Loneliness: Paradox or artifact?

Comments on the article by R. Kraut et al (see record 1998-10886-001) regarding associations between Internet use and depression and social interaction. The author examines a methodological flaw in the data: the researchers inadvertently selected participants whose social contacts (high school students graduating, their parents, and people with very high levels of community involvement) were likely to decline during the course of the study, even without Internet access. Therefore, it is possible that the reported increases in loneliness and depression would have occurred even had no Internet access been provided. Furthermore, because those participants with the greatest loss of social contacts might fill their now empty hours with Internet usage, the observed negative correlation between social contact and Internet usage might indicate that isolation leads to Internet usage—a causal relationship opposite to that posited by the researchers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arbiter: Psychologist or psychiatrist?

Presents the author's views on the tenor of the negotiations between the American Psychological Association's (APA's)Committee on Relations with Psychiatry and its opposite number from the American Psychiatric Association. His concern stems primarily from what is considered to be ambivalence on the part of the group as it is expressed in their negotiations with the psychiatrists, as well as the official position of the American Psychological Association. To be more specific: While we consider ourselves competent to handle our affairs as scientists and teachers, and would resent any intrusion in these areas, we appear to be less sure of ourselves in the area of practice, and much more explicitly, private practice. He points to the Ethical Standards of Psychologists (1953) that state, under Principle 2.51-4: The psychologist who engages in psychotherapy is obligated to assist his client, in obtaining professional help for all important aspects of his problem which fall outside the boundaries of the psychologist's competence. Most frequently this principle will require that adequate provision be made for the diagnosis and treatment of medical problems. As a commentary on this principle it is stated: To this end, psychologists doing psychotherapy may be expected to establish and maintain effective inter-communication with a psychologically-oriented physician. The usual and most desirable interpretation of this principle is that the clinical psychologist will establish an effective working relationship with a psychiatrist. He feels that while one can enthusiastically endorse the principle, it becomes changed in the commentary, so that the competence of the psychology practitioner is questioned. In effect the commentary acknowledges the psychiatrist's greater competence in the psychological, as well as the medical sphere. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning curves: Facts or artifacts?

"It is our purpose in this paper to show that the arbitrary choice of a cutoff point in the dichotomizing of continuous response distributions can impose significant constraints upon the shape of resulting learning curves, and that this can form the basis of misleading theoretical interpretations. We have chosen for illustration of this point the use of time-on-target scores as indicants of the level of skill attained in tracking tasks. However, we believe that the principles developed are quite general and apply to many learning situations." 18 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rhinotillexomania: psychiatric disorder or habit?

BACKGROUND: Conditions once considered bad habits are now recognized as psychiatric disorders (trichotillomania, onychopagia). We hypothesized that nose picking is another such "habit," a common benign practice in most adults but a time-consuming, socially compromising, or physically harmful condition (rhinotillexomania) in some. METHODS: We developed the Rhinotillexomania Questionnaire, mailed it to 1000 randomly selected adult residents of Dane County, Wisconsin, and requested anonymous responses. The returned questionnaires were analyzed according to age, sex, marital status, living arrangement, and educational level. Nose picking was characterized according to time involved, level of distress, location, attitudes toward self and others regarding the practice, technique, methods of disposal, reasons, complications, and associated habits and psychiatric disorders. RESULTS: Two hundred fifty-four subjects responded. Ninety-one percent were current nose pickers although only 75% felt "almost everyone does it"; 1.2% picked at least every hour. For 2 subjects (0.8%), nose picking caused moderate to marked interferences with daily functioning. Two subjects spent between 15 and 30 minutes and 1 over 2 hours a day picking their nose. For 2 others, perforation of the nasal septum was a complication. Associated "habits" included picking cuticles (25%), picking at skin (20%), biting fingernails (18%), and pulling out hair (6%). CONCLUSION: This first population survey of nose picking suggests that it is an almost universal practice in adults but one that should not be considered pathologic for most. For some, however, the condition may meet criteria for a disorder-rhinotillexomania.     

Vascular dementia: dead or alive?

Allergic respiratory inflammation in target organs does not occur in any atopic (genetically susceptible) subject, since other not fully characterized factors can influence the subsequent development of overt clinical disease. Here are presented some recent developments in experimental animal and human research that can offer a new "non-classical" interpretation about the way by which allergens are recognized and allergic inflammation persists. These aspects of the immunopathogenesis of allergic diseases can now be viewed as organ-specific pathways, acting independently from other peripheral lymphoid organs. This is a consequence of new knowledge about the function of, and molecular interactions by, intraepithelial gammadelta T cells and CD1+ dendritic cells. The allergic subject, unlike the normal one, is equipped at the mucosal surface by particular T cell and antigen-presenting cell (APC) subsets that enable them to recognize undenatured proteic and non-proteic (glycolipidic) external structures of aerodispersed particles, presented in the context of CD1 molecules. Once initiated, the mucosal allergic reaction cannot be turned off in atopic individuals because CD4+ allergen-specific T cells lack surface Fas receptor. This defect, that impairs the so-called activation-induced programmed cell death (determined by Fas/FasL interaction), is caused by the local Th2-type cytokine milieu.     

Dementia: Continuum or distinct entity?

The latent structure of dementia was examined in a group of 10,775 older adults with indicators derived from a neuropsychological test battery. The author conducted taxometric analysis of these data using mean above minus below a cut, maximum covariance, and latent mode factor analysis and found results more consistent with dementia as a dimensional (lying along a continuum) than categorical (representing a distinct entity) construct. A second study conducted with a group of 2,375 adults whose ages ranged from 21 to 64 years produced similar results. These findings denote that dementia, as measured by deficits in episodic memory, attention and concentration, executive function, and language, differs quantitatively rather than qualitatively from the cognitive status of adults without dementia. The implications of these results for classification, assessment, etiology, and prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Models for psychiatry: icons or effigies?

Toulmin notes that a good model takes us beyond the phenomena from which we began [67]. It also tempts us. Models demand that we attempt to represent the dynamic relationships between variables. When we use them, we risk insulating our findings from empirical disproof [68]. Self-certifying myths, like articles of faith, need to yield to the demands of science. Psychiatric theory and practice need to yield to the demands of experience. We need to move away from ethereal assumptions to tangible mastery of the understanding of behavior. Freud, in The Interpretation of Dreams [69], writes, "Analogies of this kind are only intended to assist us in our attempt to make the complications of mental functioning intelligible. We are justified, in my view, in giving free rein to our speculations so long as we retain the coolness of our judgment and do not mistake the scaffolding for the building. We have been obliged to build. If we are not wholly in error, other lines of approach are bound to lead us into much the same region and the time may come when we shall find ourselves more at home in it!"     

Space phobia: syndrome or agoraphobic variant?

Four elderly women had intense fears of falling when there was no visible support at hand or on seeing space cues while driving. Two patients had cervical spondylosis. The mean age at onset of the fear was 54--thirty years later than that for agoraphobia. Fear of public places and of heights was not prominent, nor was depersonalisation or depression. These "space phobias" might be a hitherto unrecognised syndrome or an unusual variant of agoraphobia. The visuospatial reflexes involved might illuminate the pathogenesis of certain fears.     

Change on SVIB: Dice or men?

The profile report form for the strong Vocational Interest Blank has shaded areas, established by throwing dice, to indicate chance scores on the various scales. The SVIB manual suggests that this shaded area be used as a reference point to determine if a given score is significant. This article suggests that the shaded areas should be determined by scores of the Men-in-General group instead of throwing dice. The effect of this on the shaded area is shown on a sample profile report form. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Schizophrenic intellectual impairment: uniform or differential?

The SRA Tests of Primary Mental Abilities were selected as instruments to investigate the hypothesis that differential impairment of intellectual test performance is a concomitant of schizophrenia. A wide variety of hospitalized schizophrenic and normal subjects matched roughly as to age and education were used. The results of this investigation do not support the hypothesis of differential impairment of schizophrenic test performance; however, severe overall impairment of schizophrenic intellectual performance and differential impairment of performance on certain kinds of intellectual tasks as a result of aging in normals were clearly shown. 28 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use it or lose it? Wii brain exercise practice and reading for domain knowledge.

We investigated the training effects and transfer effects associated with 2 approaches to cognitive activities (so-called brain training) that might mitigate age-related cognitive decline. A sample of 78 adults between the ages of 50 and 71 completed 20 one-hr training sessions with the Nintendo Wii Big Brain Academy software over the course of 1 month and, in a second month, completed 20 one-hr reading sessions with articles on 4 different current topics (order of assignment was counterbalanced for the participants). An extensive battery of cognitive and perceptual speed ability measures was administered before and after each month of cognitive training activities, along with a battery of domain-knowledge tests. Results indicated substantial improvements on the Wii tasks, somewhat less improvement on the domain knowledge tests, and practice-related improvements on 6 of the 10 ability tests. However, there was no significant transfer of training from either the Wii practice or the reading tasks to measures of cognitive and perceptual speed abilities. Implications for these findings are discussed in terms of adult intellectual development and maintenance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual behavior at work: Fun or folly?

Sexual behavior at work (e.g., sexual jokes and propositions) has been largely portrayed as offensive and harmful. The current research represents the first studies to test whether this is typically the case. Study 1 surveyed manufacturing and social service workers (N = 238) about their psychological well-being, work withdrawal, and exposure to sexual behavior at work. Respondents indicated how often they were exposed to different sexual behaviors and how much they enjoyed or were bothered by them. Study 2 surveyed university staff (N = 1,004) about their psychological well-being, drug use, feelings of being valued at work, and exposure to sexual behavior at work. Fifty-eight percent of employees in Study 1 were exposed to sexual behavior in the past 2 years; 40% of employees in Study 2 were exposed to sexual behavior in the past year. Some women and many men reported enjoying sexual behavior at work. Despite this, exposure to sexual behavior at work predicted negative employee work and psychological well-being, even for employees who said they enjoyed the experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The powerful placebo effect: fact or fiction?

In 1955, Henry K. Beecher published the classic work entitled "The Powerful Placebo." Since that time, 40 years ago, the placebo effect has been considered a scientific fact. Beecher was the first scientist to quantify the placebo effect. He claimed that in 15 trials with different diseases, 35% of 1082 patients were satisfactorily relieved by a placebo alone. This publication is still the most frequently cited placebo reference. Recently Beecher's article was reanalyzed with surprising results: In contrast to his claim, no evidence was found of any placebo effect in any of the studies cited by him. There were many other factors that could account for the reported improvements in patients in these trials, but most likely there was no placebo effect whatsoever. False impressions of placebo effects can be produced in various ways. Spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment, conditional switching of placebo treatment, scaling bias, irrelevant response variables, answers of politeness, experimental subordination, conditioned answers, neurotic or psychotic misjudgment, psychosomatic phenomena, misquotation, etc. These factors are still prevalent in modern placebo literature. The placebo topic seems to invite sloppy methodological thinking. Therefore awareness of Beecher's mistakes and misinterpretations is essential for an appropriate interpretation of current placebo literature.     

Collaborative practice in pharmacy: Substance or semantics?

Medication use has become increasingly complex with expanding numbers of medications and growing populations of chronically ill patients. Changes in state and federal law and regulation have attempted to keep pace with the need for health care practitioners to oversee safe and effective medication use in various patient populations, including recent changes in Medicare. Pharmacists have experienced significant advancement in their education as well as in the roles they play in acute and chronic health care delivery. Over 44 states now recognize pharmacists' collaborative practice authority that allows for the initiation, monitoring, and modification of medication therapy for patients, typically under protocol. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Atherosclerotic renal artery stenosis: ostial or truncal?

PURPOSE: To evaluate a discrepancy between the location of renal artery stenoses on intraarterial digital subtraction angiographic (DSA) images and that on spiral computed tomographic (CT) angiograms. MATERIALS AND METHODS: The spiral CT angiograms and intraarterial DSA images of 40 consecutive patients with atherosclerotic renal artery stenoses were examined retrospectively. Stenoses were classified as truncal or ostial. The atherosclerotic changes in the abdominal aorta were graded. RESULTS: Fifty-eight stenoses were demonstrated. In 48 ostial stenoses, there was no discrepancy in the location of the stenoses on spiral CT angiograms and DSA images. In 10 patients, spiral CT angiography showed an ostial lesion, whereas DSA demonstrated an apparent truncal lesion. Most of these stenoses ("pseudotruncal" ostial stenoses) were in patients with severe aortic atherosclerotic disease. CONCLUSION: A renal artery stenosis at or within 10 mm of an atherosclerotic aorta at DSA may be diagnosed as an ostial stenosis.     

Emotional intelligence: New ability or eclectic traits?

Some individuals have a greater capacity than others to carry out sophisticated information processing about emotions and emotion-relevant stimuli and to use this information as a guide to thinking and behavior. The authors have termed this set of abilities emotional intelligence (EI). Since the introduction of the concept, however, a schism has developed in which some researchers focus on EI as a distinct group of mental abilities, and other researchers instead study an eclectic mix of positive traits such as happiness, self-esteem, and optimism. Clarifying what EI is and is not can help the field by better distinguishing research that is truly pertinent to EI from research that is not. EI--conceptualized as an ability--is an important variable both conceptually and empirically, and it shows incremental validity for predicting socially relevant outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Revisiting the insanity defense: contested or consensus?

The author assesses the accuracy of both the public's opinion and researchers' conclusions regarding the method of adjudication of insanity cases and investigates the impact of the various types of reforms enacted in the 1980s on the degree to which insanity cases are contested. Data from seven states are analyzed. The public's view that insanity cases are typically resolved by a jury trial is inaccurate. Only 14.4 percent of the 7,299 insanity cases involved a jury trial. Likewise, scholars' views that most cases are resolved through plea-bargained insanity acquittals are inaccurate. Only 42.9 percent of all insanity cases are plea bargains, and 87.9 percent of all plea bargains are to a conviction. Jury trials are most likely to occur when the case involves a violent crime such as murder and the defendant has not been diagnosed with a major mental illness. Public fears that defendants easily "fool" juries into an inappropriate insanity acquittal are also unfounded. Only 16.1 percent of all jury trials result in an insanity acquittal. In three states, the figure is 10 percent or less. Contrary to the conclusions drawn by some scholars, this author finds that several types of reforms enacted in the 1980s affected the processing of insanity cases.     

The 1992 ethics code: boon or bane?

Discusses the 1992 version of the American Psychological Association (APA) Ethical Principles of Psychologists and Code of Conduct that marks the first major revision since 1981. It has a table of contents that facilitates location of standards about specific topics and it is the 1st code to be divided into 2 sections. These include a set of principles that are aspirational, representing the professional ideals, and a set of enforceable standards that are intended to be used as compelling rules. The most controversial standard pertains to sexual relationships with former psychotherapy clients. Standards related to other topics for the first time, such as the practice of forensic psychology and bartering, distinguish the 1992 APA code from its predecessors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)