facilitation/presentation of these interventions.     

Impact of recent findings on study design of future autism clinical trials

There are specific challenges to studying the design of pharmacologic trials in child/adolescent and adult autism, such as subject stratification and parallel versus crossover designs. This article describes how optimal study design is influenced by subject selection and outcome measures chosen. Lessons learned in study design from the Research Units on Pediatric Psychopharmacology Autism Network trial with risperidone, Seaver Center trials with fluoxetine and valproate, Dartmouth trials with amantadine, and National Institutes of Health secretin trials are highlighted. The Internet System for Assessing Autistic Children system for managing multicenter clinical trials in autism and statistical issues in autism research are also described.     

Training parents to implement pediatric feeding protocols

Four different multicomponent training packages were evaluated to increase the treatment integrity of parents implementing pediatric feeding protocols. In Study 1 we exposed 3 parents to a training package that consisted of written protocols (baseline), verbal instructions, therapist modeling, and rehearsal training. Results suggested that the package was successful in increasing treatment integrity of the feeding protocols to high levels. Study 2 investigated three different parent-training packages comprised of components used in Study 1. Two parents were exposed to written protocols, verbal instructions, and modeling; 2 parents were exposed to written protocols, verbal instructions, and rehearsal; and 2 parents were exposed to written protocols and verbal instructions. Results of Study 2 showed that each parent-training package produced very high treatment integrity. Follow-up data in the clinic and home for 5 participants suggested that the results were durable for up to 3 months. These results demonstrate a first step in the transfer and application of research findings into routine clinical practice because we evaluated several methods for training parents to implement behavioral feeding protocols, and we demonstrated that these methods resulted in high levels of treatment integrity in a controlled clinical setting.     

Violence: incidence and frequency of physical and psychological assaults affecting mental health providers in Georgia

Threats to the physical safety and psychological well-being of mental health professionals present serious problems, according to 1,131 licensed mental health professionals in the state of Georgia. The professionals included clinical social workers, marriage and family therapists, professional counselors, psychiatrists, psychologists, and social workers. From a total of 6,431 surveys sent out, 1,131 (18%) were returned. The results revealed 2.696 separate accounts of 14,120 acts of physical or psychological assaults committed by 8,292 perpetrators. The results also showed that 61% of the respondents had been victimized in violent acts of a psychological or physical nature and that 29% had feared for their lives at least once during their professional careers. These data are consistent with other research that indicates that 6 out of 10 professionals will be assaulted during their professional careers.