Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease

Parkinson’s disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD. This study was conducted at the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. The first author was previously affiliated with the Houston Center for Quality of Care and Utilization Studies.     

Meta-Analysis of Cognition in Parkinson’s Disease Mild Cognitive Impairment and Dementia Progression

Neuropsychology Review - Mild cognitive changes, including executive dysfunction, are seen in Parkinson’s Disease (PD). Approximately 30% of individuals with PD develop Parkinson’s...     

Sleep Disorders and Cognitive Dysfunctions in Parkinson’s Disease: A Meta-Analytic Study

Neuropsychology Review - A relationship between sleep disorders and cognitive dysfunctions was reported in Parkinson’s Disease (PD), however, some studies did not confirm the link. A...     

Eye-Hand Coordination in Aging and in Parkinson’s Disease

Aiming movements to defined target positions were performed as fast and as accurately as possible by younger and older subjects and by patients in the early stages of Parkinson's disease (PD). Movement time and accuracy were tested in two conditions: with and without a centre cue. Older subjects exhibited slower movement time relative to the younger subjects only when the centre cue was present suggesting inefficient feedback processing. The performance of patients with PD was found to be as precise as that of older subjects. The movements of PD subjects, however, were slower in both conditions. Finally, the performance of subjects improved over trials. The data suggest that there is no difference in the nature of the control processes used by older and early-stage PD subjects, but that there is a reduction in the speed of these processes in PD.     

Parkinson’s Disease as a Disconnection Syndrome

Parkinson’s disease (PD) is a major neurodegenerative disorder that is usually considered in terms of midbrain and basal ganglia dysfunction. Regarding PD instead as a disconnection syndrome may prove beneficial to understanding aspects of cognition, perception, and other neuropsychological domains in the disease. PD is usually of unilateral onset, providing evidence of intrahemispheric dissociations and an imbalance in the usual relative strengths of the right and left hemispheres. Hence, in order to appreciate the neuropsychology of PD, it is important to apply to this disease our understanding of hemispheric lateralization effects and within-hemisphere circuitry from brainstem to higher-order association cortex. The focus of this review is on the relevance of PD-related disconnections among subcortical and cortical structures to cognition, perception, emotion, and associated brainstem-based domains such as sleep and mood disturbance. Besides providing information on disease characteristics, regarding PD as a disconnection syndrome allows us to more completely understand normal brain-behavior relations in general.     

Parkinson’s Disease: Patients’ Knowledge,Attitudes, and Interest in Genetic Counseling

The objective of this study was to assess the genetics knowledge of patients with Parkinson’s disease (PD), and to explore their attitudes on genetic testing and interest in genetic counseling. We surveyed 158 patients from the University of Maryland Parkinson’s Disease and Movement Disorders Center. Patients averaged a score of 63% on general genetics knowledge and 73% on PD genetics knowledge. Participants had an overall positive attitude toward genetic testing: 80% believed that the use of genetic tests among people should be promoted, and 83% would undertake genetic test for PD if it was available. Patients reported a high interest to discuss the benefits, risks, and impacts of genetic testing for PD (mean sum score?=?26, range?=?9–35), and 43% patients expressed interest in meeting with a genetic counselor. Multivariate regression analysis showed that patients who had more positive attitudes toward genetic testing for PD were more interested in meeting with a genetic counselor (β?=?0.6, p?<?0.001). This study is the first to demonstrate an interest in genetic counseling among patients with PD. Our findings demonstrate a new niche for genetic counselors to support patients in clarifying gaps or misconceptions in knowledge about PD genetics as well as the possible risks, benefits, and limitations of genetic testing.     

Sensorimotor Impairment of Speech and Hand Movement Timing Processing in Parkinson’s Disease

Models of motor control have highlighted the role of temporal predictive mechanisms in sensorimotor processing of speech and limb movement timing. We investigated how these mechanisms are affected in Parkinson’s disease (PD) while patients performed speech and hand motor reaction time tasks in response to sensory stimuli with predictable and unpredictable temporal dynamics. Results showed slower motor reaction times in PD vs. control in response to temporally predictable, but not unpredictable stimuli. This effect was driven by faster motor responses to predictable stimuli in control subjects; however, no such effect was observed in the PD group. These findings indicated the relationship between PD pathology and sensorimotor deficits in temporal predictive mechanisms of timing processing during speech production and hand movement.     

Cognitive Differences Between Patients with Left-sided and Right-sided Parkinson’s Disease. A Review

At disease onset, patients with Parkinson’s disease (PD) typically report one side of the body to be more affected than the other. Previous studies have reported that this motor symptom asymmetry is associated with asymmetric dopaminergic degeneration in the brain. Research on the cognitive repercussions of this asymmetric degeneration has yielded inconsistent results. Here, we review studies that reported on the cognitive performance of patients with left-sided (LPD) or right-sided (RPD) motor symptom predominance. We present evidence that patients with RPD typically experience problems with language-related tasks and verbal memory, whereas patients with LPD more often perform worse on tasks of spatial attention, visuospatial orienting and memory and mental imagery. In general, no differences were found between both groups on tasks measuring attention and executive function. The association between motor asymmetry and cognitive performance indicates that PD does not lead to one typical cognitive profile. The effect of symptom laterality on the cognitive complaints should be considered in the assessment and treatment of each individual patient.     

Functional Neural Correlates of Anosognosia in Mild Cognitive Impairment and Alzheimer’s Disease: a Systematic Review

Neuropsychology Review - Functional neuroimaging techniques (i.e. single photon emission computed tomography, positron emission tomography, and functional magnetic resonance imaging) have been used...     

Exploring the Relationships Between Maternal Mental Health Symptoms and Young Children’s Functioning in a Low-Income,Minority Sample

Poor maternal mental health, including depression and high stress levels, can negatively impact many domains of child development, particularly among low-income, ethnic minority families experiencing multiple stressors. Low-income minority mothers, particularly Hispanic mothers, are also at increased risk of experiencing exposure to community violence and other types of trauma. However, studies exploring the additional impact of maternal trauma symptoms on children’s functioning are rare. This study aims to address this gap by examining the impact of maternal trauma symptoms on young children’s functioning in a low-income, predominantly Hispanic sample through the mechanisms of maternal depressive symptoms, and mother’s experiences of parenting stress and strain. The sample consisted of 158 biological mothers (58% Hispanic, 13% African American, 5.7% White American) who were participating in community-based mental health treatment for their children (M_AGE?=?3.7, SD?=?1.2). Mothers completed questionnaires providing information on their children’s behaviors and their own mental health and stress levels at intake. Path analysis indicated that there was a significant indirect effect of maternal trauma symptoms on children’s behavior problems through maternal depressive symptoms and maternal stress in the parent-child relationship (β?=?0.09, p?<?0.01). In addition, there was a direct effect of maternal trauma symptoms on children’s behavior problems (β?=?0.32, p?<?0.001). The results suggest that maternal trauma symptoms, in addition to maternal depressive symptoms, contribute to poor maternal and child functioning.     

Antisaccades in Parkinson’s Disease: A Meta-Analysis

Neuropsychology Review - The usefulness of eye-tracking tasks as potential biomarkers for motor or cognitive disease burden in Parkinson’s disease (PD) has been subject of debate for many...     

(Neuro)Psychological Interventions for Non-Motor Symptoms in the Treatment of Patients with Parkinson’s Disease: a Systematic Umbrella Review

Neuropsychology Review - Conducted in a multidisciplinary and multimodal setting, the main objectives of neuropsychological treatment are to improve cognition, alleviate affective disorders, and to...     

The Relationships Among Parental Anxiety, Parenting, and Children’s Anxiety: The Mediating Effects of Children’s Cognitive Vulnerabilities

Theoretical models have emphasized the roles played by parental anxiety and behavior in the development of childhood anxiety problems. Little is known regarding the differential impacts of mothers and fathers or regarding the processes that mediate these influences. The present study examines the relationships between maternal and paternal trait anxiety, overprotection, and emotional support on the one hand and anxiety symptoms in children on the other hand. This study also explores the mediating role of children’s cognitive vulnerabilities to anxiety disorders in the relationship between parental variables and children’s anxiety. A sample of 80 children and their parents (fathers and mothers), selected from an initial screening of 905 school-aged children, participated in this study. The results indicate that both parents had unique influences on children’s anxiety symptoms: maternal trait anxiety and paternal overprotection and concern were found to independently and positively contribute to children’s anxiety. Furthermore, children’s interpretative biases mediated the relation between maternal trait anxiety and children’s anxiety symptoms. The results of this study underline the importance of considering both paternal and maternal factors in the development of children’s anxiety problems. These findings also have implications for theoretical models of the etiology of anxiety and for the treatment of these problems in children.     

Attachment Anxiety, Conflict Behaviors, and Depressive Symptoms in Emerging Adults’ Romantic Relationships

The present study examined attachment anxiety, conflict behaviors (attacking and compromising), and depressive symptoms in a sample of 45 emerging adults ages 18–25?years (M?=?19.51). Emerging adults’ romantic partners also participated in the study. In order to assess the study variables, emerging adults and their romantic partners completed self-report questionnaires. Using hierarchical regression analyses, a statistical model was tested wherein emerging adults’ depressive symptoms were regressed on their own and their partner’s attributes. Emerging adults’ own attachment anxiety and attacking behaviors and their romantic partner’s attacking behaviors, each explained significant portions of the variance in emerging adults’ depressive symptoms. Findings highlight the importance of considering the role of emerging adults’ and their romantic partners’ attributes in their depressive symptoms and offer important targets for therapeutic intervention.     

Cognitive,Affective, and Behavioral Responses to Ingroup’s Devalued Social Status: a Field Study at a Public University

In this study based on an actual event, we examined how group members cognitively, affectively, and behaviorally respond to devaluation of ingroup’s social status. Integrating predictions from Social Identity Theory (SIT; Tajfel and Turner 1986) and Intergroup Emotions Theory (IET; Smith et al. Journal of Personality and Social Psychology, 93(3), 431–446 (2007)), we explored how appraisals about ingroup’s perceived decrease in status (i.e., stability and legitimacy of status change and permeability of group boundaries) are associated with discrete group-level emotions (e.g., anger, shame), and how those emotions in turn predict different coping strategies Blanz et al. European Journal of Social Psychology, 28(5), 697–729 (1998). Analyses of the results showed that: First, preference for each coping strategy varied according to appraisals of ingroup status, and the patterns were largely consistent with what SIT predicts. Second, different group-level emotions were reported according to appraisals of ingroup status. Third, inclusion of group-level emotions as mediators of associations between ingroup status appraisals and coping strategies significantly increased the explanatory power of the path models. In sum, this study demonstrated how the two theories on intergroup relations can be used together to offer a more detailed account of group identity management. For future direction, experimental or longitudinal designs as well as cross-cultural comparisons were suggested.     

Children’s Demonstrative Comprehension and the Role of Non-linguistic Cognitive Abilities: A Cross-Linguistic Study

Previous studies have shown that young children often fail to comprehend demonstratives correctly when they are uttered by a speaker whose perspective is different from children’s own, and instead tend to interpret them with respect to their own perspective (e.g., Webb and Abrahamson in J Child Lang 3(3):349–367, 1976); Clark and Sengul in J Child Lang 5(3):457–475, 1978). In the current study, we examined children’s comprehension of demonstratives in English (this and that) and Mandarin Chinese (zhe and na) in order to test the hypothesis that children’s non-adult-like demonstrative comprehension is related to their still-developing non-linguistic cognitive abilities supporting perspective-taking, including Theory of Mind and Executive Function. Testing 3 to 6-year-old children on a set of demonstrative comprehension tasks and assessments of Theory of Mind and Executive Function, our findings revealed that children’s successful demonstrative comprehension is related to their development of Theory of Mind and Executive Function, for both of the language groups. These findings suggest that the development of deictic expressions like demonstratives may be related to the development of non-linguistic cognitive abilities, regardless of the language that the children are acquiring.     

Moderators of the Relationship Between Maternal Substance Abuse Symptoms and Preschool Children’s Behavioral Outcomes

While maternal substance use problems increase the likelihood of behavior problems in children, child outcomes are varied, leading to interest in understanding additional family factors that contribute to the development of behavior problems in children impacted by maternal substance abuse. The purpose of this study is to examine harsh parenting and family conflict as potential moderators of the relationship between symptoms of maternal substance use problems and child externalizing behavior problems. The non-clinical sample for this study included 250 low-income parents whose preschool age children were enrolled in Head Start programs in a Southern state. This study utilized data collected during two home visits, an average of 10 months apart, with data on family functioning and maternal symptoms of substance use problems collected at the first time point and child externalizing behavior collected at the second time point. Over one-third of the children (38.1 %) had clinically elevated externalizing behavior scores. We used regression analysis to examine whether harsh parenting or family conflict moderated the relationship between maternal substance use symptoms and child externalizing behavior. In this community sample, we found that in the absence of family risks related to harsh parenting and family conflict, maternal symptoms of substance use problems did not have a significant impact on child externalizing behavior in preschool children. However, when high levels of family conflict or harsh parenting were present, symptoms of maternal substance use problems increased the risk of externalizing behavior problems in children.     

Parental Divorce,Relationships with Fathers and Mothers,and Children’s Romantic Relationships in Young Adulthood

The current study examined parent–child relationships during adolescence as a moderator between earlier parental divorce and children’s romantic relationships in emerging adulthood. In addition, the study examined the potential different outcomes in children’s romantic relationships according to the gender of parents and children as well as to fathers’ different residence types. The data for this study came from a 22-year 9-wave investigated longitudinal study, Michigan Study of Life Transitions (MSALT), which began in 1983. The sample for the current study was 520 (female?=?311 and male?=?209) from ‘always-married’ and 154 (female?=?107 and male?=?47) from ‘divorced’ families. Some of main findings are that residential father–child relationships during adolescence were more critical for children’s satisfaction in their romantic relationships in emerging adulthood than non-residential divorced father–child relationships, and that relationships with fathers during adolescence mattered for daughters’ satisfaction in their romantic relationships in emerging adulthood, but not for the sons’ satisfaction. Possible explanations of the findings, limitations, and strengths in the current study are discussed, and future research directions are addressed.