Addressing complex hospital discharge by cultivating the virtues of acknowledged dependence

Theoretical Medicine and Bioethics - Every day around the country, patients are discharged from hospitals without difficulty, as the interests of the hospital and the patient tend to align: both...     

Changes in sleep quality and levels of psychological distress during the adaptation to university: The role of childhood adversity

Stress-related sleep disturbances are common, and poor sleep quality can negatively affect health. Previous work indicates that early-life adversity is associated with compromised sleep quality later in life, but it is unknown whether it predicts greater declines in sleep quality during stressful life transitions. We propose and test a conceptual model whereby individuals who reported experiencing greater levels of child maltreatment would experience greater psychological distress during a stressful life transition, which in turn would contribute to greater declines in sleep quality, relative to their quality of sleep before the stressful transition. Controlling for potential confounding variables (e.g., age, gender), structural equation modelling demonstrated that psychological distress experienced during a stressful transition (i.e., beginning life at university) mediated the relationship between childhood emotional neglect and changes in sleep quality. The hypothesized model demonstrated a good overall fit to the data, χ ² (15) = 17.69, p = .279, CFI = .99, TLI = .97, SRMR = .04, RMSEA = .04 (90% CI <0.001–0.09). Emotional neglect (β = .22) was positively associated with psychological distress which in turn was positively associated with poor sleep quality (β = .31) during a stressful transition. Future research should aim to understand the specific stressors in the university environment that are most challenging to individuals who faced early-life emotional maltreatment. These findings will help inform interventions to facilitate adaptation to a new environment and improve sleep quality for these university students.     

Teaching social perception skills to adolescents with autism and intellectual disabilities using video‐based group instruction

Few interventions focus on teaching social skills to adolescents with autism spectrum disorder (ASD) and intellectual disabilities (ID) that are consistently used during interactions with peers ( Carter et al., 2014). The present study evaluated the effects of video‐based group instruction (VGI) on the acquisition of social perception skills of five adolescents with ASD or ID in a public school setting. Social perception involves observing affective behaviors of others, discriminating relevant environmental stimuli, and differentially reinforcing the affective behavior of another person. Typically developing peers supported VGI implementation as social partners for participants. A multiple probe design across behaviors demonstrated the effectiveness of VGI for teaching social perception skills. Four of five participants acquired and maintained the targeted social perception skills, and we observed some transfer to a nontreatment setting. Results of this study suggest VGI may support the acquisition of social perception among adolescents with ASD or ID.     

Examining the Utility of the New Raney Vocabulary Measure Alongside the WAIS-III

Psychometric tests related to vocabulary assessments are, for the most part, restricted in their use by trained professionals and/or are costly. These restrictions limit their use, especially for research purposes. To circumvent these limitations, the Raney Vocabulary Measure was created for assessing vocabulary proficiency, specifically for research purposes. The measure consists of 30 questions where participants were instructed to choose the best definition of each word. The purpose of the study was to examine the utility of the new measure using the highly standardized but protected Wechsler Adult Intelligence Scale. Results from the linear combination of the subscales revealed the significant prediction of the Raney Vocabulary Measure, with the Vocabulary subtest contributing most to the unique variance. These results support that the test examines vocabulary ability. The current results are promising as the test would allow for greater accessibility for researchers who do not have access to restricted psychometric tests.     

Investigating social functioning after early mild TBI: the quality of parent–child interactions

The young brain is particularly vulnerable to injury due to inherent physiological and developmental factors, and even mild forms of traumatic brain injury (mTBI) can sometimes result in cognitive and behavioural difficulties. Despite the high prevalence of paediatric mTBI, little is known of its impact on children's social functioning. Parent–child relationships represent the centre of young children's social environments and are therefore ideal contexts for studying the potential effects of mTBI on children's social functioning. The aim of this study was to assess the quality of parent–child interactions after mTBI using observational assessment methods and parental report. The sample included 130 children (18–60 months at recruitment) divided into three groups: children with uncomplicated mTBI (n = 47), children with orthopaedic injury (OI, n = 27), and non‐injured children (NI, n = 56). The quality of parent–child interactions was assessed 6 months post‐injury using the Mutually Responsive Orientation (MRO) scale, an observational measure which focuses on the dyadic nature of parent–child exchanges, and the Parental Stress Index questionnaire (Parent‐Child Dysfunctional Interaction (PCDI) domain). Significant differences with medium effect sizes were found between the mTBI group and the NI group on the MRO, but not between the OI group and the other two groups. PCDI scores did not differ across groups, suggesting that observational measures may be more sensitive to changes in parent–child interactions after TBI. The current findings have implications for children's post‐injury social development and highlight the importance of monitoring social outcomes even after minor head injuries.     

Learning implicitly to produce avoided behaviours

The literature on repetition processing reveals an intriguing paradox between the particular salience of repetitions, which makes them easy to learn, and a tendency to avoid them when generating sequences. The aim of this experiment was to study the extent to which children can learn to produce these avoided behaviours by means of an artificial grammar paradigm using generation tests with implicit or explicit instructions. The analysis of the control group's performance confirmed the presence of a spontaneous tendency to avoid generating repetitions. A comparison with chance revealed that the children learned to produce repetitions in the explicit test but not in the implicit test. However, a comparison with the control group showed that learning nonetheless occurred in the experimental group with the implicit test. The discussion focused on this antirepetition behavioural bias and how it interacted with the type of information processes elicited by the tests selected for assessing implicit learning effects.     

Does length or neighborhood size cause the word length effect?

Jalbert, Neath, Bireta, and Surprenant (2011) suggested that past demonstrations of the word length effect, the finding that words with fewer syllables are recalled better than words with more syllables, included a confound: The short words had more orthographic neighbors than the long words. The experiments reported here test two predictions that would follow if neighborhood size is a more important factor than word length. In Experiment 1, we found that concurrent articulation removed the effect of neighborhood size, just as it removes the effect of word length. Experiment 2 demonstrated that this pattern is also found with nonwords. For Experiment 3, we factorially manipulated length and neighborhood size, and found only effects of the latter. These results are problematic for any theory of memory that includes decay offset by rehearsal, but they are consistent with accounts that include a redintegrative stage that is susceptible to disruption by noise. The results also confirm the importance of lexical and linguistic factors on memory tasks thought to tap short-term memory.     

When does length cause the word length effect?

The word length effect, the finding that lists of short words are better recalled than lists of long words, has been termed one of the benchmark findings that any theory of immediate memory must account for. Indeed, the effect led directly to the development of working memory and the phonological loop, and it is viewed as the best remaining evidence for time-based decay. However, previous studies investigating this effect have confounded length with orthographic neighborhood size. In the present study, Experiments 1A and 1B revealed typical effects of length when short and long words were equated on all relevant dimensions previously identified in the literature except for neighborhood size. In Experiment 2, consonant-vowel-consonant (CVC) words with a large orthographic neighborhood were better recalled than were CVC words with a small orthographic neighborhood. In Experiments 3 and 4, using two different sets of stimuli, we showed that when short (1-syllable) and long (3-syllable) items were equated for neighborhood size, the word length effect disappeared. Experiment 5 replicated this with spoken recall. We suggest that the word length effect may be better explained by the differences in linguistic and lexical properties of short and long words rather than by length per se. These results add to the growing literature showing problems for theories of memory that include decay offset by rehearsal as a central feature.     

Backward recall and the word length effect

The word length effect, the finding that words that have fewer syllables are recalled better than otherwise comparable words that have more syllables, is one of the benchmark effects that must be accounted for in any model of serial recall, and simulation models of immediate memory rely heavily on the finding. However, previous research has shown that the effect disappears when participants are asked to recall the items in strict backward order. The present 2 experiments replicate and extend that finding by manipulating the participant's foreknowledge of recall direction (Experiment 1) and by giving the participant repeated practice with one direction by blocking recall direction (Experiment 2). In both experiments, a word length effect obtained with forward but not backward recall. The results are problematic for all models that currently have an a priori explanation for word length effects. The finding can be accounted for but is not predicted by Scale-Independent Memory, Perception, and Learning (SIMPLE), a model in which item and order information are differentially attended to in the 2 recall directions.