Measurement invariance of the group climate inventory across adults with and without mild intellectual disability in secure residential facilities.

BACKGROUND: The Group Climate Inventory (GCI) was tested for measurement invariance across 332 adults with and 225 adults without mild intellectual disabilities in Dutch forensic treatment, and for latent mean differences on its Support, Growth, Repression, and Atmosphere subscales. METHOD: Multigroup confirmatory factor analysis was used to evaluate the configural, threshold, and loading and threshold invariance of the GCI across both groups, and to compare group latent means on each subscale. RESULTS: Measurement invariance was found across groups. Latent mean group comparisons showed small but significant differences reflected in lower scores on Support and Atmosphere in the group with mild intellectual disabilities. CONCLUSION: The GCI allows meaningful comparisons between clients with and without mild intellectual disabilities in secure facilities. Results from the between-group comparisons suggest that consideration should be given as to whether, and why, the support and atmosphere perceptions of clients with mild intellectual disabilities might be less good.

Psychometric analysis of the Group Climate Inventory-Revised in adults with mild intellectual disability or borderline intellectual functioning in a secure residential facility.

BACKGROUND: In secure residential facilities, group climate perceptions of clients with mild intellectual disability or borderline intellectual functioning are systematically assessed for quality improvement. A valid and reliable measure may ensure that this process is consistent. The Group Climate Inventory-Revised (GCI-R) is a new measure to assess group climate perceptions. METHOD: Confirmatory factor analysis was conducted in 148 adult clients (79% male) with mild intellectual disability or borderline intellectual functioning in a secure facility to examine internal structure validity and internal consistency reliability of the GCI-R. RESULTS: The results indicate support for the five-factor structure of the GCI-R ('Support', 'Growth', 'Repression', 'Peer interactions', and 'Physical environment'). The internal consistency reliability of its scales ranged from acceptable to good (α: .72-.87; ω: .76-.86). CONCLUSION: The GCI-R demonstrates evidence of psychometric adequacy when applied to adult clients with mild intellectual disability or borderline intellectual functioning in secure residential facilities.

A Meta-Analysis on Differences and Associations between Alliance Ratings in Child and Adolescent Psychotherapy.

OBJECTIVE: The alliance in child and adolescent psychotherapy is widely recognized as an important factor in therapy. Studies on the alliance have increasingly focused on assessment of the alliance as a dyadic construct, measuring both client and therapist alliance ratings. However, cross-informant reports of the alliance in child psychotherapy have not yet been subjected to meta-analysis. Therefore, the present meta-analysis aims to increase knowledge on the degree of convergence and divergence between child, parent, therapist, and observer alliance ratings in child and adolescent psychotherapy. METHODS: A series of three-level meta-analyses of 78 studies was conducted to investigate differences and associations between child, parent, therapist, and observer alliance ratings in child and adolescent psychotherapy. RESULTS: Findings indicated that children and parents in general rated the alliance more positively than their therapists (d = 0.35, d = 0.72, respectively), and that child-therapist and parent-therapist alliance ratings were moderately correlated (r = .32, r = .23, respectively). Associations between child and therapist ratings and observer ratings were moderate to large (r = .43, r = .53, respectively). CONCLUSIONS: It can be concluded that children and parents generally report more positively on the alliance compared to their therapists, which is consistent with research on the alliance in adult populations. The small to moderate associations between alliance ratings indicate that individuals to some extent have a shared perspective on their alliance, and that the various perspectives on alliance should be acknowledged when dealing with children and parents in therapy. Implications for future research are discussed.

Relationships between dynamic risk factors for externalising problem behaviour and group climate in adults with mild intellectual disability in forensic treatment.

BACKGROUND: Relationships between dynamic risk factors for externalising problem behaviour and group climate were investigated in 151 adult in-patients with mild intellectual disability or borderline intellectual functioning in a Dutch secure residential facility. METHOD: Regression analysis was used to predict total group climate score and Support, Growth, Repression, and Atmosphere subscales of the 'Group Climate Inventory'. Predictor variables were Coping Skills, Attitude towards current treatment, Hostility, and Criminogenic attitudes subscales of the 'Dynamic Risk Outcome Scales'. RESULTS: Less hostility predicted a better overall group climate, better support and atmosphere, and less repression. A positive attitude towards current treatment predicted better growth. CONCLUSION: Results indicate relationships of hostility and attitude towards current treatment with group climate. A focus on both dynamic risk factors and group climate may provide a basis for improving treatment for this target group.

Psychometric properties of the Group Climate Instrument (GCI) in individuals with mild intellectual disability or borderline intellectual functioning.

BACKGROUND: This study examined the psychometric properties of the Group Climate Instrument (GCI) in a sample of N = 189 adults (79% men) with mild intellectual disability or borderline intellectual functioning who were residents of a treatment facility in the Netherlands. METHOD: Construct validity of the GCI was examined by means of confirmatory factor analysis. Also, reliability and convergent validity of the GCI were examined. We also examined the variability in perception of the living group climate between and within living groups by computing intraclass correlation coefficients. RESULTS: The model contained four first-order factors (support, growth, group atmosphere and repression) and a second-order factor overall climate, providing preliminary support for construct validity of the GCI. Reliability coefficients were good for all factors. Preliminary evidence for convergent validity was found in significant moderate associations between subscales and single item ratings for the factors of group climate. The intraclass correlation coefficients indicated that a considerate proportion of variance can be attributed to between-group differences. CONCLUSIONS: The GCI might be used to assess perception of the living group climate for individuals with mild intellectual disability or borderline intellectual functioning in psychiatric and forensic care settings, although further development of the GCI and replication of our findings seem necessary.

The Feelings of Others Don't Impress Me Much - Effects of Living Group Climate on Empathy in Adolescent Male Offenders.

The present study is a replication in Germany of a study originally performed in the Netherlands regarding the association between a positive living group climate and self-reported empathy in incarcerated adolescent male offenders (n = 49). A structural equation model was fitted to the data and showed a relation between a positive living group climate and increased empathy after six months. The discussion focuses on group dynamics in youth prisons. The present results open the way to further research into the importance of group processes in residential youth care. A positive living group climate could turn out to be an important factor contributing to the effectiveness of secure institutional treatment.

Group Climate in Residential Youth Care: Development and Validation of the Group Climate Instrument-Revised.

Group climate in residential youth care is considered to be essential for treatment of youth and young adults. Various instruments exist to measure quality of living group climate, but some are lengthy, use complicated wording, which make them difficult to fill out by youth and individuals with a mild intellectual disability. The present study describes the development and rationale for the Group Climate Instrument-Revised (GCI-R). Construct validity and reliability of the GCI-R were examined by means of Confirmatory Factor Analysis (CFA) in a two-step validation process using a construction sample (n = 190 youth, representing 41 groups) and a validation sample (n = 207 youth, representing 42 groups). Results indicated a good fit of a five-factor model (Support, Growth, Physical Environment, Peer interactions, and Repression). Reliability of the scales was good. These findings indicate that the GCI-R can be used as a parsimonious, valid, and reliable instrument to assess perceptions of group climate in youth. Recommendations for future research and practice are suggested.

Academic Motivation of Incarcerated Juveniles From the Perspective of Self-Determination Theory: A Multiple Case Study in Kosovo Context.

This qualitative (multiple case) study investigated incarcerated juveniles' experiences of being enrolled in an educational institution outside the correctional facility, and how this impacted their motivation, well-being, life satisfaction, and future social integration. Self-determination theory was used to understand how youth experienced fulfillment of their psychological needs (i.e., autonomy, competence, and relatedness). Results showed that the need for autonomy and competence were gradually met by education, whereas the need for relatedness was primarily fulfilled through relationships within the existing social network instead of through relationships with peers in the education setting. Reluctance to become acquainted with peers in the education setting may be explained by feelings of self-stigmatization. We conclude that attending education of juveniles outside prison may contribute to their future perspective and rehabilitation, in particular if sufficient attention is paid to opportunities for meaningful contact with (prosocial) fellow students outside the correctional facility.

A Three-level Meta-analysis on the Alliance-Outcome Association in Child and Adolescent Psychotherapy.

Previous meta-analyses have found small to moderate associations between child-therapist alliance and treatment outcomes. However, these meta-analyses have not taken into account changes in alliance (i.e., alliance shifts), alliance agreement (i.e., congruence or discrepancies between child-therapist ratings), and the role of alliance as a moderator in relation to treatment outcomes (i.e., an interaction effect of alliance and treatment condition on treatment outcomes). A series of multilevel meta-analyses of 99 studies was conducted to investigate several types of alliance-outcome associations in child and adolescent psychotherapy. Associations between child-therapist alliance and child outcomes (r = 0.17), changes in child-therapist alliance and child outcomes (r = 0.19), child-therapist alliance as a moderator of outcomes (r = 0.09), and parent-therapist alliance and child outcomes (r = 0.13) were small. Associations between child-therapist alliance agreement and outcomes (r = 0.21) and between parent-therapist alliance and parent outcomes (r = 0.24) were small to moderate. This meta-analysis provides the most updated and comprehensive overview of the alliance-outcome association in child and adolescent psychotherapy, showing that the alliance continues to show impact on treatment outcomes. Alliance research in youth psychotherapy has increasingly focused on several complex aspects of the alliance-outcome association, such as the role of changes in alliance, alliance discrepancies, client and therapist variability, and the reciprocal association between alliance and prior symptom change in relation to treatment outcomes. Implications for future research and clinical practice are discussed.

Stability and Change of Adolescents' Aggressive Behavior in Residential Youth Care.

BACKGROUND: Aggression in residential youth care institutions is a frequent problem. OBJECTIVE: The present short-term longitudinal study examined individual and institutional predictors of aggression in a group of 198 adolescents placed in open, semi-secure and secure residential institutions from the perspective of the importation and deprivation model. METHODS: A total of 198 adolescents in residential youth care filled in questionnaires regarding group climate and aggression with a 3 month interval. Hierarchical multiple regression analyses were performed to test the degree to which individual and contextual factors predict aggression. RESULTS: Very limited support was found for the effect of contextual factors; only repression showed a trend, predicting direct aggression, while gender composition of the living groups yielded a small effect. Girls placed in same-gender groups showed lower levels of indirect (relational) aggression compared to adolescents placed in mixed-gender or boys-only groups, even when controlled for gender and initial levels of aggression. Type of institution (i.e., level of security) did not predict differences in aggression. In particular individual characteristics of the adolescents were associated with later aggression, including initial levels of aggression, showing substantial 3 months stability, age and gender of the adolescents. CONCLUSIONS: These findings are in line with research showing that aggression is relatively stable. Very limited support for environmental effects was found.

"I Don't Care About What You Want!" The Relation Between Juvenile Delinquents' Responses to Social Problem Situations and Empathy in Secure Juvenile Institutions.

The present study examined the relation between juvenile delinquents' responses to social problem situations and empathy in secure juvenile institutions. The sample consisted of 79 delinquent boys (62%) and 49 delinquent girls (38%), aged 12 to 19 years. Results showed problems with accepting authority to be negatively related to both affective and cognitive empathy. Inadequate coping with competition was negatively related to cognitive empathy, whereas problems with receiving or giving help were negatively related to affective empathy. The central role of authority problems suggests that group workers could influence adolescents' empathy development by helping them to learn to cope with social problem situations.

Mantle-cell lymphomas have more widespread disease and a slower response to chemotherapy compared with follicle-center lymphomas: results of a prospective comparative analysis of the German Low-Grade Lymphoma Study Group.

PURPOSE: To compare mantle-cell lymphomas (MCLs) and follicle-center lymphomas (FCLs) for their features of clinical presentation, response to chemotherapy, and prognosis on the basis of a prospective randomized clinical trial. PATIENTS AND METHODS: Patients with MCL and FCL who entered onto the prospective randomized comparison of cyclophosphamide, vincristine, and prednisone (COP) versus prednimustine and mitoxantrone (PmM) followed by a second randomization for interferon (IFN) maintenance versus observation only. RESULTS: One hundred sixty-five of 234 patients had FCL and 45 of 234 patients had MCL. With FCL, both sexes were equally affected (men, 47%); patients with MCL were predominantly men (78%; P < .0004) and had a higher median age (64 v 53 years; P < .0001). Patients with MCL also had more widespread disease, reflected by the proportion of patients with two or greater extranodal manifestations (43% v 21%; P < .005) and nine or greater involved nodal areas (64% v 45%; nonsignificant [NS]). Response to chemotherapy was significantly lower in patients with MCL (complete remission [CR] + partial remission [PR], 69% v 88%; P < .05) and occurred at a slower pace. Patients with MCL also had a shorter event-free interval (median, 8 v 24 months; P < .0001) and overall survival (median, 28 v 77 months; P < .0001). In both subtypes, however, patients with less than two residual lymphoma manifestations in remission experienced a relatively good prognosis with an estimated 5-year survival of greater than 60% for MCL and greater than 75% for FCL. CONCLUSION: MCL and FCL differ substantially in their features of presentation, response to chemotherapy, and long-term prognosis. The extent of residual disease after completion of chemotherapy discriminates patients with different prognosis and may be used for the stratification of postremission strategies.

Therapy with OKT3 monoclonal antibody in refractory T cell acute lymphoblastic leukemia induces interleukin-2 responsiveness.

Administration of cytokines to patients with leukemia or lymphoma may recruit dormant malignant cells into cell cycle and thus make them more susceptible to chemotherapy. We treated a patient with refractory T cell acute lymphoblastic leukemia (ALL) with OKT3 monoclonal antibody and observed a dramatic but transient decrease of lymphoblasts. The T ALL cells were rather mature by morphology and immunophenotyping, expressing CD7, CD4, CD8 and CD3 surface antigens and nuclear TdT. Cytogenetic analysis revealed inversion of chromosome 14(q11q32.1). A total of 500 mg OKT3 (maximum dose 50 mg/day) was given. A decrease of lymphoblasts in the blood and a reduction of spleen size was observed. Complement levels dropped remarkably. Despite increasing serum levels of tumor necrosis factor, treatment was well tolerated overall. CD3 therapy induced strong IL-2 responsiveness of the lymphoblasts. Thus, OKT3 antibody treatment not only significantly decreased CD3-positive tumor cells, but also induced IL-2-mediated proliferation. This may also allow sequential application of CD3 and IL-2 to render certain T cell tumors more susceptible to chemotherapy.

Morphologic analysis of BMP-9 gene therapy-induced osteogenesis.

The present study was performed to determine the histological, ultrastructural, and radiographic changes that occur over time at intramuscular BMP-9 gene therapy treatment sites. Several members of the bone morphogenetic protein (BMP) family have the potential to induce osteochondrogenesis when the protein is delivered to rodents, canines, rabbits, and nonhuman primates. Previous studies have also demonstrated that BMP gene therapy utilizing adenoviral vectors can also stimulate orthotopic and heterotopic bone formation in rodents and rabbits. Athymic nude and Sprague-Dawley rats were injected with Ad-BMP-9 or Ad-beta-Gal (3.75 x 10(9) particles) in their thigh musculature and light microscopic, electron microscopic, and computerized tomography analysis was performed 3, 6, 9, 12, 15, 18, 21, and 100 days later. To assess early mesenchymal cell proliferation, a bromodeoxyuridine (BrdU) immunohistochemical analysis was also performed 48, 60, and 72 hr postinjection in athymic nude rats. All animals demonstrated extensive endochondral bone formation at the Ad-BMP-9 treatment sites within 3 weeks. The Sprague-Dawley rats also exhibited a massive, acute inflammatory infiltrate during the first week. Proliferating mesenchymal stem cells were clearly evident as early as 2 days after treatment, which differentiated into small or hypertrophied chondrocytes during the next week. During the third week, the cartilaginous matrix mineralized and formed woven bone, which converted to lamellar bone by 3 months. No evidence of bone formation was demonstrated at the Ad-beta-Gal injection sites in the athymic nude or Sprague-Dawley rats. In addition, no cellular proliferation was seen at the Ad-beta-Gal treatment sites in the athymic nude animals as assessed by light microscopy and BrdU immunohistochemistry. The extensive bone formation induced by Ad-BMP-9 suggests that BMP gene therapy may have potential utility in the treatment of degenerative, rheumatic, or traumatic bone pathology.

In vivo endochondral bone formation using a bone morphogenetic protein 2 adenoviral vector.

Bone morphogenetic proteins (BMPs) are polypeptides that induce ectopic bone formation in standard rat in vivo assay systems. Previous studies have demonstrated the clinical utility of these proteins in spinal fusion, fracture healing, and prosthetic joint stabilization. Gene therapy is also a theoretically attractive technique to express BMPs clinically, since long-term, regulatable gene expression and systemic delivery with tissue-specific expression may be possible in future. This study was performed to determine whether an adenoviral vector containing the BMP-2 gene can be used to express BMP-2 in vitro and promote endochondral bone formation in vivo. In vitro, U87 MG cells transduced per cell with 20 MOI of an adenoviral construct containing the BMP-2 gene under the control of the universal CMV promoter (Ad-BMP-2) showed positive antibody staining for the BMP-2 protein at posttransfection day 2. The synthesis and secretion of active BMP-2 into the conditioned medium of Ad-BMP-2-transduced 293 cells were confirmed by Western blot analysis and the induction of alkaline phosphatase activity in a W-20 stromal cell assay. In vivo, Sprague-Dawley rats and athymic nude rats were injected with Ad-BMP-2 in the thigh musculature and were sacrificed on day 3, 6, 9, 12, 16, 21, 60, and 110 for histological analysis. The Sprague-Dawley rats showed evidence of acute inflammation, without ectopic bone formation, at the injection sites. In the athymic nude rats, BMP-2 gene therapy induced mesenchymal stem cell chemotaxis and proliferation, with subsequent differentiation to chondrocytes. The chondrocytes secreted a cartilaginous matrix, which then mineralized and was replaced by mature bone. This study demonstrates that a BMP-2 adenoviral vector can be utilized to produce BMP-2 by striated muscle cells in athymic nude rats, leading to endochondral bone formation. However, in immunocompetent animals the endochondral response is attenuated, secondary to the massive immune response elicited by the first-generation adenoviral construct.

Choline acetyltransferase- and substance P-like immunoreactive elements in fetal striatal grafts in the rat: a correlated light and electron microscopic study.

Fetal striatal neurons were transplanted into the ibotenic acid-lesioned rat striatum. Three months after transplantation, the graft tissue was processed for choline acetyltransferase- and substance P-like immunoreactivity and was subsequently examined at the light and electron microscopic levels. The study demonstrated that choline acetyltransferase- and substance P-like-immunoreactive neurons were homogenously present throughout fetal striatal grafts, although in decreased numbers compared with those in the normal rat striatum. The majority of the choline acetyltransferase-immunoreactive neurons had fusiform, oval, or polygonal somata with somatic diameters greater than 20 microns and contained deeply invaginated nuclei surrounded by copious cytoplasm. In addition, choline acetyltransferase-immunoreactive neurons with somatic diameters between 10 and 20 microns were also demonstrated. The grafts' substance P-like-immunoreactive neurons, which had somatic diameters between 10 and 25 microns and had oval or polygonal perikarya, could be classified into two types based on their ultrastructural characteristics. Type I neurons contained an unindented nucleus which was surrounded by a thin rim or moderate amount of cytoplasm, whereas Type II immunoreactive neurons contained an indented nucleus which was surrounded by copious cytoplasm. Choline acetyltransferase- and substance P-like-immunoreactive dendrites in the grafts' neuropil were contacted by multiple unlabeled axon terminals. In addition, choline acetyltransferase- and substance P-like-immunoreactive axon terminals forming symmetric contacts with unlabeled dendrites were present within the graft. The study demonstrated that many of the neuroanatomical features of choline acetyltransferase- and substance P-like-immunoreactive elements found in the normal rat striatum are present in mature fetal striatal grafts.

Fetal neostriatal transplants in the rat: a light and electron microscopic Golgi study.

Fetal striatal neurons were transplanted into the ibotenic acid lesioned rat striatum. Three months after transplantation the grafted tissue was Golgi-impregnated and examined at the light microscopic level to determine the morphological characteristics of the transplanted neurons. Golgi-impregnated neurons were then gold-toned and examined at the electron microscopic level. The transplanted neurons were classified by both somatic size and somatic and dendritic morphology, which demonstrated that at least seven distinct cell types are present in striatal grafts. Type I large neurons had aspinous somata, sparsely spined dendrites, and indented nuclei, whereas type II large neurons displayed somatic spines, sparsely spined dendrites, and indented nuclei. Type I medium neurons exhibited aspinous somata and proximal dendrites, heavily spined distal dendrites, and unindented nuclei. Type II medium neurons had somatic spines, sparsely spined dendrites, and indented nuclei. Type III medium neurons had aspinous somata, poorly branched and sparsely spined dendrites, and indented nuclei, while type IV medium neurons had aspinous somata, highly branched and sparsely spined dendrites, and indented nuclei. Type V medium neurons displayed aspinous somata, varicose dendrites, and indented nuclei. These results demonstrate that transplanted fetal striatal neurons differentiate into morphologically and ultrastructurally distinct striatal cell types.

Descriptive morphology of developing fetal neostriatal allografts in the rhesus monkey: a correlated light and electron microscopic Golgi study.

Primate fetal striatal neurons were transplanted into the ibotenic acid lesioned rhesus monkey striatum. Ten weeks after transplantation the monkeys were transcardially perfused and graft tissue was histologically stained. Golgi impregnated, and processed for electron microscopy. The monkeys received magnetic resonance imaging (MRI) scans before lesioning, after lesioning, and ten weeks after transplantation to noninvasively study the striatal grafts. The study demonstrated that fetal striatal grafts, measuring up to 0.4 x 0.8 cm, can survive for extended periods of time in the non-human primate. Hematoxylin-eosin stained sections of the transplant demonstrated that neuronal, glial, vascular, and lymphocytic cells were present in the graft. The majority of the neurons had somatic diameters between 8 and 20 microns and were characterized by nuclei containing multiple nucleoli. A few neurons within the graft had somatic diameters up to 40 microns. These larger neurons exhibited more mature cytoplasm containing a moderate amount of Nissl substance. Some of the blood vessels within the graft were surrounded by a large number of plasma cells, but there was no evidence of hemorrhage or necrosis. Bielschowsky staining and Golgi impregnation of the transplanted tissue demonstrated that there were neurons at various degrees of differentiation. Some of the neurons had varicose dendrites, growth cones, and filopodia, which are all characteristics of immature neurons, while others had a much more mature appearance, including a moderate number of dendritic spines. Some of these neurons had an appearance typical of differentiating "medium spiny" neurons of the normal striatum. Electron microscopic analysis of the transplanted tissue and individual Golgi-impregnated neurons within the transplant confirmed that there were developing neurons within the graft. These neurons had an increased nuclear-to-cytoplasmic ratio and had nuclei containing multiple nucleoli. The neuropil surrounding these neurons was loosely organized and contained large areas of extracellular space. The neuropil exhibited developing dendrites, numerous growth cones, and mature synapses. In summary, the study demonstrated that fetal striatal allografts can survive for up to three months in the rhesus monkey and undergo normal differentiation as assessed by Golgi impregnation and electron microscopy.

Ontogeny of peptide-containing neurons in human gut--an immunocytochemical study.

Neurons containing enkephalin, substance P (SP), vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), galanin, calcitonin gene-related peptide (CGRP), peptide histidine isoleucine (PHI) or gastrin-releasing peptide (GRP) are known to occur in the human intestinal tract. The knowledge of the ontogeny of these neurones is, however, limited. Intestinal specimens from 24 human foetuses with gestational ages varying between 8 and 40 weeks were examined by immunocytochemistry. No peptide-containing neurones could be detected before the 14th week of gestation after which a rapid development was seen. Generally, peptide immunoreactivity was first noted in the myenteric ganglia and somewhat later in the other layers of the intestinal wall. There was no major difference between the peptides studied or between different parts of the intestinal tract with respect to time of appearance.

Neurogenic relaxation mediated by vasoactive intestinal polypeptide (VIP) in the isthmus of the human fallopian tube.

The smooth musculature of the Fallopian tube is important for normal ovum transport, fertilization and implantation. Little is known about the factors controlling the motor activity of the isthmic sphincter. Studies were performed on smooth muscle preparations from the human tube in vitro. Electrical field stimulation of the nerves in the isthmic region reduced the motor activity, particularly in the circular muscle. The response was unaffected by adrenergic and cholinergic antagonists, but blocked by tetrodotoxin, suggesting a neural involvement. Vasoactive intestinal polypeptide (VIP) was considered a likely candidate for the neural mediation of this response in view of the high density of VIP-containing nerve fibres in this region, and in view of the fact that exogenous VIP causes a marked reduction of the tubal motor activity. To test whether VIP might be the endogenous mediator of this effect, nerve stimulation was carried out in the presence of large amounts of exogenous VIP in order to occupy all VIP receptors; the motor inhibitory action of VIP was counteracted by vasopressin. Under these conditions, nerve stimulation failed to reduce isthmic motor activity. This was not due to vasopressin since reduction occurred in the presence of this peptide alone. The results suggest that VIP is responsible for the neurogenic inhibition of motor activity in the isthmus region of the human Fallopian tube.