This study utilized the Medical Symptom Validity Test (MSVT) and a set of standard neuropsychological instruments to determine the underlying construct of the MSVT that accounts for effort in mild traumatic brain injury (mTBI) patients by comparing/contrasting mTBI with dementia and an analog simulation. The results indicate that a common underlying neurocognitive construct (memory) exists between mTBI and dementia patients, which may account for poor effort as measured by the MSVT. Other underlying factors emerged for both groups, though they did not point to a common construct. This finding suggests that the overall effect of brain injury in neurologically impaired groups also impacts effort performance as measured by the MSVT. Similarly impaired performance patterns also emerged between mTBI and dementia groups in sub-groups that failed effort measures. Thus, failed effort tests may be a function of more pronounced deficits in these groups, rather than a function of effort. Finally, although similar effort profiles were noted between mTBI and analog simulators, the analog group was unable to mimic the neurocognitive effects of mTBI.

The purpose of this study was to determine if attention-deficit/hyperactivity disorder (ADHD) subtypes (predominantly hyperactive/impulsive, ADHD-HI; predominantly inattentive, ADHD-IA; combined, ADHD-C) exhibit distinct neuropsychological profiles, using the Attention and Executive Function subtests of the Developmental Neuropsychological Assessment, (NEPSY) and the omission and commission scores obtained on the Conners' Continuous Performance Test-II (CPT-II), a test that assesses attention processes. The sample was selected using archival data collected in a neurodevelopmental clinic over the past decade and consisted of 138 children between the ages of 6 and 12 years old. Using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) criteria, the children were placed in either the ADHD-HI (n = 40), ADHD-IA (n = 35), or ADHD-C (n = 36) group, or a symptom free comparison group (n = 27). It was hypothesized that children with elevations on the impulsivity/ hyperactivity (ADHD-HI and ADHD-C) scale would be impaired on measures of inhibition and those with elevations on the inattention scale (ADHD-IA and ADHD-C) would be impaired on tests of attention, vigilance, and other executive functions. A one-way multivariate analyses of variance (MANOVA) was conducted (Group X Task), with significant results for overall main effect for group on the 7 …

Diabetes is a disease with a deleterious pathology that currently impacts 4.5 million individuals within the United States. This study examined the ability of a specific neuropsychological battery to identify and classify dementia type, investigated the impact of diabetes on cognition and analyzed the ability of the memory measures of the 7 Minute Screen (7MS) and the Rey-Osterrieth Recall to correctly categorize dementia type when not used in combination with a full battery. The battery in addition to exhaustive patient history, medical chart review and pertinent tests were used in initial diagnosis. Results indicated the battery was sufficient in the identification and classification of dementia type. Within the sample, diabetes did not appear to significantly impact overall battery results whereby only two measures were minimally affected by diabetes. Finally, the memory measures of the 7MS and the Rey-Osterrieth Recall were sufficient to predict membership into the Alzheimer's (AD) and vascular dementia (VD) groups with 86.4% accuracy. The classification percentage dropped to 68.3% with addition of the mild cognitive impairment category. The full battery correctly classified AD and VD dementia 87.5% and appeared to be the most robust.

Intimate partner violence is endemic in the United States. According to the American Medical Association (1992), one-fifth to one-third of women will sustain violence from a partner or ex-partner in their lifetime. The relevant literature was organized by ICD-9-CM categories. This study examined the health consequences of partner abuse in a sample of community women using a sample consisting of 564 women in three ethnic groups. Because prior research has failed to account for variations by type of abuse on health consequences, this study assessed psychological abuse, violence and sexual aggression by women's partners. To determine whether or not different types of abuse had an effect on women's health, hierarchical regression analyses were conducted. The regression equations were calculated for women within each ethnic group to facilitate identification of similarities and differences and to control for ethnic differences in risk for specific diseases. The results were consistent with past research on health consequences of abuse and extended the prior literature by showing that psychological abuse had a pervasive effect on health conditions, distress and use of health care resources. Additionally, ethnic differences emerged. As expected, ethnicity appeared to function as a moderator. Clinical implications and recommendations are made for future …

The Rey-Osterrieth Complex Figure Task (ROCFT) has been a standard in neuropsychological assessment for six decades. Many researchers have contributed administration procedures, additional scoring systems and normative data to improve its utility. Despite the abundance of research, the original 36-point scoring system still reigns among clinicians despite documented problems with ceiling and floor effects and poor discrimination between levels of impairment. This study is an attempt to provide a new method based upon item response theory that will allow clinicians to better describe the impairment levels of their patients. Through estimation of item characteristic curves, underlying traits can be estimated while taking into account varying levels of difficulty and discrimination within the set of individual items. The ultimate goal of the current research is identification of a subset of ROCFT items that can be examined in addition to total scores to provide an extra level of information for clinicians, particularly when they are faced with a need to discriminate severely and mildly impaired patients.

After an initial four week baseline period, during which headache activity and medication consumption were monitored, 28 migraineurs were randomly assigned to one of the following groups: (a) the biofeedback temperature warming group, (b) the visual imagery group, (c) the combined treatment group, or (d) the comparison group. All four groups continued to monitor their headache activity and medication consumption during the eight week treatment period and the eight week follow-up period. A two way analysis of variance computed on groups over time indicated a significant decrease in headache activity and medication consumption. During the follow-up period (a) the combined treatment group had significantly fewer headaches than the biofeedback group or the comparison group and (b) the visual imagery group and the combined treatment group had significantly fewer headache hours than the biofeedback group or the comparison group. These results do not appear to be attributable to differences between groups on the amount of time spent in home practice or subjective ratings of relaxation. There was no consistent relationship between increases in finger temperature and headache activity improvement. Decreases in powerful other scores, as measured by the Health Attribution Test, and increases in subjective ratings of internal control were consistent …

The efficacy of multidisciplinary inpatient and outpatient treatment for transitioning children with severe pediatric feeding disorders from gastrostomy tube dependency to oral nutrition was investigated utilizing caloric and fluid intakes as an outcome measure. The study involved 29 children ages 12 months to 5 years of age with gastrostomy tube dependency. Treatments were provided by speech therapists, occupational therapist, dietician and psychologist for a 30 day period. Four treatment groups were evaluated and average intakes compared at 4 observation periods including pretreatment, initiation of treatment, completion of treatment at 30 days and 4 month follow-up. Children receiving inpatient treatment for feeding disorders evidenced significant differences in oral caloric intake from pretreatment to discharge than outpatient treatment (p < .01) and wait list control group (p = .04). Oral caloric intake from discharge to 4 month follow up yielded no significant differences indicating treatment gains were maintained. Change in environment and caretaker showed a significant effect for the inpatient group (d = 1.89). Effects of treatment by age and weight at 4 month follow up were also analyzed.

This study was conducted to examine the sequelae of cardiovascular conditioning on locus of control, short-term mood, and psychological well-being. A pre-post test design, with control group, was used to measure the effects of a one month program of aerobic conditioning on adult volunteers. This study also sought to examine ways in which fitness changes covaried with psychological changes, and to describe patterns of change taking place during aerobic conditioning.

The purpose of this study was to validate a stress inventory which would differentiate between a normative group and a patient population suffering from environmental illness. The hypotheses of this study were: (1) the Total Stress Load Inventory would be predictive in discriminating between clinical ecology patients and a normative group; (2) each section or subscale of the Total Stress Load Inventory would be predictive of psychological, cognitive, nutritional, and/or medical factors.

Low back pain has long been estimated to be the most prevalent and debilitating source of chronic pain. The present study first reviews the literature addressing the various theories of pain, the physiological and psychological variables important in pain research, and the psychotherapeutic approaches that have been used to date to reduce pain. Thirty-seven hospitalized chronic back pain patients were administered the cold-pressor test and a medical pain stimulus procedure which was medically relevant to their back pathology. A card-sort method was utilized in order to assess the coping strategies employed by the patients during these two pain stimulus tasks. These procedures were repeated following treatment. Coping strategies used by patients during the two pain tasks were compared. Results demonstrated that there was a significant difference in the manner in which patients coped with the two types of pain. Cold-pressor measures of pain threshold and tolerance were not significantly different between pretreatment and post-treatment. These measures were also not positively correlated with treatment outcome. A multiple regression approach demonstrated that particular coping strategies were significantly predictive of treatment outcome. The medical pain stimulus procedure was found to provide more significant pedictor variables than the cold-pressor test. At pre-treatment assessment, patients …

Childhood sexual abuse (CSA) has been linked to a number of adult psychological maladies. The MMPI-2 has shown specific patterns such as an inverted V in the validity scales, a floating profile, and a 4-5-6 configuration to be present more often in adults who have experienced childhood trauma. Both children and adults who have experienced trauma have shown a number of neurophysiological differences when compared to non-traumatized individuals. However, little research has looked at differences in quantitative electroencephalography (QEEG) patterns in these individuals. The purpose of this study is to determine differences seen in the MMPI-2 and the QEEG when comparing adults who report CSA to adults who deny any history of childhood abuse. Differences between the two groups in MMPI-2 basic scales and supplementary scales PK and PS were determined. This study also examined the ability to correctly classify individuals into the two groups using three patterns seen in the MMPI-2 basic scale profiles (inverted V, floating profile, and 4-5-6 configuration). In addition, this research included exploratory analyses to develop predictor models for CSA group membership. Predictors in the models were derived from MMPI-2 scales, alpha relative power at each of the 19 sites in the International 10/20 electrode …

The primary objective of this study was to examine the association between the theory of planned behavior (TBP) and adherence to a multidisciplinary pain center (MPC) treatment program for chronic pain. While the results of several studies have provided support for the efficacy of MPC treatment in chronic pain, the problems of adherence and attrition are important. TPB is a cognitive/social model of behavior that has been used to predict a variety of behaviors, although it has never been used to predict adherence to a multidisciplinary chronic pain treatment program. It was predicted that Adherence would be predicted by Intentions and that Intentions would be predicted by 1) Perceived Social Norms, 2) Perceived Behavioral Control, 3) Attitudes Toward New Behavior (completing the treatment program), and 4) Attitude Toward Current Behavior (maintaining current treatment and coping strategies). It was found that the total Intentions scores did not predict the total Adherence scores. However, Intentions was predicted by 1) Perceived Behavioral Control, 2) Attitudes Toward New Behavior (completing the treatment program), and 3) Attitude Toward Current Behavior (maintaining current treatment and coping strategies). The finding that Perceived Social Norms did not predict Intentions was consistent with results of previous studies with the …

The purpose of the current study was to investigate the effects of a multidisciplinary pain management program on five measures of subjective psychosocial factors. Ninety-five participants in the comprehensive multidisciplinary treatment group and the standard medical intervention control group were surveyed about various psychosocial factors using Axis II of the West Haven - Yale Multidimensional Pain Inventory (MPI), pre- to post-treatment. It was hypothesized that post-treatment levels would be significantly lower than pre-treatment levels for all five psychosocial variables. Additionally, gender and ethnicity variables were examined. Based on preliminary analyses indicating pre-treatment differences between the experimental and control group, five 2 x 2 x 3 analyses of covariances (ANCOVAs) were used to examine the above hypotheses. Results indicated significant differences between the treatment conditions on measures of control, with the comprehensive group feeling more in control than the standard group at post-treatment. No other significant main effects for treatment condition were found on the measures of pain severity, interference with daily activities, negative mood, or social support. However, a significant gender main effect was found for social support at post-treatment, with females reporting more social support than males. A significant gender x ethnicity interaction was also found for post-treatment control, …