Pavlovian conditioning of drug reactions: Some implications for problems of drug addiction

This paper reviews the classical conditioning of drug reactions, with special emphasis on the relationship of this phenomenon to drug addiction. Several aspects of drug addiction such as drug craving, high relapse tendencies, and the recurrence of withdrawal symptoms are reviewed and interpreted in light of classical conditioning theory and data. A theory is proposed that attempts to account for various aspects of the addictive process. The implications and empirical methods for testing this theory are outlined.     

Generalization of tacting actions in children with autism

This intervention compared the effects of two procedures on the generalization of a tacting repertoire (labeling) in 6 children with autism spectrum disorder. In one procedure the verbal antecedent stimulus “What is she doing?” appeared together with a person performing an action; in the other procedure, the antecedent stimulus was just the presence of the action. In initial tests, children emitted tacts only when the action was presented with the verbal antecedent. Thereafter, they learned to tact an action without the verbal antecedent and received tests to evaluate generalization to another action. Results indicated that in order to obtain generalization of tacting actions, it was necessary to learn to tact other actions without the verbal antecedent as well as learning to tact the action with the verbal antecedent. These findings have relevance for generalization of tacting actions from control by verbal antecedents to natural conditions and the production of spontaneous language.     

冲动性对不同成瘾行为发展的调控及其神经机制

近年来越来越多的研究证据提示, 个体冲动性在成瘾疾患发生发展机制中具有关键作用, 可能成为成瘾行为的潜在易感标记以及早期识别和干预的重要靶点, 但冲动性对不同成瘾行为变化发展的调控机制尚不明确。项目拟综合跨成瘾谱系比较、纵向追踪设计、冲动行为干预等研究途径, 采用人格测量、神经认知、神经影像等技术, 首先比较尼古丁依赖者与网络游戏成瘾者的冲动性结构及其在前额叶–纹状体环路的结构功能改变; 然后采用混合分组设计筛选出具有高低冲动性的非成瘾青少年进行连续追踪研究, 考察冲动性对尼古丁依赖与网络游戏成瘾的预测效力; 并采用认知行为训练, 对吸烟成瘾者与网络游戏成瘾者进行冲动干预, 考察行为干预对冲动性水平及前额叶–纹状体环路功能的改变, 以及对不同成瘾行为发展的抑制后效。旨在探索冲动性作为成瘾的潜在易感标记及干预靶点的效力。     

Children with autism are impaired in the understanding of teaching

Children learn novel information using various methods, and one of the most common is human pedagogical communication or teaching – the purposeful imparting of information from one person to another. Neuro‐typically developing (TD) children gain the ability to recognize and understand teaching as a core method for acquiring knowledge from others. However, it is not known when children with Autism Spectrum Disorder (ASD) acquire the ability to recognize and understand teaching. This study (total N = 70) examined whether children with ASD recognize the two central elements that define teaching: (1) that teaching is an intentional activity; and (2) that teaching requires a knowledge difference between teacher and learner. Theory of mind understanding was also tested. Compared to individually matched TD children, high cognitively functioning children with ASD were impaired in their comprehension of both components of teaching understanding, and their performance was correlated with theory of mind understanding. These findings could have broad implications for explaining learning in children with autism, and could help in designing more effective interventions, which could ultimately lead to improved learning outcomes for everyday life skills, school performance, health, and overall well‐being.     

The direct way may not be the best way: Children with ADHD and their understanding of self-presentation in social interactions

Knowledge and use of self-presentational tactics is an important social skill. We examined understanding of the function of three different self-presentational tactics (self-promotion, ingratiation and blasting) in 11 8–12-year-old boys with attention-deficit/hyperactivity disorder (ADHD) and 11 matched comparison children. Children were given six different self-presentation stories, two for each one of the three different tactics. After each story, they were asked to evaluate the effects of the self-presentational tactic used. Children with ADHD rated self-promotion and blasting as more positive and more effective—and ingratiation as less positive and less effective—than children in the control group. This implicates that children with ADHD prefer simple and direct self-presentational strategies (like self-promotion), and, therefore, may not as easily understand more subtle strategies (like ingratiation). They also seem to be more inclined to use negatively connoted strategies (like blasting). We suggest that this limited understanding of self-presentational strategies in children with ADHD may explain some of their problems in social interactions. Therefore, social skill interventions in children with ADHD should incorporate elements focusing on use and understanding of different self-presentational strategies.     

Rrepresentations of trauma in infancy: Clinical and theoretical implications for the understanding of early memory

Understanding the nature of the infant's internal experience is a crucial prerequisite for delineating the developmental effects of an early trauma. In addition, to the extent that internal representations of a trauma can be traced over time, traumatic experiences present unique opportunities for the study of early memory. This article will describe case vignettes of children who experienced a trauma in the preverbal period and who evidenced forms of memory of their trauma at subsequent points in time. In conjunction with the clinical material, developmental research bearing on the types of early memories described will be discussed. The clinical data, reinforced by research findings, indicate that preverbal children, even in the first year of life, can establish and retain some form of internal representation of a traumatic event over significant periods of time. The specificity and enduring nature of the internal representations suggest that specific therapeutic interventions over and above general comforting will be required if an infant is to maximally recover from a trauma. The clinical findings have relevance for a number of issues currently under debate in the area of infant memory, including the role of reminders in memory retention, the nature of early memory systems, and the development of autobiographical memory. ©2002 Michigan Association for Infant Mental Health.     

The understanding and self-reported use of emotional display rules in children with autism spectrum disorders

Two studies examined the understanding and self-reported use of rules for the expressive display of emotions in children with high functioning autism spectrum disorders (HFASD) and in typically developing children. In Study 1, children from the two groups reported display rules equally often when presented with hypothetical situations that provided clear motives for using display rules, although emotion-masking displays were more commonly identified for vignettes with prosocial rather than self-protective motives. In Study 2, children were interviewed about display rule use in real life. Children with HFASD reported display rules less often, included more prototypical examples, and referred less often to prosocial motives than typically developing children. Children with HFASD appear to be aware of display rules, but are less adept at identifying the interpersonal functions of such rules than their typically developing peers.     

The understanding and self-reported use of emotional display rules in children with autism spectrum disorders

Two studies examined the understanding and self-reported use of rules for the expressive display of emotions in children with high functioning autism spectrum disorders (HFASD) and in typically developing children. In Study 1, children from the two groups reported display rules equally often when presented with hypothetical situations that provided clear motives for using display rules, although emotion-masking displays were more commonly identified for vignettes with prosocial rather than self-protective motives. In Study 2, children were interviewed about display rule use in real life. Children with HFASD reported display rules less often, included more prototypical examples, and referred less often to prosocial motives than typically developing children. Children with HFASD appear to be aware of display rules, but are less adept at identifying the interpersonal functions of such rules than their typically developing peers.     

Specialization of the motor system in infancy: from broad tuning to selectively specialized purposeful actions

In executing purposeful actions, adults select sufficient and necessary limbs. But infants often move goal‐irrelevant limbs, suggesting a developmental process of motor specialization. Two experiments with 9‐ and 12‐month‐olds revealed gradual decreases in extraneous movements in non‐acting limbs during unimanual actions. In Experiment 1, 9‐month‐olds produced more extraneous movements in the non‐acting hand/arm and feet/legs than 12‐month‐olds. In Experiment 2, analysis of the spatiotemporal dynamics of infants’ movements revealed developmental declines in the spatiotemporal coupling of movements between acting and non‐acting arms. We also showed that the degree of specialization in infants’ unimanual actions is associated with individual differences in motor experience and visual attention, indicating the experience‐dependent and broad functional nature of these developmental changes. Our study provides important new insights into motor development: as in cognitive domains, motor behaviours are initially broadly tuned to their goal, becoming progressively specialized during the first year of life.     

The neurobiology of addiction: implications for voluntary control of behavior

There continues to be a debate on whether addiction is best understood as a brain disease or a moral condition. This debate, which may influence both the stigma attached to addiction and access to treatment, is often motivated by the question of whether and to what extent we can justly hold addicted individuals responsible for their actions. In fact, there is substantial evidence for a disease model, but the disease model per se does not resolve the question of voluntary control. Recent research at the intersection of neuroscience and psychology suggests that addicted individuals have substantial impairments in cognitive control of behavior, but this "loss of control" is not complete or simple. Possible mechanisms and implications are briefly reviewed.     

孤独症儿童动作发展障碍的神经机制

动作发展障碍(Developmental motor disorders)是孤独症谱系障碍的常见特征。通过系统回顾孤独症儿童动作发展障碍的神经科学研究, 发现γ-氨基丁酸和5-羟色胺浓度的改变及γ-氨基丁酸相关蛋白和Shank蛋白的表达异常不仅会损害中枢神经系统的发育, 而且还能导致突触兴奋性与抑制性失衡, 进而改变孤独症儿童小脑和大脑皮层运动区的功能连接。孤独症儿童小脑、基底神经节和胼胝体结构的改变对全脑的连通性产生了负面影响。神经生化机制和脑结构的异常共同导致了脑功能的异常, 最终造成孤独症儿童的动作发展障碍。此外, 动作发展障碍与孤独症核心症状共同的神经基础主要包括镜像神经元系统紊乱, 丘脑、基底神经节和小脑异常以及SLC7A5和PTEN 基因突变。未来研究需要关注与运动密切相关的其他神经递质, 如乙酰胆碱和多巴胺; 探索动作发展障碍神经网络的动态机制及其形成; 剖析该障碍的神经机制和自闭症核心症状神经机制的相互作用。     

Intact and impaired mechanisms of action understanding in autism

Typically developing children understand and predict others' behavior by extracting and processing relevant information such as the logic of their actions within the situational constraints and the intentions conveyed by their gaze direction and emotional expressions. Children with autism have difficulties understanding and predicting others' actions. With the use of eye tracking and behavioral measures, we investigated action understanding mechanisms used by 18 children with autism and a well-matched group of 18 typically developing children. Results showed that children with autism (a) consider situational constraints in order to understand the logic of an agent's action and (b) show typical usage of the agent's emotional expressions to infer his or her intentions. We found (c) subtle atypicalities in the way children with autism respond to an agent's direct gaze and (d) marked impairments in their ability to attend to and interpret referential cues such as a head turn for understanding an agent's intentions.     

Minding the gap between neuroscientific and psychoanalytic understanding of autism

This paper offers an integrative approach to the increasingly complex puzzle of autistic spectrum disorders. The author demonstrates how the work of one group of neuroscientists in Parma, on a special class of brain cells called ‘mirror neurons', and the work of researchers at the University of California in San Diego, applying these findings to the problem of autism, intersect with Frances Tustin's discoveries about the nature, function and meaning of psychogenic autism in children and even autistic states in neurotic adults. Included in the author's considerations are the results of some by now well-known studies conducted by a group of biologists at the University of California at Berkeley in the 1960s on the effects of ‘enriched’ versus ‘deprived’ environments upon the development of the brain, and a study of autistic children diagnosed as brain damaged and treated psychoanalytically at the Paediatric Neuro-Psychiatric Institute of the University of Rome in the 1980s. The author concludes with a coherent picture of various dimensions of autistic phenomenon that may constitute more than just the sum of its parts, and points towards new areas for discussion and study.     

干预胆碱M受体对药物成瘾的影响及其与多巴胺的关系

药物成瘾是一类精神及行为障碍, 涉及到中枢神经系统的病变。毒蕈碱受体(Muscarinic receptor, M受体)属于胆碱能受体, 分5种亚型。行为学研究表明, 干预M受体能有效影响药物成瘾行为, 但其神经机制还亟待探索。阿片类药物与精神活性药物均能激活中枢多巴胺系统, 而M受体与多巴胺系统在多个脑区产生了交互作用。其中激动M2及M4受体抑制了多巴胺系统功能, 而激动M5受体增强了多巴胺系统功能, 与干预M2、M4、M5受体对药物成瘾行为的影响相对应。以上证据提示, 干预M受体可能通过影响多巴胺系统对药物成瘾起作用。     

Bringing a mentalizing framework to understanding mothers with addiction: The groundbreaking work of Nancy E. Suchman

Nancy Suchman is remembered as a pioneer whose mentalization-based intervention—Mothering from the Inside Out (MIO)—transformed the treatment of parents struggling with substance use disorders. Specifically, Suchman's work highlighted the neural mechanisms underlying substance use disorders and identified the promotion of parental mentalizing as a key therapeutic focus in enhancing early parent-child relationships. Her work transformed parenting support models for this population of parents. Several randomized controlled trials (RCT) show the effectiveness of MIO in promoting parental reflective functioning (PRF) and positive relational outcomes in parents with substance use disorders and their children. Suchman's MIO model has since been extended to parenting in many contexts. She is also remembered as a generous colleague, a gifted researcher and clinician, and an inspiration to generations of researchers and practitioners working with parents who aspire to raise healthy, secure children despite multiple challenges and adversities. This special issue compiles the work of researchers inspired by Suchman as they carry on her legacy in examining aspects of parental mentalization. Collectively, the research presented yields confirmation of MIO core assumptions, offers new insights into roles of positive sentiment and savoring in mentalization processes, and presents evaluations of MIO in multiple contexts and with new adaptations.     

A functional role for the motor system in language understanding: evidence from theta-burst transcranial magnetic stimulation

Does language comprehension depend, in part, on neural systems for action? In previous studies, motor areas of the brain were activated when people read or listened to action verbs, but it remains unclear whether such activation is functionally relevant for comprehension. In the experiments reported here, we used off-line theta-burst transcranial magnetic stimulation to investigate whether a causal relationship exists between activity in premotor cortex and action-language understanding. Right-handed participants completed a lexical decision task, in which they read verbs describing manual actions typically performed with the dominant hand (e.g., "to throw," "to write") and verbs describing nonmanual actions (e.g., "to earn," "to wander"). Responses to manual-action verbs (but not to nonmanual-action verbs) were faster after stimulation of the hand area in left premotor cortex than after stimulation of the hand area in right premotor cortex. These results suggest that premotor cortex has a functional role in action-language understanding.     

Responses of the human motor system to observing actions across species: A transcranial magnetic stimulation study

Ample evidence suggests that the role of the mirror neuron system (MNS) in monkeys is to represent the meaning of actions. The MNS becomes active in monkeys during execution, observation, and auditory experience of meaningful, object-oriented actions, suggesting that these cells represent the same action based on a variety of cues. The present study sought to determine whether the human motor system, part of the putative human MNS, similarly represents and reflects the meaning of actions rather than simply the mechanics of the actions. To this end, transcranial magnetic stimulation (TMS) of primary motor cortex was used to generate motor-evoked potentials (MEPs) from muscles involved in grasping while participants viewed object-oriented grasping actions performed by either a human, an elephant, a rat, or a body-less robotic arm. The analysis of MEP amplitudes suggested that activity in primary motor cortex during action observation was greatest during observation of the grasping actions of the rat and elephant, and smallest for the human and robotic arm. Based on these data, we conclude that the human action observation system can represent actions executed by non-human animals and shows sensitivity to species-specific differences in action mechanics.     

阐释学语境下的医患沟通——探寻理解之路

在信息不对称、医疗结果不确定的情况下,很多医疗纠纷是由于缺乏充分的沟通导致不信任和误解造成的。加强医患沟通是增进理解、减少误解、构建和谐医患关系的重要途径。结合阐释学提出的理解之“主体间性”、“视阈融合”、“效果历史”的观点,探寻医患沟通的理解之路并指出医患沟通的限度。