Consciousness and working memory: Current trends and research perspectives

Working memory has long been thought to be closely related to consciousness. However, recent empirical studies show that unconscious content may be maintained within working memory and that complex cognitive computations may be performed on-line. This promotes research on the exact relationships between consciousness and working memory. Current evidence for working memory being a conscious as well as an unconscious process is reviewed. Consciousness is shown to be considered a subset of working memory by major current theories of working memory. Evidence for unconscious elements in working memory is shown to come from visual masking and attentional blink paradigms, and from the studies of implicit working memory. It is concluded that more research is needed to explicate the relationship between consciousness and working memory. Future research directions regarding the relationship between consciousness and working memory are discussed.     

Small theory and the strategic choices of prevention research

Our comments on the discussion of mediational screening for prevention research highlight two issues: (a) There are advantages to giving a high priority to theory in a strategic sequence of prevention research studies. (b) Screening to identify a subgroup that is experiencing problems on processes the program is designed to change may be useful in accomplishing specific goals within an overall strategy of prevention research studies.     

Additive factor method applied to psychopathology with special reference to childhood hyperactivity

A review is made of available studies using the Additive Factor Method (AFM) in clinical research. The paper argues that by using the AFM in studies of psychological dysfunctioning a major contribution can be made: first, in preventing spurious findings, second, distinguishing between group differences with and without information processing deficits, and third, by identifying fundamental processes which may be impaired. This may offer psychodiagnostics an empirical basis on which to define disorders. This paper reviews studies contributing to this endeavour. It further raises the question of how to interpret clinical research, which is conducted in the tradition of information processing but not within the frame of reference of the AFM. It is suggested that such research is useful and complementary to that conducted using the AFM. Further, it is suggested that the role of energetical factors in clinical disorders and in their treatment is an important area for future experimental clinical research.     

Complex Genetic Disorders: Evaluating When Genetic Research Findings Are Applicable for Genetic Counseling Practice

Traditional genetic counseling processes and principles will be extended to a new realm—complex disorders. Although it may seem like a daunting task, understanding the methodologies used to study complex genetic disorders will enable genetic counselors to critically analyze research studies involving complex disorders. In this article, we explain newly evolving methodologies for genetic research, including case-control studies and transmission disequilibrium testing (TDT). Additionally, a framework is provided for evaluating original research findings and replication studies.     

Ten Ways to Improve the Use of Statistical Mediation Analysis in the Practice of Child and Adolescent Treatment Research

Despite guidelines and repeated calls from the literature, statistical mediation analysis in youth treatment outcome research is rare. Even more concerning is that many studies that have reported mediation analyses do not fulfill basic requirements for mediation analysis, providing inconclusive data and clinical implications. As a result, after more than five decades of research, it is still largely unknown through which processes youth treatment works and what the effective treatment components are. In this article, we present ten ways in which the use of statistical mediation analysis in youth treatment outcome research may be improved. These ten ways are related both to conceptual and methodological issues. In discussing how youth clinical researchers may optimally implement these directions, we argue that studies should employ the strongest research designs possible. In so doing, we describe different levels of a mediation evidence ladder. Studies on each step of the ladder contribute to an understanding of mediation processes, but the strongest evidence for mediation is provided by studies that can be classified at the highest level. With the help of the ladder of mediation evidence, results from youth mediation treatment outcome research can be evaluated on their scientific as well as clinical impact.     

Simulation as a tool in family therapy research

The efficacy and validity of simulation for purposes of training and evaluation are well established. Simulation has proven valuable in human behaviour research as well. However, based on the belief that families and other small groups behave differently, many family theorists have concluded that simulation may not be valid for family research despite the fact that some empirical studies showed little difference between simulated and actual families, suggesting that the disparity may not be as great as commonly believed. Ongoing and future studies controlling for 'time together', a dimension presumed to be critical in comparing simulated with actual families, may demonstrate that differences are not sufficiently large to preclude the use of simulated families in family research. Methodological problems are addressed and directions for future research proposed.     

Maternal depression and developmental disability: research critique

Maternal depression in families having a child with a disability has been the subject of considerable research over the past 25 years. This review was designed to describe the literature on maternal depression, critique its research methodology, identify consensus findings across studies, and make recommendations for future research. A particular emphasis is on the distinction between exhibiting depressive symptoms and meeting clinical criteria for a depressive disorder, how or whether research studies made this distinction, and implications for our understanding of maternal adaptation to disability in a family member. Of the 42 articles reviewed, only eight were clinically diagnosed depression; most of them used a scale rating depressive symptoms. Across the studies, mothers of children with disabilities generally exhibited a higher than average rate of depressive symptoms and are more at risk for clinical depression, but the incidence may be lower than reported in previous literature. Child behavior problems, maternal stress, coping style, and support were consistently associated with depressive symptoms. We conclude that we know relatively little about clinical depression in mothers of children with disabilities. The distinction between clinical depression and depressive symptoms may be important in conceptualizing how a child with a disability can influence family members and the nature of support that may need to be provided. Future research should incorporate gold standard diagnostic tools and assess history, severity, and type of depression. Research is also needed to study treatments to reduce the occurrence of both depressive symptoms and clinical depression.     

Prevention science and neighborhood influences on low-income children's development: theoretical and methodological issues

Despite the rapid growth of research on neighborhood influences on children, little of this research may be useful to prevention scientists. Most studies have ignored processes by which neighborhood conditions influence individual outcomes. To encourage neighborhood research that can better guide the development of preventive interventions, we propose a model that focuses attention on mediating and moderating processes, is appropriate for studies interested in individual differences in outcomes, acknowledges the transactions between residents and neighborhoods, and is sensitive to how neighborhood influences may differ for children at different developmental stages. Furthermore, we argue that greater attention to several methodological issues also can make neighborhood research more useful for the next generation of prevention programs to help low-income urban families and children cope successfully with the challenges posed by their neighborhoods.     

Capacity to consent to research in schizophrenia: the expanding evidence base

Capacity to consent to research, fundamental to informed consent and thus vital to the ethical conduct of research, may be impaired among a variety of research populations. Until recently, relatively little empirical evidence has been available to inform discussion and policy-making regarding whose capacity should be assessed, what should be measured, and how it should be measured. Capacity to consent to research has emerged as a central topic in the field of "empirical ethics," an important area of biomedical research devoted to bringing evidence-based methods to the study of ethically salient issues in biomedical and biopsychosocial research. In this paper, empirical studies of capacity to consent to research are reviewed, with a particular focus on studies involving people with schizophrenia. These studies provide intriguing data regarding the nature, correlates, and modifiability of decisional abilities among potentially vulnerable research populations, including individuals with serious neuropsychiatric illnesses. Areas in need of further empirical ethics research are highlighted.     

Neuropsychiatry of hypersexuality

Relatively few studies of the psychobiology of hypersexuality have been undertaken. Nevertheless, the literature does suggest the possibility of a neurobiology of hypersexuality. Three cases of hypersexual behavior are presented in the context of neuropsychiatric disorders, and the literature on this phenomenon is briefly reviewed. These case studies and the literature provide evidence that different brain systems may play a role in this disorder. Frontal lesions may be accompanied by disinhibition, including impulsive hypersexual response to external cues, while striatal lesions may be accompanied by repetitive triggering of internally generated response patterns. Temporal-limbic lesions may be accompanied by disturbances in sexual appetite itself, including change in the direction of sexual drive. These case studies demonstrate that a neurobiology of hypersexuality may prove of some heuristic value in the clinic. However, further research is required to consolidate the literature in this area.     

Interventions for suicide survivors: a review of the literature

Mourning after suicide is frequently a difficult experience. Research suggests that suicide survivors may be at elevated risk for several psychiatric and somatic complications. Despite this, very little research has focused on developing and empirically evaluating clinical interventions for this population. This paper attempts to stimulate interest in intervention research by reviewing three relevant areas: (a) studies of the perceived needs of survivors; (b) implications of the research on general bereavement interventions for work with survivors; and (c) research documenting the efficacy of specific interventions for adult survivors. Recommendations for future studies are discussed.     

Religion and spirituality in the context of bipolar disorder: a literature review

Religion and spirituality (R/S) may play an important role for individuals with bipolar disorder (BD) by providing a means of coping with, and an explanatory model for, their disorder. We conducted a systematic review of empirical studies that have explored R/S in individuals with BD or samples that explicitly delineate individuals with BD. Only six studies met our inclusion criteria. Findings from these studies suggest that R/S strategies may be important for some people in the management of BD. Religion and spirituality thus become relevant concerns for a therapeutic regime that seeks to develop wellness within a bio-psycho-social model. However, the limited body of research and methodological shortcomings of existing research make it difficult to draw relevant conclusions about how this might be accomplished. The authors propose a need for longitudinal, prospective, mixed methods research in order to inform evidence-based practice.     

The psychology of risk taking: toward the integration of psychometric and neuropsychological paradigms

The prevention of counterproductive or antisocial risk taking is a research priority. Attempts to understand risk-taking behaviors are dominated by the psychometric and neuropsychological paradigms, which have developed in relative isolation. Previous studies indicate that risk taking is associated with the sensation-seeking personality trait, although the relationship with impulsivity may be complex. Poor risk-related decision making is associated with lesions to the ventromedial prefrontal cortex. Further research is necessary to establish which forms of risk taking are associated with the 5-factor model of personality and may be influenced by ventromedial prefrontal cortex functioning. The relationship between risk-related decision making and personality traits is also discussed in order to provide a basis for future research adopting an integrated model of risk taking behavior.     

Ethical considerations in psychotherapy effectiveness research: choosing the comparison group

The primary purpose behind effectiveness research is to determine whether a treatment with demonstrated efficacy has utility when administered to the general population. The main questions these studies are meant to answer are these: Can the typical patient respond to treatment? Is the treatment acceptable to the typical patient? Can the treatment be administered safely and in its entirety in the typical treatment setting? Is the treatment under study significantly better than the community standard of care both from and a cost and outcome perspective? Answering these questions is meant to provide sufficient information to providers and policymakers so that effective interventions can be adopted and become the new community standard. For this research to make a meaningful impact on a provider and policymaker's decision to change the status quo, study interventions should be compared to the existing community standard of treatment, often referred to as treatment as usual (TAU). From an ethical perspective, this decision may not always be the safest choice. In some populations, TAU may mean no treatment at all, and in others TAU may be worse than withholding treatment. The effectiveness researcher is then caught between the pull to do no harm and the need for research to have an impact on change. The purpose of this article is to highlight certain conditions when TAU is ethically acceptable and to discuss alternatives when TAU may be an unethical treatment condition. For purposes of precision, we focus exclusively on psychotherapy effectiveness research rather than system-intervention research or medication-intervention research.     

Ethical Considerations in Psychotherapy Effectiveness Research: Choosing the Comparison Group

The primary purpose behind effectiveness research is to determine whether a treatment with demonstrated efficacy has utility when administered to the general population. The main questions these studies are meant to answer are these: Can the typical patient respond to treatment? Is the treatment acceptable to the typical patient? Can the treatment be administered safely and in its entirety in the typical treatment setting? Is the treatment under study significantly better than the community standard of care both from a cost and outcome perspective? Answering these questions is meant to provide sufficient information to providers and policymakers so that effective interventions can be adopted and become the new community standard.

For this research to make a meaningful impact on a provider and policymaker's decision to change the status quo, study interventions should be compared to the existing community standard of treatment, often referred to as treatment as usual (TAU). From an ethical perspective, this decision may not always be the safest choice. In some populations, TAU may mean no treatment at all, and in others TAU may be worse than withholding treatment. The effectiveness researcher is then caught between the pull to do no harm and the need for research to have an impact on change. The purpose of this article is to highlight certain conditions when TAU is ethically acceptable and to discuss alternatives when TAU may be an unethical treatment condition. For purposes of precision, we focus exclusively on psychotherapy effectiveness research rather than system-intervention research or medication-intervention research.     

Patient variable biases in clinical judgment: conceptual overview and methodological considerations

Specific conceptual factors are presented as having contributed to the negative findings of past psychotherapy bias research. Among these factors are the restrictive nature of both the definition of bias and the model of the biased clinician. A review of published studies of several patient variable biases (e.g., gender, race/ethnicity, and age) indicated that bias may best be defined in broader terms and that its occurrence may be more circumscribed than originally conceived. In addition, the lack of a theoretical perspective in this area of research is noted and the applicability of some social cognitive processes is discussed. Methodological factors are also considered, and recommendations for future research are offered.     

The Risks,Benefits, and Ethics of Trauma-Focused Research Participation

With the rising interest in the field of trauma research, many Institutional Review Boards, policymakers, parents, and others grapple with the impact of trauma-research participation on research participants' well-being. Do individuals who participate in trauma-focused research risk experiencing lasting negative effects from participation? What are the potential benefits that may be gleaned from participation in this work? How can trauma research studies be designed ethically, minimizing the risk to participants? The following review seeks to answer these questions. This review indicates that most studies in this area have found that only a minority of participants experience distress when participating in trauma-focused research. Furthermore, these negative feelings tend to dissipate quickly over time, with the majority of participants self-appraising their participation as positive, rewarding, and beneficial to society. Design characteristics that may serve to minimize participants' risk of experiencing distress are discussed, as well as implications for public policy and future research.     

“Socializing” Achievement Goal Theory: The Need for Social Goals

Cultures shape the types of goals that students pursue in the classroom. However, research in achievement goal theory seems to have neglected this cultural aspect with its exclusive focus on individualistically-based goals such as mastery and performance goals. This emphasis on mastery and performance goals may reflect Western individualist psychological thinking. Thus, social goals, which may be more salient in collectivist cultures, are relatively neglected. There is a dearth of studies investigating the role of social goals in academic motivation, and the few studies that did explore them are somewhat problematic. This paper reviews research done within the achievement goal theory, considers the need for more studies on social goals, and concludes with the argument that social goals are important in understanding student motivation especially in collectivist cultures.     

Risk and dynamics of violence in Asperger's syndrome: A systematic review of the literature

The main purpose of this article is to delineate findings from a review of the literature on the empirical basis for the existence of a relationship between Asperger's syndrome (AS) and violence risk. A second aim is to examine whether certain characteristics of the disorder may have a higher violence-triggering potential. Results of this review show that there are very few empirical studies that confirm a stable link between AS and violence. Only 11 studies involving 22 patients and 29 violent incidents met the criteria for inclusion in the review after the search of the literature. However, a qualitative analysis of the studies yielded some indications of possible patterns of dynamics of violence that may prove to be typical of persons with AS. A tentative comparison of AS and psychopathy indicated that there may be qualitative differences in the characteristics of violent behavior between the disorders. Suggestions for further research are presented.     

Hyperactivity in Children: A Focus on Genetic Research and Psychological Theories

Hyperactivity has attracted a large amount of research interest in recent years. Here we review developments in genetic research and in research testing psychological theories of the condition. Family, adoptee and twin studies indicate a strong role for genetic factors in the etiology of hyperactivity. Evidence is emerging also from molecular genetic studies, implicating specific genes that may be involved. At the level of cognitive functioning, a divided, focused or sustained attention deficit does not seem to be a core deficit in hyperactivity. Although children with hyperactivity often perform poorly on certain executive function tasks, there is disagreement about the interpretation of these findings. The association reported in some studies between a slow inhibitory process and hyperactivity may reflect a generally slow, variable in speed and inaccurate pattern of responding. Hypotheses about psychological mechanisms such as state regulation or delay aversion provide alternative, and particularly encouraging, interpretations of the findings. We discuss the possible integration of the two lines of research—those of genetic research and research on psychological mechanisms.