Working memory and attention are still impaired after three years in patients with stress‐related exhaustion

Cognitive impairment is one of the most pronounced symptoms reported by patients with stress‐related mental health problems. Impairments related to executive function and to some extent speed and attention are therefore common in patients with stress‐related burnout/exhaustion. In this paper we present a follow‐up of cognitive performance in patients with stress‐related exhaustion several years after they initially sought medical care. Thirty patients and 27 healthy controls, mean age 49 years (SD 6.5) and 55 years (SD 6.7) respectively, were included, all of whom had undergone baseline measurements of neuropsychological functioning. The mean follow‐up time was three years. Half of the patients still reported mental health problems at follow‐up and over time no major changes in cognitive performance were noted. The patients still performed significantly poorer than controls with regard to cognitive functions, mainly related to speed, attention and memory function. Long‐lasting impairment of cognitive functions related to speed, attention and memory function noted in patients with stress‐related exhaustion should be acknowledged and taken into consideration during treatment and when discussing a return to work. Follow‐up periods longer than three years are needed to explore the persistence of the cognitive impairment.     

Auditory perception of speech and speech sounds in recent and recovered cases of aphasia

Auditory perception of speech and speech sounds was examined in three groups of patients with cerebral damage in the dominant hemisphere. Two groups consisted of brain-injured war veterans, one group of patients with high-frequency hearing loss and the other, a group of patients with a flat hearing loss. The third group consisted of patients with recent cerebral infarcts due to vascular occlusion of the middle cerebral and internal carotid artery. Word and phoneme discrimination as well as phoneme confusions in incorrect responses were analyzed from conventional speech audiometry tests with bisyllabic Finnish words fed close to the speech reception threshold of the patient. The results were compared with those of a control group with no cerebral disorders and normal hearing. The speech discrimination scores of veterans with high-frequency hearing loss and patients with recent cerebral infarcts were some 15–20% lower than those of controls or veterans with flat hearing loss. Speech sound feature discrimination, analyzed in terms of place of articulation and distinctive features, was distorted especially in cases of recent cerebral infarcts, whereas general information transmission of phonemes was more impaired in patients with high-frequency hearing loss.     

Effects of family interaction on the child's behavior in single-parent or reconstructed families

The effects of the family interaction on children's behavior were studied in single-parent or reconstructed families (N = 63) in a white population in Finland. The focus was on the spousal and the parent-child interaction. Teachers assessed children's behavior and parents were interviewed. The interviews were analyzed qualitatively using the grounded-theory method. The boundary ambiguity theory developed by Pauline Boss was used to examine the interaction in the families. About two fifths of the parents reported that their spousal interaction was good, family boundaries were clear, and the children were taken care of together. Another two fifths interacted only because of the child and family boundaries were ambiguous. In 14 families the involvement of the noncustodial parent was both physically and psychologically low. The physically close but psychologically distant parent-child interaction seemed to affect the child's behavior detrimentally, whereas children with physically and psychologically close interaction with their parents showed less behavioral problems. The children with behavioral problems were more likely to have problems with both parents. They were also more likely to have a stepparent with whom they had conflicts. In conclusion, a good interaction between the parents and clarified family boundaries protect children's mental health after their parents' divorce or separation.     

On how high performers keep cool brains in situations of cognitive overload

What happens in the brain when we reach or exceed our capacity limits? Are there individual differences for performance at capacity limits? We used functional magnetic resonance imaging (fMRI) to investigate the impact of increases in processing demand on selected cortical areas when participants performed a parametrically varied and challenging dual task. Low-performing participants respond with large and load-dependent activation increases in many cortical areas when exposed to excessive task requirements, accompanied by decreasing performance. It seems that these participants recruit additional attentional and strategy-related resources with increasing difficulty, which are either not relevant or even detrimental to performance. In contrast, the brains of the high-performing participants “keep cool” in terms of activation changes, despite continuous correct performance, reflecting different and more efficient processing. These findings shed light on the differential implications of performance on activation patterns and underline the importance of the interindividual-differences approach in neuroimaging research.     

Against representations with two directions of fit

The idea that there are representations with a double direction of fit has acquired a pride of place in contemporary debates on the ontology of institutions. This paper will argue against the very idea of anything at all having both directions of fit. There is a simple problem which has thus far gone unnoticed. The suggestion that there are representations with both directions of fit amounts to a suggestion that, in cases of discrepancy between a representation and the world, both should change—the representation and the world. But that would merely amount to another discrepancy, and so both should change again, ad infinitum. The paper will first elucidate the notion of a “direction of fit” and clarify how the criticism to be presented here differs from earlier criticisms (Section 1).The next section sheds some light on why and how acts and attitudes with both directions of fit have seemed to play a part in explaining the existence of institutional reality (Section 2). The next sections present the argument against any representations with both directions of fit, relying on a normative understanding of the distinction. The argument will have three steps (Sections 3, 4, and 5). The section that follows shows that the criticism also applies to the dispositional understanding of the notion of a direction of fit (Section 6), and then the paper asks whether a third kind of reading would be available (Section 7) and whether the infallibility of the relevant representations would be of help (Section 8). Finally, the paper assesses briefly the consequences of dropping the notion of two directions of fit (Section 9).     

Danto's rejection of immanent causation

This article suggests first that the concept of interpersonal recognition be understood in a multidimensional (as opposed to one-dimensional), practical (as opposed to symbolic), and strict (as opposed to broad) way. Second, it is argued that due recognition be seen as a reason-governed response to evaluative features, rather than all normativity and reasons being seen as generated by recognition. This can be called a response-model, or, more precisely, a value-based model of due recognition. A further suggestion is that there is a systematic basis for distinguishing three dimensions of recognition, depending on whether recognition is given to someone qua a person, qua a certain kind of person, or qua a certain person. Finally, it is argued that recognition is a necessary condition of personhood, but whether it is of direct or indirect relevance depends on our theories of personhood (social vs. capacity-theory) and practical identity (dialogical definition model vs. feature-model). Despite the apparent opposition, it is shown that interpersonal recognition is both a response to value and a precondition of personhood.     

Effectiveness of cognitive behavioral therapy on health‐related quality of life: An evaluation of therapies provided by trainee therapists

The present study was carried out to examine the treatment effect of cognitive behavioral therapy provided by trainee therapists at a university clinic, focusing on health‐related quality of life (HRQOL) optimism and symptoms. The study was conducted through a repeated measures design and included a treatment group (n = 21), which received cognitive behavioral therapy for an average of 10.7 therapy sessions and a control group (n = 14), that was put on a wait list for 8.6 weeks on average. After treatment, the treatment group improved significantly concerning general health (p = 0.028) and optimism (p = 0.027). In addition, clients improved in several areas within mental health and displayed some reduction in anxiety symptoms. Concurrently, the results also indicated some improvement within the control group, which may have been caused by the initial therapeutic contact, expectancy effects or spontaneous remission. The study concluded that cognitive behavioral therapy provided by trainee therapists may have a positive effect on areas within HRQOL and optimism.