Effects of live exposure on symptoms of posttraumatic stress disorder: the role of reduced behavioral avoidance in improvement

Although the effectiveness of cognitive-behavioral treatment in posttraumatic stress disorder (PTSD) is well established, few studies examined its effects on individual PTSD symptoms and possible mechanisms of improvement in symptoms. In a previous randomized controlled study [Ba?og lu, M., Salciog lu, E., Livanou, M., Kalender, D., & Acar, G. (2005). Single-session behavioral treatment of earthquake-related posttraumatic stress disorder: A randomized waitlist controlled trial. Journal of Traumatic Stress, 18, 1-11] a single session of behavioral treatment involving self-exposure instructions was highly effective in reducing earthquake-related PTSD. In the present study we examined the effects of treatment on each PTSD symptom and which symptoms improved early in treatment. Because the intervention focused solely on behavioral avoidance, we hypothesized that avoidance would be the first symptom to change and that reduction in avoidance would generalize to all other symptoms. The results showed significant between-groups treatment effect on only behavioral avoidance early in treatment (week 6). At 6 months post-treatment recovery rates ranged from 60% to 89% for 15 PTSD symptoms, including the numbing symptoms. Lack of improvement in avoidance was associated with lack of improvement in 12 symptoms. The critical process in recovery thus appeared to be increased sense of control associated with reduction in avoidance. These findings imply that live exposure to fear cues designed to enhance sense of control might be sufficient for recovery from PTSD.     

Perceived Social Support and Caregiver Strain in Caregivers of Children with Tourette’s Disorder

The research on Tourette’s disorder (TD), a neuropsychological disorder consisting of motor and phonic tics, has largely focused on individuals with TD and not on the caregivers of children with TD. We investigated the effects of several variables on caregiver strain of caregivers of children with TD, including perceived social support, caregiver characteristics, and characteristics of the child’s disorder. An online survey was completed by 140 caregivers of children with TD between the ages of 6 to 18 years. We performed a path analysis to examine the outcome of caregiver strain in relation to the research variables. Our results indicated that caregiver age, symptom severity of the child’s TD, and perceived social support accounted for variance in caregiver strain, and that perceived social support was a partial mediator of child’s symptom severity and caregiver strain. Symptom severity and caregiver strain were also related to the presence of other comorbid disorders, such as Oppositional Defiant Disorder (ODD), anxiety, or Attention Deficit Hyperactivity Disorder (ADHD) when compared to children either having no other comorbid disorders or other types of disorders.     

Classification of spelling errors and their relationship to reading ability, sex, grade placement, and intelligence

A simple scheme for the classification of spelling errors was applied to the errors of four groups of children, totaling 483 subjects, in grades 3 to 12. The subjects in two of the groups, Group I and Group IV, consisted of individuals who attended special schools for children with dyslexia or specific reading disability (SRD). Group II included school age siblings of subjects in Group I, and Group III included subjects drawn from regular school programs. It was shown that (a) type of spelling error is independent of sex, (b) there are no consistent effects of IQ or grade level on type of spelling error, and (c) disabled readers as a group are more likely to produce dysphonetic errors than are normal readers. Although the type of spelling error produced by children who had a spelling disability only was shown to be similar to that of normal readers and to differ from that of disabled readers as a group, disabled readers were shown to differ among themselves, lending strong support to the use of spelling error type as a characteristic for identifying subgroups.     

Predictive value and psychological meaning of vocational aspirations

The psychological meaning and predictive value of a person's vocational aspirations were examined by applying Holland's typology to the vocational aspirations of high school juniors (N = 1005), college juniors (N = 692), employed adults (N = 140), and a second sample of college students studied over a one-year interval (N = 624). The aspirational data were obtained from the Daydreams section of the Self-Directed Search (Holland, 1972). Categorical and correlational analyses show that a person's retrospective vocational aspirations have coherence and yield efficient predictions of subsequently expressed choice. In addition, the degree of coherence or similarity among a person's vocational aspirations provides a potentially useful index of a person's decision-making ability.     

The virtues of the SDS and its associated typology: A second response to Prediger and Hanson

The author reviews the evidence for the beneficial effects of the Self-Directed Search (SDS), indicates that Hanson and Prediger have misinterpreted the theory, that their evidence is misleading, and that other evidence indicates that males and females of the same type are similar. The virtues of raw scores are summarized. The author recalls some methodological adventures and outlines where we are now in this controversy about the measurement of interests for special groups.     

Cognitive correlates of map-reading ability

The performance of ROTC students on the Relief Format Assessment Test (RFAT) was regressed on psychometric variables and a measure of hemisphericity. Contrary to expectation, it was found that measures of visual-spatial ability and hemisphericity were not good predictors of map-reading ability, whereas the Extended Range Vocabulary and Mathematical Aptitude Tests were significant predictors. Factor analysis of the RFAT indicated the existence of two factors, one tentatively associated with terrain analysis and the other with altitude estimation. Mathematical Aptitude along with Form Board predicted performance on the altitude estimation factor, whereas Extended Range Vocabulary along with Similarities and Institution predicted performance on the terrain analysis factor. These results suggest that at least for our subjects, the solution of map-reading problems is primarily dependent upon verbal-analytic and to a lesser extent upon visual-spatial ability.     

Evaluation of self-contained training procedures for the Time-Sample Behavioral Checklist

The comparative effectiveness of two time-limited modes of training observers to code the behavior of clients in residential treatment programs on the Time-Sample Behavioral Checklist (TSBC) was evaluated. The susceptibility of training procedures to consensual observer drift and the predictability of TSBC mastery from trainee characteristics were also examined. Two equated groups of undergraduate students (N=15 each) participated in full-time training on the TSBC and another instrument for 27 days, followed by criterion testingin vivo and on videotapes. One group was trained by experienced personnel using procedures known to be effective but potentially subject to consensual observer drift. The other group was trained using a previously untested set of written and videotape procedures that do not rely on experienced personnel. Comparative effectiveness and observer drift were evaluated by multivariate and univariate ANOVAs on mastery scores reflecting both pattern agreement and level differences between each trainee and criterion codings. The new, more efficient training procedures were found to be as effective as the original training procedures in the degree of mastery achieved by trainees. Original training procedures were found to be resistant to consensual observer drift, with such a phenomenon appearing in only 1 instance of 156 opportunities. The high degree of mastery achieved by trainees during the time-limited training period was comparable to that previously achieved with the original training procedures. No meaningful predictions of coding mastery were found, with only one trainee characteristic being significantly related to one of six mastery criteria. The results document procedures that are both efficient and resistant to invalidity for training observers in the use of multidimensional observational systems, as well as providing guidelines for the development of standardized procedures.This article is based on a thesis submitted to the Graduate College of the University of Illinois at Urbana-Champaign in partial fulfillment of the requirements for the Ph.D. degree in psychology by the first author and under direction of the second author. The third and fourth authors also participated as supervisors. Appreciation is extended to other members of the thesis committee, Fred Kanfer, Ross Parke, and Julian Rappaport, and to John Gottman and W. Robert Nay for their comments and recommendations. This study was partially supported by Public Health Service Grants MH-25464 and MH-14257 from the National Institute of Mental Health and by grants from the Joyce Foundation, the MacArthur Foundation, and the Illinois Department of Mental Health and Developmental Disabilities.     

Are American children's problems still getting worse? A 23-year comparison

Child Behavior Checklists were completed in home interviews by parents of 7–16-year-olds in 1976, 1989, and 1999. Competence scores decreased from 1976 to 1989, but increased in 1999. Problem scores increased from 1976 to 1989 and decreased in 1999 but remained higher than in 1976. Items, empirically based scales, and DSM-oriented scales showed similar patterns for demographically similar nonreferred samples assessed in 1976, 1989, and 1999 and for national samples that included referred children assessed in 1989 and 1999. For the 114 problem items that were common to the 1976, 1989, and 1999 assessments, the Q correlation was .98 between the mean scores on the 114 items in 1976 versus 1989 and was .94 between the mean scores on the 114 items in 1976 vs. 1999. This indicated very high stability in the rank ordering of item scores across intervals up to 23 years. For all children, the 1-year prevalence rate for mental health services use was 13.2% in 1989 versus 12.8% in 1999. For children with deviant Total Problems scores, the 1989 prevalence for service use was 30.5 versus 26.6% in 1999. Neither difference was statistically significant.     

状态医学——中医学的现代概念

为人体机能状态定义,以中医同病异治,异病同治,说明中医学的本质是状态医学。人体机能状态正常与否的第一个感受者是自我,因此,症状是诊断状态的第一要素,体征是客观依据。由于人体机能状态并非各器官机能的简单加减,因此,现代医学的理化指标在诊断状态时,只供参考。状态医学的模式实质上就是现代中医学,其诊断依据、状态的评价与西医截然不同。在引入现代病因病理学说的基础上,状态医学是一个新的临床诊疗体系,其药学体系有如镜面,反映状态医学的各种特征。