Randomized Controlled Trial of Cognitive–Behavioral Group Therapy for Irritable Bowel Syndrome in a Medical Setting

Standard medical treatments have not been effective for irritable bowel syndrome (IBS) patients. Though individualized cognitive–behavior therapy is an empirically supported treatment option, cognitive–behavioral group therapy (CBGT) has yet to be established as an effective alternative in a randomized controlled trial. This study compared the efficacy of a 10-session CBGT with a home-based symptom monitoring with weekly telephone contact (SMTC) treatment for IBS, extending previous quasi-experimental research in this area. Twenty-eight refractory IBS patients, evaluated and referred by gastroenterologists using the Rome criteria, participated in the study. IBS symptoms, psychological functioning, and health-related quality of life were assessed pre- and posttreatment, and at 3-month follow-up. CBGT patients reported significantly more gastrointestinal (GI) symptom improvement than SMTC patients on posttreatment global measures and had significantly reduced daily diary pain scores at 3-month follow-up. Based on MANOVA, there was significant improvement in psychological distress and health-related quality of life for the CBGT patients in comparison to the SMTC patients. These improvements were also maintained at the 3-month follow-up. Reductions in GI symptoms, psychological distress, and improved health related quality of life may contribute to less behavioral avoidance, disability, and health care utilization in refractory IBS patients.     

Cloninger's Temperament and Character Inventory Correlates with Personality Characteristics of Organ Donation Advocates

Temperament and Character Inventory (TCI) and background questionnaire data were collected from a sample of men and women organ donation advocates (N = 362) as part of a national study to investigate their personality characteristics, temperaments, and attitudes about organ donation advocacy. Goals included identifying unique traits for advocates, and response consistency between the TCI and questionnaire. The TCI results included high scores on Cooperativeness and Self-Directedness, and low on Harm Avoidance dimensions. The questionnaire results indicated that most advocates were White, married, college-educated females, who typically spent less than 2 hr with potential donor families, were satisfied with life and job, and believed they would be in a donation position 2 years from the time surveyed. TCI and questionnaire measures were correlated for Self-Transcendence and Spirituality, Helpfulness and Job Satisfaction, and Compassion and Identification variables.     

Neuropsychological Performance in Gulf War Era Veterans: Traumatic Stress Symptomatology and Exposure to Chemical–Biological Warfare Agents

Because complaints of diminished concentration and memory are among the most common health symptoms reported by Gulf War (GW) veterans with unexplained illnesses, this study investigated neuropsychological functions among GW veterans and controls. Relationships between neuropsychological performance, severity of posttraumatic stress disorder (PTSD) symptomatology, and exposure to chemical–biological warfare agents (CBW) were assessed. Participants were 225 veterans recruited from three cohorts: GW-deployed veterans from Ft. Devens, MA ( n = 141) and New Orleans, LA (n = 37), and Germany-deployed veterans from a Maine National Guard unit (n = 47). A comprehensive evaluation was completed. Severity of subclinical PTSD symptomatology was significantly related to scores on specific neuropsychological tests. PTSD symptom severity in GW-deployed veterans was found to be greater and associated with a broader range of neuropsychological deficits than in Germany-deployed veterans. PTSD severity was associated with lower performance on a range of neuropsychological tasks, whereas CBW exposure contributed to performance deficits on specific cognitive tasks.     

Cognitive Functioning in Treatment-Seeking Gulf War Veterans: Pyridostigmine Bromide Use and PTSD

Gulf War (GW) deployed veterans have reported health symptoms since returning from the war that suggest dysfunction of the central nervous system (CNS). These symptoms include memory and concentration difficulties, fatigue, and headaches. Leading hypotheses for the etiology of these cognitive complaints include psychological factors and/or exposures to chemicals with neurotoxic properties. In this study, cognitive functioning was compared in treatment-seeking GW-deployed veterans and a treatment-seeking non–GW-deployed veteran control group. Results indicated that GW-deployed veterans performed significantly worse than the comparison group on tests of attention, visuospatial skills, visual memory, and mood. GW-deployed veterans who reported taking pyridostigmine bromide (PB) performed worse than GW-deployed veterans without PB use on executive system tasks. Treatment-seeking GW-deployed veterans with diagnoses of posttraumatic stress disorder (PTSD) did not differ on cognitive test measures compared with GW-deployed veterans without PTSD. No interaction effect of PTSD and PB use was found.     

Successive independence and behavioral contrast in a closed economy.

Two pigeons had access to multiple concurrent schedules of reinforcement for 24 hours per day in their home cages. The variable-interval schedules comprising the multiple concurrent schedules were varied across 16 conditions. In three sets of conditions, one schedule was varied while its concurrent alternative and the concurrent schedules in the other component were held constant. Behavioral contrast was observed; that is, as the rate of reinforcement arranged by the varied schedule decreased, response rates on the constant schedules typically increased. These conditions formed part of two larger sets of conditions in which the concurrent schedules in one multiple-schedule component remained constant while the concurrent schedules in the other component were varied. Successive independence was found, in that behavior allocation during the constant component did not vary as a function of the reinforcer ratios in the varied component. Successive independence between components in multiple concurrent schedules is a robust result that occurs in closed economies and under conditions that promote behavioral contrast.     

Social evaluation research: the evaluation of two police patrolling strategies

In most social evaluation research it is difficult to achieve the degree of experimental rigor possible in an applied behavioral study. This study illustrates how the evaluation researcher can increase experimental rigor in the analysis of social interventions. In the first evaluation, a variation of the time-series design that offered maximum experimental control given the limitations of the situation, was employed to evaluate the effects of a specialized home-burglary police patrol. This design revealed that no effects could be attributed to the patrol. In the second evaluation, a multiple baseline-like design was possible in determining the effects of a police walking patrol. This design revealed that the patrol produced an increase in crime reporting but not in arrests. Social interventions often occur in a manner that allows varying degrees of experimental analysis. The evaluation researcher must attain optimal experimental analysis given the limitations of each social intervention.     

Evaluation of multiple schedules with naturally occurring and therapist‐arranged discriminative stimuli following functional communication training

Many studies have shown that (a) functional communication training (FCT) is effective for reducing problem behavior, and (b) multiple schedules can facilitate reinforcer schedule thinning during FCT. Most studies tha have used multiple schedules with FCT have included therapist‐arranged stimuli (e.g., colored cards) as the discriminative stimuli (S^Ds), but recently, researchers have evaluated similar multiple‐schedule training procedures with naturally occurring S^Ds (e.g., overt therapist behavior). The purposes of the current study were to compare the effects of arranged and naturally occurring S^Ds directly during (a) acquisition of discriminated functional communication responses (FCRs) and (b) generalization of discriminated FCRs when we introduced the multiple schedules in novel contexts in which the naturally occurring stimuli were either relatively easy or difficult to discriminate. Results showed that (a) 2 of 3 participants acquired discriminated responding of the FCR more rapidly with arranged than with naturally occurring stimuli, (b) 2 of 3 participants showed resurgence of problem behavior , and (c) 2 of 3 participants showed greater generalization of discriminated responding to novel contexts with arranged stimuli than with naturally occurring stimuli. We discuss these results relative to the conditions under which naturally occurring and arranged S^Ds may promote rapid and generalized treatment gains.     

Dealing with Multiple Solutions in Structural Vector Autoregressive Models

Structural vector autoregressive models (VARs) hold great potential for psychological science, particularly for time series data analysis. They capture the magnitude, direction of influence, and temporal (lagged and contemporaneous) nature of relations among variables. Unified structural equation modeling (uSEM) is an optimal structural VAR instantiation, according to large-scale simulation studies, and it is implemented within an SEM framework. However, little is known about the uniqueness of uSEM results. Thus, the goal of this study was to investigate whether multiple solutions result from uSEM analysis and, if so, to demonstrate ways to select an optimal solution. This was accomplished with two simulated data sets, an empirical data set concerning children's dyadic play, and modifications to the group iterative multiple model estimation (GIMME) program, which implements uSEMs with group- and individual-level relations in a data-driven manner. Results revealed multiple solutions when there were large contemporaneous relations among variables. Results also verified several ways to select the correct solution when the complete solution set was generated, such as the use of cross-validation, maximum standardized residuals, and information criteria. This work has immediate and direct implications for the analysis of time series data and for the inferences drawn from those data concerning human behavior.