Differential memory impairment in dementia with Lewy bodies and Alzheimer's disease

This study was conducted in order to elucidate the functioning of the Central Executive System of Working Memory (WM) and to clarify the status of other cognitive functions in Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). Fourteen DLB, 22 AD, and 23 control subjects were assessed with the dual task paradigm and other cognitive tests. When compared with controls, DLB subjects performed more poorly in concurrent conditions on semantic WM tasks, and AD subjects performed more poorly on the spatial WM task. The DLB subjects had an inferior verbal span and AD subjects, an inferior recall on the CVLT. These data suggest relative impairments of verbal and semantic WM in DLB and relative impairments of spatial WM and verbal episodic memory in AD.     

Different Ways to Hurt: An Elderly Woman's Narrative of Suffering

This article presents and interprets the case study of an elderly woman's story of suffering. It results from interviews conducted with African-American and Caucasian men and women, aged 70 and above, concerning their personal definitions, attributions, and theories about suffering. Elders' experiences of suffering were examined under the rubrics of gerontology, narrative, and religious studies. Key themes offered in this case study are: (a) How the life course unfolds because of or despite suffering, (b) what moral status an elder confers on past or present suffering, (c) how a personal sense of the sacred accommodates suffering, (d) how this particular respondent alters her identity based on assimilating the new information of suffering, and (e) how the story of suffering stands out against or blends in with the backdrop of the life story. The uniqueness of this case study also mirrors commonalities of elders' narratives of suffering, particularly those of women. This elder's story demonstrates that smaller individual suffering is rooted in the frame of the larger public world. It also illustrates that the language women use to attribute, define, and theorize suffering is embedded in relationships.     

Planning and executing simple movements: contributions of relative-time and overall-duration specification

In 3 experiments, the authors used a precuing protocol to examine the nature and cost of programming and the subsequent reprogramming of a movement's relative time and overall duration. Initial programming followed a fixed-order specification; knowledge of the necessary relative time was required before information regarding overall duration could be used in a manner that expedited response planning. In the case of reprogramming, however, when a modification had to be made in either the relative time or overall duration of the anticipated and already-prepared response, performers chose to completely reprogram the entire response. Complete reprogramming occurred even when the performer had correctly prepared the higher order relative-time component and only had to modify the overall duration of the movement. The data indicate that organizing movement timing before movement initiation is accomplished in a fundamentally different manner depending on whether the movement is being initially compiled or modified.     

Patterns of apraxia associated with the production of intransitive limb gestures following left and right hemisphere stroke

The model of apraxia proposed by Roy (1996) states that three patterns of apraxia should be observed across pantomime and imitation conditions. In the present analysis the frequency and severity of each pattern of apraxia were examined in a consecutive sample of left-(LHD) and right-hemisphere-damaged (RHD) patients during the production of intransitive limb gestures. The results indicated that a significant proportion of LHD and RHD patients were selectively impaired in formulating the ideational component of intransitive limb gestures.     

Making Music Together: Discussion of Gianni Nebbiosi’s “The Smell of Paper”

Finding life in our patients is a common goal for analysts. Historically this project had been defined as one of freeing unacceptable impulses from their imprisoning defenses with the analyst, via interpretation, then contrasting the patient’s internal fantasied reality with “actual” reality. Untangling fantasy from reality could free the impulses to provide energy for more realistic projects. This imagery stands in stark contrast to the fluidity of a contemporary relational conceptualization of human experience where our inner experience is now understood to be the lens through which we construct our vision of external reality, always a subjective perception. Clinical change—finding life—now depends more on the activation of a generative intersubjective process between patient and analyst, which contributes to the expansion of the patient’s subjective experience. Gianni Nebbiosi’s use of music and of mime to help him feel his way into his patient’s and ultimately into his own similarly defended experience demonstrates the creativity and idiosyncratic clinical approaches that emerge from a contemporary relational orientation. This orientation recognizes the analyst’s subjectivity as a fundamental tool of clinical change—a vehicle through which any theoretical approach will necessarily be shaped. Differing approaches to a clinical situation do not always simply reflect theoretical disagreements; they may also reflect the expression of the particular subjectivity of the analyst.     

Behavioral Approach System Sensitivity and Risk Taking Interact to Predict Left-Frontal EEG Asymmetry

The Behavioral Approach System (BAS) hypersensitivity theory of bipolar disorder (BD; Alloy & Abramson, 2010; Depue & Iacono, 1989) suggests that hyperreactivity in the BAS results in the extreme fluctuations of mood characteristic of BD. In addition to risk conferred by BAS hypersensitivity, cognitive and personality variables may play a role in determining risk. We evaluated relationships among BAS sensitivity, risk taking, and an electrophysiological correlate of approach motivation, relative left-frontal electroencephalography (EEG) asymmetry. BAS sensitivity moderated the relationship between risk taking and EEG asymmetry. More specifically, individuals who were high in BAS sensitivity showed left-frontal EEG asymmetry regardless of their level of risk-taking behavior. However, among individuals who were moderate in BAS sensitivity, risk taking was positively associated with asymmetry. These findings suggest that cognitive and personality correlates of bipolar risk may evidence unique contributions to a neural measure of trait-approach motivation. Clinical implications of these findings are discussed.     

An Investigation of Couples’ Help-Seeking: A Multiple Case Study

Research of the effectiveness of couples counseling has demonstrated clear benefits (e.g.; Lebow et al. (Journal of Marital and Family Therapy, 38(1):145–168, 2012)). However, relatively few couples initiate counseling and seek help. This exploratory study employed a qualitative multiple case study approach to heterosexual couples (N?=?7) that were currently in the process of seeking conjoint therapy to identify intra and interpersonal factors that influence relational help-seeking. Participants reported that female partners were the first to perceive a problem and suggest seeking professional help. In turn, male partners reported feeling a sense of failure and fear of judgment when considering couples counseling. Patterns of blame, withdrawal, and aggression contributed to increased distress, which eventually led these couples to counseling, some with mixed-agendas for services.