Cognitive Progression in Epilepsy

The issue of cognitive progression in people with epilepsy is of considerable interest and has important clinical and theoretical implications. In this paper, we review recent studies in both the adult and childhood epilepsy literature which have included a longitudinal test–retest design to examine this question. Several important methodological issues of this literature are highlighted and areas which require more investigation are identified.     

Establishing and Evaluating the Substantive Adequacy of Positive Behavioral Support Plans

The Individuals with Disabilities Education Improvement Act (2004) renewed the commitment to provide positive behavioral support (PBS) for students that engage in persistent problem behavior. Behavior intervention plans (also known as PBS plans) serve as legal documents that help guide the implementation of intervention strategies to encourage more positive forms of behavior. The purpose of this study was to evaluate the substantive adequacy of PBS plans developed for special education students. This was accomplished by documenting the content of plans developed by two different groups of educators using a rating instrument based on the key concepts of PBS planning. Results revealed that the majority of plans developed by teams without identified training and expertise in PBS were rated as substantively inadequate, lacking critical information related to effective behavioral support planning. The implications of the results for everyday practice in the schools and directions for future research are discussed.     

Attraction, personality, and prejudice: liking none of the people most of the time

Unfavorable evaluations of others reflect both specific prejudice and generalized negativity. Study 1 examined self-reported norms and personal endorsement of prejudices to various social groups. Study 2 used judgments of overweight persons to examine links among prejudice, personality, and prosocial motives. Study 3 examined negative evaluations and social distancing during interpersonal interaction. Study 4 observed the translation of negative evaluations into overt discrimination. Study 5 experimentally manipulated the behavior of the target and observed its interactive effects with weight, personality, and prosocial motives. Results suggest that prejudice can emerge from otherwise unprejudiced persons when situations permit justification. Patterns in negative evaluations are linked distinctively to (a) the Big Five dimension of Agreeableness, (b) proximal social cognition and motives, and (c) discrimination.     

A normative zone of RPE ratings for use during graded exercise testing

The purposes of this investigation were to identify a zone of normality for ratings of perceived exertion (RPE) and to compare the RPE responses in patients with coronary artery disease to this zone. The zone was generated from RPE estimated during the last minute of each stage of a Bruce treadmill test in 44 normal adult men. RPE were regressed against the corresponding MET level for each exercise stage. The zone was established as the 95% confidence interval (CI) spanning the average RPE vs MET regression line. RPE estimated during the last 1.0 min. of a Bruce or Modified Balke treadmill test administered to adult men (n=37) with coronary artery disease were compared to the 95% CI zone. A total of 19 (51%) of the coronary artery disease patients estimated RPE during a progressively incremented treadmill test that were above the zone, indicating a comparatively greater than normal perception of strain for a given metabolic stress. The presently generated zone provides a practical use of RPE in the interpretation of clinical exercise tests.     

Neurogenesis decreases with age in the canine hippocampus and correlates with cognitive function

New neurons are continually produced in the adult mammalian brain from progenitor cells located in specific brain regions, including the subgranular zone (SGZ) of the dentate gyrus of the hippocampus. We hypothesized that neurogenesis occurs in the canine brain and is reduced with age. We examined neurogenesis in the hippocampus of five young and five aged animals using doublecortin (DCX) and bromodeoxyuridine (BrdU) immunostaining. The total unilateral number of new neurons in the canine SGZ and granule cell layer (GCL) was estimated using stereological techniques based upon unbiased principles of systematic uniformly random sampling. Animals received 25mg/kg of BrdU once a day for 5 days and were euthanized 9 days after the last injection. We found evidence of neurogenesis in the canine brain and that cell genesis and neurogenesis are greatly reduced in the SGZ/GCL of aged animals compared to young. We further tested the hypothesis that an antioxidant fortified food or behavioral enrichment would improve neurogenesis in the aged canine brain and neurogenesis may correlate with cognitive function. Aged animals were treated for 2.8 years and tissue was available for six that received the antioxidant food, five that received the enrichment and six receiving both treatments. There were no significant differences in the absolute number of DCX or DCX-BrdU neurons or BrdU nuclei between the treatment groups compared to control animals. The number of DCX-positive neurons and double-labeled DCX-BrdU-positive neurons, but not BrdU-positive nuclei alone, significantly correlated with performance on several cognitive tasks including spatial memory and discrimination learning. These results suggest that new neurons in the aged canine dentate gyrus may participate in modulating cognitive functions.     

Interpersonal factors and perinatal depressive symptomatology in a low-income Latina sample

Interpersonal factors are among the risk factors that predispose women to experiencing mood disturbances during the childbearing years. This study investigates the trajectory of change in depressive symptomatology over the course of the perinatal period as related to interpersonal risk factors (marital quality and social support) in a sample of 69 low-income, mostly immigrant Latina mothers at high and low risk for depression. We found a significant linear change in depressive symptomatology from baseline (pregnancy) through the postpartum period. This decline was steeper for high-risk women who reported high levels of social support compared with those who reported low levels of social support. In addition, a greater decline in depressive symptom scores was found for women who reported better postnatal marital quality, irrespective of risk group status. The results suggest the importance of considering marital quality and social support in estimations of risk for depression. These findings also have implications for targeting social support and marital quality in preventive interventions for perinatal depression in Latinas.     

Socioeconomic gradients predict individual differences in neurocognitive abilities

Socioeconomic status (SES) is associated with childhood cognitive achievement. In previous research we found that this association shows neural specificity; specifically we found that groups of low and middle SES children differed disproportionately in perisylvian/language and prefrontal/executive abilities relative to other neurocognitive abilities. Here we address several new questions: To what extent does this disparity between groups reflect a gradient of SES‐related individual differences in neurocognitive development, as opposed to a more categorical difference? What other neurocognitive systems differ across individuals as a function of SES? Does linguistic ability mediate SES differences in other systems? And how do specific prefrontal/executive subsystems vary with SES? One hundred and fifty healthy, socioeconomically diverse first‐graders were administered tasks tapping language, visuospatial skills, memory, working memory, cognitive control, and reward processing. SES explained over 30% of the variance in language, and a smaller but highly significant portion of the variance in most other systems. Statistically mediating factors and possible interventional approaches are discussed.     

Dissemination of effective mental health treatment procedures: Maximizing the return on a significant investment

While much is known about the efficacy of evidence-based practices, it is currently less clear how to implement these practices into the broader mental health system. Dissemination and implementation research will play a critical role in addressing this uncertainty. This commentary reviews the most recent and compelling research related to these topics while advocating a broader and more defined perspective of dissemination for future research. Three of the authors' most pressing questions are proposed and explored.