„Neglekt“ bei der Aufmerksamkeitsdefizit-und-Hyperaktivitäts-Störung

They say he is an attention-deficit hyperactivity disorder (ADHD) child. He cannot engage in anything and cannot even play as normal. At home fierce and very loud power struggles are frequent. He has no friends, mostly he is sitting alone before his computer and he has no other interests. He suffers from sleep disturbances, he sleeps only with the light on, he comes often into the bed of the parents, where he makes a fuss. What does this child have? Is he only ill-bred? Is he anxious – at school or at home? Does he suffer from separation? Or is it a matter of a genetic development problem? The strange phenomenon of “neglect” is traced here in connection with the diagnosis of an ADHD. Lopsided considerations are implicitly connected with this disorder and entice to neglect the developmental disorder in its real cognitive and somatic complexity. In a critical review of biomedical and psychodynamical models, it becomes apparent that newer concepts and results in research are, beside further illuminating this disorder, also helpful for the therapy of these children. Finally, a detailed discussion of the specificities of a psychodynamic developmental therapy follows.     

Disentangling Context Availability and Concreteness in Lexical Decision and W ord Translation

This study examines contrasting predictions of the dual coding theory and the context availability hypothesis regarding concreteness effects in monolingual and bilingual lexical processing. In three experiments, concreteness was controlled for or confounded with rated context availability. In the first experiment, bilingual subjects performed lexical decision in their native language (Dutch, L1). In the second experiment, lexical decision performance of bilinguals in their second language (English, L2) was examined. In the third experiment, bilinguals translated words 'forwards' (from L1 to L2) or 'backwards' (from L2 to L1). Both monolingual and bilingual tasks showed a concreteness effect when concreteness was confounded with context availability. However, concreteness effects disappeared when abstract and concrete words were matched on context availability, and even occasionally reversed. Implications of these results for theories that account for concreteness effects, particulary in bilingual processing, are discussed.     

Mandatory Cancer Risk Warnings on Alcoholic Beverages: What Are the Ethical Issues?

The link between alcohol consumption and cancer is well established, but public awareness of the risk remains low. Mandated warning labels have been suggested as a way of ensuring “informed choice” about alcohol consumption. In this article we explore various ethical issues that may arise in connection with cancer warning labels on alcoholic beverages; in particular we highlight the potentially questionable autonomy of alcohol consumption decisions (either with or without labels) and consider the implications if the autonomy of drinking behavior is substantially compromised. Our discussion demonstrates the need for the various ethical issues to be considered and addressed in any decision to mandate cancer warning labels.     

Micro- and macrodevelopmental changes in language acquisition and other representational systems

In this paper, it will be argued that each time a procedure in a representational system is functioning adequately and automatically, the child steps up to a metaprocedural level and considers the procedure as a unit in its own right. Data will be drawn from microdevelopment in children's creation of external memory devices (i.e., changes in representation of a spatial task during a one hour's session) as well as from macrodevelopment in language acquisition (i.e., changes occurring over age in a study of nominal determiners, pronouns and gender markers). These two aspects of development of representational systems are examined with respect to the spontaneous passage from concrete reference to abstract systems, from idiosyncratic to conventional notations, from redundant to economic marking, from unifunctional to plurifunctional meaningful units. These micro- and manodevelopmental changes take place in a spontaneous fashion despite the fact that the child's earlier system is adequate for successfully conveying the information required. A discussion will be made of the way in which children tend to indicate externally, by unifunctional markers, information which was implicit in their earlier use of an adult-like system. They appear to be striving for the delicate balance between encoding and decoding efforts, ultimately leading to a felicitous representational system. Metaprocedural behavior is hypothesized to act as a control mechanism in the striving for this delicate balance of information content and information processing effort. It also appears to act as a control mechanism for the interprocedural organizotion of what was previously a plethora of juxtaposed, unconnected procedures yielding superficially analogous behavior. The stepping-up to a metaprocedural level seems to occur each time the child has a handle on his currently functioning, goal-oriented system. This enables the child to treat the system, or procedures which are part thereof, as units functioning in their own right. Thus there appears to be a deep-rooted psychological tendency for a representational tool which functions well procedurally to become subsequently a problem-space per se.     

Mechanisms of developmental regression in autism and the broader phenotype: a neural network modeling approach

Loss of previously established behaviors in early childhood constitutes a markedly atypical developmental trajectory. It is found almost uniquely in autism and its cause is currently unknown (Baird et al., 2008). We present an artificial neural network model of developmental regression, exploring the hypothesis that regression is caused by overaggressive synaptic pruning and identifying the mechanisms involved. We used a novel population-modeling technique to investigate developmental deficits, in which both neurocomputational parameters and the learning environment were varied across a large number of simulated individuals. Regression was generated by the atypical setting of a single pruning-related parameter. We observed a probabilistic relationship between the atypical pruning parameter and the presence of regression, as well as variability in the onset, severity, behavioral specificity, and recovery from regression. Other neurocomputational parameters that varied across the population modulated the risk that an individual would show regression. We considered a further hypothesis that behavioral regression may index an underlying anomaly characterizing the broader autism phenotype. If this is the case, we show how the model also accounts for several additional findings: shared gene variants between autism and language impairment (Vernes et al., 2008); larger brain size in autism but only in early development (Redcay & Courchesne, 2005); and the possibility of quasi-autism, caused by extreme environmental deprivation (Rutter et al., 1999). We make a novel prediction that the earliest developmental symptoms in the emergence of autism should be sensory and motor rather than social and review empirical data offering preliminary support for this prediction.     

Are Residents Willing to Discuss Spirituality with Patients?

Family medicine is redefining itself in the wake of the Future of Family Medicine Project, the move to the Patient-Centered Medical Home, and the 2010 Patient Protection and Affordable Care Act’s emphasis on primary care. This effort has included representing family doctors as physicians who “care for the whole person” and who “specialize in you.” Many patients believe that whole person care involves attention to spirituality and wish to share their beliefs in the medical encounter. This national survey investigated whether a random sample of family medicine residents were willing to address spirituality upon patient request. With varying degrees of willingness, most doctors said that they would discuss patient beliefs if asked. Denominational preference, residency training in addressing spirituality, and self-rated spirituality were all predictive of the strength of reported willingness. These results indicate that training in addressing spirituality may create residents more likely to discuss the topic in clinical practice.     

Special People? An Exploratory Study into Re-entering Missionaries’ Identity and Resilience

Home country re-entry from cross-cultural missionary work abroad may be associated with psychological distress. Re-entrants experience multiple losses including loss of identity which may be associated with personal/relational identity gaps and depersonalization/dehumanization. However, research suggests that some re-entrants are resilient with good mental health, while others are fragile with poor mental health. The aims of this paper are to explore the nature and frequency of re-entering missionaries’ identity gaps and their depersonalization/dehumanization in resilient and fragile re-entrants. Fifteen re-entering adult Australian cross-cultural missionary workers from four interdenominational Australian mission organizations completed semi-structured interviews. Results were analysed using modified Consensual Qualitative Research methods. Links were established between personal/relational identity gaps, depersonalization/dehumanization and resilience on re-entry. Implications for re-entrants’ care are discussed with suggestions for further research.