Steven R. Howe

The measurement of optimism and pessimism

Procedures employed in the development and validation of a new Optimism & Pessimism Scale are described, and information about test-retest reliability is reported. Internal consistency analyses and other data suggest that optimism and pessimism are not polar opposites and bring up questions about the intrerelatedness of the cognitive and affective realms. The magnitude of the correlation between pessimism and measures of anxiety suggests a link between this measure and the Negative Affectivity construct, and the potential relationships among optimism, pessimism, the Pollyanna Principle, and Positive and Negative Affect are discussed. Conceptually, it appears that optimism and pessimism may aid in psychological defense by helping to bind anxiety.

A survey of clinical psychologists on treating lesbian, gay, and bisexual clients.

Should the average psychologist receive specific training on lesbian, gay, and bisexual (LGB) concerns? On the basis of a random sample of practicing psychologists, LGB clients are present in most caseloads. Respondents rated the most important therapeutic issues with LGB clients and identified training that would improve their work with LGB clients (including the topics of coming out, estrangement from family, support system development, and internalized homophobia). In addition, participants reported on the types of training that they are getting (most frequently reading articles, supervision, and continuing education). The implications for training programs and private practitioners are considered.

The effect of seizures on working memory and executive functioning performance

The aim of this study was to assess whether duration of seizure disorder and lifetime seizure load are associated with deficits in higher cognitive functions in patients with temporal lobe epilepsy (TLE) (N=207) or psychogenic nonepileptic seizures (PNES) (N=216). Multivariate regression analyses revealed that age at onset, duration, and group assignment were significant predictors of neuropsychological performance (all P<or=0.02), with group having a moderating relationship. Univariate analyses revealed different patterns of predictor effects on cognitive functioning within each diagnostic group. An impairment index was calculated for each individual, and univariate analyses revealed that age at TLE but not PNES onset was the only significant predictor of impairment (b=-0.005, P<0.001). The results suggest that earlier age at seizure onset, longer duration, and higher lifetime seizure frequency affect cognitive functioning in both the TLE and PNES groups, but differently within each group. These results have implications for early diagnosis and intervention in both groups.

Alcohol expectancies and drinking motives in college drinkers: Mediating effects on the relationship between generalized anxiety and heavy drinking in negative-affect situations

The current study tested the hypotheses that drinking to cope motives and alcohol expectancies of tension- and worry-reduction mediate the relationship between generalized anxiety (GA) and negative-affect heavy drinking in a cross-sectional sample of 782 college drinkers. As expected, structural equation modeling results indicated that alcohol expectancies mediated the relationship between GA and drinking to cope motives, and drinking to cope motives mediated the relationship between alcohol expectancies and heavy drinking in negative-affect situations. Unexpectedly, drinking to cope motives also mediated the relationship between GA and negative-affect heavy drinking. The model predicting negative-affect heavy drinking was tested in subsamples of 413 hazardous and 366 nonhazardous drinkers and did not differ structurally; however, omnibus measurement of model indirect effects was stronger for hazardous than nonhazardous drinkers. Finally, the results of a similar post-hoc model to predict general problem drinking support the specificity of the interrelationships among GA, cognitive mediators and to negative-affect drinking. These results inform cognitive-behavioral theories and interventions for comorbid GA and alcohol use problems.

The Effect of Temperament and Neuropsychological Functioning on Behavior Problems in Children with New-Onset Seizures

The present study is part of a larger project that seeks to identify factors that predict childrens behavioral, social, and cognitive adaptation to epilepsy. Children with seizures are more likely to have internalizing and externalizing behavior problems than either healthy children or children with other chronic illnesses. The present research examines risk factors for behavior problems. Early temperament and neuropsychological functioning, specifically executive function and language abilities, are evaluated as unique and moderating predictors of adverse behavioral outcomes in 229 children with a first recognized seizure. Parents assessed temperament, children were administered neuropsychological tests, and teachers evaluated behavior 36 months after seizure onset. Results revealed that early temperament and neuropsychological functioning, specifically executive function, predicted behavioral outcomes 3 years after seizure onset.

Measuring depressive symptoms among treatment-resistant seizure disorder patients: POMS Depression scale as an alternative to the BDI-II

Major depressive disorder (MDD) is the most prevalent psychiatric comorbidity among patients with treatment-resistant seizures. The Beck Depression Inventory-II (BDI-II) is often used to measure the severity of self-reported depressive symptoms among patients with seizure disorders. In contrast, researchers often use the Profile of Mood States (POMS) Depression (D) scale to assess depressed mood among other medical patient groups. The clinical significance of POMS-D scores among seizure disorder patients is not clear. In this study, we computed the correlation of POMS-D and BDI-II scores, determined a formula for converting POMS-D scores to BDI-II scores, and computed the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the POMS-D among seizure disorder patients. Two BDI-II cutoffs (BDI-II16 and 20) were used as criteria for significant reported depressive symptoms. We found a strong correlation between POMS-D and BDI-II scores. Analyses indicated that POMS-D scores strongly predict BDI-II scores. In addition, the sensitivity, specificity, PPV, and NPV values obtained demonstrated that POMS-D scores accurately classify seizure disorder patients who endorse significant depressive symptoms. These results suggest that the POMS-D may be effective in measuring reported depressive symptoms among seizure disorder patients.

Data analytic techniques for treatment outcome studies with pretest/posttest measurements: an extensive primer.

This paper discusses several data analytic technique, for examining treatment efficacy in pretest-posttest control group designs. The following approaches are described: ANOVA on post scores, ANOVA on difference scores, split-plot repeated measures ANOVA, profile analysis, and ANOCOVA with prescore as the co-variate. Guidelines for choosing between available techniques are provided; the primary focus here is on the nature of the null hypothesis, the assumptions underlying the approach, and the power of the procedure. The importance of examining the characteristics of the data set in selecting an analytic technique is illustrated.

Interictal and postictal language testing accurately lateralizes language dominant temporal lobe complex partial seizures.

Purpose: Noninvasive tests that accurately localize seizure onset provide great value in the presurgical evaluation of patients with intractable epilepsy. This study examined the diagnostic utility of three expressive language disturbances in lateralizing language‐dominant (DOM) temporal lobe complex partial seizures: (1) the postictal language delay (PILD; time taken to correctly read a test phrase out loud immediately following seizures); (2) the production of postictal phonemic paraphasic errors (PostPE); and (3) interictal phonemic paraphasic errors (InterPE).

Superior longitudinal fasciculus and language functioning in healthy aging

Structural deterioration of brain tissue in older adults is thought to be responsible for the majority of age-related cognitive decline. Disruption of widespread cortical networks due to a loss of axonal integrity may also play an important role. Research examining correlations between structural change and functional decline has focused heavily on working memory, processing speed, and executive processes while other aspects of cognition, such as language functioning, have received less attention. The current study aimed to determine whether age-related changes in the superior longitudinal fasciculus (SLF), are responsible for the deterioration in language functioning associated with age. Subjects included 112 right-handed volunteers (ages 19-76). For each subject, the SLF of the left hemisphere was reconstructed from diffusion tensor images (DTI). Mean fractional anisotropy (FA) values were extracted from parietal (SLFp) and temporal (SLFt) bundles. Language functioning was measured using the Peabody Picture Vocabulary Test (PPVT), Boston Naming Test (BNT), Controlled Oral Word Association Test (COWAT), and Semantic Fluency Test (SFT). Regression analyses revealed that males and females showed a different pattern of decline in FA across adulthood. For males, greater SLFt FA was significantly associated with increased COWAT performance, and there was a positive relationship between both age and SLFp FA with BNT scores. In females, greater SLFp FA was related to lower COWAT performance. Taken together, the results suggest that white matter integrity of the SLF follows a different pattern of decline in adulthood for males and females, and this decline differentially affects language functioning.

Presurgical neuropsychological testing predicts cognitive and seizure outcomes after anterior temporal lobectomy

We sought to determine significant predictors of seizure and cognitive outcome following surgery for epilepsy. Participants included 41 patients who had undergone anterior temporal lobectomy (ATL). Higher presurgical verbal/language scores and lower nonverbal memory scores were predictive of seizure-free status following ATL. Overall, the presurgical predictors were 93% accurate in discriminating between seizure-free and non-seizure-free patients postsurgery. Surgery in the nondominant-for-language hemisphere was predictive of higher postsurgical verbal/language and verbal memory scores. Higher presurgical visual/construction, nonverbal memory, and verbal/language scores were predictive of better postsurgical verbal/language functioning. Better presurgical verbal/language functioning was predictive of the same skills postsurgically as well as visual/construction outcomes. Exploratory analyses in a subset of participants (n=25) revealed that dominant and nondominant intracarotid amobarbital (Wada) memory scores added unique variance only for predicting nonverbal memory following ATL. Presurgical neuropsychological testing provides significant and unique information regarding postsurgical seizure freedom and cognitive outcome in patients who have undergone ATL.