Anticipation of affect in dysthymia: behavioral and neurophysiological indicators.

Anticipation for future affective events and prediction uncertainty were examined in healthy controls and individuals with dysthymia (DYS) using behavioral responses and the contingent negative variation (CNV) and post-imperative negative variation (PINV) event-related potential (ERP) components. Warning stimuli forecasted the valence of subsequently presented adjectives ("+", positive; "=", neutral; "-", negative), and participants indicated whether each adjective would describe them over the next two weeks. Controls expected fewer negative, and individuals with DYS expected fewer positive, adjectives to apply to them. CNV amplitudes were enhanced in controls prior to positive versus other adjectives. Response times and PINV amplitudes were greater following neutral compared to other adjectives, and PINV was larger overall in dysthymics compared to controls. In sum, healthy controls and individuals with DYS exhibit different behavioral and neurophysiological biases in anticipation for future affective events. These results are discussed in the context of cognitive theories of depression.

Effects of LifeSkills training on medical students' performance in dealing with complex clinical cases.

OBJECTIVE: Sound clinical judgment is the cornerstone of medical practice and begins early during medical education. The authors consider the effect of personality characteristics (hostility, anger, cynicism) on clinical judgment and whether a brief intervention can affect this process. METHODS: Two sophomore medical classes (experimental, comparison) were assessed on several personality dimensions and responded to a series of clinical vignettes. The experimental group received cognitive behavior training to improve stress, coping, and interpersonal skills. Participants were reassessed within 1 week of the initial assessment. RESULTS: Significant associations between hostility and cynicism and maladaptive responses to the clinical vignettes were noted. Following the intervention, hostility, cynicism, anger, and aggression were significantly reduced, with concomitant reductions in maladaptive decision-making. CONCLUSION: The relationship between the quality of clinical decision-making and personality characteristics was confirmed. The potential to modify this relationship using a brief cognitive behavior intervention suggests that such interventions should be an essential component of medical education.