Role expectation and role performance in distressed and normal couples.

To determine the relative importance of role expectations vs role performances in differentiating distressed from nondistressed couples, the Kelly-Tharp Marital Role Questionnaire was administered to 26 couples seeking psychiatric services and to 26 matched control couples. Distressed and nondistressed Ss were found to reflect very similar responses on expectation items and highly dissimilar responses on corresponding enactment items—findings that were particularly striking for items within the Sexuality and Solidarity scales. Methodological and theoretical considerations relevant to these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A dose-response study of anorectic drug effects on food intake, self-stimulation, and stimulation-escape

The DNA polymerase of Ustilago maydis is stimulated by a DNA binding protein from the same organism. Analysis of this stimulation shows that there is an increase in affinity for both substrates of the reaction. The apparent Km for deoxynucleoside triphosphates is decreased 3 fold, and that for denatured DNA by 4 fold. In both cases the maximum velocity (Vmax) is increased 1.2 to 1.4 fold. It is suggested that the variability in the affinity of the enzyme for deoxynucleoside triphosphates mediated by the binding protein may provide the basis for the UV sensitivity of pyrimidine auxotrophs in this organism.     

Persistent symptoms among survivors of Hodgkin's disease: An explanatory model based on classical conditioning.

Persistent symptoms of nausea, distress, and vomiting triggered by reminders of cancer treatment were examined among 273 Hodgkin's disease survivors, 1 to 20 years posttreatment. Prevalence rates were high for distress and nausea but low for vomiting. Retrospective report of anticipatory symptoms during treatment was the strongest predictor of persistent symptoms, suggesting that treatment-induced symptoms are less likely to persist if conditioning does not occur initially. Time since treatment was also a significant predictor, with patients more recently treated more likely to experience persistent symptoms. Thus, an explanatory model based on classical conditioning theory successfully predicted presence of persistent symptoms. Symptoms also were associated with ongoing psychological distress, suggesting that quality of life is diminished among survivors with persistent symptoms. Recommendations for prevention and treatment of symptoms are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brain transections selectively alter ingestion and behavioral activation in neonatal rats.

Food-deprived neonatal rats actively ingest milk that is infused into their mouths through intraoral cannulas. This ingestion is accompanied by behavioral activation. The involvement of various brain regions in ingestion and activation was examined in 2-day-old Charles River pups by making transections along the neuraxis from the olfactory bulbs to the anterior pons. Following a 24-hr deprivation period, a series of oral milk infusions was given, and milk intake and activity were measured. Intake was severely reduced only in Ss with diencephalic transections. Cuts in front of or behind the diencephalon resulted in normal or slightly decreased intake. In contrast, activity tended to decline as the level of the transection became more caudal. Thus ingestion and its accompanying behavioral activation could be separated neuroanatomically. These results suggest that 2 brain mechanisms are involved in the ingestive response of the infant rat, one in the diencephalon and another caudal to the mesencephalon. However, behavioral activation appears less discretely organized, involving most of the neuraxis. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparative study of the long term psychosocial functioning of childhood acute lymphoblastic leukemia survivors treated by intrathecal methotrexate with or without cranial radiation

BACKGROUND: Although previous research has delineated medical, cognitive, and neuropsychologic late effects of central nervous system (CNS) prophylaxis for childhood acute lymphoblastic leukemia (ALL), it has been difficult to draw conclusions about the long term psychosocial sequelae of these treatments due to methodologic problems that led to inconclusive results in past studies. In the current study, the authors examined the long term psychosocial functioning of childhood ALL survivors who had been treated on a Phase III clinical protocol (Cancer and Leukemia Group B [CALGB] 7611) between 1976 and 1979, in which they were randomized to receive either 2400 centigray of cranial radiation (CRT) with intrathecal methotrexate (IT-MTX) or intermediate dose systemic methotrexate (IV-MTX) with IT-MTX. METHODS: One hundred ten survivors of childhood ALL (mean age, 20.8 years) treated on CALGB 7611 who were age 14 years or older and disease free for at least 1 year were studied a mean of 14.7 years after their entry on CALGB 7611. In a telephone interview, a psychosocial assessment battery was administered to the patients, consisting of measures that assessed psychologic, sexual, social, and vocational functioning as well as any delayed physical effects. RESULTS: Survivors who had received CRT + IT-MTX had significantly poorer academic achievement (P = 0.0001), poorer self-images with regard to their bodies (P = 0.001), and greater psychologic distress (P = 0.005). CONCLUSIONS: Cranial radiation used to treat children with ALL has significant long term sequelae in terms of poorer academic achievement and psychosocial functioning. These data add weight to the conclusion that CRT prophylaxis should only be used to treat children who are at high risk of CNS relapse.     

Three-year trials of personal therapy among schizophrenic patients living with or independent of family, I: Description of study and effects on relapse rates

OBJECTIVE: The study of individual psychotherapeutic approaches to the treatment of schizophrenia has yielded equivocal findings, partly because of methodologic problems. Further, the ability of psychosocial treatments to prevent psychotic relapse appears to lessen over time. The authors' goal was to develop and test a demonstrably effective individual therapy for schizophrenia. METHOD: Using a study design that addressed previous methodologic issues, the authors evaluated personal therapy specifically designed to forestall late relapse in patients with schizophrenia. They evaluated the effectiveness of personal therapy over a period of 3 years after hospital discharge among 151 patients with schizophrenia or schizoaffective disorder diagnosed according to Research Diagnostic Criteria. The patients were randomly assigned to receive either personal therapy or contrasting therapies in one of two concurrent trials. One trial studied patients who were living with family (N = 97); the other studied patients who were living independent of family (N = 54). RESULTS: All of the patients had extensive psychiatric histories, but only 44 (29%) experienced recurrent psychotic episodes over the 3-year study period, and only 27 (18%) prematurely terminated the study; most of those who left the study were in the no-personal-therapy conditions. Among patients living with family, personal therapy was more effective than family and supportive therapies in preventing psychotic and affective relapse as well as noncompliance. However, among patients living independent of family, those who received personal therapy had significantly more psychotic decompensations than did those who received supportive therapy. CONCLUSIONS: Personal therapy had a positive effect on adverse outcomes among patients who lived with family. However, personal therapy increased the rate of psychotic relapse for patients living independent of family. The application of personal therapy might best be delayed until patients have achieved symptom and residential stability.     

The future of therapy for glioblastoma

Effective therapy for malignant gliomas has centered on traditional approaches such as surgery and radiation therapy. Over the past two decades, more innovative approaches involving the use of chemotherapy and immunotherapy have been developed. Although these techniques have improved the quality of survival for many patients, the median survival following diagnosis and adjuvant treatment still remains only about a year. Recently, genetically engineered viruses for gene transduction and targeted cell killing have been used successfully in the experimental treatment of glioblastoma multiforme. We provide a review of the current and possible future therapies for malignant glioma with the belief that molecular biologic and genetic techniques offer the greatest hope of significantly altering the course of disease.     

Differences between social skills therapists and psychotherapists in treating depression.

Segments of audiotaped individual therapy sessions with 20 unipolar depressed women conducted by 4 experienced psychologists were coded on a variety of dimensions and rated by 2 trained graduate-student judges. Skills therapists were more directive, displayed greater initiative, appeared more supportive, and emitted significantly more directive and nondirective statements than psychotherapists. Findings confirm and expand on previous data concerning differences in therapist style. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rapid screening for psychologic distress in men with prostate carcinoma: a pilot study

BACKGROUND: As more oncology care is moved to the outpatient setting, the need for a rapid means for oncologists to identify patients with significant distress has increased. Concurrent with this move has been the pressure to reduce time spent with each patient, adding to the likelihood that a distressed patient will not be recognized and will remain untreated in the current health care environment. METHODS: A pilot program was conducted in a prostate carcinoma oncology clinic to test the feasibility of a two-stage approach that identifies patients in significant distress and refers them for treatment. Two pencil and paper self-report measures were used to detect psychologic distress in patients over the previous week: 1) The Hospital Anxiety and Depression Scale (HADS) and 2) "The Distress Thermometer." Patients who scored above an agreed upon cutoff score on either measure (HADS = 15+; Thermometer = 5+) were referred to the psychiatric liaison in the clinic for evaluation. RESULTS: Compliance in filling out the measures was excellent; only 8 of 121 patients (6.6%) refused. Thirty-one percent of evaluable patients were referred based on elevated scores. Seventeen of 29 patients actually were evaluated. Eight of 17 patients met Diagnostic and Statistical Manual (of Mental Disorders)-IV criteria for a psychiatric disorder. CONCLUSIONS: This approach for rapid screening for distress was acceptable in prostate carcinoma patients, although these older men were reluctant to agree to evaluation and treatment. This simple screening method needs further testing and the identification of barriers on the part of the patient and oncologist that impede the identification of the most distressed patients.