Gender differences in patterns of emotional distress following heart transplantation

The study provides the first empirical evaluation of gender differences in psychological symptomatology and DSM-III-R major depressive disorder (MDD) across the first year following heart transplantation. An important goal was to identify physical health-related and psychosocial factors that could account for, or mediate, any association between gender and psychological distress. The sample for the present analyses was drawn from a larger cohort of 172 heart recipients and included all 28 women in the cohort plus 118 men who were matched demographically with the group of women. Detailed patient assessments were completed at 2, 7, and 12 months posttransplant. As expected, women's symptom levels were consistently higher than men's. However, while men's symptom levels in all areas declined with time posttransplant, women's distress in the area of depression initially improved but then worsened by the 12-month assessment. The distribution of episodes of MDD showed a temporal pattern of gender differences similar to that of depressive symptoms. The most important mediators of the gender-depression relationship were factors related to early posttransplant daily functional limitations: women reported more impairments in daily activities. Higher levels of such impairments, in turn, predicted subsequently higher depression levels by 12 months posttransplant. Several additional variables pertaining to transplant-related concerns and a low sense of personal mastery—while not serving as mediators—exerted their own independent effects on 12-month depression levels. The findings are relevant to the tailoring of educational and clinical interventions to the individual needs of women and men who receive heart transplants.Roberta G. Simmons, Ph.D., died on February 15, 1993, during data collection for this paper.     

Personality disorders and response to outpatient treatment of chronic pain

As part of a comprehensive interdisciplinary evaluation conducted prior to participation in an outpatient chronic pain treatment program, the psychological status of 101 persons was assessed. The majority of participants was found to have a form of personality disorder, determined by conservative cutoff scores applied to their Millon Clinical Multiaxial Inventory (MCMI) profiles. DSM-III-R Cluster C disorders (i.e., Avoidant, Dependent, Obsessive-Compulsive, and Passive-Aggressive) were overrepresented in this sample. Subsequent analyses revealed that personality disorders were related to higher levels of self-reported distress and pain at both the beginning and the end of outpatient treatment. Differential responses to treatment were observed on self-report measures; however, few relations were found between personality disorder and physical therapist ratings of impairment and improvement. Implications for the assessment of personality disorders in outpatient pain treatment programs are discussed and appropriate intervention strategies are considered.     

THE DIFFERENTIAL EFFECTS OF TEACHER AND PEER ATTENTION ON THE DISRUPTIVE CLASSROOM BEHAVIOR OF THREE CHILDREN WITH A DIAGNOSIS OF ATTENTION DEFICIT HYPERACTIVITY DISORDER

We conducted functional analyses of classroom disruption during contingent teacher and peer attention conditions for 3 children with attention deficit hyperactivity disorder. Attention provided by peer confederates appeared to function as a distinct form of positive reinforcement for all 3 children.     

Agreement of parent and teacher rating scales with comprehensive clinical assessments of attention deficit disorder with hyperactivity

Forty-one clinic-referred children were given the DSM-III diagnosis of attention deficit disorder with hyperactivity (ADD/H) based on structured diagnostic interviews of the child and mother and on two teacher and two parent rating scales. The degree of agreement between diagnostic classification of ADD/H based solely on criterion scores on each rating scale and classification based on the comprehensive clinical assessments that included use of the same rating scaleswas assessed by comparing the ratings of the 41 children with ADD/H to those of 47 clinic-referred children given other diagnoses or no diagnosis. The accuracy of classification was highly similar across scales. Increasing the cutoff score increased the acing true positives. Using the point of intersection of these two curves to choose the optimal cutoff scores resulted in 70–75% accurate classification and 25–30% misclassification of children given clinical diagnoses of ADD/H. This rate of misclassification suggests that rating scales alone should not be used to classify ADD/H for most clinical and research purposes, especially because the method of comparison used in this study favored finding a high degree of correspondence.     

TO WAIT OR TO RESPOND?

Emitting a certain response and waiting for a specified time without making that response had the same consequence. In Experiment 1, food-deprived pigeons were as likely to wait as to respond only if waiting provided food at a much higher frequency than did pecking. In Experiment 2, the consequence for humans was a brief light flash and tone. People were not biased for responding over waiting. Instead, their choices suggested crude payoff maximization. In Experiment 3, pigeons again obtained food, but they were not food deprived and could eat freely at each opportunity. Their behavior was more like that of the humans of Experiment 2 than that of food-deprived pigeons given small quantities of food at each feeding opportunity. The three experiments together showed that biases for responding over waiting were neither inherent characteristics of species nor inevitable outcomes of particular schedules. Choice between active search and waiting depended on ecological–motivational factors even when species and schedules were held constant.     

脑外伤后患者的认知障碍

本文对83例脑外伤患者在智力、记忆、信息处理速度及语言流畅性等方面进行了研究.结果表明:脑外伤损害了患者的高级皮质功能,使其在相当长的时期内,仍遗留有智力、记忆、注意、信息处理速度及语言流畅性等方面的障碍,只是轻、重程度不等而已。从中我们选出相对比较灵敏的测验,做为今后研究脑外伤病人心理功能障碍的方法,并拟定出脑外伤病人心理功能的评定指标。     

Intensive Child-Centered Play Therapy for Children on the Autism Spectrum: A Pilot Study

To investigate the effectiveness of intensive child-centered play therapy (CCPT) for children diagnosed with autism spectrum disorder (ASD), the authors randomly assigned 23 children with diagnosed ASD and symptoms of ASD on the Social Responsiveness Scale–2nd Edition (Constantino, 2012), to an intensive CCPT condition (n = 12) or a no-intervention control group (n = 11). Children who participated in 24 sessions of CCPT showed a statistically significant decrease in ASD core symptoms and behavioral symptoms, such as externalizing problems, attention problems, and aggression, compared with children in the control group. Implications are discussed.     

HiTOP thought disorder,DSM-5 psychoticism,and five factor model openness

HiTOP internalizing, detachment, antagonistic externalizing, and disinhibited externalizing align comfortably with respective domains of the Five-Factor Model (FFM) of general personality. The alignment of HiTOP thought disorder and DSM-5 Section III psychoticism with FFM openness though has been disputed, with the existing research obtaining weak and/or inconsistent results. The purpose of the current paper is to discuss possible reasons for this problematic alignment. The strength of the relationship is hindered in part because it is an alignment of a largely adaptive domain of personality with an entirely maladaptive domain (whereas this is not the case for the other four HiTOP-FFM alignments). The strength of the relationship is also affected by how both openness and psychoticism have been conceptualized and/or assessed.     

Intolerance of uncertainty and difficulties in emotion regulation: Proposal for an integrative model of generalized anxiety disorder

Introduction

The Intolerance of Uncertainty Model (IUM) is a well-tested model of generalized anxiety disorder (GAD).