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.     

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.     

Two Concepts or Two Approaches? A Bifactor Analysis of Psychological and Subjective Well-Being

Researchers often debate about whether there is a meaningful differentiation between psychological well-being and subjective well-being. One view argues that psychological and subjective well-being are distinct dimensions, whereas another view proposes that they are different perspectives on the same general construct and thus are more similar than different. The purpose of this investigation was to examine these two competing views by using a statistical approach, the bifactor model, that allows for an examination of the common variance shared by the two types of well-being and the unique variance specific to each. In one college sample and one nationally representative sample, the bifactor model revealed a strong general factor, which captures the common ground shared by the measures of psychological well-being and subjective well-being. The bifactor model also revealed four specific factors of psychological well-being and three specific factors of subjective well-being, after partialling out the general well-being factor. We further examined the relations of the specific factors of psychological and subjective well-being to external measures. The specific factors demonstrated incremental predictive power, independent of the general well-being factor. These results suggest that psychological well-being and subjective well-being are strongly related at the general construct level, but their individual components are distinct once their overlap with the general construct of well-being is partialled out. The findings thus indicate that both perspectives have merit, depending on the level of analysis.     

Difficulties adjusting to post-discharge life following a spinal cord injury: an interpretative phenomenological analysis

Individual semi-structured interviews were conducted with 17 individuals who had experienced a traumatic spinal cord injury (SCI), focusing on the participants' lived experience of SCI. The interviews were transcribed verbatim and were analysed for recurrent themes using interpretative phenomenological analysis (IPA). Here, we present three inter-related recurrent themes all concerning difficulties in adjusting to home life following hospital discharge: "loss of camaraderie", "lack of post-discharge care" and "other people's reactions to spinal cord injury". Participants reported that the camaraderie they formed with fellow patients during their rehabilitative stay in hospital generated feelings of security and community. This was discussed in stark contrast to the isolation and loneliness that they subsequently experienced post-hospital discharge. A perceived lack of physical, practical and psychological support coupled with negative and stigmatising reactions of the wider community served to make adjustment to home life post-SCI particularly difficult for the participants. The findings are discussed in relation to extant SCI literature, and recommendations for future health care of individuals with SCI are made.     

Refining the understanding of inhibitory processes: how response prepotency is created and overcome

Understanding (a) how responses become prepotent provides insights into when inhibition is needed in everyday life. Understanding (b) how response prepotency is overcome provides insights for helping children develop strategies for overcoming such tendencies. Concerning (a), on tasks such as the day‐night Stroop‐like task, is the difficulty with inhibiting saying the name of the stimulus due to the name being semantically related to the correct response or to its being a valid response on the task (i.e. a member of the response set) though incorrect for this stimulus? Experiment 1 (with 40 4‐year‐olds) suggests that prepotency is caused by membership in the response set and not semantic relation. Concerning (b), Diamond, Kirkham and Amso (2002) found that 4‐year‐olds could succeed on the day‐night task if the experimenter sang a ditty after showing the stimulus card, before the child was to respond. They concluded that it was because delaying children’s responses gave them time to compute the correct answer. However, Experiment 2 (with 90 3‐year‐olds) suggests that such a delay helps because it gives the incorrect, prepotent response time to passively dissipate, not because of active computation during the delay.