Background:

The purpose of this study was to examine the efficacy of three experimental therapies for ameliorating the symptoms of Kurlu. The ANOVA design is a simple oneway ANOVA with four groups--a control group and three experimental groups.

Patients for this study were forty males between the ages of 21 and 60 who were consecutive admissions to the Waldo Jones Kurlu Clinic and were independently diagnosed by two clinicians as meeting the American Psychiatric Association’s Diagnostic and Statistical Manual, V Edition (provisional), criteria for Kurlu. These diagnostic criteria are: (1) the belief that one's penis is shrinking; (2) exclusion of female gender and known medical conditions or other psychiatric disturbance that may explain (1).

The forty patients were randomly assigned to one of four therapies with exactly ten patients per therapy. The first therapy, termed the control therapy here, was the traditional approach to Kurlu taken in the clinic. In the control condition, patients were informed that this is a well-understood disorder and that there was no real reason to suspect that the penis was in fact getting smaller. These patients were also given massive doses of Thorazine in case they were crazy.

The remaining three therapies were experimental treatments. Therapy number two, the first of the experimental treatments, was a cognitive therapy in which the patients were to read daily a statement that told them they were really good people. These patients then completed a form detailing their self-esteem and the degree to which their self-esteem affected penis size.

Therapy number three used a behavioral modification approach. Here patients were given a little ruler and were to record penis size each time they went to the bathroom. Daily charts of size over time were then plotted. We considered dropping one patient from this group but in the end included him in the analysis. (He worked outside where it was very cold and his symptoms continually got worse.)

The final therapy was based on abreaction principles. On the first clinic visit the attending physician would say, "Oh my God!" and admonish the patient not to touch it for a week or he will go blind and it will fall off.

Three standard instruments were used to assess outcome. These instruments are the Symptom Index for Kurlu Evaluation (SIKE), the Social Functioning with Kurlu Disorder Inventory (SFKDI), and the Occupational Adjustment Scale (OAS). The three measures were given at two time points. The first time point, termed the pretest herein, was when patients entered the clinic and before assignment to one of the four treatments. The second time point, the post-test, occurred exactly two weeks after the start of treatment.

Make sense of these data and write a report about the efficacy of the therapies. The data for this study may be found on samiam in the directory ~carey/p7291dir. There is a raw data file called kurlu.dat. The SAS code to read in this file is in kurlu.sas, and the SPSS code in kurlu.sps. There are also SAS and SPSS data sets on this directory.