Eleanor Moodie

Fluvoxamine, placebo, and cognitive behaviour therapy used alone and in combination in the treatment of panic disorder and agoraphobia☆

Abstract One hundred and ninety patients meeting DSM-III-R criteria for panic disorder with or without agoraphobia were randomly allocated to (a) Fluvoxamine, (b) placebo, (c) Fluvoxamine + cognitive behaviour therapy, (d) placebo + cognitive behaviour therapy, or (e) cognitive behaviour therapy alone. Patients were treated over 13 weeks and all participated in nine sessions plus follow-up at 6 months. Numbers in each group were as follows—(a) Fluvoxamine: entered n = 36, completed n = 29, attended follow-up n = 23; (b) placebo: entered n = 37, completed n = 28, attended follow-up n = 21; (c) Fluvoxamine + cognitive behaviour therapy: entered n = 38, completed n = 29, attended follow-up n = 24; (d) placebo + cognitive behaviour therapy: entered n = 36, completed n = 33, attended follow-up n = 30; (e) cognitive behaviour therapy: entered n = 43, completed n = 30, attended follow-up n = 28. A balance across treatments for therapist contact was attempted. A fixed-dose medication regimen was used with patients taking 150mg Fluvoxamine per day. A range of process and outcome measures both therapist- and patient-rated was used. Outcome at treatment end point and at 6-month follow-up was assessed in terms of both statistical and clinical significance and revealed that all active treatments showed improvement over time. This improvement was better preserved over follow-up in those groups receiving cognitive behaviour therapy (Groups c, d, and e) with these groups showing larger proportions of patients continuing to achieve predetermined criteria of clinically significant change on the Hamilton Anxiety Scale, Kellner and Sheffield Symptom Rating Test, and the Fear Questionnaire-Agoraphobia Scale at 6-month follow-up than those of the medication-alone groups (Groups a and b). The largest and most consistent treatment gains were evidenced by the cognitive behaviour therapy (Group e) and the Fluvoxamine + cognitive behaviour therapy (Group c) groups, with the latter showing these gains 2 weeks earlier in treatment, at Day 28 rather than Day 42.

Social representations of the individual: a post-Communist perspective

Social representations of the individual are examined in three post-Communist Central European nations, i.e. the Czech Republic, Slovakia and Hungary, and in three West European nations, i.e. Scotland, England and France. All six nations share a common European history since the Renaissance and Humanism, based on such values as freedom, agency, individual rights and individual responsibility. Many of these values were rejected by the Communist regimes in which people lived for 40 years. Extreme forms of individualism developed in certain West European nations during the same period. In view of these historical events we have asked the following questions: Do people in the post-Communist countries of Central Europe, after 40 years of totalitarian collectivism, still adhere to the values of the common European heritage? What is the meaning of ‘the individual’ today, in Western democracies and in Central European post-Communist nations? Which issues are important for the well-being of the individual and how do they relate to the political and economic circumstances of those individuals? The results show that the values of the common European heritage in Central Europe have not been destroyed and that factors relating to the well-being of the individual differ between the two parts of Europe. These data are discussed in terms of the political and economic situations in Central and Western Europe, the relationship between language and social representations and the structure of social representations.

Augmentative and alternative communication systems used by people with cerebral palsy in Scotland: Demographic survey

The present survey shows that in 1991–1992 there were 72 children, 37 adolescents, and 107 adults with cerebral palsy in Scotland who used some form of an augmentative and alternative communication (AAC) system. Among these, 61% were males and 39% were females. There has been a substantial increase in the use of AAC systems over the last 3 years and, indeed, over 50% of users have had their AAC systems no longer than 1 year. The AAC systems identified in this study were broadly divided into low-technology and high-technology systems. Although the data show a tremendous increase in the use of high-technology systems, the low-technology systems still accounted for more than 50% of all AAC systems used at present. There were a variety of methods of access both with low- and high-technology systems, indicating that a considerable proportion of users must rely on methods of access other than hand pointing. The majority of high-technology systems had voice output and all of the low-technology systems required l...

Are alarming events good for captive monkeys

Abstract To evaluate a hypothesis suggesting that brief arousal may be beneficial to laboratory animals, 39 cotton-top tamarins living in four families were observed following stimulating husbandry procedures. Arousal led to an improvement in behaviour (i.e. decrease in activity and an increase in affiliation) during the remainder of the day, changes similar to patterns reported as positive effects of enrichment but opposite to negative effects of long-term stressors; a wider range of normal behaviour; but we found no evidence for an improved response to challenge.

Characteristics and management of prisoners at risk of suicide behaviour

This study provides data on the characteristics and management of all prisoners identified at risk of suicidal behaviour over a 12 month period in all Scottish prisons. From a total of 44,093 admissions, 1,984 (4.5%) prisoners were identified at time of reception as ‘at risk’ while 857 (1.9%) inmates were classified as ‘at risk’ at some other point during custody. Of those identified ‘at risk’ at time of reception, 19.1% were retained on suicidal supervision, while 58.2% of those identified ‘at risk’ during custody were maintained on some form of suicidal supervision. Average length of time kept on strict suicidal supervision for those identified at time of reception was 1.87 days, and for those identified at some other point during custody was 2.59 days. Results are discussed in relation to the problems associated with suicide prediction and prevention in prison settings and the tendency for risk assessment to create significant numbers of false positives at time of reception.

The Meanings of the Community and of the Individual in Slovakia and in Scotland

The purpose of this paper was to examine meanings of the terms ‘individual’, ‘the community’ and ‘local community’ in Slovakia and Scotland. The social, cultural, political and economic histories of these two small European nations are quite different. Slovakia is one of the post-communist countries in which rapid changes have recently taken place. In contrast, Scotland has enjoyed a relatively stable parliamentary democracy within the UK. Two groups of respondents, 200 from Slovakia and 200 from Scotland, were presented with a word association task which included 38 political and economic terms and with two scales containing the same list of terms. They rated phenomena referring to these terms with respect to their importance for the well-being of the individual and to the well-being of the community. The results suggest that for Scots but not for Slovaks, the term ‘local community’ evokes positive associations and that local community is a meaningful concept. The data suggest that local attachments and loyalties were destroyed in Slovakia during communism. (© 1997 by John Wiley & Sons, Ltd.)

Training staff to support AAC users in Scotland: current status and needs

The focus of the present study was twofold: to discover what types of training in augmentative and alternative communication (AAC) are perceived to be both available and desired by those people involved in the implementation of AAC equipment for adults in Scotland and to document the extent to which they have received relevant training in AAC. Two questionnaires were distributed to those people responsible for AAC implementation (e.g., speech and language therapists [SLTs], day and residential staff, nurses, teachers). One questionnaire requested details of any “general” AAC training received by the respondent, and the other questionnaire requested details of any training received by the respondent that was specific to a particular AAC system. With respect to general training, perceptions suggested that what training exists is beneficial, but that there is insufficient training available, and non-SLTs, in particular, have had little general training. With respect to “specific” training, about half of the ...