Use of Legal Drugs by Psychiatric Outpatients: Benefits, Costs, and Change

Caffeine, nicotine, and alcohol use by persons with a severe mental illness occurs frequently but is poorly understood. We used qualitative methods to elicit information regarding the functional relationships between legal substance use and its antecedents and consequences. This report summarizes responses provided by 37 psychiatric outpatients who participated in focus groups and key informant interviews regarding the use and functions of alcohol, caffeine, and nicotine. We describe major themes regarding positive and negative consequences, triggers for use, change efforts, and offer observations regarding substance use in this under-served population.     

Toddlers’ referential understanding of pictures

Pictures are referential in that they can represent objects in the real world. Here we explore the emergence of understanding of the referential potential of pictures during the second year of life. In Study 1, 15-, 18-, and 24-month-olds learned a word for a picture of a novel object (e.g., “blicket”) in the context of a picture book interaction. Later they were presented with the picture of a blicket along with the real object it depicted and asked to indicate the blicket. Many of the 24-, 18-, and even 15-month-olds indicated the real object as an instance of a blicket, consistent with an understanding of the referential relation between pictures and objects. In Study 2, children were tested with an exemplar object that differed in color from the depicted object to determine whether they would extend the label they had learned for the depicted object to a slightly different category member. The 15-, 18-, and 24-month-old participants failed to make a consistent referential response. The results are discussed in terms of whether pictorial understanding at this age is associative or symbolic.     

Patients taking the lead. A naturalistic investigation of a patient led approach to treatment in primary care

In an earlier paper (Carey, T. A. (2005). Can patients specify treatment parameters? A preliminary investigation. Clinical Psychology and Psychotherapy, 12, 326–335) an approach to treatment delivery was examined in which the duration and frequency of the appointments was scheduled by patients. Results of this approach were encouraging but the generalizability of the results was constrained because only one clinician trialed the approach and no standardized assessment measures were used. In the present study there are two clinicians involved and the Depression Anxiety Stress Scale (DASS) was used. The approach was introduced at one GP practice and monitored over a six-month period. Results suggest that this approach might be an effective way of promoting patient access to, and involvement in, service delivery as well as reducing waiting times.     

Review

Book reviewed:
Matthew B. Ostrow. Wittgenstein's Tractatus: A Dialectical Interpretation.     

Math weaknesses in survivors of acute lymphoblastic leukemia compared to healthy children.

Difficulties in math are the most frequently reported area of academic deficit in survivors of acute lymphoblastic leukemia (ALL) and the most frequent academic complaint among parents of ALL survivors. However, previous studies that included measures of math skills have been limited by the use of only a single measure of math skills, most often a measure of written calculations, without any assessment of math reasoning or math application skills. Further, the nature of these math difficulties has not been adequately investigated. The purpose of this study was to examine the performance of ALL survivors using multiple measures of math skills. Performance was compared to a group of healthy controls matched for age and sex as well as to normative levels. Other measures of neuropsychological function were also administered, and the relationships between these measures and the math measures were explored. Converging evidence for math difficulties in ALL survivors compared to healthy controls and normative levels was found. While ALL survivors generally performed within the average range on measures of math skills, math performance was mostly related to memory function and dominant-hand psychomotor speed. By contrast, math performance of healthy children was mostly related to basic reading skills and visual-motor integration. These findings shed light on the nature of math difficulties in ALL survivors and have implications for intervention.     

Perspective taking in children and adults: Equivalent egocentrism but differential correction

Children generally behave more egocentrically than adults when assessing another's perspective. We argue that this difference does not, however, indicate that adults process information less egocentrically than children, but rather that adults are better able to subsequently correct an initial egocentric interpretation. An experiment tracking participants' eye movements during a referential communication task indicated that children and adults were equally quick to interpret a spoken instruction egocentrically but differed in the speed with which they corrected that interpretation and looked at the intended (i.e., non-egocentric) object. The existing differences in egocentrism between children and adults therefore seems less a product of where people start in their perspective taking process than where they stop, with lingering egocentric biases among adults produced by insufficient correction of an automatic moment of egocentrism. We suggest that this pattern of similarity in automatic, but not controlled, processes may explain between-group differences in a variety of dual-process judgments.     

Précis of 'The Origin of Concepts'

A theory of conceptual development must specify the innate representational primitives, must characterize the ways in which the initial state differs from the adult state, and must characterize the processes through which one is transformed into the other. The Origin of Concepts (henceforth TOOC) defends three theses. With respect to the initial state, the innate stock of primitives is not limited to sensory, perceptual, or sensorimotor representations; rather, there are also innate conceptual representations. With respect to developmental change, conceptual development consists of episodes of qualitative change, resulting in systems of representation that are more powerful than, and sometimes incommensurable with, those from which they are built. With respect to a learning mechanism that achieves conceptual discontinuity, I offer Quinian bootstrapping. TOOC concludes with a discussion of how an understanding of conceptual development constrains a theory of concepts.