The effects of distraction and a brief intervention on auditory and visual-spatial working memory in college students with attention deficit hyperactivity disorder

Two studies addressed how young adult college students with attention deficit hyperactivity disorder (ADHD) (n?=?44) compare to their nonaffected peers (n?=?42) on tests of auditory and visual-spatial working memory (WM), are vulnerable to auditory and visual distractions, and are affected by a simple intervention. Students with ADHD demonstrated worse auditory WM than did controls. A near significant trend indicated that auditory distractions interfered with the visual WM of both groups and that, whereas controls were also vulnerable to visual distractions, visual distractions improved visual WM in the ADHD group. The intervention was ineffective. Limited correlations emerged between self-reported ADHD symptoms and objective test performances; students with ADHD who perceived themselves as more symptomatic often had better WM and were less vulnerable to distractions than their ADHD peers.     

The interrupt distraction procedure: a brief hypnotic intervention for belief change and diminishing distress

The Interrupt Distraction Procedure (IDP) is a brief therapeutic technique for cognitive and emotional change. It is comprised of a hypnotic induction, several 20-sec iterations during which the person concentrates on distressing thoughts or imagery or a thought they would like to believe, as well as on a neutral distracting image. It is simple to administer for clinicians familiar with other hypnotic techniques. IDP is useful when a change in beliefs is desired by a client, but some internal process is preventing such a change, and it lessens concomitant distress. It appears to be a simple therapeutic intervention that decreases emotional reactions that accompany certain thoughts or imagery providing some alleviation of symptoms in somatoform, mood and anxiety disorders.     

Hypnosis and distraction differ in their effects on cold pressor pain

On the bases of Hilgard's neodissociation theory and Spano's (1982) sociocognitive theory, volunteers stringently selected for high (N = 10) and low (N = 10) hypnotizability were exposed to a cold pressor pain test during counterbalanced conditions of waking relaxation, distraction, and hypnosis. To better discriminate between hypnosis and distraction conditions, a new distraction procedure was developed involving the memorization of a sequence of colored lights. High hypnotizables showed significantly greater pain relief for hypnosis versus distraction or waking relaxation conditions. High hypnotizables also demonstrated significantly greater pain relief than low hypnotizables in response to hypnosis. Quantitative electroencephalographic (EEG) findings showed significantly greater high theta (5.5-7.5 Hz) activity for highs as compared to lows at parietal (P3) and occipital (01) sites during both hypnosis and waking relaxation conditions. The findings fail to support the socio-cognitive conceptualization of hypnotic behavior while providing additional evidence supporting the neo-dissociation theory and state based theories of hypnosis in general.     

Hypnosis as an intervention in pain management: A brief review

While there is a consensus that psychosocial factors play an important role in the experience of pain, clinical interventions for acute and chronic pain remain primarily biomedical. This pattern persists despite a body of recent empirical work supporting the effectiveness of a number of behavioral and relaxation interventions for these problems. One of these interventions is hypnosis. We briefly discuss hypnotic analgesia and describe how hypnosis can be integrated into biomedical treatment for acute and chronic pain. Special attention is given to indications and contraindications, preparation of patients, and technique.     

Long-term effects of brief acceptance and commitment therapy for psychosis

A previous report explored the impact of a brief (four session) acceptance and commitment therapy (ACT) intervention as compared with treatment as usual (TAU) on rehospitalization over 4 months in a sample of 80 inpatients with psychosis. The present study extended the follow-up period to 1 year and used a more sophisticated survival analysis to take previous hospitalization and length of the current hospitalization into account. Those in the ACT condition showed reduced hospitalization as compared to those in TAU at 4 months post discharge and again at 1 year post discharge. A test of proportionality of hazard showed that survival curves continued to diverge in the 5- to 12-month postdischarge period after adjusting for differences in the 0 to 4 month period. Future directions are discussed.     

Long-term effects of a community intervention for early identification of first-episode psychosis

Objective: To assess whether an Early Case Identification Program (ECIP) for first‐episode psychosis (FEP), which showed no significant short‐term effects, has a delayed impact on duration of untreated psychosis (DUP). Method: Using a historical control design, FEP patients were assessed on clinical variables over three consecutive phases, 2 years prior, 2 years during and 3 years after implementation of the ECIP. Additional analyses were conducted on non‐affective and schizophrenia spectrum psychoses cases only. Results: There was no overall significant difference in DUP across the three phases. For cases treated within the first year of illness a nonsignificant reduction in DUP to less than 2 months observed during the active phase was sustained post‐ECIP. Conclusion: In some jurisdictions community‐wide early case detection may fail to have an immediate or delayed effect on DUP, especially for cases who normally present for treatment with DUP >1 year.     

Long-term effects of transcranial magnetic stimulation on hippocampal reactivity to afferent stimulation.

Transcranial magnetic stimulation (TMS) has become a promising treatment of affective disorders in humans, yet the neuronal basis of its long-lasting effects in the brain is still unknown. We studied acute and lasting effects of TMS on reactivity of the rat hippocampus to stimulation of the perforant path. Application of TMS to the brain of the anesthetized rat caused a dose-dependent transient increase in population spike (PS) response of the dentate gyrus to perforant path stimulation. In addition, TMS caused a marked decrease in inhibition and an increase in paired-pulse potentiation of reactivity to stimulation of the perforant path. Also, TMS suppressed the ability of fenfluramine (FFA), a serotonin releaser, to potentiate PS response to perforant path stimulation. Chronic TMS did not affect single population spikes but caused an increase in paired-pulse potentiation, which was still evident 3 weeks after the last of seven daily TMS treatments. After chronic TMS, FFA was ineffective in enhancing reactivity to perforant path stimulation, probably because it lost the ability to release serotonin. In addition, the beta adrenergic receptor agonist isoproterenol, which caused an increase in PS in the control rats, failed to do so in the TMS-treated rats. These results indicate that TMS produces a long-term reduction in efficacy of central modulatory systems.     

Hostility and perceived social support: interactive effects on cardiovascular reactivity to laboratory stressors

Background: Previous research has identified trait hostility and social isolation as possible psychosocial risk factors for coronary heart disease (CHD). However, few studies have examined hostility and social support simultaneously to determine their independent and possible interactive relations with CHD and disease-promoting mechanisms.Purpose: Hypotheses derived from a general interpersonal model were tested in a study examining trait hostility and perceived social support as predictors of cardiovascular reactivity to laboratory stressors.Methods: Healthy college students (53 men, 55 women) performed speech and mental arithmetic tasks while blood pressure and heart rate were monitored.Results: There was an interactive effect of hostility and perceived social support on systolic and diastolic blood pressure (SBP and DBP) reactivity. Higher hostility scores were associated with greater SBP reactivity for participants who were high in perceived social support; whereas for those with low social support scores, greater hostility was associated with somewhat less SBP reactivity. The same pattern was obtained for DBP, but only during the speech task.Conclusions: These findings encourage further research conceptualizing trait hostility within a general interpersonal framework that calls attention to both positive and negative person-environment transactions. Yung Chen is now at Duke University Medical Center. Suzanne Gilligan is now at the Consortium for Advanced Psychological Training, Michigan State University. Elliot Coups is now at Memorial Sloan-Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences.     

Long-term effects of spinal cord stimulation in chronic pain syndromes

Summary A total of 50 patients with chronic pain syndromes were selected for treatment with spinal cord stimulation. Correct positioning of electrodes was obtained in 44 patients, leading to an initial alleviation of pain in 25 patients. In 6 patients, electrodes (though still effective in 4) had to be removed because of surgical complications within the first 5 months of use. Only 8 patients had at least some beneficial effect lasting for more than 3 years. The long-term results in patients with more severe psychological disturbances were no worse than those of the other patients.     

Malignant melanoma: effects of a brief,structured psychiatric intervention on survival and recurrence at 10-year follow-up

BACKGROUND: The influence of psychiatric intervention on cancer outcome remains a topic of considerable debate. We previously reported the survival benefits for 68 patients with malignant melanoma 5 to 6 years following their participation in a structured psychiatric group intervention. In this article, we report the effects of the intervention on disease outcome in these same patients at the 10-year follow-up. METHODS: In this univariate analysis, the survival and recurrence distributions for the intervention and control groups were estimated using the Kaplan-Meier method, and were tested for equality by the log-rank test. The multivariate analysis used the Cox proportional hazards regression model with the following prognostic factors: age, sex, Breslow depth, tumor site, and treatment status (ie, intervention group vs control group). RESULTS: When analyzed as single covariates, differences between the intervention and control groups were not significant for outcome at the 10-year follow-up. However, being male and having a greater Breslow depth were predictive of poorer outcome. Analysis of multiple covariates also revealed that sex and Breslow depth were significant for recurrence and survival. In addition, participation in the intervention was significant for survival. After adjusting for sex and Breslow depth, participation in the intervention remained significant for survival. CONCLUSIONS: These findings suggest that the survival benefit of the intervention has weakened since the 5- to 6-year follow-up; however, it has not entirely disappeared. At the 10-year follow-up, participation in the intervention remained predictive of survival when statistically controlling for the effects of other known prognostic indicators. Despite the potential health benefits, we do not propose that psychiatric intervention be used in lieu of standard medical care, but as one of its integral components.     

Changing the psychiatric knowledge of primary care physicians. The effects of a brief intervention on clinical diagnosis and treatment

This research examined the malleability of physicians' knowledge about psychiatric disorders (and their recommended treatments) based on a brief educational intervention. Primary care physicians were randomly assigned to a single-session intervention dealing with selected DSM-IIIR affective and anxiety disorders or to a wait-list control group. Posttest (vs. pretest) measures indicated that experimental physicians showed greater increases than controls in diagnostic accuracy on relevant disorders, specifically, major depression, dysthymic disorder, and agoraphobia with panic attacks. Treatment recommendations were also influenced, specifically, for major depression and panic disorder. Interestingly, treatment recommendations were also influenced for certain somatic disorders not addressed in the intervention, suggesting "halo" effects for these disorders. Overall, the intervention was effective in increasing diagnostic knowledge and altering treatment recommendations. Implications for research on psychiatric interventions among physicians are discussed.     

A brief review comparing the effects of sex steroids on two forms of aggression in laboratory mice

This brief review examines the roles of sex steroids in two forms of “aggression” in laboratory mice. The social conflict induced in male mice by individual housing or reproductive experience was contrasted with the attack shown by small groups of female mice on lactating intruders. Gonadectomy of males largely abolishes the former response but actually augments the latter activity in male subjects. Testosterone, estradiol and 5-dihydrotestosterone all restore social conflict in gonadectomized male mice but these sex steroids inhibit attack on lactating female intruders by gonadectomized males. The data clearly confirm that there is no simple relationship between a particular hormone and “aggression.” These forms of attack may serve very different functions even though they involve similar action patterns and distributions of bites on the attacked animal. A tentative discussion is included about the roles of these activities.     

Effects of distraction on pain perception: magneto- and electro-encephalographic studies

After a painful CO2 laser stimulation to the skin, the magnetoencephalography (MEG) response (164 ms in average peak latency) was not affected by distraction, but the sequential electroencephalography (EEG) responses (240-340 ms), probably generated by a summation of activities in multiple areas, were markedly affected. We suspect that the MEG response, whose dipole is estimated in the bilateral second somatosensory cortex (SII) and insula, reflects the primary activities of pain in humans.     

Oxytocin modulates neural reactivity to children's faces as a function of social salience

Oxytocin (OT) enhances social behaviors such as attachment and parental caretaking. Neural correlates of maternal attachment are found in reward-related brain regions, for example, in the globus pallidus (GP). The present work investigates the effects of OT on the neural correlates of parental attachment. Fathers viewed pictures of their own child (oC), a familiar child (fC), and an unfamiliar child (uC) after intranasal application of OT vs placebo. OT reduced activation and functional connectivity of the left GP with reward- and attachment-related regions responsive to pictures of the oC and the uC. The present results emphasize the key role of OT in human parental attachment and suggest that OT reduces neural reactivity to social cues as a function of social salience. Our results together with previous findings speak to a selective reduction of neural reactivity to social stimuli, irrespective of their valence. We argue that one major pathway by which OT exerts its positive effects on affiliative and social behaviors is the attenuation of automatic neural responses, which in turn leads to increased approach behaviors and decreased social avoidance.     

Evaluation of a brief intervention for increasing seat belt use on a college campus.

The authors evaluated a brief intervention for increasing seat belt use among the front seat occupants of cars at a junior college, in a jurisdiction with a mandatory belt use law. The intervention included public posting of performance feedback and distribution of an informational flyer to cars in target parking lot. Feedback was the display of the proportion of drivers observed wearing seat belts on the previous observation day. Seat belt use among drivers increased from 64% during the baseline phase to 71% during the intervention phase. Seat belt use among front passengers increased from 49% during the baseline phase to 67% during the intervention phase. In both cases, seat belt use at follow-up was comparable to seat belt use during the intervention phase, although a trend toward decreasing belt use was noted. Also found was higher seat belt use among females as compared with males irrespective of their front seat occupant status (driver or passenger). Effects of the intervention are discussed in the context of increasing seat belt use in a hardcore nonuser population of predominantly young adults.     

Defending against patients' pain: a qualitative analysis of nurses' responses to children's postoperative pain

OBJECTIVE: Cognitive approaches to clinical communication attribute deficits in communication to lack of skill. We examined, instead, emotional influences on communication by finding out how nurses construed patients who were in pain, and how these constructions were related to the emotional challenge of patients' pain and to deficits in clinical communication. METHODS: Data, analyzed qualitatively, included: (i) direct observations of verbal interactions of 13 nurses with 16 children after orthopedic surgery; (ii) standardized open-ended interviews with the nurses, patients and parents. RESULTS: Nurses tried to prevent children from displaying pain behavior. When pain behavior did occur, they construed pain as unreal, unwarranted or not deserving help. These findings were apparent in observations of, and interviews with, nurses and also in parents' and children's accounts of nurses' behavior. CONCLUSION: We identified behavioral and cognitive strategies whereby clinicians defend themselves emotionally against patients' pain, and which compromise communication with patients in pain.