A Critical Review of the Clinical Effects of Therapeutic Irradiation Damage to the Brain: The Roots of Controversy

We critically examined the damaging affects of therapeutic irradiation by comparing results from cross-disciplinary studies of early- and late-delayed radiotherapy effects. Focus is attained by concentrating on clinical treatment issues (volume of brain, dose, timing of effects, age, modality types, and stereotactic treatment techniques), rather than on methodological means or problems, which is necessary to understand the mechanisms and characteristics of radiotherapy-induced behavioral dysfunction including cognition. We make observations and hypotheses about the actual risks from radiotherapy that could be informative in the treatment decision process, and which may lessen the concerns of some patients and their families about the risks they take when receiving radiation. Conditions that predispose to radiation injury are reviewed: (1) higher doses even to part of the brain versus lower doses to the whole brain, (2) combined treatment modalities, (3) malignancy itself, (4) radiation early during postnatal brain development, and (5) late-delayed effects (more than 3 years posttreatment). Current neurocognitive frameworks for understanding cognitive change over time in children and adults are summarized, along with the literature on effects of brain tumors and treatment on depression. No studies have as yet identified candidate brain regions that are more sensitive to radiotherapy. Two studies have provided early, preliminary evidence for a specific vulnerability of visual attention/memory to the early stage of late radiation damage. Furthermore, radiation effects appear severe only in a minority of patients. Risk is related to direct and indirect effects of cancer type, concurrent clinical factors, and premorbid risk factors.     

Toward Mapping Daily Challenges of Living with ADHD: Maternal and Child Perspectives Using Electronic Diaries

Attention-deficit/hyperactivity disorder (ADHD) has an impact on the family as well as the affected child. This study developed and tested an electronic diary for mapping the challenges of everyday family life in a sample of children with ADHD being treated with pharmacotherapy. Across 7 days, mothers and children (27 ADHD; 25 non-ADHD) independently reported their moods, behaviors, and social contexts every 30 min during nonschool hours. Symptomatic behaviors and negative moods were elevated in the ADHD group, combined with maternal perceptions of lower parenting effectiveness and quality of life. Differences in the contexts of maternal anger were salient, with mothers in the ADHD group more often angry when with their children and comparison mothers more often angry when not. Although mothers' diaries were more informative, children's diaries also distinguished the two groups, especially during mornings and weekends. The need for family-wide interventions, the utility of child self-reports, and the promise of electronic diaries are discussed.     

The impact of Parkinson's disease on vocal-prosodic communication from the perspective of listeners

An expressive disturbance of speech prosody has long been associated with idiopathic Parkinson's disease (PD), but little is known about the impact of dysprosody on vocal-prosodic communication from the perspective of listeners. Recordings of healthy adults (n=12) and adults with mild to moderate PD (n=21) were elicited in four speech contexts in which prosody serves a primary function in linguistic or emotive communication (phonemic stress, contrastive stress, sentence mode, and emotional prosody). Twenty independent listeners naive to the disease status of individual speakers then judged the intended meanings conveyed by prosody for tokens recorded in each condition. Findings indicated that PD speakers were less successful at communicating stress distinctions, especially words produced with contrastive stress, which were identifiable to listeners. Listeners were also significantly less able to detect intended emotional qualities of Parkinsonian speech, especially for anger and disgust. Emotional expressions that were correctly recognized by listeners were consistently rated as less intense for the PD group. Utterances produced by PD speakers were frequently characterized as sounding sad or devoid of emotion entirely (neutral). Results argue that motor limitations on the vocal apparatus in PD produce serious and early negative repercussions on communication through prosody, which diminish the social-linguistic competence of Parkinsonian adults as judged by listeners.     

Target location probability effects in visual search: an effect of sequential dependencies

Target location probability was manipulated in a visual search task. When the target was twice as likely to appear on 1 side of the display as the other, manual button-press response times were faster (Experiment 1A) and first saccades were more frequently directed (Experiment 1B) to the more probable locations. When the target appeared with equal probability at each location in this search task, performance benefited from repetition of target location in the preceding trials (Experiment 2). When the trial sequence was constrained so that target location did not repeat within a series of 4 trials, there was no longer an advantage for more probable locations (Experiment 3). The authors conclude that the search benefits for more probable locations resulted from short-term target location repetitions.     

The factor structure and screening utility of the Social Interaction Anxiety Scale

The widely used Social Interaction Anxiety Scale (SIAS; R. P. Mattick & J. C. Clarke, 1998) possesses favorable psychometric properties, but questions remain concerning its factor structure and item properties. Analyses included 445 people with social anxiety disorder and 1,689 undergraduates. Simple unifactorial models fit poorly, and models that accounted for differences due to item wording (i.e., reverse scoring) provided superior fit. It was further found that clients and undergraduates approached some items differently, and the SIAS may be somewhat overly conservative in selecting analogue participants from an undergraduate sample. Overall, this study provides support for the excellent properties of the SIAS's straightforwardly worded items, although questions remain regarding its reverse-scored items.     

The Complexity and Challenges of Genetic Counseling and Testing for Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is an umbrella term referring to two chronic idiopathic intestinal diseases: ulcerative colitis (UC) and Crohn’s disease (CD). Both UC and CD are characterized by immune activation that leads to symptoms, but the location, severity and behavior of the inflammation varies among individuals and in characteristic ways between UC and CD. A majority of patients with IBD are diagnosed in young adulthood, but the response to therapy is variable and difficult to predict, with some patients demonstrating a prompt and effective remission while others have continuous symptoms that do not respond to existing medical options. Surgery remains a frequent and necessary occurrence among patients with IBD, but in UC it is considered curative, while in CD only temporizing. Clinical observations, epidemiological studies, and molecular genetics have provided strong evidence that both genetic and environmental factors are important determinants for disease susceptibility. In recent years, a number of genes have been identified that associate with CD and UC, although the clinical utility of these discoveries in patients or in susceptible family members has not been determined. Nonetheless, it is hoped that these fundamental advances in our understanding of IBD will lead to better therapies for patients and prevention strategies for those who are susceptible. Effective incorporation of clinical genetic testing for IBD into practice will require appropriate education and counseling.     

The motor theory of speech perception reviewed

More than 50 years after the appearance of the motor theory of speech perception, it is timely to evaluate its three main claims that (1) speech processing is special, (2) perceiving speech is perceiving gestures, and (3) the motor system is recruited for perceiving speech. We argue that to the extent that it can be evaluated, the first claim is likely false. As for the second claim, we review findings that support it and argue that although each of these findings may be explained by alternative accounts, the claim provides a single coherent account. As for the third claim, we review findings in the literature that support it at different levels of generality and argue that the claim anticipated a theme that has become widespread in cognitive science.     

I had a hammer: reflections on ministry in an acute schizophrenia ward

This essay details the challenges of ministry in a psychiatric hospital. Using a narrative approach through the use of three case studies, the article suggests that commonly used pastoral techniques are ineffectual with people who have severe schizophrenia. The author explores the theological implications of ministry with few tools, as well as reflecting on the presence of God with those who suffer.     

Getting by with a little help from self and others: self-esteem and social support as resources during early adolescence

Influences of social support and self-esteem on adjustment in early adolescence were investigated in a 2-year longitudinal study (N = 350). Multi-informant data (youth and parent) were used to assess both overall levels and balance in peer- versus adult-oriented sources for social support and self-esteem. Findings obtained using latent growth-curve modeling were consistent with self-esteem mediating effects of social support on both emotional and behavioral adjustment. Lack of balance in social support and self-esteem in the direction of stronger support and esteem from peer-oriented sources predicted greater levels and rates of growth in behavioral problems. Results indicate a need for process-oriented models of social support and self-esteem and sensitivity to patterning of sources for each resource relative to adaptive demands of early adolescence.     

Comparison of group climate in an eating disorders partial hospital group and a psychiatric partial hospital group

Women in an eating disorders partial hospital program and a psychiatric partial hospital program were compared on a self-report measure of group climate following a psychodynamic-interpersonal therapy group. Those with eating disorders experienced their groups as more engaged and as more avoiding than those in the psychiatric partial hospital group. Therapists may be able to use initial heightened engagement in eating disorder groups to counteract the tendency to avoid content.