An investigation of the effects of comorbid Axis II pathology on outcome of inpatient treatment for unipolar depression

DSM-based research on comorbidity has suggested thatdepression andpersonality disorder frequently occur together and that the combination of syndromes is associated with a poor response to treatment for depression. The present study was designed to explore the effect of comorbid Axis II pathology for a sample of 45 inpatients who received treatment for major depression. Both categorical and dimensional ratings of personality disorder were used in the statistical analysis. Positive categorical diagnosis of Cluster C (anxious-avoidant) disorder, as well as higher dimensional rating of Cluster A (odd-eccentric) pathology, was predictive of a poor response to treatment (p<.05), as measured by change in pre-post clinical ratings on the Montgomery-Asberg Depression Rating Scale. These results were construed as indicative of a significant Axis II comorbidity effect in the context of an inpatient, multimodal treatment setting for depression. The results also spotlight the influence of techniques of measurement in determining the outcome of statistical analysis.     

Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Three years follow-up of panic disorder patients: A naturalistic study

Forty Danish panic disorder patients participating in a placebo controlled study of alprazolam and imipramine (The Cross National Collaborative Panic Study, Phase II) were followed up by a telephone interview three years later, with essentially the same battery of evaluation procedures applied at baseline, end of study, and follow-up. The main finding was that panic disorder is a chronic disorder, but fluctuating in form and severity in the course of time. Twenty-five percent of the patients no longer fulfilled the DSM-III criteria for panic disorder, but had substantial disability due to a variety of symptoms, including panic attacks at infrequent rate, generalized anxiety symptoms, affective symptoms, and phobic avoidance behavior. Nearly three fourths of the patients were under treatment at follow-up. Benzodiazepines were the drugs most often prescribed, usually in combination with supportive psychotherapy. It was concluded that the different types of treatment offered were insufficient. Variables predicting panic disorder or substantial disability at 3-years follow-up were few.     

Personality disorder correspondence between the million behavioral health inventory (MBHI) and the minnesota multiphasic personality inventory (MMPI)

The MBHI and MMPI personality disorder scales were analyzed for convergent and discriminant validity. Correlational data demonstrated that six of the eight scales were significantly related, while the remaining two scales approached significance. Further analyses of these data, however, demonstrated that none of the scales correlated significantly better with its convergent scale compared to nonconvergent scales. The MBHI classified significantly more of the sample as personality disordered (93%) compared to the MMPI personality disorder scales (17%). Furthermore, the MBHI tended to describe the sample as falling within the Anxious cluster of personality disorders, whereas the MMPI described them within the Dramatic cluster. Single scale codetype correspondence was found to be 15%, while two-point concordance was 12.5%, indicating very low congruence between personality style codetypes. These two measures do not appear to be measuring the same personality style constructs.     

汉字阅读材料的不同排列组合对字词认知速度及准确性的影响

本研究探讨了汉字阅读材料的不同组合对字词认知速度及准确性的影响。实验材料是一篇３２０个字的短文阅读材料,分成三种不同组合形式让被试从左往右发声念读．一种是顺意排列材料形式（即文章句子符合句法及词意）,一种是逆意排列材料形式（即将文章的字词逆反排列）;一种是随机排列材料形式（即将全文字词打乱随机排列）。实验结果表明：对顺意排列材料的念读效果最好,念读速度及准确性明显高于另外两种材料组合形式;中青年组被试的结果明显优于老年组及儿童组的结果．结果提示,对字词念读的认知加工过程明显受相邻字词关系的影响及字词句子化的影响．     

THE TREATMENT OF COVERT SELF-INJURY THROUGH CONTINGENCIES ON RESPONSE PRODUCTS

Assessment and treatment of covert self-injurious behavior are complicated because it is difficult to quantify and apply differential consequences to covert responses. In this study, both tangible and social reinforcers were identified using reinforcer assessment methods. These reinforcers were then provided contingent upon the absence of tissue damage identified during physical examinations, resulting in near 100% success in physical assessment checks that was maintained over 10 months.     

SEQUENTIAL APPLICATION OF MAJOR HABIT-REVERSAL COMPONENTS TO TREAT MOTOR TICS IN CHILDREN

In this study, we sequentially administered up to four components of the habit-reversal treatment to 4 children with motor tics within a multiple baseline design. The habit-reversal components included (a) awareness training; (b) awareness training and self-monitoring; (c) awareness training, self-monitoring, and social support; and (d) awareness training, social support, and the use of a competing response. Results demonstrated that the combined use of awareness training, social support, and competing response training was effective in eliminating motor tics in 2 of 4 children, that awareness training alone was effective for 1 child, and that a combination of awareness training and self-monitoring was effective for the 4th child. The treatment and ensuing improvement were found to be socially valid. We discuss possible explanations for these results and recommend directions for future research.     

Cognitive Impairment and Its Relationship to Psychopathic Tendencies in Children with Emotional and Behavioral Difficulties

This study investigated whether performance on the card playing task (Newman, Patterson, & Kosson, 1987) and the moral/conventional distinction measure predict level of childhood conduct problems as indexed by the Psychopathy Screening Device (Frick & Hare, in press). The card-playing task indexes the child's sensitivity to changes in reinforcement rate. The moral/conventional distinction measure indexes the child's sensitivity to the difference between moral transgressions which result in harm to another from conventional transgressions which more usually result in social disorder. The Psychopathy Screening Device indexes a behavioral syndrome that consists of two dimensions: affective disturbance and impulsive and conduct problems. Thirty-nine children with emotional and behavioral difficulties were presented with both measures. Performance on both measures did predict extent of behavioral disturbance. Moreover, there was a significant association between performance on the card playing tasks and the moral/conventional distinction. The results are interpreted within the response set modulation and violence inhibition mechanism models and by reference to recent work at the anatomical level.     

汉语阅读困难儿童认知特征研究

为了解汉语阅读困难者的认知特征,本研究从９６７名５年级１１－１３岁学生中抽取了１１８名被试,将他们分成困难组（包括截点组和低成就组）和对照组,并将其在词语理解等８个认知变量上进行了比较。结果表明,图形记忆与加工能力及对词语和一般信息理解能力的缺损是汉语阅读困难者主要的认知特征。研究还表明,一般信息理解能力发展水平是区分一般阅读落后和特殊阅读落后的一个指标。