Psychological aspects of scuba diving injuries: Suggestions for short-term treatment from a psychodynamic perspective

Dive medicine is described as an area of practice in which psychologists may choose to expand their clinical service and research activities. The author argues that most research studying risk behavior and sports take into account biological, behavioral or cognitive approaches, while ignoring unconscious conflict in risk-taking and injury management. The present paper uses a psychodynamically-oriented, interview-based approach to studying psychological reactions to decompression sickness in three experienced scuba divers. Brief interventions and their outcomes are described.     

脑外伤患者内隐记忆康复护理可行性研究

探讨脑外伤患者在高强度练习和准确反馈条件下,内隐学习知识效应和底层规则迁移易化能力。结果发现：①脑外伤患者在汉字整体偏好深加工的非显著特征学习与对照组一样有效;在笔划浅加工的显著特征学习,明显低于对照组;在自由回忆和再认的重复测验中,患者组与对照组存在显著性差异。②脑外伤患者学习记忆具有整体性、直观性、模糊抽象性、无意识性等特点。③脑外伤患者存在着内隐学习知识效应和内隐知识学习效应,且随着训练强化和训练方法的改进,有增强和外显记忆转化的趋势。     

Evidence of the origin of specific spontaneous head turns during intertrial intervals

Direction and the frequency of spontaneous head movements during the ITIs following forward and backward paired trials were compared to an acquisition of a conditioned orienting (alpha) response directed to the side of the tone source. The head movements were analyzed from video recordings using classification of head turns to preferred and to nonpreferred directions. The results showed a significant increase in the alpha responses during the forward paired conditioning to the preferred direction and rapid extinction during the subsequent backward conditioning sessions. Spontaneous head movements during the ITIs increased to the same preferred direction as the conditioned alpha responses. The results of this experiment suggest that the response initially elicited by the CS can later appear as “spontaneous,” instrumental behavior, the form and the nature of which is determined by the characteristics of the conditioned alpha response developing as a result of classical conditioning.     

Changes in feeding and foraging patterns as an antipredator defensive strategy: a laboratory simulation using aversive stimulation in a closed economy.

The effects of the risk of electric shock on the meal patterns of rats living in an operant chamber were investigated. Rats could obtain food by working on a response lever that provided reinforcement according to chained fixed-ratio continuous reinforcement schedules that allowed the animals control over meal size. Using a two-compartment operant chamber with a safe nesting area and manipulanda area with a grid floor, shock could be correlated with responding on the schedule. Shocks (less than or equal to 1.25 per hour) were scheduled to occur randomly throughout the day, independent of the rat's behavior. Shock caused a reorganization of meal patterns such that the animals took less frequent but larger meals. This pattern reduced the time the animals spent at risk without compromising caloric balance. Similar changes in feeding pattern were obtained in both hooded and albino rats. Exposure to shock in a separate chamber did not produce these behavioral modifications. The magnitude of shock-induced alterations of meal patterns was greater with chained fixed-ratio 90 continuous reinforcement than with chained fixed-ratio 10 continuous reinforcement. Additionally, the rats seemed to be able to reduce food intake but increase caloric efficiency, such that the reduced food intake did not have deleterious effects on maintenance of body weight. These behavioral modifications reduced the number of shocks received from that which would have been expected if meal pattern changes had not occurred. We suggest that this technique may provide a useful laboratory simulation of the impact that the risk of predation has on foraging behavior.     

On the distinction between open and closed economies.

Open and closed economies have been assumed to produce opposite relations between responding and the programmed density of reward (the amount of reward divided by its cost). Experimental procedures that are treated as open economies typically dissociate responding and total reward by providing supplemental income outside the experimental session; procedures construed as closed economies do not. In an open economy responding is assumed to be directly related to reward density, whereas in a closed economy responding is assumed to be inversely related to reward density. In contrast to this predicted correlation between response-reward relations and type of economy, behavior regulation theory predicts both direct and inverse relations in both open and closed economies. Specifically, responding should be a bitonic function of reward density regardless of the type of economy and is dependent only on the ratio of the schedule terms rather than on their absolute size. These predictions were tested by four experiments in which pigeons' key pecking produced food on fixed-ratio and variable-interval schedules over a range of reward magnitudes and under several open- and closed-economy procedures. The results better supported the behavior regulation view by showing a general bitonic function between key pecking and food density in all conditions. In most cases, the absolute size of the schedule requirement and the magnitude of reward had no effect; equal ratios of these terms produced approximately equal responding.     

EFFECT OF SUPPORTED EMPLOYMENT ON THE VOCATIONAL OUTCOMES OF PERSONS WITH TRAUMATIC BRAIN INJURY

This paper reports the job placement of 5 males with severe traumatic brain injury. An individual placement model of supported employment was used. All individuals were placed in competitive employment and received staggered intervention over time by trained employment specialists. A multiple baseline design across persons was used to evaluate results. All individuals had been unable to work consistently or at all in competitive work environments. The range of wages was $4.25 to $5.00 per hour with an average of 339 hours of employment specialist intervention time required per case. The major problems experienced by employment specialists were insubordinate and disruptive behaviors as well as other inappropriate social behaviors displayed at the job site.     

Adapting Cognitive Processing Therapy to Treat Co-Occurring Posttraumatic Stress Disorder and Mild Traumatic Brain Injury: A Case Study

This case study aims to provide evidence for the effectiveness of adapting a particular manualized cognitive behavioral therapy intervention to treat co-occurring posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). This study presents the treatment of a woman who experienced co-occurring mTBI and PTSD following a motor vehicle accident, a dual diagnosis that was established through a flexible assessment approach involving interviews as well as standardized psychological, neuropsychological, and neurobehavioral testing. Treatment planning led to a-priori adaptation of Cognitive Processing Therapy (CPT) to treat both her PTSD symptoms and the sequelae associated with her mTBI. The therapist maintained fidelity to the manualized structure and content of CPT protocol, adapting portions of the treatment to add specific emphasis on issues of identity confusion and role loss in service of addressing these common functional impairments that can accompany mTBI. Discussion focuses on application of CPT for future treatment of comorbid PTSD and TBI amidst complicating factors, including role losses and medical and safety issues. This case study is especially relevant due to the prevalence of co-occurring PTSD and TBI across a variety of populations.     

A correlation between sickness or injury within two weeks,chronic diseases and fatigue among adults aged 18–45 years

To investigate the prevalence of fatigue, the relationship between sickness or injury within two weeks, chronic diseases and fatigue among adults aged 18–45 years. Thousand five hundred and seventy nine individuals were included in this cross-sectional study. The Chalder Fatigue Scale (CFS) was used to assess fatigue defined as CFS score ≥4. The prevalence of fatigue was 25% in this study. Our results showed that only sickness or injury within two weeks (odds ratio [OR]: 2.440) and chronic diseases (OR: 1.727) were significantly related to fatigue. Moreover, their ORs for fatigue remained the same in all models (binary logistic regression models with adjusting for demographic and health-related characteristics one by one). In conclusion, fatigue was prevalent among adults aged 18–45 years. Sickness or injury within two weeks and chronic diseases were the risk factors for fatigue independent of demographic and health-related characteristics.     

A review of social disinhibition after traumatic brain injury

Acquired social disinhibition refers to a debilitating behavioural syndrome commonly reported after a severe traumatic brain injury (TBI) and is characterized by inappropriate social behaviour, often described as immaturity and insensitivity towards others. These behaviours can have enduring effects on the social capability of the individual and their relationships with others. However, research into socially disinhibited behaviour after TBI has been thwarted by a lack of consensus in the literature on definition and measurement. This review provides an overview of our current understanding of the definition, measurement, prevalence, associated outcomes, neuropathology, and underlying mechanisms of social disinhibition after TBI. In addition, suggestions are made for future research to further our understanding of this syndrome with the eventual aim of rehabilitating problematic behaviours. It is concluded that an improved understanding of what causes disinhibited behaviour after TBI will be necessary for the development of effective treatment strategies aimed at the rehabilitation of underlying impairments.