Art therapy masks reflect emotional changes in military personnel with PTSS.

Among disabling post-traumatic stress symptoms (PTSS) are irritability, aggressive behavior, distressing memories and general impaired cognition and negative mood. Art therapy interventions, including mask-making, can potentially alleviate these symptoms. We tested the hypothesis that art conveys emotions and predicted that blinded viewers would be able to perceive changes in theoretically derived emotional profiles expressed in art made by military personnel with PTSS from the onset to the end of therapy. Five service members and veterans exhibiting PTSS were enrolled in an 8-session art therapy protocol, during which they artistically transformed papier-mâché masks at the beginning and end of the protocol. We found that blinded viewers without knowledge of the masks' creation stage (onset or end of therapy) read initial masks as conveying more negative emotions (e.g., angry, upset, and challenged) and later masks as conveying more positive emotions (calm and pleasure). Based on the assessments from the blinded evaluators, we infer the emotional transition experienced by the participants was expressed in the masks. In an exploratory arm of the study, we also found that viewers were better able to empathize with the negative emotions experienced by participants with PTSS when asked to explicitly take their perspective.

Management and complications of complete heart block in pregnancy.

Although rare, increasing numbers of women with pacemakers are becoming pregnant. We describe the complications of a woman with arrhythmia and a pacemaker for complete heart block experienced before, during, between and after her pregnancies. We illustrate the benefits of multidisciplinary care, good communication and regular assessment in a stable, but complex woman.

Correlates of premenstrual dysphoria in help-seeking women.

Comparisons were made between the premenstrual changes reported by nontreatment-seekers (NTS) (n = 32) and those of treatment-seekers (TS) (n = 52). The Premenstrual Assessment Form Luteal Phase and Follicular Phase versions were completed and the Beck Depression Inventory, the Automatic Thoughts Questionnaire and the State-Trait Anxiety Inventory were completed at both the luteal and follicular phases. Prospective daily ratings were made for two treatment cycles on the Daily Ratings Form and TS were screened for a mood-disorder history. Using the commonly cited 30% decrease in dysphoric levels from the pre- to postmenstrual phases as the criterion of prospective confirmation, women with prospectively confirmed dysphoria (PMD +) were not significantly more symptomatic than those without prospective dysphoric confirmation (PMD -). However, TS were more symptomatic than NTS on measures of depression, anxiety and frequency of negative automatic thoughts but not on mood behaviour and physical changes reflected in the PAF scales. No demographic differences were found between TS and NTS. Results did not support the issue of requiring 'confirmation' of self-reports within a help-seeking group or the use of the 30% criterion in particular. Findings further suggest that the 95-item PAF may be inadequate in differentiating TS from others.

The efficacy of cognitive behaviour therapy in treating premenstrual dysphoric changes.

This study assesses the efficacy of cognitive behaviour therapy (CBT) in treating premenstrual dysphoric changes. The CBT condition (n = 24) aimed to modify dysfunctional thinking as a means of impacting on negative premenstrual symptoms and changes. The components of CBT were cognitive restructuring and assertion training. A comparison condition called 'information-focused therapy' (IFT) (n = 9) aimed to present information only and did not address belief restructuring. The components were relaxation training, nutritional and vitamin guidelines, dietary and lifestyle recommendations, aspects of child management training and assertion training. Results indicated that the amelioration of anxiety, depression, negative thoughts and physical changes can be effectively addressed by either CBT or IFT. The extent to which a women's belief system is critical in the experience of premenstrual distress requires further empirical investigation.

A psychosocial profile of women with premenstrual dysphoria.

Sixty women from the community were used in this study to identify a profile of women who experience premenstrual dysphoria. Women with prospectively confirmed premenstrual dysphoria (PMD +; N = 24) were compared to women with prospectively unconfirmed premenstrual dysphoria (PMD -; N = 15) and controls (PMD control; N = 21). Over one menstrual cycle daily records of physical, emotional and behavioural symptoms were completed on the Daily Ratings Form. Other self report measures obtained were the Premenstrual Assessment Form, Rotter's Internal External Locus of Control, the Locke-Wallace Marital Adjustment Scale, and the State-Trait Anxiety Inventory. A psychiatric history was obtained during an interview. Analyses showed that premenstrually, PMD + and PMD - groups could be significantly differentiated from controls on reports of premenstrual dysphoric changes and levels of state and trait anxiety. Postmenstrually, they could be significantly differentiated from controls firstly, by history of affective disorder and locus of control and secondly, by premenstrual dysphoric changes. There were no significant differences between the PMD+ and PMD- women on most of the self report measures either at pre or post menstrual assessments. The present findings suggest that the characteristic profile of PMD+ and PMD- women is one of being symptomatic premenstrually in relation to dysphoric changes and levels of state and trait anxiety. Postmenstrually these symptoms appear to be superimposed on a background of a history of affective disorder and an external locus of control orientation.

Men's perception of premenstrual changes on the premenstrual assessment form.

Outcome research has shown that partner-spouse support can enhance the therapeutic outcome in a number of clinical problems. In the area of premenstrual tension, studies of treatment have apparently overlooked this issue of partners' support. This study was designed to address how men perceive premenstrual changes. 99 undergraduate men were asked whether they believed that women had premenstrual changes reflected on the 18 unipolar scales of the Premenstrual Assessment Form. Responses suggest that young men acknowledge that some women experience dysphoric features like hostility, mood swings, and low self-esteem as well as physical discomfort and behavioural changes. Clinical implications are outlined.

The relationship between premenstrual dysphoria and daily ratings dimensions.

This study assessed the relationship between premenstrual dysphoria reflected in the Premenstrual Assessment Form (PAF) and the Daily Ratings Form (DRF) dimensions of dysphoric mood, physical discomfort, energy levels, consumption and levels of alcohol, sex and activity. Reports of 59% of women with PAF Major Depressive Syndrome were confirmed by their DRF dysphoric mood score, compared with 27% of women with PAF Minor Depressive Syndrome. Women with confirmed premenstrual dysphoria (PMS + group) had significantly higher levels of mood dysphoria, physical discomfort and lower energy levels than the control group at the premenstrual phase. Higher levels of consumption overall were reported premenstrually than postmenstrually. There were no significant differences between groups on the dimension of more alcohol, sex and activity. Implications for future assessment are discussed.

Correlates of confirmed premenstrual dysphoria.

This study found that women with prospective reports of premenstrual dysphoria could be significantly differentiated from others on self-report measures of anxiety, depression and negative self-statements. Women who reported premenstrual dysphoria retrospectively but not prospectively did not significantly differ from controls on any of these measures using the State-Trait Anxiety Inventory, the Beck Depression Inventory and the Automatic Thoughts Questionnaire. Issues for further investigation are highlighted.

Habit reversal and differential reinforcement of other behaviour in the treatment of thumb-sucking: an analysis of generalization and side-effects.

This study evaluated the generalization, maintenance, and negative side-effects of Habit Reversal (HR) and Differential Reinforcement of Other Behaviour (DRO) in the elimination of thumb-sucking. Thirty children who sucked their thumbs or fingers excessively were randomly assigned to a HR, DRO or wait-list control group. Observation data were collected in three observation settings. Both procedures effectively reduced thumb-sucking in both a training setting and in two generalization settings, and initial generalization effects maintained over time. However, both procedures resulted in some temporary increases in oppositional behaviour and produced low elimination rates. Differences between HR and DRO were not statistically significant; however parents evaluated HR somewhat more favourably than DRO.

A comparison of the effects of child management and planned activities training in five parenting environments.

This study compared the effects of two procedures designed to enhance the extratraining effects of behavioral parent training. Twenty parents of oppositional children were randomly assigned to either a child management training condition or a combined child management plus planned activities condition. A further 10 nonproblem children and their parents served as a social validation group. Observations of both parent and child behavior were conducted in each of five home observation settings (breakfast time, kindy (kindergarten) or school exit, a structured playtime, bathtime, and bedtime). Both training procedures resulted in changes in both child oppositional and parent aversive behavior in all observation settings. In addition, desired positive parenting behaviors also improved in all settings. Treatment effects were maintained in all settings at 3-month follow-up. Comparisons between oppositional children following treatment and children in the social validation group showed that they each displayed similarly low levels of oppositional behavior in all settings. The implications of the results for facilitating generalized changes in behavioral parent training are discussed.