Episodic memory effects of gamma frequency precuneus transcranial magnetic stimulation in Alzheimer's disease: A randomized multiple baseline study

Episodic memory decline is the prominent neuropsychological feature of typical Alzheimer's Disease (AD), for which current treatments have a limited clinical response. Recently, gamma entrainment therapy has been used as a non-invasive treatment in AD, providing evidence that it may have the potential to alleviate brain pathology and improve cognitive function in AD patients. At the same time, the precuneus (PC) has been recognized as a key area involved in AD related memory deficits and as a key node of the Default Mode Network. This study aimed to investigate the effectiveness of a 40 Hz Transcranial Magnetic Stimulation (TMS) intervention, delivered bilaterally to the precuneus for 10 days, in improving the patients' episodic memory performance. Secondary outcome variables investigated included general cognitive function, semantic and spatial memory, as well as attention and executive function. A concurrent multiple baseline design across five cases was employed. Four patients completed the study. Visual analysis combined with effect size indices were used to evaluate changes across phases. An increase in the average level of immediate recalled words was observed in three out of four patients. Effect size indices indicated significant improvement of attention skills in two patients. No treatment effect was observed for semantic and visual memory, or for executive function. An immediate treatment effect was observed in all patients' general cognitive function as assessed with the Alzheimer's Disease Assessment Scale (mean reduction of 5 points), which was maintained and improved further three months post-treatment. The neuropsychological evaluations indicated improved performance three months post-treatment in immediate and delayed recall, attention, phonological verbal fluency, anxiety, and neuropsychiatric symptoms. This study provides preliminary evidence for the efficacy of a novel non-pharmacological treatment using gamma-band TMS in addressing cognitive dysfunction in AD.     

Good Practice in Transcultural Counselling: An Asian Perspective

In Britain today, counsellors and therapists often work with people from a diverse range of ethnic groups whose cultures are substantially different from their own. There is increasing concern that people from black and ethnic communities have limited access to appropriate services—despite service planners' and providers' statements that mental health services are being restructured to become more sensitive, relevant and meaningful to these communities. This paper is an attempt to redress the balance with an emphasis on the therapeutic needs of South Asian communities. It aims to challenge assumptions and beliefs held by therapists and counsellors, question therapeutic practice based within a white, middle-class ideology, raise awareness of an 'Asian' perspective in therapy, and provide some guidelines for good practice in transcultural counselling.     

How much processing do nonattended stimuli receive? Apparently very little, but...

The early versus late selection issue in attention models was examined by means of a new methodology. Through cues or precues, attention was directed to one location of a multistimulus visual display and, while attention was so engaged, the identity of a stimulus located at a different position in the display was changed. By varying the time after display onset before the stimulus was changed, we controlled the preview time that the original stimulus was represented on the retina. Then, using a marker cue, we directed the subject's attention to the location of the changed stimulus. The subject's response was a timed discrimination between two possible target letters. The data of main interest was the effect of preview time upon the subject's latency in identifying the new target that appeared in the changed location. We found that the preview time of the original stimulus, before RT was affected to the new target, depended upon whether the original stimulus was a neutral (noise) letter or whether it was the alternative target. When the original stimulus was a noise letter, RTs to the new target were just as fast as those obtained in the control condition in which the target was present throughout the preview interval and did not change its identity. Significant effects upon RT were obtained at preview times of 83 msec when the original stimulus was one of the targets that changed to the alternative target. Preview times also varied as a function of precuing. Preview times were correspondingly shortened when the first cue occurred 50 msec before display onset, thus providing an extra 50 msec for attention to be directed to the first display location. The results were interpreted in terms of two separate information-processing systems in the human: an automatic system and an attentional system. Even though a stimulus may have been automatically processed, when the attention system is directed to that stimulus, processing starts at the beginning again.     

Developing local lifelong guidance strategies

The background, rationale, methodology and outcomes of a project on developing local lifelong guidance strategies in four areas are outlined. The main components of the strategies developed in the four areas are analysed, and a number of issues relating to the process of strategy development are addressed. Much of the lack of coherence at local level stems from lack of coherence at national policy level: implications for national policy are examined. Finally, implications for parallel work in other localities are explored.     

Monitoring running-wheel movement using a serial mouse and an IBM-compatible system

A running-wheel-movement-detection system is described for use with an IBM-compatible system and a serial mouse. It is an adaptation of a system developed for use on a Commodore 64. The IBM-compatible system provides obvious advantages in speed, memory, data storage, and programming ease over the earlier Commodore 64 system.     

Treatment of traumagenic beliefs among sexually abused girls and their mothers: An evaluation study

The objective of this study was to evaluate and compare the efficacy of two short-term individual therapy interventions for sexually abused girls and their nonoffending female caretakers. Thirty-two girls, ages 8 to 13, and their caretakers from primarily low-income, African-American families were randomly assigned to a theoretically based, structured experimental treatment program or to a relatively unstructured comparison intervention. Measures of child outcome were completed before and after the treatment program by each parent and child, and by a clinician blind to treatment condition. Pre- and postmeasures of maternal outcome were completed by the caretaker and a clinician not involved in the treatment. Both treatment programs yielded decreases in children's posttraumatic stress disorder symptoms and traumagenic beliefs reflecting self-blame and powerlessness, and increases in children's overall psychosocial functioning. The experimental intervention was more effective than the comparison program in increasing abuse-related caretaker support of the child and in decreasing caretaker self-blame and expectations of undue negative impact of the abuse on the child. Clinical impfications of these findings include the development of interventions targeting sexually abused children's traumagenic beliefs and nonoffending parents' support of their victimized children.This research was supported by the Emory Medical Care Foundation and the Children's Trust Fund of Georgia. Preliminary findings were presented at the Society for Research in Child Development, New Orleans, March 1993.The authors thank the clinic families, volunteer therapists, and project staff members whose work together made this research possible. Core project staff members other than the authors include Milonne Ambroise, Mary Lynn Dell, Sherry Dey, Beth Dreelin, Jenny Gould, Katherine January, Suzann Lawry, Marie Simmons, and Lisseth Rojas.     

Gender typing of game choices and qualities of boys' play behavior

Relationships between gender choices and both movement patterns and social behavior were studied in first- and second-grade boys. Three-child, structured play groups were each composed of a boy whose mother saw him as high masculine in play preference on the Games Inventory, one seen as average, and one low masculine. Behaviors rated from videotapes included gender presentation variables, (e.g., leg separation), indicators of dominance and personal comfort (e.g.,range of movements), and indicators of social skill and peer response (e.g., interaction initiations). The low masculine boys were found to be the most feminine in their gender presentation, least dominant and aggressive, and the least socially successful of the boys. The greatest difference was between the low and the high masculine boys. The average masculine boys' scores were generally intermediate,but more similar to the low masculine boys on some variables and more similar to the high masculine boys on others. These conclusions apply to a group interaction play task, but not to an initial noninteractive play task. A secondary study in which girls played with low and average masculine boys is also reported. Here it was found that low masculine boys were generally intermediate between average boys and girls on gender presentation and dominance variables, but lowest of the groups on social interaction variables. The authors appreciate the comments of Peter Bentler and Spencer Thompson on a draft of this paper, the assistance of Laura McCain in running subjects and scoring tapes, and the expertise of Shu-Yeng Wong for computer programming.