Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention-deficit hyperactivity disorder

Twenty-four boys with attention deficit-hyperactivity disorder (ADHD) participating in an intensive summer treatment program each received b.i.d. placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed with two classroom settings: a behavior modification classroom including a token economy system, time out and daily home report card, and a regular classroom setting not using these procedures. Dependent variables included classroom observations of on-task and disruptive behavior, academic work completion and accuracy, and daily self-ratings of performance. Both MPH and behavior modification alone significantly improved children's classroom behavior, but only MPH improved children's academic productivity and accuracy. Singly, behavior therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted in maximal behavioral improvements, which were nearly identical to those obtained with 0.6 mg/kg MPH alone.The authors gratefully acknowledge the assistance of Patricia Donovan, Michelle Berry, Mary Ingram, Patricia Wells, Beth Gnagy, Karen Greenslade, Mary Hamilton, and the entire staff of the Western Psychiatric Institute and Clinic ADHD Summer Treatment Program.     

A study of “Belief” and “Non-belief” items from the jones irrational beliefs test with implications for the theory of RET

Evidence supporting the fundamental position of Rational-Emotive Therapy (RET) that dysfunctional emotions and behaviors are heavily influenced by irrational beliefs has been questioned due to the fact that many measures of beliefs contain items that actually refer to emotions and behaviors. In this study individual items on the Jones Irrational Beliefs Test (IBT) (Jones, 1968/69) were rated by a panel of experts in RET as to whether they referred to beliefs, behaviors, emotions, or were ambiguous. Then Belief items and Non-belief items from the responses of 368 participants were extracted and scored separately. The Non-belief scores, based on items mostly referring to emotions and behaviors, were strongly related to measures of distress, as would be expected. But scores based on items unequivocally referring to beliefs were also significantly related to measures of emotional distress, psychosomatic symptoms, and suicidal contemplation. These findings are interpreted as clear support for RET's position on the relationship between irrational beliefs (B's) and dysfunctional emotions and behaviors (C's).Co-Editor of thisJournal, is a Fellow of the Institute for Rational-Emotive Therapy in New York City, a Professor of Psychology at Hollins College, and a Licensed Psychologist in independent practice in Roanoke, Virginia.     

The relationship between personal authority in the family system and discovery of meaning in life

This study investigated the relationship between intergenerational family relationships and Frankl's concept of meaning in life. Intergenerational family relationships were measured by the Personal Authority in the Family System Questionnaire (PAFS-QE) by Bray, Williamson, and Malone. The meaning in life variables were measured by the Life Attitude Profile-Revised (LAP-R) by Reker. This quantitative study, using the BMDP Statistical Package (Dixon, 1990), correlated the scores on various subscales from both instruments, resulting in seven statistically significant relationships. The findings, although modest, suggest the existence of a relationship between these two theoretical areas.This article is based in part on the first author's doctoral dissertation at Texas Woman's University.A copy of the PAFS-Q may be obtained from: James H. Bray, PhD, 5510 Greenbriar, Houston, TX 77005. A copy of the LAP-R may be obtained from: Gary Reker, PhD, Trent University, Psychology Department, Peterborough, Ontario Canada K9J 7B8.     

‘Healthy eating’ clinics in primary care: Programme intensity and patients' health beliefs

The primary care setting is seen by many to be at the forefront of the attempt to encourage people to follow healthier diets. Conducted in a single practice, the present study firstly considered the effectiveness of three ‘healthy eating’ clinics for patients found to have elevated cholesterol levels at screening. Through the use of a randomised trial, these patients received either basic dietay information or were invited back more frequently and requested to complete food diaries, half of which were then analysed through a computer program. At one year follow up the three programmes were found to have produced a 6.7% reduction in cholesterol levels. However, no differences were found between the three programmes. The study secondly examined a range of health belieji, based on the health belief model, as predictors of reductions in cholesterol levels. These were generally found to be poor predictors, with only the belief that one's diet is related to the chances of developing a number of major conditions and the perception of bam'ers dealing with confidence predicting these reductions. Finally, the case for incorporating self-efficacy beliefs into the healh belief model is outlined and the need for health counsellors to tailor their messages to the pre-existing beliefi and behaviours of patients is highlighted.     

Relationship between religion-related factors and obsessive compulsive disorder

This exploratory study sought to determine whether selected religion-related factors differentiated between 86 patients with obsessive compulsive disorder (OCD), 73 patients with panic disorder, and 292 patients with other psychiatric (non-anxiety) disorders. A standard history questionnaire was used to obtain information from patients concerning religion of origin, involvement in religious activities, religious conflict, and perceived religiousness of parents. It was found that the percentage of patients who reported experiencing religious conflict was significantly higher for the OCD group than for the other two groups. Other findings suggested associations between Catholicism and OCD and between Protestantism and panic disorder, but further research is needed to clarify these relationships. This article is based on a paper presented at the 98th annual convention of the American Psychological Association, Boston, August 1990.     

The utilization of genetic counselors within a newborn screening program

Genetic counselors have participated in the Michigan Newborn Screening Program on a contractual basis since 1988. Their role includes newborn screening education and training, newborn nursery site visits, and monitoring newborn screening in hospitals. Their impact has been to improve the quality of newborn screening services by reducing errors and increasing completion of data fields on newborn screening cards, improving hospital nursery cooperation and problem solving, and enhancing health department response to specific problems.     

Sacred marriage in the study of religion: A perspective from India on a concept that grew out of the ancient near east

Current scholarly understandings of ‘sacred marriage’ are seriously impaired by work that focuses on ancient cultures, primarily in the Near East, but also in Greece. Even when ‘diffusionism’, ‘patternism’, and an apparent preoccupation with rituals presumed sexual are all factored out, modern scholars offer little new because they appeal to rituals never witnessed and to fragmentary texts which we can only hope had some connection to ritual. Focusing on an extant ritual tradition in India with a 200-year-old festival and an explicitly associated text from the 13th century , Harman suggests that here, at least, sacred marriage is an elaborate, ritual statement of kinship responsibilities and obligations reestablished each year among deities and between deities and selected human beings.     

Insight without awareness: On the interaction of verbalization, instruction and practice in a simulated process control task

Four experiments in which subjects learned to control two versions of a complex simulated process control task show that verbalizable knowledge of procedures used to perform these tasks is very limited and is acquired late in learning. Individual learning curves associated with these tasks showed sudden improvements in performance, which were not accompanied by a similar increase in verbalizable knowledge. It was also found that verbal instructions consisting of exemplar memorization, strategies for rule induction, simple heuristics, and experts' instructions were all effective in enhancing novice subjects' performance. A theoretical framework is proposed in which subjects draw on two separate but interacting knowledge structures to perform these tasks. One knowledge structure is based on memory for past experiences (close analogies), and the other is based on one's current mental model of the task. Implicit sets of competing rules that control response selection are derived from both sources of knowledge. It is suggested that dissociations between task performance and verbalizing occur because memory-based processing tends to have more control over response selection because of its greater specificity, whereas a mental model tends to be the preferred mode for verbal reporting because of its greater accessibility.     

Forecasting the impact of the federal sentencing guidelines

The Sentencing Reform Act of 1984, which created the U.S. Sentencing Commission, required that the commisson consider prison capacity in drafting sentencing guidelines. As part of the commission's efforts to meet this requirement, we developed a computer simulation capable of projecting the impact of the commission's guidelines on future sentences and prison populations. According to our projections, “straight” probation sentences will be reduced significantly under the guidelines. However, reducing the use of probation will generate only modest demands on the prisons, and then mostly for community corrections phased in over the course of 5 years. We also project that, while average time served for violent offenses will increase substantially, average time served for most property crimes will remain largely the same. Finally, while we forecast that federal prison populations will grow markedly by the end of this century, this is more a result of the Anti-Drug Abuse Act of 1986 and the career offender provision of the Comprehensive Crime Control Act of 1984 than a result of the guidelines.