Adjustment to hemodialysis treatment through behavioral controls

The present study was conducted to examine the hypothesis that compliant chronically ill patients, typically described as adjusted, reinforce more positive social environments using behavioral controls than noncompliant patients, typically described as maladjusted. Specifically, it is hypothesized that diet-compliant chronic hemodialysis patients emit significnatly more active involvement-in-treatment behaviors and more social behaviors than diet-noncompliant chronic hemodialysis patients. Subjects, who ranged in age from 30 to 77 years, were outpatients at a kidney center. Behavioral observations were conducted to assess the occurrence or frequency of (1) four involvement-in-treatment behaviors that are routinely taught to all patients and (2) two social behaviors, which were patient verbalizations and smiles. The results showed that compliant patients emitted significantly more involvement-in-treatment behaviors and smiles than noncompliant patients. Results support the proposed control framework that compliant, in contrast to non-compliant, chronically ill patients have recourse through positive behavioral controls when adjusting to the stresses of illness. It was proposed that through these controls, compliant patients reinforce positive environments rather than simply respond to life circumstances as given.     

认知评价、心理控制感、社会支持与高考压力关系的研究

采用问卷法,随机选取河北省三类中学(重点、普通、私立)324名高三考生为被试,考察了学生对高考的认知评价、心理控制感、社会支持与高考压力的关系.结果表明:(1)重点中学、普通中学学生心理控制感显著高于私立中学学生,女生在社会支持的寻求上显著高于男生;(2)积极认知评价、心理控制感和社会支持与高考压力有显著负相关,而消极认知评价与高考压力有显著的正相关;(3)消极认知评价、心理控制感和社会支持对高考压力有直接影响;而积极认知评价通过心理控制感和社会支持间接影响高考压力.     

Regional brain activity change predicts responsiveness to treatment for stuttering in adults

Developmental stuttering is known to be associated with aberrant brain activity, but there is no evidence that this knowledge has benefited stuttering treatment. This study investigated whether brain activity could predict progress during stuttering treatment for 21 dextral adults who stutter (AWS). They received one of two treatment programs that included periodic H₂¹⁵O PET scanning (during oral reading, monologue, and eyes-closed rest conditions). All participants successfully completed an initial treatment phase and then entered a phase designed to transfer treatment gains; 9/21 failed to complete this latter phase. The 12 pass and 9 fail participants were similar on speech and neural system variables before treatment, and similar in speech performance after the initial phase of their treatment. At the end of the initial treatment phase, however, decreased activation within a single region, L. putamen, in all 3 scanning conditions was highly predictive of successful treatment progress.     

Fairy-tales in psychotherapy

Fairy-tales, like mythologies, can be found all over the world containing the same motif and chains of motifs. In this paper I have presented some theories on the occurrence of this archetypal phenomenon ranging from the old migration theory to Sheldrake's theory of morphogenetic fields. I have then tried to show how fairy-tale-motifs can appear in various ways in analytical therapy, often in hidden forms. We find them in patients' dreams as well as in their fantasies and associations. If the therapist is open to them they will also appear in his or her amplifications. He or she might then take note of the fairy-tale or point it out to the patient; in the latter case it might provide better access to the patient's problems and complexes as fairy-tales have an emotional completeness because of their pictorial character. Finally I have described the favourite fairy-tale of one of my patients and related it to his symptoms, his central complex and his personal ways of experiencing and behaving. This survey of how fairy-tales can be used in therapy with children and with adults far from exhaustive.     

Agoraphobia and Locus of Control

This study investigated whether external locus of control, as measured with the Rotter Internal-External Locus of Control Scale, is a specific feature of agoraphobia or whether it characterizes neurosis in general. Forty agoraphobic patients, 81 nonagoraphobic neurotic controls, and 49 normal controls completed the Dutch version of the Rotter Internal-External Locus of Control Scale. Agoraphobic patients were found to have a more external orientation as compared to the normal controls, but as a group, they could not be identified as being different from neurotic controls.This study was supported in part by a grant from the Dutch Organization for Fundamental Research (ZWO/Psychon 560-268-001).     

The importance of impaired physical health and age in normal cognitive aging

The objective of this study was to investigate the importance of impaired physical health and age in normal cognitive aging. In our cross-sectional, clinical and explorative study, medical and neuropsychological data from 118 voluntary healthy controls aged 26-91 years were collected from five recruitment occasions. Health was assessed according to a criterion reflecting clinical and subclinical severity. The examinations included a clinical investigation, brain neuroimaging, and a comprehensive neuropsychological assessment. Regression analyses showed a significant incidence of clinical and subclinical medical disorders that explained 10.8% of the variation in cognitive performance, while age-related impairment explained 5.6%. Findings of the central nervous system were important but various other medical findings explained about half of the health-related variation. Cognitively demanding tasks were more susceptible to impaired physical health while tasks comprising salient motor- and visual spatial elements were more prone to be impaired by age. Our findings suggest (1) that impaired physical health is more important than chronological age in accounting for cognitive impairment across the adult lifespan, (2) that age and health dissociate with regard to cognitive functions affected, and (3) that selection for so-called "super healthy" elderly people might be justified in cognitive research. Because the prevalent diseases in normal aging are potentially preventable, the present findings promise good prospect for prevention of future cognitive disability among elderly people.     

Meta-analysis of CBT for Bulimia Nervosa: Investigating the Effects Using DSM-III-R and DSM-IV Criteria

This meta-analysis reports the effects of cognitive-behavioural treatment (CBT) on bulimia nervosa as defined by the DSM-III-R or DSM-IV criteria. In a previous meta-analysis, 26 studies were included using less strict diagnostic criteria for inclusion. The present meta-analysis only included randomized controlled studies fulfilling the DSM-III-R or DSM-IV criteria. Computer searches in MedLine, PsychLIT and references cited herein resulted in a large number articles, of which only seven fulfilled the criteria for inclusion. Effect sizes for binge eating and purging frequency were estimated using both between-group (treatment vs control) and within-group (pre- vs post-treatment) comparisons. The combined within-group effect size for binge eating was r = 0.55 ( d = 1.32) and for purging r = 0.61 ( d = 1.54). The corresponding combined effects for the between-group comparisons were r = 0.23 ( d = 0.47) and r = 0.28 ( d = 0.58), respectively. The combined probabilities for frequency of purging in between- and within-group comparisons were p = 0.00001 and p = 0.00000001, respectively. Although the number of studies included in the meta-analysis was limited, the obtained results are in line with the findings of the previous meta-analysis, and support the efficacy of CBT for the treatment of bulimia nervosa. This suggestion is also supported by the fact that in all the studies except one, comparison groups had received other active treatments.     

Psychological Aspects of Tinnitus: A Comparison With Hearing Loss and Ear,Nose and Throat Disorders

Abstract

It is well established that tinnitus is sometimes associated with marked psychological distress, including anxiety and depression. As yet, however, it is unclear whether the problems are specific to tinnitus or may occur in other hearing disorders too. A total of 95 patients with tinnitus were compared with 73 people with hearing loss but no tinnitus, and with a further 80 people attending an out-patient clinic for a variety of other ear, nose and throat (ENT) problems. The principal measures were the Hospital Anxiety and Depression Scale and the Eysenck Personality Questionnaire. The tinnitus patients were significantly more anxious, depressed, and neurotic than the hearing loss group, but were equivalent to the ENT group; and, like the hearing loss group, they were significantly less extraverted than the ENT controls. There were no differences between tinnitus patients with severe hearing loss, mild hearing loss, and no hearing loss. Results from Hallam's Short Tinnitus Questionnaire revealed that tinnitus patients without hearing loss reported significantly fewer difficulties with auditory perception than either of the other tinnitus groups, and significantly fewer irrational beliefs than the group with severe hearing loss. It is concluded that patients with tinnitus were more distressed than people with hearing loss, but that their distress was shared by patients with a variety of other ENT problems. People who reported the greatest problems with their tinnitus were generally those who also had severe hearing loss.     

Selecting the Right Tool For the Job

There are competing ethical concerns when it comes to designing any clinical research study. Clinical trials of possible treatments for Ebola virus are no exception. If anything, the competing ethical concerns are exacerbated in trying to find answers to a deadly, rapidly spreading, infectious disease. The primary goal of current research is to identify experimental therapies that can cure Ebola or cure it with reasonable probability in infected individuals. Pursuit of that goal must be methodologically sound, practical and consistent with prevailing norms governing human subjects research. Some maintain that only randomized controlled trials (RCTs) with a placebo or standard-of-care arm can meet these conditions. We maintain that there are alternative trial designs that can do so as well and that sometimes these are preferable to RCTs.