Non-lateralised deficits of drawing production in hemispatial neglect

Spatially lateralised deficits that typically define the hemispatial neglect syndrome have been shown to co-occur with other non-lateralised deficits of attention, memory, and drawing. However even a simple graphic task involves multiple planning components, including the specification of drawing start position and drawing direction. In order to investigate the influence of these factors in neglect we presented patients with a circle-copying task, and specified the drawing start point. The ability to draw from the instructed location was strongly related to tests that measure constructional abilities, but not related to start point laterality. In contrast, the direction in which patients drew the circle was affected by start point laterality: patients with neglect were less likely to draw in a typical direction when the cue was on the affected side of space and this was strongly related to severity of the neglect. Patients with neglect consistently produced circles that were smaller than the model; however, the scaling was not affected by the laterality of the start point, nor was the proportion of drawings correctly started at the cue. These findings demonstrate the complex relationship between neglect and even the simplest test for the syndrome.     

Does severity predict distress? The relationship between subjective and objective measures of appearance and psychological adjustment,during treatment for facial lipoatrophy

The intuitive or lay belief that the severity of a disfiguring condition predicts psychological distress is not demonstrated in clinical practice, nor in research studies. This within group study used standardised measures repeated at six month intervals, to investigate the relationship between subjective and objective measures of appearance and psychological adjustment in 51 patients undergoing treatment for facial lipoatrophy using a synthetic filler, Newfill^®. Results demonstrate a dissociation between objective and subjective measures with only subjective assessment predicting psychological outcomes. It is recommended that Moss's (2005) hypothesis of discrete group membership (normal/not normal) should be adapted to include an internal standard for comparison, and that all evaluations of treatment modifying disfigurement should include a standardised subjective measure of appearance.     

The Leader’s Illumination of Group Phenomena Hidden in Plain Sight: Why Is No One Talking About the Elephant in the Room?

This article discusses an important leadership function: calling attention to phenomena in group therapy that are NOT observed or observed but not commented on by group members. The article includes group scenarios that often generate member omission, ways to mitigate shame that can result from uncovering members’ blind spots, and misuses of this leadership function. Numerous clinical examples are provided. Concepts borrowed from attachment theory and interpersonal neurobiology help explain how the group’s internalization of this leader function may help the group become a more potent therapeutic environment. The limited contribution of neurological findings to clinical decision-making is discussed.     

A Comprehensive Review of Wraparound Care Coordination Research, 1986–2014

Wraparound is a team-based care coordination strategy for children and youth with complex behavioral health needs and their families. Despite widespread adoption, a review of the literature pertaining to Wraparound has not previously been conducted. To address this gap, we conducted a comprehensive review, ultimately identifying 206 unique Wraparound-related publications in peer-reviewed outlets. We then coded and analyzed the publications’ methods, main foci, measures, and findings. Eighty-three publications (40%) were non-empirical, most of which focused on defining Wraparound and advocating for its use, largely based on its alignment with the System of Care philosophy. Among empirical studies (n?=?123; 60%), 22 controlled studies were found, most finding positive or mixed evidence for Wraparound’s effectiveness. Other empirical studies examined implementation issues such as necessary system conditions and measurement and influence of fidelity. Major gaps include rigorous tests of Wraparound’s change mechanisms, workforce development models, peer support, and the use of specific treatments. We conclude that literature produced to date has provided useful information about Wraparound’s core components, program-level and system-level implementation supports, and applicability across systems and populations, as well as preliminary information about effectiveness and cost-effectiveness. The Wraparound research base would, however, benefit from additional studies of the model’s intervention and implementation components, as well as more rigorous effectiveness studies.     

Comparisons of power for some exact multinomial significance tests

Two small-sample tests (proposed by Tate and Clelland and by Chapanis respectively) of hypotheses about the parameters of the multinomial distribution, where

$$f(x|p) = n!\prod\limits_{i = 1}^k {\frac{{p_i^{x_i } }}{{x_i !}}} $$     

Modeling the effects of payoff on response bias in a perceptual discrimination task: bound-change, drift-rate-change, or two-stage-processing hypothesis

Three hypotheses--the bound-change hypothesis, drift-rate-change hypothesis, and two-stage-processing hypothesis--are proposed to account for data from a perceptual discrimination task in which three different response deadlines were involved and three different payoffs were presented prior to each individual trial. The aim of the present research was to show (1) how the three different hypotheses incorporate response biases into a sequential sampling decision process, (2) how payoffs and deadlines affect choice probabilities, and (3) the hypotheses' predictions of response times and choice probabilities. The two-stage-processing hypothesis gave the best account, especially for the choice probabilities, whereas the drift-rate-change hypothesis had problems predicting choice probabilities as a function of deadlines.     

Personality disorder as harmful dysfunction: DSM'S cultural deviance criterion reconsidered

The DSM's general criteria for personality disorder (PD) attempt to define PD versus nondisordered personality conditions. If dimensionalization of PD occurs in the DSM-V (perhaps, it is suggested, with PD diagnosis moved to Axis I and overall personality assessment in Axis II, thus separating diagnosis from case formulation), general criteria likely will still be needed to prevent massive false positives. In this article, one of the general criteria, the cultural deviance requirement (CDR), is examined from the perspective of the evolution-based harmful-dysfunction analysis of disorder. The CDR is often assumed to express value relativity of harm in diagnosis, but cultural values are a designed feature of human social functioning that influence personality formation. The CDR is thus argued to be an indicator of whether an individual's personality organization is due to an evolutionary dysfunction. Value relativity and evolutionary analysis thus converge.     

Neurocognitive outcomes in children with chronic kidney disease: Current findings and contemporary endeavors

Given the rise in chronic kidney disease (CKD) in both children and adults, CKD has recently been targeted as a public health priority. Childhood onset kidney disease is generally a noncurable and progressive condition that leads to kidney failure by early adulthood. Fortunately, improved identification of kidney problems allows for early intervention, which is thought to slow progression toward end-stage renal disease. In addition, medical interventions for pediatric end-stage renal disease have also improved, allowing children to take advantage of lifesaving renal replacement treatments such as dialysis and kidney transplantation. In spite of improvements in identification and treatment, CKD causes both direct and indirect insults to a variety of organ systems. This paper reviews recently published studies pertaining to the neurocognitive and psychosocial impact of CKD on children of various ages and at various stages of kidney failure. Specific attention is focused on summarizing peer reviewed research that describes associations between kidney functioning and cognitive functioning, language acquisition, visual spatial abilities, memory, and executive functioning. In addition, peer reviewed research describing psychosocial outcomes associated with CKD related to academic achievement, social-behavioral functioning, and quality of life are summarized. The authors also identified disease-specific factors that likely mediate neurocognitive outcomes (e.g., anemia, hypertension, cardiovascular) and endorse the importance of continued interdisciplinary research collaborations that will provide a better understanding of the mechanisms responsible for improved neurocognitive functioning after transplantation. The authors conclude this review by describing a multicenter, prospective, longitudinal, National Institutes of Health funded study that is currently examining the developmental outcomes of children with mild to moderate CKD. The authors speculate that the Chronic Kidney Disease in Children Prospective Cohort Study (CKiD) findings will provide additional evidence-based guidance for clinicians and researchers working with children and adolescents with deteriorating kidney function to improve medical and developmental outcomes.     

Comparison of basic assumptions embedded in learning models for experience-based decision making

The present study examined basic assumptions embedded in learning models for predicting behavior in decisions based on experience. In such decisions, the probabilities and payoffs are initially unknown and are learned from repeated choice with payoff feedback. We examined combinations of two rules for updating past experience with new payoff feedback and of two choice rule assumptions for mapping experience onto choices. The combination of these assumptions produced four classes of models that were systematically compared. Two methods were employed to evaluate the success of learning models for approximating players’ choices: One was based on estimating parameters from each person’s data to maximize the prediction of choices one step ahead, conditioned by the observed past history of feedback. The second was based on making a priori predictions for the entire sequence of choices using parameters estimated from a separate experiment. The results indicated the advantage of a class of models incorporating decay of previous experience, whereas the ranking of choice rules depended on the evaluation method used.     

The Assessment of Preterm Infants' Behavior (APIB): furthering the understanding and measurement of neurodevelopmental competence in preterm and full-term infants

The Assessment of Preterm Infants' Behavior (APIB) is a newborn neurobehavioral assessment appropriate for preterm, at risk, and full-term newborns, from birth to 1 month after expected due date. The APIB is based in ethological-evolutionary thought and focuses on the assessment of mutually interacting behavioral subsystems in simultaneous interaction with the environment. The subsystems of functioning assessed include the autonomic (respiration, digestion, color), motor (tone, movement, postures), state organization (range, robustness, transition patterns), attention (robustness, transitions), and self-regulation (effort, success) systems as well as the degree of facilitation required to support reorganization and subsystem balance. The environment is represented by a sequence of distal, proximal, tactile, and vestibular challenges, derived from the BNBAS. The APIB conceptualizes infant competence as the degree of differentiation of subsystem function and degree of modulation of subsystem balance at any stage in infant development. Infants are understood as actively seeking their next differentiation, while counting on good enough environments to assure progressing developmental competence. In the case of interference such as premature birth, the mismatch of expectation and actual experience causes misalignment, which may become developmentally costly. The assessment is a finely tuned dialogue between examiner and infant, which requires training, skill and self-knowledge. The APIB has well established inter-rater-reliability, concurrent and construct validity, and is clinically relevant for behavioral intervention and individually appropriate and supportive care.