Group interventions for patients with cancer and HIV disease: Part II. Effects on immune, endocrine, and disease outcomes at different phases of illness

There has been great interest in the potential impact of group interventions on medical outcomes. This article reviews the effects of professionally-led groups on immune activity, neuroendocrine function, and survival among patients with cancer or HIV disease. We examine findings concerning different types of group services at different phases of illness. Results are mixed, but the most prominent changes in immune and endocrine activity were associated with structured group interventions for patients with early-stage disease. These findings offer provocative illustrations of relevant mind-body interactions, but their clinical importance has yet to be demonstrated empirically. Group interventions have not been tied consistently to improved survival rates for patients with advanced cancer; few studies as yet have focused on survival outcomes among patients with early-stage cancer or HIV disease.     

Group interventions for patients with cancer and HIV disease: Part III. Moderating variables and mechanisms of action

Growing evidence supports the value of group interventions for individuals who are at risk for or have developed cancer or HIV disease. However, information is more limited concerning how these services can be delivered in an optimal manner, and what processes contribute to their benefits. Parts I and II of this review examined the efficacy of different interventions for individuals at different phases of illness, ranging from primary prevention to late-stage disease, in both psychosocial and biological domains. The current paper examines some of the factors other than phase of illness that might influence group treatment effects (e.g., intervention parameters, participant characteristics), and explores mechanisms of action.     

Visual search across the life span

Gains and losses in visual search were studied across the life span in a representative sample of 298 individuals from 6 to 89 years of age. Participants searched for single-feature and conjunction targets of high or low eccentricity. Search was substantially slowed early and late in life, age gradients were more pronounced in conjunction than in feature search, and all age groups were uniformly affected by eccentricity manipulations. However, developmental and aging trends were distinctly asymmetrical: Children's performance was particularly affected by the mere presence of distractors; whereas in late life, performance was particularly impaired on target-absent trials and with increasing numbers of distractors. The implications for life span theories of cognitive and attentional development and for cognitive-speed and inhibitory-control accounts are discussed.     

Contiguity and contingency in action-effect learning

According to the two-stage model of voluntary action, the ability to perform voluntary action is acquired in two sequential steps. Firstly, associations are acquired between representations of movements and of the effects that frequently follow them. Secondly, the anticipation or perception of an acquired action effect primes the movement that has been learnt to produce this effect; the acquired action-effect associations thus mediate the selection of actions that are most appropriate to achieve an intended action goal. If action-effect learning has an associative basis, it should be influenced by factors that are known to affect instrumental learning, such as the temporal contiguity and the probabilistic contingency of movement and effect. In two experiments, the contiguity or the contingency between key presses and subsequent tones was manipulated in various ways. As expected, both factors affected the acquisition of action-effect relations as assessed by the potency of action effects to prime the corresponding action in a later behavioral test. In particular, evidence of action-effect associations was obtained only if the effect of the action was delayed for no more than 1 s, if the effect appeared more often in the presence than in the absence of the action, or if action and effect were entirely uncorrelated but the effect appeared very often. These findings support the assumption that the control of voluntary actions is based on action-effect representations that are acquired by associative learning mechanisms.     

Transformations in the couplings among intellectual abilities and constituent cognitive processes across the life span

Abstract— Two-component theories of intellectual development over the life span postulate that fluid abilities develop earlier during child development and decline earlier during aging than crystallized abilities do, and that fluid abilities support or constrain the acquisition and expression of crystallized abilities. Thus, maturation and senescence compress the structure of intelligence by imposing age-specific constraints upon its constituent processes. Hence, the couplings among different intellectual abilities and cognitive processes are expected to be strong in childhood and old age. Findings from a population-based study of 291 individuals aged 6 to 89 years support these predictions. Furthermore, processing robustness, a frequently overlooked aspect of processing, predicted fluid intelligence beyond processing speed in old age but not in childhood, suggesting that the causes of more compressed functional organization of intelligence differ between maturation and senescence. Research on developmental changes in functional brain circuitry may profit from explicitly recognizing transformations in the organization of intellectual abilities and their underlying cognitive processes across the life span.     

Preparing for perception and action (I): the role of grouping in the response-cuing paradigm

Human skilled behavior requires preparatory processes that selectively make sensory and motor systems more efficient for perceiving the upcoming stimulus and performing the correct action. We review the literature concerning these preparatory processes as studied by response-cuing paradigm, and propose a model that accounts for the major findings. According to the Grouping Model, advance or precue information directs a dynamic process of subgroup making-that is, a process of stimulus- and response-set reconfiguration-whereby the internal representation of the task is simplified. The Grouping Model assigns a critical role to the unit of selection, with Gestalt factors and interresponse dependencies mediating the formation and strength of stimulus and response subgroups. In a series of five experiments, we manipulated perceptual and motoric grouping factors, and studied their independent and interactive effects on the pattern of precuing benefits. Generally, the results were consistent with the Grouping Model's account of response-cuing effects.     

Unconscious symmetrical inferences: A role of consciousness in event integration

Explicit and implicit learning have been attributed to different learning processes that create different types of knowledge structures. Consistent with that claim, our study provides evidence that people integrate stimulus events differently when consciously aware versus unaware of the relationship between the events. In a first, acquisition phase participants sorted words into two categories (A and B), which were fully predicted by task-irrelevant primes-the labels of two other, semantically unrelated categories (C and D). In a second, test phase participants performed a lexical decision task, in which all word stimuli stemmed from the previous prime categories (C and D) and the (now nonpredictive) primes were the labels of the previous target categories (A and B). Reliable priming effects in the second phase demonstrated that bidirectional associations between the respective categories had been formed in the acquisition phase (A<-->C and B<-->D), but these effects were found only in participants that were unaware of the relationship between the categories! We suggest that unconscious, implicit learning of event relationships results in the rather unsophisticated integration (i.e., bidirectional association) of the underlying event representations, whereas explicit learning takes the meaning of the order of the events into account, and thus creates unidirectional associations.     

Priming and binding in and across perception and action: a correlational analysis of the internal structure of event files

Individual performance was compared across three different tasks that tap into the binding of stimulus features in perception, the binding of action features in action planning, and the emergence of stimulus-response bindings (“event files”). Within a task correlations between the size of binding effects were found within visual perception (e.g., the strength of shape-location binding correlated positively with the strength of shape-colour binding) but not between perception and action planning, suggesting different, domain-specific binding mechanisms. To some degree, binding strength was predicted by priming effects of the respective features, especially if these features varied on a dimension that matched the current attentional set.     

Action-feature integration blinds to feature-overlapping perceptual events: evidence from manual and vocal actions

Previous studies showed that the identification of a left- or right-pointing arrowhead is impaired when it appears while planning and executing a spatially compatible left or right keypress (Müsseler & Hommel, 1997a). We attribute this effect to stimulus processing and action control operating on the same feature codes so that, once a code is integrated in an action plan, it is less available for perceptual processing. In three pairs of experiments we tested the generality of this account by using stimulus-response combinations other than arrows and manual keypresses. Planning manual left-right keypressing actions impaired the identification of spatially corresponding arrows but not of words with congruent meaning. On the contrary, planning to say "left" or "right" impaired the identification of corresponding spatial words but not of congruent arrows. Thus, as the feature-integration approach suggests, stimulus identification is impaired only with overlap of perceptual or perceptually derived stimulus and response features while mere semantic congruence is insufficient.     

Target integration and the attentional blink

If people monitor a visual stimulus stream for targets they often miss the second (T2) if it appears soon after the first (T1)--the attentional blink. There is one exception: T2 is often not missed if it appears right after T1, i.e., at lag 1. This lag-1 sparing is commonly attributed to the possibility that T1 processing opens an attentional gate, which may be so sluggish that an early T2 can slip in before it closes. We investigated why the gate may close and exclude further stimuli from processing. We compared a control approach, which assumes that gate closing is exogenously triggered by the appearance of nontargets, and an integration approach, which assumes that gate closing is under endogenous control. As predicted by the latter but not the former, T2 performance and target reversals were strongly affected by the temporal distance between T1 and T2, whereas the presence or the absence of a nontarget intervening between T1 and T2 had little impact.