Some factors associated with compliance in the treatment of alcoholism.

The investigation set out to examine the extent of problems of low compliance at an alcoholism clinic, to investigate some variables that might differentiate referral failures and initial clinic attenders as well as categories of patients who attend for treatment, and to generate hypotheses concerning these differences as a means of developing a compliance-enhancement strategy. Information, including sociodemographic and personality variables, patient self-reports of drinking behaviour, self-perceptions of their need for help and of drinking problem severity, and therapist ratings of drinking problem severity, was gathered on one hundred referrals to a clinic for new patients. Results showed that 46% of patients were referral failures and that, in comparison with attenders, the former group had both waited longer for the initial appointment and were younger. Few variables differentiated the categories of attenders. A greater proportion of those remaining in treatment contact for longer than a month rated the change in their drinking problem over the previous year as 'worse' and more of them had been arrested for public drunkenness. Those who made five or more clinic visits had waited a shorter time for their initial appointment, and a greater proportion rated the effects of their drinking on their work as 'serious' and the change in their social life as 'worse' than patients who had made fewer visits. The findings suggest that variables related to personal perceptions of drinking problems offer a better account of compliance behaviour than the sociodemographic variables which have been the focus of previous research.

Further observations of evoked potentials in obsessional patients.

This study was designed to replicate and extend earlier findings. Evoked potentials (EP) were recorded, using a task of varying complexity involving shape discrimination, with matched groups of obsessional and normal subjects. Results confirmed previous findings that obsessional patients are characterized by reduced amplitudes and decreased latencies of late EP components; divergences between the groups were more marked for tasks of increased complexity.

Some electrophysiological observations in obsessional states.

Averaged evoked potentials were recorded from a group of obsessional patients and matched normal controls for three types of visual stimulation: passive monitoring of a light flash, a pattern consisting of gratings and a cognitive task involving discrimination of two similar shapes. As the complexity of information processing required by the tasks increased, differences in the evoked potentials of obsessionals became more marked. The main finding was of faster latency and reduced amplitude of the N220 component in the cognitive task. The relevance of this finding to a theory of obsessional disorder is discussed.

Premenstrual symptomatology: an interaction hypothesis.

An experiment on mood changes in relation to the premenstrual phase of the cycle is reported. Two groups of 24 female phobic patients (one with natural cycles and the other taking the oral contraceptive) were tested either premenstrually or intermenstrually using concurrent and retrospective methods of mood assessment. Although subjects retrospectively reported experiencing negative mood changes during the premenstrual phase as compared to the intermenstrual phase, no such differences were found when subjects were tested at these particular phases when the purpose of the study was disguised. The implication of this finding, together with those reported previously concerning conditionability and defensive reactions, are discussed.

Vulnerability and defensive reactions in relation to the human menstrual cycle.

The effects of alterations of the organism's internal state, attributable to the menstrual cycle, upon heart-rate responsivity and conditioning are reported. Two groups of 24 female phobic patients (one with natural cycles and the other taking the oral contraceptive) were tested, either premenstrually or intermenstrually, using a conditioning procedure in which a small blue light was the CS and white noise the UCS. Subjects tested premenstrually were significantly differentiated from those tested intermenstrually respecting HR responsivity to the first UCS. Significant differences were also found in conditioned responses following three acquisition trials. The type of reactions observed are similar to those which have been called defensive reactions. Subjects taking the oral contraceptives showed increased susceptibility to acquisition of conditioned responses.

Vulnerability and conditioning in relation to the human menstrual cycle.

An experiment aimed at testing some implications of a model of symptom acquisition is reported. In particular, the effect conditioning and extinction is examined. Sixteen female phobic patients were tested either immediately pre-menstrually or inter-menstrually. Using white noise as the UCS and a blue light as the CS, conditioned GSR responses were readily established in members of the pre-menstrual group, who also showed resistance to extinction. Subjects tested inter-menstrually were less susceptible to these effects. Those subjects taking the contraceptive pill showed increased sensitivity to the acquisition of conditioned responses.