Developing a treatment manual for attention management in chronic pain

This article reports the development of a protocol for the therapeutic application of "attention control" for chronic pain. Attention control is the limitation of the impact of pain by switching or retunning attention. An expert systems approach was used to develop the protocol. In the first stage an extensive literature search retrieved published and unpublished accounts of attention control strategies and a draft treatment manual was prepared. In the second stage 6 experts were recruited and they independently read and reviewed the draft manual. They were interviewed using a semi-structured protocol to elicit their views on the draft manual. The manual was then revised to accommodate the information and expertise. In addition to providing expert opinion on the manual the experts also raised issues about the process of change in psychological treatment for chronic pain. These issues were organized into a process model of change in chronic pain.     

Contour grouping inside and outside of facial contexts

We examine how contours group in isolation compared with when they are embedded in face-like contexts. As previously shown, contours that seem to group by phenomenological observation also show powerful effects on task performance: with contours that group, selective attention to one while ignoring another is poor (as indexed by Garner Interference (GI), but not Stroop Interference), whereas divided attention across contours is good. With contours that do not group, however, the reverse happens. Here we test pairs of curved lines (parentheses) displayed either in isolation or within contexts including cartoon faces, where these curves may serve as mouths or eyebrows. The results with isolated contours replicate previous findings of poor selective attention, but within face-like contexts the same contours showed nearly perfect selective attention (i.e., zero GI). Thus, contour grouping was weaker inside than outside of faces, a finding that contrasts with the widely-held belief that faces are processed configurally, not by local features.     

A critique of Lilienfeld et al.'s (2000) "The scientific status of projective techniques"

Lilienfeld, Wood, and Garb (2000) published a largely negative critique of the validity and reliability of projective methods, concentrating on the Comprehensive System for the Rorschach (Exner, 1993), 3 systems for coding the Thematic Apperception Test (TAT; Murray, 1943) cards, and human figure drawings. This article is an effort to document and correct what I perceive as errors of omission and commission in the Lilienfeld et al. article. When projective measures are viewed in the light of these corrections, the evidence for the validity and clinical usefulness of the Rorschach and TAT methods is more robust than Lilienfeld et al. represented.     

Postrecognition of interleaved melodies as an indirect measure of auditory stream formation

Primitive processes involved in auditory stream formation are measured with indirect, objective method. A target melody interleaved with a distractor sequence is followed by a probe melody that was identical to the target or differed by 2 notes. Listeners decided whether the probe melody was present or not in the composite sequence. Interleaved melody recognition is not possible when distractor sequences have the same mean frequency and maximum contour crossover with target melodies. Performance increases with mean frequency separation and timbral dissimilarity and is unaffected by the duration of the silent interval between composite sequence and probe melody. The relation between this indirect task measuring the interleaved melody recognition boundary and direct judgments measuring the fission boundary is discussed.     

Switching between tasks of unequal familiarity: the role of stimulus-attribute and response-set selection

It has been reported that it is harder to switch to a strong, well-practiced task from a weaker, less-practiced task than vice versa. Three experiments replicated this surprising asymmetry and investigated how it is affected by a reduction in interference between tasks. Experiment 1 progressively delayed the onset of the stimulus attribute associated with the stronger task. Experiments 2 and 3 separated the response sets of the tasks. Both manipulations reduced, without eliminating, interference of the stronger with the weaker task but reversed the asymmetry of switch costs, resulting in a larger cost of switching to the weaker task. The results are interpreted in terms of a model of the interactions between control input, task strength, and task priming.     

Do separate processes identify objects as exemplars versus members of basic-level categories? Evidence from hemispheric specialization

When an object is identified as a specific exemplar, is it analyzed differently than when it is identified at the basic level? On the basis of a previous theory, we predicted that the left hemisphere (LH) is specialized for classifying objects at the basic level and the right hemisphere (RH) is specialized for classifying objects as specific exemplars. To test this prediction, participants were asked to view lateralized pictures of animals, artifacts, and faces of famous people; immediately after each picture was presented, a label was read aloud by the computer, and the participants decided whether the label was correct for that picture. A label could name the object at either the basic level (e.g., bird) or as an exemplar (e.g., robin). As predicted, we found that basic-level labels were matched faster when pictures were presented in the right visual field (and hence encoded initially in the LH), whereas exemplar labels were matched faster when pictures were presented in the left visual field (and hence encoded initially in the RH).     

A population-based study of the association between pathological gambling and attempted suicide

The association between pathological gambling and attempted suicide was examined using data from a prevalence study conducted in Edmonton, Alberta, Canada. The sample size was 7,214, the questionnaire was the Diagnostic Interview Schedule, and diagnoses were made on a lifetime basis according to DSM-III criteria. Logistic regression analysis was performed, with attempted suicide as the dependent variable. The odds ratio for pathological gambling was statistically significant (odds ratio = 4.91; 95% confidence interval = [1.41,17.1]) when major depression was the only comorbid mental disorder in the model. As terms for additional mental disorders were included, pathological gambling ceased to be statistically significant. It was concluded that a history of pathological gambling is associated with previous attempted suicide, and that the association may be due to a common factor--"mental illness."     

Involuntary competence

This article addresses whether the state has the right to medicate involuntarily a defendant who is incompetent either to plead guilty or to stand trial for the purpose of restoring legal competence. It first presents the constitutional background concerning incompetence and the right of prisoners generally to refuse psychotropic medication. Then the article examines the individual and state interests that must be considered to decide specifically whether the state may involuntarily medicate a criminal defendant solely for the purpose of restoring competence. Although the individual interests are strong, the article contends that the state does have a right to medicate involuntarily defendants charged with most crimes to restore trial competence, and that adequate remedies are available to ensure that medicated defendants receive a fair trial.     

Decoding digit symbol: speed,memory, and visual scanning

The authors evaluated the relative contributions of speed, memory, and visual scanning to Digit Symbol score in a sample of young adults (N = 87). Speed (Symbol Copy) explained 35% of Digit Symbol variance; only half of this was attributable to graphomotor speed (Name Printing), implying a role for perceptual speed. Visual-scanning tests (e.g., Symbol Scan) explained (on average) 34% of Digit Symbol variance, much of which was independent of perceptual-motor speed, establishing an important role for visual-scanning efficiency in Digit Symbol performance. By contrast, memory tests (on average) explained only 4% to 5% of Digit Symbol variance: statistically significant but clearly subsidiary, although a visual memory composite correlated more strongly with Digit Symbol. The Digit Symbol incidental learning procedures did, however, correlate moderately with other memory measures, suggesting that they are valid memory screening devices.     

Cost-effectiveness and test-performance factors in relation to universal newborn hearing screening

The first portion of this paper reviews current understanding of the cost of universal newborn hearing screening (UNHS), including capital and operating expenses, as well as the costs for follow-up testing on infants who do not pass the hearing screening test in the perinatal period. Capital expenses include the cost of equipment. Operating expenses include the costs for disposables and personnel. Follow-up costs relate to the diagnostic testing that must be performed in order to determine hearing status in those infants who do not pass the newborn hearing screening test. This section is followed by a more theoretical approach, in which test performance, prevalence, program costs, and "costs of hearing loss" are combined in a model that includes all costs of hearing loss, including screening, follow-up testing, and costs (benefits) associated with identifying hearing loss early in life. While some of the model's cost/benefit assumptions may be incorrect, the general approach of taking into account both costs and benefits provides a framework for evaluating the utility of UNHS in a more global manner. Model assumptions (costs, benefits, prevalence, sensitivity, specificity) can be changed to values deemed more appropriate, but the general approach is still informative. With the present assumptions, it is shown that initially, the costs of UNHS exceed its benefits. However, after only four years of operation, UNHS programs will result in a net savings to society. These savings increase rapidly, reaching a maximum annual benefit of seven billion dollars 75 years after initiation of the program, which is also the societal benefit for all years thereafter.