Autobiographical memory specificity predicts social problem-solving ability in old and young adults

Based on recent research with young, depressed adults, age-related cognitive declines and decreased autobiographical specificity were hypothesized to predict poorer social problem-solving ability in older than in younger healthy adults. Priming autobiographical memory (ABM) was hypothesized to improve social problem-solving performance for older adults. Subsequent to cognitive tests, old and young participants' specific ABMs were tested using a cued recall task, followed by a social problem-solving task. The order of the tasks was counterbalanced to test for a priming effect. Autobiographical specificity was related to cognitive ability and predicted social problem-solving ability for both age groups. However, priming of ABM did not improve social problem-solving ability for older or younger adults. This study provides support for the hypothesis that autobiographical memory serves a directive function across the life-span.     

Autobiographical memory specificity predicts social problem-solving ability in old and young adults

Based on recent research with young, depressed adults, age-related cognitive declines and decreased autobiographical specificity were hypothesized to predict poorer social problem-solving ability in older than in younger healthy adults. Priming autobiographical memory (ABM) was hypothesized to improve social problem-solving performance for older adults. Subsequent to cognitive tests, old and young participants' specific ABMs were tested using a cued recall task, followed by a social problem-solving task. The order of the tasks was counterbalanced to test for a priming effect. Autobiographical specificity was related to cognitive ability and predicted social problem-solving ability for both age groups. However, priming of ABM did not improve social problem-solving ability for older or younger adults. This study provides support for the hypothesis that autobiographical memory serves a directive function across the life-span.     

Modeling change in memory performance and memory perceptions: findings from the ACTIVE study

Within the context of the ACTIVE study, the current investigation explored the relationships between objective memory and two components of subjective memory (frequency of forgetting and use of external aids) over a five-year period. Relationships were assessed using parallel process latent growth curve models. Results indicated that changes in objective memory were associated with changes in perceived frequency of forgetting, but not with use of external aids (calendars, reminder notes) over time. Findings suggest that memory complaints may accurately reflect decline in objective memory performance, but that these memory changes are not necessarily related to compensatory behaviors.     

Memory self-efficacy predicts memory performance: results from a 6-year follow-up study

The purpose of this study was to examine the relationship between memory self-efficacy (MSE) and a 6-year follow-up assessment of memory functioning in a sample of Dutch older adults. MSE was assessed by a Dutch abridged version of the Metamemory in Adulthood questionnaire (MIA; R. A. Dixon, D. F. Hultsch, & C. Hertzog, 1988; C. Hertzog, D. F. Hultsch, & R. A. Dixon, 1989; R. W. H. M. Ponds & J. Jolles, 1996). The total MSE score predicted memory performance at 6 years, as measured by the Visual Verbal Learning Task (VVLT; N. Brand & J. Jolles, 1985). A separate analysis of the different MSE subscales indicated that the MIA Change score was the most salient domain-specific MSE predictor of subsequent memory performance after 6 years. An extreme groups analysis of the MIA Change score revealed a pattern of performance for those who perceived that their memory was worsening, performing less well on the 3 trials of the VVLT when these were readministered at the 6-year follow-up.     

Age differences in everyday problem-solving and decision-making effectiveness: a meta-analytic review

The authors report a meta-analysis of age differences in everyday problem-solving/decision-making effectiveness (EPSE). Effect sizes were calculated to reflect 3 age group comparisons: old versus young, young versus middle-aged, and middle-aged versus old. Findings from the meta-analysis of 28 separate studies with an aggregate of 4,482 participants do not support theories of preserved EPSE in late adulthood. Although significant age differences of moderate magnitude persisted across methodological and theoretical domains, rating criteria (experimenter vs. participant) emerged as a significant moderator of the effect magnitude and direction. In addition, EPSE in older adults was bolstered when problem content was interpersonal and when samples were highly educated. Finally, the current results support the conceptual integration of findings from the everyday problem-solving and everyday decision-making literatures.     

The cost-effectiveness of cognitive behavior therapy for borderline personality disorder: results from the BOSCOT trial

Borderline personality disorder places a significant burden on healthcare providers and other agencies. This study evaluated the cost-effectiveness of cognitive behavior therapy plus treatment as usual compared to treatment as usual alone for patients with borderline personality disorder. The economic analysis was conducted alongside a multi-center, randomized controlled trial. The costs of primary and secondary healthcare utilization, alongside the wider economic costs, were estimated from medical records and patient self-report. The primary outcome measure used was the quality-adjusted life year (QALY), assessed using EuroQol. On average, total costs per patient in the cognitive behavior therapy group were lower than patients receiving usual care alone (-689 pounds sterling), although this group also reported a lower quality of life (-0.11 QALYs). These differences were small and did not approach conventional levels of statistical significance. The use of cognitive therapy for borderline personality disorder does not appear to demonstrate any significant cost-effective advantage based on the results of this study.     

Memory training and strategy use in older adults: results from the ACTIVE study

Little is known about the long-term effects of memory training in later life on strategy use. Data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (n = 1,401) were used to describe strategy use in a community-dwelling sample of older adults. Strategy clustering scores on verbal list learning tasks of episodic memory were used to test the impact of memory training on strategy use and study longitudinal associations between strategy clustering, memory performance, and everyday functioning. Results suggested that younger, female, white, healthier, and more educated participants show higher strategy clustering scores initially but no characteristics were consistently associated with different trajectories in strategy clustering across all strategy clustering measures together. Memory training had significant immediate effects on all measures of strategy use that were maintained through five years of follow-up. With respect to longitudinal mediation, pre-post training changes in most strategy clustering scores mediate changes in objective memory performance and everyday functioning, implying that strategies can be modified and are closely related to both memory ability and the ability to function independently. This study provides evidence that older adults can be trained to use cognitive strategies, the effects are durable, and strategies are associated with memory and everyday functioning.     

Goals and everyday problem solving: examining the link between age-related goals and problem-solving strategy use

Qualitative interviews on family and financial problems from 332 adolescents, young, middle-aged, and older adults, demonstrated that developmentally relevant goals predicted problem-solving strategy use over and above problem domain. Four focal goals concerned autonomy, generativity, maintaining good relationships with others, and changing another person. We examined both self- and other-focused problem-solving strategies. Autonomy goals were associated with self-focused instrumental problem solving and generative goals were related to other-focused instrumental problem solving in family and financial problems. Goals of changing another person were related to other-focused instrumental problem solving in the family domain only. The match between goals and strategies, an indicator of problem-solving adaptiveness, showed that young individuals displayed the greatest match between autonomy goals and self-focused problem solving, whereas older adults showed a greater match between generative goals and other-focused problem solving. Findings speak to the importance of considering goals in investigations of age-related differences in everyday problem solving.     

Sleep disruption explains age-related prospective memory deficits: implications for cognitive aging and intervention

The high prevalence of sleep disruption among older adults may have implications for cognitive aging, particularly for higher-order aspects of cognition. One domain where sleep disruption may contribute to age-related deficits is prospective memory—the ability to remember to perform deferred actions at the appropriate time in the future. Community-dwelling older adults (55–93 years, N = 133) undertook assessment of sleep using actigraphy and participated in a laboratory-based prospective memory task. After controlling for education, sleep disruption (longer awakenings) was associated with poorer prospective memory. Additionally, longer awakenings mediated the relationship between older age and poorer prospective memory. Other metrics of sleep disruption, including sleep efficiency and wake after sleep onset, were not related to prospective memory, suggesting that examining the features of individual wake episodes rather than total wake time may help clarify relationships between sleep and cognition. The mediating role of awakening length was partially a function of greater depression and poorer executive function (shifting) but not retrospective memory. This study is among the first to examine the association between objectively measured sleep and prospective memory in older adults. Furthermore, this study is novel in suggesting sleep disruption might contribute to age-related prospective memory deficits; perhaps, with implications for cognitive aging more broadly. Our results suggest that there may be opportunities to prevent prospective memory decline by treating sleep problems.     

Screening for cognitive impairment in the elderly: Impact of physical function measures added to cognitive screening instruments

This study examines the relationship between cognitive impairment and impaired physical function to determine if the sensitivity and specificity of the Modified Mini-Mental State Examination (3MS) can be improved by the addition of physical function measures. One hundred and sixty-two subjects from the Nova Scotia sample of the Canadian Study of Health and Aging were studied. Subjects were tested using the 3MS and physical function measures prior to undertaking a detailed clinical examination. Receiver Operating Characteristic (ROC) curves were constructed to determine optimal cutpoints for the 3MS and a new 3MS score which included physical function measures. While the 3MS distinguished demented from unimpaired subjects (.9618), it showed less efficiency for classification of unimpaired subjects and subjects who have cognitive impairment without dementia (.7536). the addition of physical function data increased performance of the 3MS in its ability to discriminate unimpaired from demented subjects (.9854), but not significantly. the relationship between cognitive impairment and functional impairment needs clearer definition in cognitively impaired yet non-demented individuals. the addition of widely used function measures is inadequate in improving the parameters of the 3MS as a screening instrument.     

Mindfulness-based cognitive therapy improves emotional reactivity to social stress: results from a randomized controlled trial

The high likelihood of recurrence in depression is linked to a progressive increase in emotional reactivity to stress (stress sensitization). Mindfulness-based therapies teach mindfulness skills designed to decrease emotional reactivity in the face of negative affect-producing stressors. The primary aim of the current study was to assess whether Mindfulness-Based Cognitive Therapy (MBCT) is efficacious in reducing emotional reactivity to social evaluative threat in a clinical sample with recurrent depression. A secondary aim was to assess whether improvement in emotional reactivity mediates improvements in depressive symptoms. Fifty-two individuals with partially remitted depression were randomized into an 8-week MBCT course or a waitlist control condition. All participants underwent the Trier Social Stress Test (TSST) before and after the 8-week trial period. Emotional reactivity to stress was assessed with the Spielberger State Anxiety Inventory at several time points before, during, and after the stressor. MBCT was associated with decreased emotional reactivity to social stress, specifically during the recovery (post-stressor) phase of the TSST. Waitlist controls showed an increase in anticipatory (pre-stressor) anxiety that was absent in the MBCT group. Improvements in emotional reactivity partially mediated improvements in depressive symptoms. Limitations include small sample size, lack of objective or treatment adherence measures, and non-generalizability to more severely depressed populations. Given that emotional reactivity to stress is an important psychopathological process underlying the chronic and recurrent nature of depression, these findings suggest that mindfulness skills are important in adaptive emotion regulation when coping with stress.     

Spatial memory in the real world: long-term representations of everyday environments

When people learn an environment, they appear to establish a principle orientation just as they would determine the “top” of a novel object. Evidence for reference orientations has largely come from observations of orientation dependence in pointing judgments: Participants are most accurate when asked to recall the space from a particular orientation. However, these investigations have used highly constrained encoding in both time-scale and navigational goals, leaving open the possibility that larger spaces experienced during navigational learning depend on a different organizational scheme. To test this possibility, we asked undergraduates to perform judgments of relative direction on familiar landmarks around their well-learned campus. Participants showed clear evidence for a single reference orientation, generally aligned along salient axes defined by the buildings and paths. This result argues that representing space involves the establishment of a reference orientation, a requirement that endures over repeated exposures and extensive experience.     

Age benefits in everyday prospective memory: the influence of personal task importance, use of reminders and everyday stress

The present diary study examined everyday prospective memory tasks in younger and old adults and explored the role of personal task importance, use of reminders and everyday stress as possible correlates of age-related prospective memory performance in everyday life. Results revealed an age benefit in everyday prospective memory tasks. In addition, task importance was identified as a critical moderator of age-related prospective memory performance. More frequent use of reminders and lower levels of stress, however, were associated with better prospective memory performance in general but did not contribute to age-related prospective memory performance. Exploring further possible correlates of prospective memory revealed that the strategy to reprioritize initially planned intentions was associated with age benefits in everyday prospective memory. Results suggest that the age-related benefit observed in experimenter-given tasks transfers to everyday prospective memory and varies in dependence of motivational and cognitive factors. Implications for theoretical models of prospective memory and aging are discussed.     

Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: results from a randomized controlled trial

Social anxiety disorder (SAD) is highly prevalent and associated with a substantial societal economic burden, primarily due to high costs of productivity loss. Cognitive behavior group therapy (CBGT) is an effective treatment for SAD and the most established in clinical practice. Internet-based cognitive behavior therapy (ICBT) has demonstrated efficacy in several trials in recent years. No study has however investigated the cost-effectiveness of ICBT compared to CBGT from a societal perspective, i.e. an analysis where both direct and indirect costs are included. The aim of the present study was to investigate the cost-effectiveness of ICBT compared to CBGT from a societal perspective using a prospective design. We conducted a randomized controlled trial where participants with SAD were randomized to ICBT (n = 64) or CBGT (n = 62). Economic data were assessed at pre-treatment, immediately following treatment and six months after treatment. Results showed that the gross total costs were significantly reduced at six-month follow-up, compared to pre-treatment in both treatment conditions. As both treatments were equivalent in reducing social anxiety and gross total costs, ICBT was more cost-effective due to lower intervention costs. We conclude that ICBT can be more cost-effective than CBGT in the treatment of SAD and that both treatments reduce societal costs for SAD.     

Context retrieval and context change in free recall: recalling from long-term memory drives list isolation

Three experiments used the "list-before-the-last" free recall paradigm (Shiffrin, 1970) to investigate retrieval for context and the manner in which context changes. This paradigm manipulates target and intervening list lengths to measure the interference from each list, providing a measure of list isolation. Correct target list recall was only affected by the target list length when participants engaged in recall between the lists, whereas there were effects of both list lengths with other activities. This suggests that the act of recalling drives context change, thus isolating the target list from interference. Correspondingly, incorrect recall of intervening list items was affected only by the length of the intervening list when recall occurred between the lists, but was otherwise affected by both list lengths. Concurrent with these changes in context similarity, there were apparent changes in context retrieval, as indicated by the overall levels of target retrieval versus intervening recall. A multinomial model of sampling and recovery was implemented to assess the adequacy of this account and to quantify context similarity and context retrieval.     

Participation in a bystander intervention experiment and subsequent everyday helping: ethical considerations

This study examines how participation in a bystander experiment involving deception affects later everyday helping. Both subjects who had formerly participated in a bystander intervention experiment and a group of matched controls who had not participated were interviewed in a survey either 6–10 months (early) or 11–20 months (late) after completion of the experiment. Half of the previous subjects were prompted to recall their experimental experience in the interview. After leaving the interview, subjects encountered a needy person. Mere participation in the prior experiment did not influence helping during the early period but enhanced helping after 10 months had elapsed. Participation plus recall inhibited helping during the early period but not later. Compared with controls, past participants helped more with the passage of time. The results suggest that participation in bystander intervention experiments induces both context-specific cognitions about possible inauthenticity of need and generalized beliefs about the value of helping. With the passage of time, the former fade while the latter become more salient. Ethical implications of these findings are discussed.     

Goal-directed memory: the role of cognitive control in older adults' emotional memory

The present study revealed that older adults recruit cognitive control processes to strengthen positive and diminish negative information in memory. In Experiment 1, older adults engaged in more elaborative processing when retrieving positive memories than they did when retrieving negative memories. In Experiment 2, older adults who did well on tasks involving cognitive control were more likely than those doing poorly to favor positive pictures in memory. In Experiment 3, older adults who were distracted during memory encoding no longer favored positive over negative pictures in their later recall, revealing that older adults use cognitive resources to implement emotional goals during encoding. In contrast, younger adults showed no signs of using cognitive control to make their memories more positive, indicating that, for them, emotion regulation goals are not chronically activated.     

Rapid response predicts binge eating and weight loss in binge eating disorder: findings from a controlled trial of orlistat with guided self-help cognitive behavioral therapy

OBJECTIVE: It is important to find ways to predict response to treatments as this may inform treatment planning. We examined rapid response in obese patients with binge eating disorder (BED) who participated in a randomized placebo-controlled study of orlistat administered with cognitive behavioral therapy delivered by guided self-help (CBTgsh) format. METHODS: Fifty patients were randomly assigned to 12-week treatments of either orlistat+CBTgsh or placebo+CBTgsh, and were followed in double-blind fashion for 3 months after treatment discontinuation. Rapid response, defined as 70% or greater reduction in binge eating by the fourth treatment week, was determined by receiver operating characteristic curves, and was then used to predict outcomes. RESULTS: Rapid response characterized 42% of participants, was unrelated to participants' demographic features and most baseline characteristics, and was unrelated to attrition from treatment. Participants with rapid response were more likely to achieve binge eating remission and 5% weight loss. If rapid response occurred, the level of improvement was sustained during the remaining course of treatment and the 3-month period after treatment. Participants without rapid response showed a subsequent pattern of continued improvement. CONCLUSION: Rapid response demonstrated the same prognostic significance and time course for CBTgsh as previously documented for individual CBT. Among rapid responders, improvements were well sustained, and among non-rapid responders, continuing with CBTgsh (regardless of medication) led to subsequent improvements.     

Feasibility and impact of a school-based intervention for families of urban adolescents with asthma: results from a randomized pilot trial

The purpose of this study was to test the feasibility and short-term outcomes of Asthma: It's a Family Affair!, a school-based intervention for adolescents with asthma and their caregivers. Twenty-four ethnic minority families with a middle school student with asthma were randomized to immediate intervention or no-treatment control. Intervention students received six group sessions on prevention and management of asthma. Caregivers received five group sessions teaching child-rearing skills to support the youth's autonomy and asthma self-management. All students attended all sessions; caregivers attended an average of three. Two months post-intervention, relative to controls, intervention caregivers reported better problem-solving with children. Intervention students were more responsible for carrying medication, took more prevention steps, and woke fewer nights from asthma. The intervention resulted in positive short-term changes in family relations, asthma management by students, and health status.     

The allocation of memory resources during sentence comprehension: Evidence from the elderly

Two experiments were carried out to examine the ability of elderly subjects to establish syntactically governed dependency relations during the course of sentence comprehension. The findings reveal the manner in which memory constraints operate during syntactic processing.