Diagnosis and treatment of depression during pregnancy

Pregnancy has frequently been described as a time of affective well-being. However, a growing literature suggests that women are neither "protected" against new-onset or recurrence of depression during this time. Diagnosis and effective treatment of depression during pregnancy requires a careful weighing of risk of treatment which may include psychotropic medications against the risks associated with failure to adequately manage affective distress and its potential impact of maternal and fetal well-being. Treatment options during pregnancy are reviewed in the context of developing the most appropriate risk/benefit decision for individual patients with past or current depression who either anticipate pregnancy or who become pregnant.     

Why aren’t all deep superior colliculus neurons multisensory? A Bayes’ ratio analysis

Multisensory neurons in the deep superior colliculus (SC) show response enhancement to cross-modal stimuli that coincide in time and space. However, multisensory SC neurons respond to unimodal input as well. It is thus legitimate to ask why not all deep SC neurons are multisensory or, at least, develop multisensory behavior during an organism's maturation. The novel answer given here derives from a signal detection theory perspective. A Bayes' ratio model of multisensory enhancement is suggested. It holds that deep SC neurons operate under the Bayes' ratio rule, which guarantees optimal performance-that is, it maximizes the probability of target detection while minimizing the false alarm rate. It is shown that optimal performance of multisensory neurons vis-à-vis cross-modal stimuli implies, at the same time, that modality-specific neurons will outperform multisensory neurons in processing unimodal targets. Thus, only the existence of both multisensory and modality-specific neurons allows optimal performance when targets of one or several modalities may occur.     

Medication as object

People experience and treat medication as though it were a person: in other words, as an object. Among the many symbolic meanings attributed to medication, this sort of personification, or object representation, is a meaning that medication is uniquely positioned to contain and convey: imbued with intentionality and influence, medication moves beyond the sphere of static, iconic representation and enters the changeable, dynamic object world of action, aim, and agency. Unlike more generic or stereotypic meanings, object representations attributed to medication may reflect the patient's specific dynamics and object relations. These representations are many and mutable, and take on shifting and overlapping forms that evolve with the analytic process. Medication may represent a third person within the framework of an analytic treatment, expanding the analytic dyad into a triad and offering new transference paradigms to explore. The defensive displacement of transferential qualities and attitudes, or split-off parts thereof, from the analyst onto medication can serve as a powerful resistance to the awareness of the transference to the analyst. Clinical examples illustrate the utility and importance of the analysis of medication as object, for both patient and analyst, with particular attention to the transference.     

Modeling the effects of payoff on response bias in a perceptual discrimination task: bound-change, drift-rate-change, or two-stage-processing hypothesis

Three hypotheses--the bound-change hypothesis, drift-rate-change hypothesis, and two-stage-processing hypothesis--are proposed to account for data from a perceptual discrimination task in which three different response deadlines were involved and three different payoffs were presented prior to each individual trial. The aim of the present research was to show (1) how the three different hypotheses incorporate response biases into a sequential sampling decision process, (2) how payoffs and deadlines affect choice probabilities, and (3) the hypotheses' predictions of response times and choice probabilities. The two-stage-processing hypothesis gave the best account, especially for the choice probabilities, whereas the drift-rate-change hypothesis had problems predicting choice probabilities as a function of deadlines.     

What Predicts the Use of Genetic Counseling Services After the Birth of a Child with Down Syndrome?

In the state of Victoria, Australia, a government funded genetic counseling service exists to meet the needs of families. An audit showed that many families do not use this service after the birth of a child with a genetic problem. To investigate this we surveyed families of children born with Down syndrome over 2 years in Victoria. Questionnaires were completed by 74 mothers, of whom only 18 had received genetic counseling between the birth and the time of the study (mean 3.5 years). Of those not receiving genetic counseling, 71% said they were not offered or had not heard of it. Mothers who had genetic counseling were younger than those who had not, and were more likely to have attended University. Those who had genetic counseling indicated less satisfaction with care at the diagnosis and were more likely to perceive their child as unwell at birth than those who were aware of genetic counseling but did not have it. Of those who did not have genetic counseling, over half were unclear about what it is, although 74% agreed with the statement genetic counseling is most useful when planning to have another child. Of those who had heard of genetic counseling, 73% said they were not sure how it could help. Many families with children with Down syndrome are not aware of the existence or functions of genetic counseling. With greater awareness, some may still choose not to have genetic counseling, but others enunciated needs that could be met by this service if it were offered to them.     

Bootstrapping conceptual deduction using physical connection: rethinking frontal cortex

The age at which infants can demonstrate the ability to deduce abstract rules can be reduced by more than half, from 21 months to 9 months. The key is to introduce a physical connection between the items to be conceptually related. I argue here that making the same change in how items are presented might also help some preschoolers with learning delays, especially some children with autism. I also suggest that the roles of premotor and ventrolateral prefrontal cortices in deducing abstract rules might have been misinterpreted behaviorally and anatomically. The crucial brain region may be the periarcuate, which partially overlaps both premotor and lateral prefrontal cortex. The cognitive ability made possible by this region might be something far more elementary than previously considered: the ability to perceive conceptual connections in the absence of physical connection.     

Facilitating Family Communication About Predictive Genetic Testing: Probands’ Perceptions

The responsibility of informing relatives that predictive genetic testing is available often falls to the proband. Support is required during this process, however the perceived utility of genetic counseling and other strategies to facilitate communication have not been explored. We investigated the experiences of 12 individuals with hereditary nonpolyposis colorectal cancer (HNPCC) in a semistructured telephone interview. Respondents informed their immediate family about the availability of genetic testing, however many more-distant relatives were not directly informed. Respondents were mostly satisfied with the way they told family members about testing and had mixed views about the usefulness of genetic counseling. Gender differences were observed, with most men expressing a need for guidance or support in communicating to relatives. Letters and booklets were thought to enhance the quality of information but the provision of further aids is unlikely to increase the number of relatives made aware of predictive testing by the proband.     

Why Managerial Women are Less Happy Than Managerial Men

Women with managerial careers are significantly less satisfied with their life than their male counterparts. Why? In a representative German panel dataset (GSOEP) we find biological constraints and substitutive mechanisms determining the subjective well-being of female managers. Women’s terminated fertility has a negative impact on women’s life satisfaction between the ages of 35 and 45, when managerial careers usually take off. Money and spare time can compensate for this biological difference. But to maintain an equivalent level of happiness, women need to be compensated by much more income for each hour of spare time given up than men do. So, in order to reach better gender equality in leadership positions, women must be either paid higher incomes (on average around 10%) or must be incentivized with more spare time than men. In the conclusion, we speculate on a new mix of carrots and sticks for advanced careers in order to boost female representation in leadership positions.     

Methodological issues in the use of the concurrent activities paradigm

This paper presents a critical analysis of one type of dual-task procedure, the lateralized concurrent activities paradigm. Extrinsic and intrinsic factors that may influence the interpretation of results obtained with this paradigm are isolated and methodological refinements in experimental design and analysis are suggested.