A biopsychosocial approach to liver transplant evaluation in two patients with Wilson's disease

Wilson's disease (WD) is characterized by hepatic, neurological, and/or psychiatric disturbances. In some cases, liver transplantation is indicated. Because psychologists and other health care workers play an increasing role in the evaluation of individuals presenting for transplant, an understanding of the heterogeneous phenotype of WD is important for mental health professionals working in medical settings. This article reviews two cases of patients with WD (one probable, one confirmed) presenting for liver transplantation and a biopsychosocial assessment approach is demonstrated. Patients are presented in terms of medical, psychiatric, and psychosocial history, neuropsychological examination results, and the subsequent indications for liver transplantation. Both patients exhibited neurocognitive and psychiatric symptoms. One patient was determined to be a marginally suitable candidate for transplantation, whereas the other was considered at high risk for negative outcome post-transplant. This article demonstrates the importance of considering phenotypic presentation, neurocognitive function, psychiatric status, and psychosocial circumstances in assessing transplant readiness in patients with WD. A comprehensive and integrative biopsychosocial assessment approach is appropriate for evaluating patients with WD presenting for liver transplantation.     

Causation and melanoma classification

In this article, I begin by giving a brief history of melanoma causation. I then discuss the current manner in which malignant melanoma is classified. In general, these systems of classification do not take account of the manner of tumour causation. Instead, they are based on phenomenological features of the tumour, such as size, spread, and morphology. I go on to suggest that misclassification of melanoma is a major problem in clinical practice. I therefore outline an alternative means of classifying these tumours based on causal factors. By analogy with similar systems that have recently emerged for other cancers, I suggest that this causal classification is likely to be both workable and helpful, even in the absence of a full causal-mechanistic understanding of the aetiology of the tumour.     

The plausibility of spiritual intelligence: spiritual experience,problem solving and neural sites

Australian teachers in Church related schools have begun to use the term ‘spiritual intelligence’ in their educational discourse. Is it accurate to describe spirituality as a form of intelligence? This paper explores whether the notion of spiritual intelligence is plausible. It addresses this firstly by discussing the notion of spiritual experience as a mechanism for problem solving—one of the central themes that underlies the concept of intelligence. Secondly, it examines some of the neural sites of the human brain that have been found to be active in those who apperceive spiritual experience. In light of this discussion, this paper argues that although some concerns prevail in considering spirituality as a form of intelligence, the concept of spiritual intelligence may nonetheless be rendered as plausible.     

Resilience-Based Intervention with Underserved Children: Impact on Self-Regulation in a Randomized Clinical Trial in Schools

Resilience and emotion regulation are crucial for optimal psychosocial functioning in children. This study assessed whether a group-based intervention, the Resilience Builder Program (RBP), improved student report of emotion regulation when administered in elementary schools. Sixty-seven students aged 9–12 years (M = 10.50, SD =.74; 82.1% male, 98.5% ethnic/racial minority) were randomly assigned to receive the RBP intervention immediately or following a semester delay. Participants reported their emotional control using the How I Feel scale. Students who received the RBP reported a significant increase in their emotional control and a significant decrease in negative emotion compared to those students in the delayed treatment sample who had not yet received the intervention. Further, students indicated a strongly positive perception of the therapy.     

Impact of Child and Parent Motivation on Social Skills Training Outcome

This study explores child and parent motivation at the start of a social skills training group program and its relationship with treatment outcome. A total of 59 children (aged 7–12) participated. Parents were more aware of, distressed by, and motivated to change the presenting problem than were their children. Greater parent awareness of their child’s difficulty making and keeping friends and perceived importance of their child learning ways to make and keep more friends significantly predicted more improved social skills. Increasing parents’ awareness and perceived importance of treating the presenting problem at the start of therapy may increase treatment effectiveness.     

Effects of aging on the relation between episodic simulation and prosocial intentions

Imagining helping a person in need can facilitate prosocial intentions. Here we investigated how this effect can change with aging. We found that, similar to young adults, older adults were more willing to help a person in need when they imagined helping that person compared to a baseline condition that did not involve helping, but not compared to a conceptual helping control condition. Controlling for heightened emotional concern in older adults revealed an age-related difference in the effect of imagining on willingness to help. While we observed age-related condition effects, we also found that the subjective vividness of scene imagery predicted willingness to help for both age groups. Our findings provide insight into the relations among episodic simulation, healthy aging, emotion, and prosociality. Implications for effects of episodic memory and aging on social decision-making are discussed.