The nature and treatment of stuttering as revealed by fMRI A within- and between-group comparison

This article reviews some of our recent functional magnetic resonance imaging (fMRI) studies of stuttering. Using event-related fMRI experiments, we investigated brain activation during speech production. Results of three studies comparing persons who stutter (PWS) and persons who do not stutter (PWNS) are outlined. Their findings point to a region in the right frontal operculum (RFO) that was consistently implicated in stuttering. During overt reading and before fluency shaping therapy, PWS showed higher and more distributed neuronal activation than PWNS. Immediately after therapy differential activations were even more distributed and left sided. They extended to frontal, temporal, and parietal regions, anterior cingulate, insula, and putamen. These over-activations were slightly reduced and again more right sided two years after therapy. Left frontal deactivations remained stable over two years of observation, and therefore possibly indicate a dysfunction. After therapy, we noted higher activations in persons who stutter moderately than in those who stutter severely. These activations might reflect patterns of compensation. We discuss why these findings suggest that fluency-inducing techniques might synchronize a disturbed signal transmission between auditory, speech motor planning, and motor areas.

Educational objectives: The reader will learn about and be able to: (1) identify regions of brain activations and deactivations specific for PWS; (2) describe brain activation changes induced by fluency shaping therapy; and (3) discuss the correlation between stuttering severity and brain activation.     

Event-related brain potential markers of high-language proficiency in adults

The central issue addressed is whether there are electrophysiological markers for high-language proficiency in adults. Event-related brain potentials (ERPs) were recorded in 19 young adults who demonstrated either "normal" or "high" language proficiency. ERPs were obtained during a sentence-processing task and analyzed for specific response components elicited by different word types. The ERPs in the normal and high-language proficiency groups were similar for early sensory related processing but differed in the later components thought to be more closely related to lexical access and post-lexical processing. The findings for the ERP waveforms suggest that adults with high-language proficiency show slightly faster lexical access over left anterior brain regions for closed class items, and a reduced reliance on contextual information contained in sentences.     

Impaired processing of prosodic and musical patterns after right hemisphere damage

The distinction between the processing of musical information and segmental speech information (i.e., consonants and vowels) has been much explored. In contrast, the relationship between the processing of music and prosodic speech information (e.g., intonation) has been largely ignored. We report an assessment of prosodic perception for an amateur musician, KB, who became amusic following a right-hemisphere stroke. Relative to matched controls, KB's segmental speech perception was preserved. However, KB was unable to discriminate pitch or rhythm patterns in linguistic or musical stimuli. He was also impaired on prosodic perception tasks (e.g., discriminating statements from questions). Results are discussed in terms of common neural mechanisms that may underlie the processing of some aspects of both music and speech prosody.     

Age,acculturation, cultural adjustment,and mental health symptoms of Chinese,Korean, and Japanese immigrant youths

This study of Chinese, Japanese, and Korean immigrant junior high and high school students (N = 319) investigated the association between age, acculturation, cultural adjustment difficulties, and general mental health concerns. Hierarchical regression analyses determined that among all of the independent variables, age, acculturation, and cultural adjustment difficulties had significant predictive effects on mental health symptoms. Implications for theory, research, and practice are addressed, particularly as they relate to developmental issues among immigrant youths.     

Ethnicity and Social Support During Pregnancy

Data from two multi-ethnic prospective studies of African American, Latina, and non-Hispanic White pregnant women were used to examine the influence of contextual factors on social support processes during pregnancy. Multiple types of support (perceived support, received support, support satisfaction, network support) and sources of support (baby's father, family, friends) were assessed. The role of ethnicity in social support was examined after controlling for the contribution of related contextual factors (SES, marital status, age, parity, employment) to these processes. The impact of ethnicity and related contextual factors differed across sources of social support. Ethnic differences in support from family and friends, but not from the baby's father, emerged. However, marital status was a consistent predictor of support from the baby's father, and SES was a consistent predictor of support from friends. Overall, the findings of two studies suggest that although ethnicity is associated with support from friends and family, other contextual factors, such as marital status and SES, influence support processes during pregnancy.     

Sequence-Specific Impairment of Memory Formation by NCAM Antisense Oligonucleotides

The functional role of NCAM gene expression in memory formation was studied in the one-trial passive avoidance task in day-old chicks by pretraining injections of one of three different 18-mer end-protected oligonucleotides corresponding to positions 190-, 207-, and 332- of the NCAM Ig1 domain. Twenty-four-hour-old chicks were trained by pecking at a bitter-tasting bead and tested for avoidance 30 min, 3, 8, or 24 hr later. Memory retention was significantly reduced only in the group of animals injected with the NCAM antisense corresponding to position 207- (AS-ODN-207), and only if given twice, both immediately after hatching and 12 hr before training. This antisense was without effect on the general behavior of the chicks, training or acquisition, and did not produce observable neurotoxic damage. Under such conditions amnesia was evident by 3 hr after training and lasted until at least 24 hr after training. The two other tested oligonucleotides were without behavioral effect. To control for nonsequence-specific effects of AS-ODN-207, brains from injected and trained animals were processed for Western blotting and probed using anti-NCAM, anti-L1, and anti-actin antibodies. NCAM antisense corresponding to position 207- significantly reduced the level of NCAM, whereas the level of L1 and actin remained unchanged. These results confirm our earlier conclusion that NCAM is necessary for longer term memory retention.     

Self-Efficacy as a Mediator of Caregiver Coping: Development and Testing of an Assessment Model

Development and utilization of two self-efficacy measures thought to be relevant to stressed family caregivers, Caregiver Self-Care Self-Efficacy and Caregiver Problem-Solving Self-Efficacy, are described. Data obtained in the context of a psychoeducational intervention program are available for 217 caregivers of frail and/or cognitively impaired elders. Analyses of psychometric properties of the efficacy measures demonstrate good internal consistency and test-retest reliability for both measures. In addition, both measures of self-efficacy are related to depression as measured by the Beck Depression Inventory and caregiver distress as measured by the Zarit Burden Scale. Problem-Solving Self-efficacy also is related to subjective caregiver burden as measured by Zarit's Memory and Behavior Problem Checklist. Results are promising in terms of the utility of the measure and the application of self-efficacy theory to the caregiving situation. Limitations of these measures are discussed and suggestions made for improved second-generation self-efficacy scales.     

COMPETITION BETWEEN POSITIVE AND NEGATIVE REINFORCEMENT IN THE TREATMENT OF ESCAPE BEHAVIOR

We compared the effects of reinforcing compliance with either positive reinforcement (edible items) or negative reinforcement (a break) on 5 participants' escape-maintained problem behavior. Both procedures were assessed with or without extinction. Results showed that compliance was higher and problem behavior was lower for all participants when compliance produced an edible item rather than a break. Treatment gains were achieved without the use of extinction. Results are discussed regarding the use of positive reinforcement to treat escape behavior.     

Evaluation of a Health Careers Program for Asian American and Pacific Islander High School Students

The authors evaluated a health careers program in a U.S. urban public high school. After small subgroups of the original sample were removed, participants included 162 Asian American and Pacific Islander students. Analyses of covariance indicated that, compared with the comparison group, the treatment group reported significantly higher levels of social support, school engagement, interest in learning, vocational expectations, and ethnic identity. Implications for multicultural counseling in schools are discussed. Los autores evaluaron un programa de carreras sanitarias en una escuela secundaria pública de Estados Unidos. Tras la eliminación de pequeños subgrupos de la muestra original, los participantes incluyeron 162 estudiantes Asiático‐Americanos e Isleños del Pacífico. Los análisis de covarianza indicaron que, comparado con el grupo de comparación, el grupo de tratamiento expresó unos niveles significativamente mayores de apoyo social, participación escolar, interés en el aprendizaje, expectativas vocacionales e identidad étnica. Se discuten las implicaciones para la consejería multicultural en escuelas.     

Perfectionism, Coping, Social Support, and Depression in Maltreated Adolescents

The current study examined the associations among dimensions of perfectionism, coping, social support, and depression in 58 adolescents with a history of maltreatment. Participants completed the Child-Adolescent Perfectionism, multidimensional measures of coping and social support, and the CES-D Depression Scale. Correlational analyses showed that depression was associated with socially prescribed perfectionism, internalized emotion-oriented coping, avoidant-oriented distancing, and low family support and peer support. Analyses of coping responses and perfectionism established links between self-oriented perfectionism and internalized emotion-oriented coping responses and self-reliant problem-solving. Socially prescribed perfectionism was associated with avoidance-oriented coping (i.e., distancing). While self-oriented perfectionism and social support were unrelated, socially prescribed perfectionism was associated with reduced levels of family support. Collectively, the findings highlight the roles of poor coping and social support as contributors to the emotional distress experienced by maltreated adolescents. Moreover, it is suggested that the distress experienced by perfectionistic youth with a history of maltreatment reflects, in part, the role of maladaptive coping styles and coping resource deficits. Our findings support further consideration of personality dimensions such as perfectionism as contributors to poor functioning among maltreated youth.