Acute pain in a clinical setting: Effects of cognitive-behavioural skills training

The present study evaluated the efficacy of cognitive-behavioural skills training, patterned after stress-inoculation training, as a preventive intervention for the attenuation of acute clinical pain during a noxious X-ray procedure—the knee arthrogram. Thirty-six adult male outpatients were randomly assigned to one of three groups: Skills Training. Attention-Placebo, and No-Treatment Control. An experimental pain test was administered before and after the interventions, as a generalization measure. Arthrogram pain was assessed by three dependent measures: patient's ratings, radiologist's ratings and videotape ratings completed by two‘blind’ raters. The results failed to support the efficacy of skills training for the attenuation of acute clinical pain, or its generalization to the experimental pain test. Although Skills Training subjects reported using significantly more coping strategies during the arthrogram. many subjects in the two control groups also reported using their own spontaneous strategies. Equivocal data were obtained on the role of ‘self-efficacy’ expectancies in mediating pain behaviour and experience. Experimental pain threshold but not pain tolerance was significantly related to acute clinical pain experienced during the arthrogram.     

Expressed and inventoried vocational interests as predictors of college graduation and vocational choice

This is a follow-up study of 195 agricultural students originally tested when they entered college in 1970. Students whose Strong Vocational Interest Blank (SVIB) patterns were consistent with their stated choice of major were the congruent sample. Students whose SVIB patterns were inconsistent with their stated choices of major were the discrepant sample. A follow-up was made on graduation rates, eventual major, and job placement. Discrepant subjects changed major more often but graduated at the same rate as congruents. The SVIB did not seem to add anything to the student's expressed interests in predicting college continuation. There was a trend for congruent graduates to more frequently take jobs which matched their majors.     

Speech disturbances in presenile dementia related to local cerebral blood flow abnormalities in the dominant hemisphere

Ten female patients, age 50–70 years, suffering from presenile dementia and showing signs of defective speech function were analyzed. All patients underwent measurements of regional cerebral blood flow (rCBF) by the xenon clearance technique using a 32-detector piece of equipment, and all showed a marked reduction of the hemisphere mean blood flow level. In addition, regional decreases of blood flow of the gray matter was demonstrated. Patients with a marked reduction in the temporo-parieto-occipital regions showed signs of receptive aphasia including alexia and agraphia. Patients with a marked frontal reduction showed signs of expressive aphasia of various types including stereotyped language, voluble speech, echolalia, and mutism in later stages. The results give further support to our previous conclusion that subsymptoms of presenile dementia, apparently also speech disturbances, can be related to local degenerative changes in the brain, which in their turn are accompanied by local reductions of the blood flow of the gray matter. There is pathoanatomical evidence to support this conclusion.     

Prosopagnosia and visual object agnosia: A behavioral study

A left-handed woman developed visual object agnosia, prosopagnosia, and visual disorientation after resection of the right occipital lobe. Color agnosia and alexia were absent. When asked to identify objects presented visually, the patient's errors represented visually related objects (underspecifications) or perseverations. Identification was facilitated when she observed the object being used in a natural way. Identification was impaired by surrounding the object with unrelated objects, decreasing the background illumination, decreasing the duration of exposure of the object to the patient, and probably also by decreasing the visual angle subtended by the object. In addition, there were disturbances of visualization (i.e., imaging in the absence of a visual stimulus) that paralleled the perceptual difficulties. We conclude that: (1) A deficit in visual perception, characterized by insufficient feature analysis of visual stimuli, was the basis of the visual agnosia in this case. (2) The visual agnosia could not be explained by (a) a vision-language disconnection syndrome, (b) decay of visual memory traces, or (c) deficiencies in the visual fields (pathologic Funktionswandel). (3) The ability to visualize (visual imagery) probably utilizes some of the same neural pathways used in perception. (4) The results in this case probably can be generalized to some but not all cases of visual agnosia; in particular, the deficit in most previously reported patients with prosopagnosia is similar to that of our case. However, agnosic alexia and color agnosia usually have a different neuropsychological basis.