Brief Cognitive Behavioral Therapy for Insomnia in Parkinson's Disease: A Case Series Study1

Parkinson's disease (PD) patients frequently suffer from insomnia and insomnia can result in reduction of quality of life in PD. Although pharmacotherapy is most applicable for insomnia, it may cause side-effects in PD. The purpose of the study was to investigate the efficacy of brief cognitive behavioral therapy for insomnia (CBTI) in PD. A total of 11 PD patients aged 43–84 years with chronic insomnia received two sessions of CBTI. Patients reported a significant decrease in total score for the Insomnia Severity Index (ISI). The total score for the Parkinson's Disease Sleep Scale (PDSS) improved. Although objective sleep measured by actigraph did not improve, subjective sleep measured by sleep diary improved. Functional impairment measured by the Sheehan Disability Scale (SDS) significantly decreased. These results revealed that brief CBTI was effective in improving insomnia in PD, with improvements extending to functional impairments that had been affected by insomnia. Additionally, this non-pharmacotherapy treatment could be easily applied to PD patients who may have difficulty coming to the clinic frequently due to physical symptoms.     

The effects of providing access to stimuli following choice making during vocal preference assessments

Two variations of a vocal paired-stimulus preference assessment were evaluated to determine whether the verbal reports of preference, given by individuals with developmental disabilities when no access to the activity was given, matched their verbal reports when access to the activity was given contingent on their choice. The results indicated different outcomes between the two methods for 6 of the 7 participants. Subsequent reinforcer assessments, conducted for 2 participants, showed that activities identified in the preference assessments that provided access contingent on selection resulted in more responding than did activities identified in the preference assessment that did not include access to items following their selection.     

An evaluation of the value of choice with preschool children

The current study examined the reinforcing effects of choosing among alternatives in a four-part evaluation. In the first study, initial-link responses in a concurrent-chains arrangement resulted in access to terminal links in which the completion of an academic task resulted in (a) the choice of a reinforcer (choice), (b) the delivery of an identical reinforcer (no choice), or (c) no material reinforcer (control). Three patterns of responding emerged: persistent preference for choice (3 participants); initial preference for choice, which did not persist (2 participants); and preference for no choice (1 participant). Additional evaluations determined if preference for choice could be enhanced (Study 2) or established (Study 3) by including more stimuli from which to choose. Choice-link selections systematically increased for all participants when more items were available from which to choose. Study 4 identified the precise value of the opportunity to choose by progressively increasing the response requirement during the choice terminal links for 3 children and determining the point at which these children stopped selecting the choice link. All children continued to select the choice link even when the work required in the choice link was much greater than that arranged in the no-choice link.     

The generalized matching law in elite sport competition: football play calling as operant choice

A mathematical model of operant choice, the generalized matching law was used to analyze play-calling data from the 2004 National Football League season. In all analyses, the relative ratio of passing to rushing plays was examined as a function of the relative ratio of reinforcement, defined as yards gained, from passing versus rushing. Different analyses focused on season-aggregate data for the league as a whole, game-by-game data for the league as a whole, and game-by-game data for individual teams. In all analyses except those for a few individual teams, the generalized matching law accounted for a majority of variance in play calling. The typical play-calling pattern reflected undermatching (suggesting imperfect sensitivity of play calling to yardage-gained reinforcers) and a bias for calling rushing plays. Bias was found to be a function of both the relative risk of turnovers and the relative variability in yards gained associated with passing versus rushing plays. The external validity of the matching analyses was supported by significant correlations between parameters of the generalized matching law and team success on offense and season winning percentage. These results illustrate the broad applicability of the generalized matching law to problems outside of the laboratory.     

Rapid acquisition in concurrent chains: evidence for a decision model

Pigeons' choice in concurrent chains can adapt to rapidly changing contingencies. Grace, Bragason, and McLean (2003) found that relative initial-link response rate was sensitive to the immediacy ratio in the current session when one of the terminal-link fixed-interval schedules was changed daily according to a pseudorandom binary sequence (e.g., Schofield & Davison, 1997). The present experiment tested whether the degree of variation in delays across sessions had any effect on acquisition rate in Grace et al.'s (2003) rapid-acquisition procedure. In one condition ("minimal variation"), the left terminal link was always fixed-interval 8 s and the right terminal link was either fixed-interval 4 s or fixed-interval 16 s. In the other condition ("maximal variation"), a unique pair of fixed-interval values was used in each session. Responding was sensitive to the current-session immediacy ratio in both conditions, but across subjects there was no systematic difference in sensitivity. These results challenge the view that initial-link responding in the rapid-acquisition procedure is determined by changes in the learned value of the terminal-link stimuli, and suggests instead that a process resembling categorical discrimination may control performance. A decision model based on the assumption that delays are categorized as short or long relative to the history of delays provided a good account of the data and shows promise in being able to explain other choice phenomena.     

Psychosocial Issues That Face Patients With Charcot-Marie-Tooth Disease: The Role of Genetic Counseling

Charcot-Marie-Tooth (CMT) disease is a hereditary debilitating progressive muscular atrophy and sensory neuropathy of the distal extremities. CMT is usually nonlife threatening. Signs of the disease usually present in childhood or in young adulthood and the level of disability can be variable within and between families. Research addressing specific psychosocial and emotional issues faced by individuals with CMT is limited. Fourteen adults with a clinical and/or molecular diagnosis of CMT (ages 32–74 years) consented to an audio taped interview. The format of the interview was based around an informal questionnaire to prompt and guide the interviewee to describe their experiences of living with a disabling genetic disorder. The interviews focused on their experiences of first symptoms and diagnosis, their life experience with CMT, their limitations due to disability and the role of genetic counseling. This study identifies and explores life issues that individuals with CMT may face, specifically grief over the loss of independence, emotional pain and stress such as embarrassment and guilt of passing on a gene mutation, impact on quality of life, the impact of wearing orthopedic devices, and fear of progressive disability. Our findings suggest that that there are emotional and psychosocial issues specific to affected individuals at different life stages and genetic counselors need to be aware of these issues in order to provide age appropriate support and advice to individuals affected by CMT.     

Causing Students to Choose More Language Arts Work: Enhancing the Validity of the Additive Interspersal Procedure

Research on the additive interspersal procedure was extended by exposing seventh-grade students to curricula-based (e.g., educationally valid) language arts assignments. In Experiment I, each student was given a control language arts assignment containing 20 discrete target items and an experimental assignment containing 24 equivalent target items, plus eight interspersed briefer items. After working on both assignments for 10 minutes, significantly more students chose a new experimental assignment for homework. Individual analysis showed that 85% of the students preferred or chose the assignment associated with higher discrete task completion rates. In Experiment II, students completed both assignments. Results extended previous research by showing that even after expending more effort to complete the 20% more target items plus the additional interspersed items on the experimental assignments, significantly more students chose an experimental assignment for homework. Applied and theoretical implications are discussed along with limitations of the current study and directions for future research.     

In a no-win situation: The employment–health dilemma

Work and organizational psychology (WOP) research has to date mostly focused on people privileged to have the choice between several attractive job options and less on people who are restricted in their job choice (e.g., due to their qualification or personal contingencies) and have to choose from fewer and often less-than-optimal jobs. Often, the jobs available to the latter are characterized by precarious employment and hazardous working conditions which can put them in the difficult situation of having to choose between a health-threatening job and possible unemployment. Building on interdisciplinary literature, we propose the employment–health dilemma (E-H dilemma) as a framework for analyzing this intrapersonal conflict of having to choose between employment (incurring health threats) and health (incurring economic threats) and discuss potential antecedents and consequences of the E-H dilemma at the societal, organizational, and individual level. We outline the implications of the E-H dilemma and make a case for examining the full spectrum of job choice situations in WOP research. In doing so, we demonstrate what WOP can gain by embracing a more inclusive and multidisciplinary approach: uncovering processes in their entirety (e.g., job choice decisions of all people) and strengthening the role and legitimacy of WOP in society.     

青少年早期网络欺凌/受欺凌对睡眠质量的影响：社交焦虑和抑郁情绪的链式中介作用

基于压力认知失眠模型,采用网络欺凌/受欺凌问卷、青少年社交焦虑问卷、流调中心抑郁问卷和匹兹堡睡眠质量指数问卷,对582名中小学生进行三次追踪测查,每次间隔半年,并运用结构方程模型考察社交焦虑和抑郁情绪在网络欺凌/受欺凌对睡眠质量的影响的中介作用及其性别差异。结果表明：(1)社交焦虑和抑郁情绪在网络欺凌/受欺凌影响睡眠质量的路径中均起到链式中介作用;(2)网络欺凌/受欺凌影响睡眠质量的链式中介模型存在性别差异。这启示要改善网络欺凌者与受欺凌者的睡眠质量,应关注网络欺凌给他们带来的情绪困扰,只有从根本上解决其情绪问题,才能最终有效促进其睡眠质量。