Understanding Obsessive–Compulsive Disorder: Focus on Decision Making

Current approaches to obsessive-compulsive disorder (OCD) have suggested that neurobiological abnormalities play a crucial role in the etiology and course of this psychiatric illness. In particular, a fronto-subcortical circuit, including the orbitofrontal cortex, basal ganglia and thalamus appears to be involved in the expression of OCD symptoms. Neuropsychological studies have also shown that patients with OCD show deficits in cognitive abilities that are strictly linked to the functioning of the frontal lobe and its related fronto-subcortical structures, such as executive functioning deficits and insufficient cognitive-behavioral flexibility. This article focuses on decision making, an executive ability that plays a crucial role in many real-life situations, whereby individuals choose between pursuing strategies of action that involve only immediate reward and others based on long-term reward. Although the role of decision-making deficits in the evolution of OCD requires further research, the collected findings have significant implications for understanding the clinical and behavioral heterogeneity that characterizes individuals with OCD.     

Focused attention improves working memory: implications for flexible-resource and discrete-capacity models

Performance in working memory (WM) tasks depends on the capacity for storing objects and on the allocation of attention to these objects. Here, we explored how capacity models need to be augmented to account for the benefit of focusing attention on the target of recall. Participants encoded six colored disks (Experiment 1) or a set of one to eight colored disks (Experiment 2) and were cued to recall the color of a target on a color wheel. In the no-delay condition, the recall-cue was presented after a 1,000-ms retention interval, and participants could report the retrieved color immediately. In the delay condition, the recall-cue was presented at the same time as in the no-delay condition, but the opportunity to report the color was delayed. During this delay, participants could focus attention exclusively on the target. Responses deviated less from the target’s color in the delay than in the no-delay condition. Mixture modeling assigned this benefit to a reduction in guessing (Experiments 1 and 2) and transposition errors (Experiment 2). We tested several computational models implementing flexible or discrete capacity allocation, aiming to explain both the effect of set size, reflecting the limited capacity of WM, and the effect of delay, reflecting the role of attention to WM representations. Both models fit the data better when a spatially graded source of transposition error is added to its assumptions. The benefits of focusing attention could be explained by allocating to this object a higher proportion of the capacity to represent color.     

Research off the couch: Re-visiting the transsexual conundrum

This paper outlines the findings of a qualitative study involving interviews with eight transsexual individuals who had volunteered to take part in a television (TV) documentary about transsexuality. The participants were interviewed before taking part in the documentary and after its screening on national TV. The author proposes that for either biological and/or psychological reasons, some transsexual individuals experience early on a profound and disturbing incongruence at the level of the bodily self. In turn, this experience of incongruity is not contingently mirrored by primary attachment figures and remains unmentalized, thus disrupting self-coherence. In an attempt to restore self-coherence, the individual searches for the ‘right’ body that is anticipated to relieve the felt incongruity. The way this modified body relieves the incongruity is through the certainty it imparts that the image in the ‘mirror’ will match the subjective experience of the body. In this study, the experience of being mirrored through the group process during filming and the audience's response to the TV series, which was very positive, appeared to be associated with an attenuation in the urgency with which planned body modifications were being discussed post-TV screenings.     

The contributions of visual and central attention to visual working memory

We investigated the role of two kinds of attention—visual and central attention—for the maintenance of visual representations in working memory (WM). In Experiment 1 we directed attention to individual items in WM by presenting cues during the retention interval of a continuous delayed-estimation task, and instructing participants to think of the cued items. Attending to items improved recall commensurate with the frequency with which items were attended (0, 1, or 2 times). Experiments 1 and 3 further tested which kind of attention—visual or central—was involved in WM maintenance. We assessed the dual-task costs of two types of distractor tasks, one tapping sustained visual attention and one tapping central attention. Only the central attention task yielded substantial dual-task costs, implying that central attention substantially contributes to maintenance of visual information in WM. Experiment 2 confirmed that the visual-attention distractor task was demanding enough to disrupt performance in a task relying on visual attention. We combined the visual-attention and the central-attention distractor tasks with a multiple object tracking (MOT) task. Distracting visual attention, but not central attention, impaired MOT performance. Jointly, the three experiments provide a double dissociation between visual and central attention, and between visual WM and visual object tracking: Whereas tracking multiple targets across the visual filed depends on visual attention, visual WM depends mostly on central attention.     

What Can Bilingual Children Tell Us About the Developmental Relationship Between Vocabulary and Grammar?

Strong correlations between vocabulary and grammar are well attested in language development in monolingual and bilingual children. What is less clear is whether there is any directionality in the relationship between the two constructs, whether it is predictive over time, and the extent to which it is affected by language input. In the present study, we analyzed data from 100 bilingual children with English as an additional language who were tested on measures of vocabulary breadth and depth, morphology, and syntax at three time points at 6-month intervals from the age of 5;8. We used bivariate growth models to test the directionality of the relationship between vocabulary breadth and depth, and measures of morphology and syntax; testing bilingual children allowed us to use measures of English input as covariates in the analyses. All the models showed a correlation between vocabulary and grammar, but no correlation between their growth slopes, suggesting that vocabulary and grammar grow independently. Three of the four bivariate models showed a significant correlation between the intercept of grammar skills and the slope of vocabulary growth. Length of exposure to English predicted the intercept of vocabulary breadth and grammar, suggesting that children exposed to English earlier had larger vocabularies and better morpho-syntactic skills. Current English input predicted the intercept of both measures of vocabulary as well as the slope for vocabulary depth, the only measure for which there was a significant relationship between intercept and slope, suggesting a Matthew effect for this dimension of vocabulary. All materials, data, and code are available at https://osf.io/x3wht/ . Research highlights

• Vocabulary breadth and morphological and syntactic skills increased linearly for all participants, without any difference between lower and higher achieving children.
• Vocabulary depth grew more over time for those children with deeper vocabulary knowledge and higher levels of current English input at the start of the study.
• All of the bivariate growth models showed a correlation between vocabulary and grammar, but failed to show any correlation between their growth.
• Significant relationships between the intercept of grammar and the growth of vocabulary showed steeper lexical growth in children with better grammar skills.
• Length of exposure to English had an effect on morphological and syntactic skills, while only current English input had an effect on vocabulary depth.

     

Vaginal bleeding and spotting in transgender men after initiation of testosterone therapy: A prospective cohort study (ENIGI)

Abstract

Background: Previous studies have cross-sectionally described amenorrhea in cohorts of transgender men on intramuscular or subcutaneous testosterone injections. It remains uncertain which testosterone preparations most effectively suppress vaginal bleeding and when amenorrhea occurs after testosterone initiation.

Aim:To investigate the clinical effects of various testosterone preparations on vaginal bleeding and spotting in transgender men.

Methods: This prospective cohort study was part of the European Network for the Investigation of Gender Incongruence (ENIGI). Data on the persistence and intensity of vaginal bleeding and spotting, serum sex steroid levels and body composition were prospectively and cross-sectionally assessed in 267 transgender men during a three-year follow-up period, starting at the initiation of various testosterone preparations.

Results: After three months of testosterone, 17.9% of transgender men reported persistent vaginal bleeding and 26.8% reported spotting. The percentages reporting vaginal bleeding and spotting decreased over the first year of testosterone (bleeding 4.7% and spotting 6.9% at 12?months, respectively), with no participants reporting vaginal bleeding or spotting after 18?months of testosterone. Factors associated with vaginal bleeding or spotting included lower serum testosterone levels and being on testosterone gel as compared to injections (e.g., esters or undecanoate preparations). If vaginal bleeding persisted, starting progestogens at three months resulted in a decrease in the intensity of vaginal bleeding and spotting.

Discussion: Transgender men and hormone-prescribing providers can be reassured that vaginal bleeding and spotting usually stop within three months after testosterone initiation. If not, serum testosterone levels should be measured and testosterone dose adjusted to achieve serum testosterone levels in the physiologic male range. Adding a progestin can be considered after three to six months if bleeding persists. Providers should be aware that cessation of bleeding can be more difficult to achieve in transgender men with lower serum testosterone levels or those on testosterone gel.