Adjustment modes in the trajectory of progressive multiple sclerosis: a qualitative study and conceptual model

Objective: We examined cognitive and behavioural challenges and adaptations for people with progressive multiple sclerosis (MS) and developed a preliminary conceptual model of changes in adjustment over time.

Design: Using theoretical sampling, 34 semi-structured interviews were conducted with people with MS. Participants were between 41 and 77 years of age. Thirteen were diagnosed with primary progressive MS and 21 with secondary progressive MS. Data were analysed using a grounded theory approach.

Results: Participants described initially bracketing the illness off and carrying on their usual activities but this became problematic as the condition progressed and they employed different adjustment modes to cope with increased disabilities. Some scaled back their activities to live a more comfortable life, others identified new activities or adapted old ones, whereas at times, people disengaged from the adjustment process altogether and resigned to their condition. Relationships with partners, emotional reactions, environment and perception of the environment influenced adjustment, while people were often flexible and shifted among modes.

Conclusions: Adjusting to a progressive condition is a fluid process. Future interventions can be tailored to address modifiable factors at different stages of the condition and may involve addressing emotional reactions concealing/revealing the condition and perceptions of the environment.     

Anvil or Onion? Determinism as a Layered Concept

Kellert (In the Wake of Chars, University of Chicago press, Chicago, 1993) has argued that Laplacean determinism in classical physics is actually a layered concept, where various properties or layers composing this form of determinism can be peeled away. Here, I argue that a layered conception of determinism is inappropriate and that we should think in terms of different deterministic models applicable to different kinds of systems. The upshot of this analysis is that the notion of state is more closely tied to the kind of system being investigated than is usually considered in discussions of determinism. So when investigating determinism corresponding changes to the appropriate notion of state – and, perhaps, the state space itself – also need to be considered.     

Pharmacological treatment effects on eye movement control

The increasing use of eye movement paradigms to assess the functional integrity of brain systems involved in sensorimotor and cognitive processing in clinical disorders requires greater attention to effects of pharmacological treatments on these systems. This is needed to better differentiate disease and medication effects in clinical samples, to learn about neurochemical systems relevant for identified disturbances, and to facilitate identification of oculomotor biomarkers of pharmacological effects. In this review, studies of pharmacologic treatment effects on eye movements in healthy individuals are summarized and the sensitivity of eye movements to a variety of pharmacological manipulations is established. Primary findings from these studies of healthy individuals involving mainly acute effects indicate that: (i) the most consistent finding across several classes of drugs, including benzodiazepines, first- and second- generation antipsychotics, anticholinergic agents, and anticonvulsant/mood stabilizing medications is a decrease in saccade and smooth pursuit velocity (or increase in saccades during pursuit); (ii) these oculomotor effects largely reflect the general sedating effects of these medications on central nervous system functioning and are often dose-dependent; (iii) in many cases changes in oculomotor functioning are more sensitive indicators of pharmacological effects than other measures; and (iv) other agents, including the antidepressant class of serotonergic reuptake inhibitors, direct serotonergic agonists, and stimulants including amphetamine and nicotine, do not appear to adversely impact oculomotor functions in healthy individuals and may well enhance aspects of saccade and pursuit performance. Pharmacological treatment effects on eye movements across several clinical disorders including schizophrenia, affective disorders, attention deficit hyperactivity disorder, Parkinson’s disease, and Huntington’s disease are also reviewed. While greater recognition and investigation into pharmacological treatment effects in these disorders is needed, both beneficial and adverse drug effects are identified. This raises the important caveat for oculomotor studies of neuropsychiatric disorders that performance differences from healthy individuals cannot be attributed to illness effects alone. In final sections of this review, studies are presented that illustrate the utility of eye movements for use as potential biomarkers in pharmacodynamic and pharmacogenetic studies. While more systematic studies are needed, we conclude that eye movement measurements hold significant promise as tools to investigate treatment effects on cognitive and sensorimotor processes in clinical populations and that their use may be helpful in speeding the drug development pathway for drugs targeting specific neural systems and in individualizing pharmacological treatments.     

Preschoolers' aggression and parent-child conflict: a multiinformant and multimethod study

This multiinformant and multimethod study (N=47) investigated the link between the parent-child relationship system and the display of physical and relational aggression with peers at school during early childhood. Children (mean age=43.54 months, SD=8.02) were observed (80min/child) during free play, and parents and teachers were asked to complete several standard measures. Intercorrelations between aggression subtypes revealed moderate to high levels of correlation for parents and teachers and no significant association for observations of physical and relational aggression. Interinformant agreement was examined, and teachers and parents were found to significantly agree for both physical and relational aggression, and teachers and observers also significantly agreed for both subtypes of aggression. Results of regression analyses suggest that parent-child conflict was uniquely associated with relational aggression among peers when controlling for physical aggression and gender. Ways in which these findings build on the extant literature are discussed.     

Age and Gender Differences in Adaptation and Subjective Well-being of Older Adults Residing in Monastic Religious Communities

The purpose of this study was to explore age and gender differences in the adaptation and well-being of older adults residing in Catholic monasteries. Participants included 235 members, age 64 and older, from the Order of St. Benedict. 2 (Age) × 2 (Gender) analyses of variance were computed to determine significant differences. Young-old persons reported greater friendship, coping behaviors, and personal growth, however, old-old individuals reported greater engagement in religious coping and greater depression. In addition, women reported greater coping behaviors, life satisfaction, and personal growth, but men reported greater depression. The results have implications on how pastoral care providers and counselors can improve quality of life among older adults living in contemplative religious settings.     

What Causes Specific Language Impairment in Children?

ABSTRACT— Specific language impairment (SLI) is diagnosed when a child's language development is deficient for no obvious reason. For many years, there was a tendency to assume that SLI was caused by factors such as poor parenting, subtle brain damage around the time of birth, or transient hearing loss. Subsequently it became clear that these factors were far less important than genes in determining risk for SLI. A quest to find "the gene for SLI" was undertaken, but it soon became apparent that no single cause could account for all cases. Furthermore, although fascinating cases of SLI caused by a single mutation have been discovered, in most children the disorder has a more complex basis, with several genetic and environmental risk factors interacting. The clearest evidence for genetic effects has come from studies that diagnosed SLI using theoretically motivated measures of underlying cognitive deficits rather than conventional clinical criteria.     

Appraisal Underpinnings of Affective Chronometry: The Role of Appraisals in Emotion Habituation

ABSTRACT In light of the lack of studies examining the cognitive components of affective chronometry, this research examined the appraisals associated with emotion habituation, using anger as the emotion of focus. Anger and its appraisals were assessed repeatedly over a day in the participants' naturalistic contexts. The trajectory of decline in anger over time after its first appearance was found to be a function of chronic coping styles. More importantly, the trajectories of anger-related appraisals generally corresponded to that of anger and were also moderated by coping styles in ways consistent with the moderating effects of coping styles on anger. Implications of these results for affective chronometry research and for appraisal research are discussed.