Enhancing theory of mind in behavioural variant frontotemporal dementia with transcranial direct current stimulation

Behavioural variant frontotemporal dementia (bvFTD) is a form of frontotemporal degeneration characterized by early changes in personality, emotional blunting, and/or loss of empathy. Recent research has highlighted that these features may be at least partially explained by impairments in the theory of mind (ToM; i.e., the ability to understand and predict other people’s behaviour by attributing independent mental states to them). The aim of this randomized, double-blind, placebo-controlled study was to test the hypothesis that transcranial direct current stimulation (tDCS) over the medial frontal cortex (MFC) selectively enhances communicative intention processing, a specific ToM ability. Using a single-session online design, we administered a ToM task that measures the ability to represent other people’s private and communicative intentions during active or sham tDCS to 16 bvFTD patients. To assess the impact of dementia on performance on the ToM task, we included 16 age-matched healthy volunteers who were asked to perform the entire experimental ToM task. BvFTD is characterized by an impairment in the comprehension of both communicative and private intentions relative to a healthy control group and by a disproportional impairment in communicative intention compared with private intention processing. Significant and selective accuracy improvement in the comprehension of communicative intentions after active stimulation was observed in patients with bvFTD. This is the first study that analyses ToM ability in patients with bvFTD using tDCS stimulation. Our findings could potentially contribute to the development of an effective, noninvasive brain stimulation treatment of ToM impairments in patients with bvFTD.     

Genetic Counseling in the Era of Genomics: What’s all the Fuss about?

As genomic sequencing becomes more widely available in clinical settings for diagnostic purposes, a number of genetic counseling issues are gaining precedence. The ability to manage these issues will be paramount as genetic and non-genetic healthcare professionals navigate the complexities of using genomic technologies to facilitate diagnosis and inform patient management. Counseling issues arising when counseling for diagnostic genomic sequencing were identified by four genetic counselors with 10 years of collective experience providing genetic counseling in this setting. These issues were discussed and refined at a meeting of genetic counselors working in clinical genomics settings in Melbourne, Australia. Emerging counseling issues, or variations of established counseling issues, were identified from the issues raised. Illustrative cases were selected where pre- and post-test genetic counseling was provided in clinical settings to individuals who received singleton or trio WES with targeted analysis. Counseling issues discussed in this paper include a reappraisal of how genetic counselors manage hope in the genomic era, informed consent for secondary use of genomic data, clinical reanalysis of genomic data, unexpected or unsolicited secondary findings, and trio sequencing. The authors seek to contribute to the evolving understanding of genetic counseling for diagnostic genomic sequencing through considering the applicability of existing genetic counseling competencies to managing emerging counseling issues and discussing genetic counseling practice implications.     

Adjustment Profiles of Low-Income Caregivers from the United States and South Africa: Contrasts and Commonalities

Although low-income parents living in under-resourced communities in the United States and around the world face challenges, many do well while others struggle in one or more areas of functioning. The present study examined patterns of adjustment among maternal caregivers living in the United States (US) (N?=?320) and South Africa (SA) (N?=?324). Cluster analyses across four domains of functioning representing both positive and negative adjustment and conducted within country revealed similar patterns of adjustment, with a majority of caregivers (37.8% in the US; 47.5% in SA) landing in a “holding steady” pattern, exhibiting good but not exceptional adjustment. Other patterns of adjustment (three additional in the US sample; two additional in the SA sample) showed elevated impairment in somatic complaints, problems with alcohol, or life satisfaction. In both the US and SA, support from family, friends, and neighbors differentiated the adjustment profiles. Further, both current stressors within and outside of the family and previous stressors including direct and indirect exposure to violence discriminated caregivers who were “holding steady” from those who were struggling in one or more domains. Additionally, across both countries, caregivers who were “holding steady” evidenced less avoidant coping. Implications of this work for fostering resilience among caregivers and their children are discussed.     

Family Allocentrism and Adolescent Depressive Symptoms: The Role of Self-Identity Style

Recent research has found that a strong family allocentrism relates to reduced adolescent depressive symptoms. Besides providing continuous support for this relation, this research extended the scope by exploring whether there was a U-shaped association between family allocentrism and depressive symptoms and testing the mediation effect of identity style among Italian adolescents (N?=?387, 183 boys, 204 girls, M_age?=?16.38 years). Result of hierarchical regression model showed that the association between family allocentrism and depressive symptoms was linear rather than U-shaped. More importantly, this linear relation was mediated by normative and diffuse-avoidant style. In sum, the current findings suggest that adolescents who are allocentric toward family tend to follow family members’ expectations to establish self-identity and deal with identity issues more proactively, and thus they are less likely to experience depressive symptoms. Moreover, there is no significant evidence that too much family allocentrism would lead to elevated depressive symptoms.     

Agents of Prosociality: Agency Affirmation Promotes Mutual Prosocial Tendencies and Behavior Among Conflicting Groups

Members of conflicting groups are motivated to restore their ingroup's agency, leading to antisocial tendencies against the outgroup. The present research tested the hypothesis that affirming conflicting groups' agency would increase their members' mutual prosociality. The effectiveness of agency affirmation was demonstrated in three contexts of conflict between groups: Switzerland and the EU following the 2014 referendum (Study 1), Israelis and Palestinians (Study 2), and Israeli rightists and leftists (Study 3). Study 1 found that in a nonconflictual context Swiss participants prioritized their moral (prosocial) over agentic goals, yet in the context of conflict with the EU, they prioritized their agentic over moral goals. This “primacy‐of‐agency” effect, however, was eliminated once their ingroup's agency was affirmed. Studies 2 and 3 demonstrated the positive effect of agency affirmation on prosociality among Israelis referring to Palestinians and Israeli rightists and leftists referring to the adversarial political camp. This effect was mediated by group members' readiness to relinquish some power for the sake of morality. Pointing to the importance of the affirmation's specific content, Studies 2 and 3 demonstrated that morality affirmation failed to increase prosociality. As such, the present research puts forward a promising strategy to reduce hostility and promote prosociality between conflicting groups.     

The Dialectics of Stigma,Silence, and Misunderstanding in Suicidality Survival Narratives

Modern suicidologists have noted a dearth of qualitative research on suicide. The first author conducted 20 in-depth interviews with formerly suicidal adults to understand how they accounted for their experiences contemplating or attempting suicide. According to participants, stigma necessitated impression management, which contributed to the production of silence and misunderstanding. Silence and misunderstanding reinforced stigma. This complex, dialectical, belief system about stigma yields insight into the interpretive culture of surviving suicidal ideation or a suicide attempt. These beliefs about suicide may serve as a barrier to individuals seeking help, recovering from suicidality, and larger social change regarding attitudes toward suicide.     

Giving Voice to Patients: Developing a Discussion Method to Involve Patients in Translational Research

Biomedical research policy in recent years has often tried to make such research more ‘translational’, aiming to facilitate the transfer of insights from research and development (R&D) to health care for the benefit of future users. Involving patients in deliberations about and design of biomedical research may increase the quality of R&D and of resulting innovations and thus contribute to translation. However, patient involvement in biomedical research is not an easy feat. This paper discusses the development of a method for involving patients in (translational) biomedical research aiming to address its main challenges.After reviewing the potential challenges of patient involvement, we formulate three requirements for any method to meaningfully involve patients in (translational) biomedical research. It should enable patients (1) to put forward their experiential knowledge, (2) to develop a rich view of what an envisioned innovation might look like and do, and (3) to connect their experiential knowledge with the envisioned innovation. We then describe how we developed the card-based discussion method ‘Voice of patients’, and discuss to what extent the method, when used in four focus groups, satisfied these requirements. We conclude that the method is quite successful in mobilising patients’ experiential knowledge, in stimulating their imaginaries of the innovation under discussion and to some extent also in connecting these two. More work is needed to translate patients’ considerations into recommendations relevant to researchers’ activities. It also seems wise to broaden the audience for patients’ considerations to other actors working on a specific innovation.     

Connecting the dots from a distance: Does mentally traveling through space and time increase searching for life’s meaning?

As humans, we have the ability to travel beyond the present moment by considering past and future times as well as locations that are distant from oneself. An interesting possibility is that such mental travel to far-away times and places (vs. focusing on times and places closer to the present) may increase people’s desire to search for their lives’ meaning. Since searching for meaning involves the integration of separate life events into a coherent life story, mentally traveling farther away from the present may make people aware that their life stories include more than what is happening at this very minute. Such awareness, then, may increase their desire to ‘connect the dots’ between their life events by searching for some underlying meaning. Three experiments (N = 838) tested this prediction and found that greater (vs. lower) mental travel through space or time increased the search for life’s meaning.     

Sexting as a predictor of sexual behavior in a sample of Czech adolescents

The purpose of this longitudinal study is to examine the relationship between teen sexting and offline sexual behavior. Using a sample of 1134 Czech adolescents aged 10–18 (M_age = 13.84, SD = 1.94, girls = 58.8%) from 55 schools, the latent growth model of offline sexual behavior with sexting as a time-varying covariate was employed. Participants differed at baseline for offline sexual behavior at both individual and school levels, and they varied in the growth rate of offline sexual behavior at the individual level. Only age and sensation seeking explained the variability at baseline of offline sexual behavior. The positive association between sexting and offline sexual behavior was not constant across time. However, sexting at baseline predicted offline sexual behavior a half year and one year later. Sexting may be treated as a precursor of offline sexual behavior.