Posttraumatic stress disorder arising after road traffic collisions: patterns of response to cognitive-behavior therapy.

Road traffic collisions (RTCs) are common precipitants of posttraumatic stress disorder (PTSD). Two preliminary studies suggest that cognitive-behavior therapy (CBT) is, on average, effective in treating this disorder, although the major patterns of treatment outcome remain to be identified. Such outcomes might include treatment response, partial response, and response followed by relapse. To identify these patterns. 50 people with RTC PTSD completed a 12-week course of CBT, with outcome assessment extending to 3-month follow up. Dynamic cluster analyses revealed 2 replicable patterns of outcome: one for responders (n = 30) and one for partial responders (n = 20). Partial responders, compared with responders, tended to have more severe pretreatment numbing symptoms and greater anger about their RTC, along with lower global levels of functioning, greater pain severity and interference, and greater depression and were more likely to be taking psychotropic medications. Responders and partial responders did not differ in homework adherence, number of sessions attended, therapist effects, or stressors occurring during therapy or in the presence or absence of RTC-related litigation. Implications for enhancing treatment outcome are discussed.

Epidemiology of problem gambling in Prince Edward Island: a Canadian microcosm?

OBJECTIVES: To gather information that describes the extent of gambling and problem gambling in Prince Edward Island (PEI), to rigorously analyze the relation between gambling activities and problem gambling, to document cognitive and emotional correlates of problem gambling, and to identify an at-risk gambling group. METHOD: We selected a random, stratified sample (n = 809) to represent the adult population of PEI. We administered both the South Oaks Gambling Screen (SOGS) and an early version of the Canadian Problem Gambling Index (CPGI) to participants who had gambled. RESULTS: The current rate of problem gambling was 3.1%. Problem gamblers were likely to be under age 30 years, to be single, and to report cognitive, emotional, and substance abuse correlates. Multiple-regression analysis identified a unique and substantial relation between problem gambling and video lottery terminal (VLT) use. We identified a group of at-risk gamblers (scoring 1 or 2 on the SOGS), comprising 14% of the sample. CONCLUSIONS: Gambling and problem gambling patterns in PEI resemble those in most other provinces. The relation found between problem gambling, VLT use, and cognitive, emotional, and substance use correlates should apply to the greater population as well.

A preliminary consideration of cue-exposure, response-prevention treatment for pathological gambling behaviour: two case studies.

Cue-exposure, response-prevention, a promising treatment for cigarette-smoking, substance abuse, obsessive-compulsive disorder, etc. has not been fully utilized as a treatment for pathological gambling. Two case-studies, modelled on work by R. Self (1989), with cigarette smoking behaviour, report on an active and thorough application of this treatment to pathological gambling. In both cases, self-report of gambling behaviour and urges to gamble in any situation were found to decrease substantially. Outcome differences between participants were discussed with reference to different levels of pathological gambling as measured by the South Oaks Gambling Screen. It was concluded that cue-exposure, response-prevention should be given more serious consideration as a treatment approach for pathological gambling.

Desensitization of dietary restraint anxiety and its relationship to weight loss.

In this weight reduction study, 25 female university students received desensitization treatment to lessen their dietary restraint anxiety, while a control group of 24 female university students received only relaxation training. All participants were instructed to eat less, and to return monthly to be weighed during the six-month follow-up period. Weight loss data furnished qualified support for the use of desensitization of dietary restraint anxiety as part of a comprehensive treatment program for obesity.

Dietary restraint anxiety and its relationship to human eating behavior.

Ninety-five female university students completed Stunkard and Messick's (Journal of Research Psychosomatic Research, 29, 71-83, 1985) Three-Factor Eating Questionnaire, measuring three dimensions of human eating behavior: cognitive restraint, disinhibition, and hunger susceptibility. They were led through the visualization of a neutral or pleasant scene and a food scene, but were instructed that they would not be able to eat the food. Only hunger susceptibility was found to be significantly correlated with ratings of subjective anxiety (SUDS) and urge to eat in the not eating situation after any variability associated with the neutral scene was removed. That is, internal (hunger) and external (incentive) cues when linked to not eating are sources of anxiety. Treatment programmes for obesity might well include desensitization of these cues.

Cognitive appraisal, self-efficacy, and cigarette smoking behavior.

In the context of a nicotine-fading/self-monitoring cigarette smoking cessation program, three groups were compared: high self-efficacy, low self-efficacy, and a no-treatment control group. Self-efficacy strength was enhanced by manipulating cognitive appraisal using the guidelines of Goldfried and Robbins (1982). Furthermore, throughout the study, self-efficacy values were correlated with various indices of smoking activity. Yet no between-group differences in abstinence rates at end of treatment, 1-month, and 6-month follow-up periods were found.

Frequency as a moderating variable in self-report measures of negative cognition.

Based on responses to the Distressing Thoughts Questionnaire, subjects' most frequent depressive and anxious cognitions were selected and compared with representative low frequency thought statements. The high frequency cognitions were more emotionally intense, uncontrollable and unacceptable than the low frequency thoughts. Although high frequency anxious items were rated as more frequent than high frequency depressive statements, no differences were evident in emotional intensity and controllability. Furthermore thoughts of loss and failure were specifically predictive of dysphoria only when high frequency cognitive items were utilized. The implications of these findings for cognitive assessment issues were discussed.

EEG, measures of complexity, and preference for nonrepresentational works of art.

With a heterogenous sample of human subjects, alpha abundance, an inverse function of cortical arousal, was found to increase with greater complexity of a series of 18 nonrepresentational works of art. This finding is contrary to those of previous EEG studies with artifically generated stimuli, which showed increased arousal with increasing complexity; but is consistent with those which reveal an interverted-U-shaped relation between arousal and complexity when the range of complexity sample is broad. That is, at higher levels of complexity, subjects may be less able to process the information content of paintings. Ratings of interestingness and pleasingness increased with complexity; it may be that they are dependent to some extent on social learning factors.

Approach and following behaviour of 24-hr old chicks as a function of stimulus complexity.

In a straight runway, following or approach behaviour of day-old broiler and leghorn chicks was found to be mainly a linearly decreasing function of stimulus complexity. The patterned stimuli used were checkerboard-like matrices containing, on the average, 4, 36, 100, 400, or 900 bits of information. Preference for simpler stimuli was not found to depend upon experience in the test situation nor upon the degree of complexity of the home pen. When stimulus illuminance was varied, there was a tendency for a plain grey square (zero bits) to be preferred over the pattern containing 4 bits of information, suggesting that approach or following behaviour is energized maximally by some optimal combination of stimulus illuminance and complexity.