Primary care physicians attitude toward diagnosis and treatment of late-life depression

Underdiagnosis and undertreatment of late-life depression is common, especially in primary care settings. To help assess whether physicians attitude and confidence in diagnosing and managing depression serve as barriers to care, a total of 176 physicians employed in 18 primary care groups were administered surveys to assess attitudes towards diagnosis, treatment, and management of depression in elderly patients, (individuals over 65 years of age). Logistic regression was performed to assess the association of physician characteristics on attitudes. Nearly all of the physicians surveyed felt that depression in the elderly was a primary care problem, and 41% reported late-life depression as the most common problem seen in older patients. Physicians were confident in their ability to diagnose and manage depression, yet 45% had no medical education on depression in the previous three years. Physicians confidence in their ability to diagnose, treat, and manage depression, and their reported adequacy of training, do not appear to correspond to the amount of continuing medical education in depression, suggesting that physician overconfidence may potentially be serving as a barrier to care.     

Attitudes about antidepressants: influence of information about weight-related side effects

Antidepressant drugs are frequently prescribed for women and have various side effects, including potential effects on body weight. This experiment examined the effects of information about the weight-related side effects of antidepressants on women's attitudes toward the drugs. 60 college women were randomly assigned to read about one of two drugs, fluoxetine (Prozac) or imipramine (Tofranil). Participants were either told or not told about veridical weight-related side effects, namely, weight loss for Prozac and weight gain for Tofranil. As hypothesized, weight-gain information lowered the personal acceptability of Tofranil, and weight-loss information enhanced the acceptability of Prozac. Although research with clinical populations is required, undergraduate women's decisions about the use of antidepressant medications may be influenced by societal body-image ideals.     

Oscillator-based memory for serial order

A computational model of human memory for serial order is described (OSCillator-based Associative Recall [OSCAR]). In the model, successive list items become associated to successive states of a dynamic learning-context signal. Retrieval involves reinstatement of the learning context, successive states of which cue successive recalls. The model provides an integrated account of both item memory and order memory and allows the hierarchical representation of temporal order information. The model accounts for a wide range of serial order memory data, including differential item and order memory, transposition gradients, item similarity effects, the effects of item lag and separation in judgments of relative and absolute recency, probed serial recall data, distinctiveness effects, grouping effects at various temporal resolutions, longer term memory for serial order, list length effects, and the effects of vocabulary size on serial recall.     

Diagnosing written language disabilities using the Woodcock-Johnson Tests of Educational Achievement-Revised and the Wechsler Individual Achievement Test

The writing portions of the Woodcock-Johnson Tests of Educational Achievement-Revised and the Wechsler Individual Achievement Test are often administered when establishing eligibility for special education services due to learning disabilities. The scores on these measures are typically regarded as equivalent although little is known about how scores on the two measures differ for the same students. Differences of only a few points, however, may affect eligibility for special education services. These tests were administered to 25 sixth grade students previously diagnosed with learning disabilities in written expression only. Students' Wechsler scores were consistently higher on the overall writing composite, while there was no difference in the mean scores on the language mechanics subtests. The WIAT Written Expression subtest mean, however, was significantly higher than the Woodcock-Johnson Writing Samples subtest mean. Use of the Wechsler test would be less likely to identify children for special education services in written expression when point discrepancy criteria are utilized for eligibility. Clinicians should be cognizant of the effect of the specific test chosen on eligibility outcome.     

Contrast effects do not underlie effects of preceding liquids on stop-consonant identification by humans

These experiments explored the claim by A. Lotto and K. Kluender (1998) that frequency contrast explains listeners' compensations for coarticulation in the case of liquid consonants coarticulating with following stops. Evidence of frequency contrast in experiments that tested for it directly was not found, but Lotto and Kluender's finding that high- and low-frequency precursor tones can produce contrastive effects on stop-consonant judgments were replicated. The effect depends on the amplitude relation of the tones to the third formant (F3) of the stops. This implies that the tones mask F3 information in the stop consonants. It is unknown whether liquids and following stops in natural speech are in an appropriate intensity relation for masking of the stop. A final experiment, exploiting the McGurk effect, showed compensation for coarticulation by listeners when neither frequency contrast nor masking can be the source of the compensations.     

Distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility

A large percentage of individuals who enter residential substance abuse treatment drop out before completing treatment. Given that early treatment dropout places individuals at an increased risk for relapse, identifying the mechanisms underlying treatment dropout would have several important theoretical and clinical implications. In the current study, the authors examined levels of psychological and physical distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility. In a sample of 122 individuals entering a residential substance abuse treatment facility, level of psychological distress tolerance was predictive of early treatment dropout above and beyond relevant self-report variables. There was no relationship between physical distress tolerance and early treatment dropout. Implications for future studies and treatment development or modification are discussed.     

Acculturation and contact in Japanese students studying in the United Kingdom

Acculturation theory has been the dominant model that investigators use in examining the effects of transmigration. This theory indicates the problematic effects of intercultural contact in terms of adjustment and stress. One criticism of this theory, however, is its lack of integration with the more generic contact literature. This literature suggests that intergroup contact can have positive effects on intergroup relations. The authors presented a longitudinal study of 35 Japanese nationals living in the United Kingdom over a period of 12 months. The present results suggested that both conventional acculturation variables (e.g., language ability and perceived cultural distance) and intergroup variables (e.g., in-group bias and intergroup anxiety) were associated with acculturative stress and psychosomatic illness over time. Higher intergroup anxiety was associated with increased acculturative stress, whereas higher in-group bias was associated with reduced psychosomatic illness. The present results indicated the possibility that these variables add an important dimension to the acculturation literature.     

On the effects of signaling reinforcer probability and magnitude in delayed matching to sample

Two experiments examined whether postsample signals of reinforcer probability or magnitude affected the accuracy of delayed matching to sample in pigeons. On each trial, red or green choice responses that matched red or green stimuli seen shortly before a variable retention interval were reinforced with wheat access. In Experiment 1, the reinforcer probability was either 0.2 or 1.0 for both red and green responses. Reinforcer probability was signaled by line or cross symbols that appeared after the sample had been presented. In Experiment 2, all correct responses were reinforced, and the signaled reinforcer durations were 1.0 s and 4.5 s. Matching was more accurate when larger or more probable reinforcers were signaled, independently of retention interval duration. Because signals were presented postsample, the effects were not the result of differential attention to the sample.     

The cognitive effects of trauma: reversal of alpha function and the formation of a beta screen

Following a brief review of Freud's writings on trauma, the author discusses relevant theories of Bion, and in particular the concepts of the alpha function and the beta screen. A clinical example is presented in which the patient's relatively recent trauma in adulthood had become fused with prior related experiences, leading to a propensity for repeated enactments in analysis and a failure to learn from experience. Drawing on the analyst's alpha function, the patient was gradually able to use mentalization to transform her rigidly structured traumatic organization. The author highlights the roles of dreams/dream associations and of screen memories in the patient's analysis.     

Paralinguistic processing in children with callosal agenesis: emergence of neurolinguistic deficits

Recent research revealed impaired processing of both nonliteral meaning and affective prosody in adults with agenesis of the corpus callosum (ACC) and normal intelligence. Since normal children have incomplete myelination of the corpus callosum, it was hypothesized that paralanguage deficits in children with ACC would be less apparent relative to their peers. The Familiar and Novel Language Comprehension Test (FANL-C) and Prosody Test were given to 18 children with ACC and normal intelligence and 17 controls matched for age (7-13 years), education, and IQ (83-122). When controlling for age, children with ACC were significantly poorer in comprehension of the precise meaning of both literal and nonliteral items on the FANL-C. Adults with ACC had previously been shown to have difficulty only on nonliteral items. The effect size for nonliteral comprehension in children with ACC was smaller than that seen in adults. There was only a trend for the child ACC group to perform worse on the recognition of affective prosody. Thus, while deficits in paralinguistic processing were apparent, children with ACC were not as clearly different from age peers as adults, and were equally deficient at comprehending literal and nonliteral expressions. The differences in results between adults and children with ACC are thought to reflect incomplete callosal development in normal children, and the importance of the corpus callosum in the early stages of the development of the ability to process literal language.