Neuropsychological testing: evolution and emerging trends

Neuropsychological (NP) test batteries have evolved as an amalgam of intelligence tests, various individual measures of "biological" cognition, and sensory and motor testing. The early emphasis of NP testing was to identify "organicity" and central nervous system lesion localization. More recent approaches have emphasized the profiling of performance across individual neurocognitive domains (eg, attention, memory, and language) to facilitate diagnosis and treatment planning. However, the field is still hampered by the use of many tests that are antiquated, excessively long, or of dubious psychometric quality. Some of these problems may have contributed to the current under-utilization of NP testing in diagnostic workups of neuropsychiatric disorders. This paper reviews some of the recent changes in the field that hold promise for substantially shortening assessments, improving diagnostic reliability, and making NP testing more cost-effective and practical.     

Win-shift and win-stay learning in the short-beaked echidna (<Emphasis Type="Italic">Tachyglossus aculeatus</Emphasis>)

Numerous previous investigators have explained species differences in spatial memory performance in terms of differences in foraging ecology. In three experiments we attempted to extend these findings by examining the extent to which the spatial memory performance of echidnas (or "spiny anteaters") can be understood in terms of the spatio-temporal distribution of their prey (ants and termites). This is a species and a foraging situation that have not been examined in this way before. Echidnas were better able to learn to avoid a previously rewarding location (to "win-shift") than to learn to return to a previously rewarding location (to "win-stay"), at short retention intervals, but were unable to learn either of these strategies at retention intervals of 90 min. The short retention interval results support the ecological hypothesis, but the long retention interval results do not. Electronic Publication     

Anxiety-related bias in the classification of emotionally ambiguous facial expressions

High- and low-trait socially anxious individuals classified the emotional expressions of photographic quality continua of interpolated ("morphed") facial images that were derived from combining 6 basic prototype emotional expressions to various degrees, with the 2 adjacent emotions arranged in an emotion hexagon. When fear was 1 of the 2 component emotions, the high-trait group displayed enhanced sensitivity for fear. In a 2nd experiment where a mood manipulation was incorporated, again, the high-trait group exhibited enhanced sensitivity for fear. The low-trait group was sensitive for happiness in the control condition. The mood-manipulated group had increased sensitivity for anger expressions, and trait anxiety did not moderate these effects. Interpretations of the results related to the classification of fearful expressions are discussed.     

“The Frog Ate the Bug and Made his Mouth Sad”: Narrative Competence in Children with Autism

This study compares the narrative abilities of 13 children with autism, 13 children with developmental delays, and 13 typically developing children matched on language ability. Although groups did not differ in their use of causal language or internal state terms, children with autism and children with developmental delays were less likely than typical children to identify the causes of characters' internal states. Rather, they tended simply to label emotions and explain actions. Children with autism and children with developmental delays also relied on a more restricted range of evaluative devices, which both convey point of view and maintain listener involvement. In addition, the narrative abilities of children with autism were linked to performance on measures of theory of mind and an index of conversational competence, whereas this was not the case among children with developmental delays. Findings are discussed in relation to the social, cognitive, and emotional underpinnings and consequences of narrative activity.     

The Factor Structure of the Beavers Interactional Scales

Confirmatory factor analysis and regression analyses of the Beavers Interactional Scales did not appear to support the model offered by its developers, namely, several specified family attributes contributing respectively to two global factors of Family Competence and Family Style. Moreover, regression analysis indicated that only three of 12 items predicted raters' assessments of Global Family Health, and one of seven items predicted Global Family Style. Individuals interested in the family dynamic centripetal/centrifugal might best think of that as a unitary entity and rate it accordingly.     

Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase

The concept of acceptance is receiving increased attention as an alternate approach to the suffering that is often associated with persistent and disabling pain. This approach differs from established treatments in that it does not principally focus on reducing pain, but on reducing the distressing and disabling influences of pain as they concern important areas in patients' lives. The present analyses represent a preliminary evaluation of an acceptance-based approach to chronic pain within an interdisciplinary treatment program. One hundred and eight patients with complex chronic pain conditions completed treatment and provided data for the current study. Treatment was conducted in a 3- or 4-week residential or hospital-based format. It included a number of exposure-based, experiential, and other behavior change methods focused on increasing (a) engagement in daily activity regardless of pain and (b) willingness to have pain present without responding to it. Significant improvements in emotional, social, and physical functioning, and healthcare use were demonstrated following treatment. The majority of improvements continued at 3-months post-treatment. Improvements in most outcomes during treatment were correlated with increases in acceptance, supporting the proposed process of treatment.     

Plantinga’s Reformed Epistemology: What’s the Question?

Alvin Plantingas Warranted Christian Belief is without questionone of the central texts of the Reformed epistemology movement. Critiques of Plantingas defence have been both multiple and varied. As varied as these responses are, however, it is my contention that many of them amount to the same thing. It is the purpose of this paper to offer an overview of the main lines of attack that have been directed as Plantingas project, and thereafter to show how many, if not most, of these objections can be understood as versions or aspects of the same criticism, what I call the Inadequacy Thesis.     

Distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility

A large percentage of individuals who enter residential substance abuse treatment drop out before completing treatment. Given that early treatment dropout places individuals at an increased risk for relapse, identifying the mechanisms underlying treatment dropout would have several important theoretical and clinical implications. In the current study, the authors examined levels of psychological and physical distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility. In a sample of 122 individuals entering a residential substance abuse treatment facility, level of psychological distress tolerance was predictive of early treatment dropout above and beyond relevant self-report variables. There was no relationship between physical distress tolerance and early treatment dropout. Implications for future studies and treatment development or modification are discussed.     

The impact of enhanced incentives on vocational rehabilitation outcomes for dually diagnosed veterans

This study evaluated the efficacy of adding contingency management techniques to vocational rehabilitation (VR) to improve treatment outcome as measured by entry into competitive employment. Nineteen dually diagnosed veterans who entered VR in the Veterans' Administration's compensated work therapy (CWT) program were randomly assigned to CWT (n = 8) or to CWT with enhanced incentives (n = 11). Over the first 16 weeks of rehabilitation, those in the incentives condition could earn up to dollar 1,006 in cash for meeting two sets of clinical goals: (a) remaining abstinent from drugs and alcohol and (b) taking steps to obtain and maintain a competitive job. Results indicate that relative to participants in the CWT-only group, those in the incentives condition engaged in more job-search activities, were more likely to remain abstinent from drugs and alcohol, were more likely to obtain competitive employment, and earned an average of 68% more in wages. These results suggest that rehabilitation outcomes may be enhanced by restructuring traditional work-for-pay contingencies to include direct financial rewards for meeting clinical goals.     

Moral conviction: another contributor to attitude strength or something more?

Attitudes held with strong moral conviction (moral mandates) were predicted to have different interpersonal consequences than strong but nonmoral attitudes. After controlling for indices of attitude strength, the authors explored the unique effect of moral conviction on the degree that people preferred greater social (Studies 1 and 2) and physical (Study 3) distance from attitudinally dissimilar others and the effects of moral conviction on group interaction and decision making in attitudinally homogeneous versus heterogeneous groups (Study 4). Results supported the moral mandate hypothesis: Stronger moral conviction led to (a) greater preferred social and physical distance from attitudinally dissimilar others, (b) intolerance of attitudinally dissimilar others in both intimate (e.g., friend) and distant relationships (e.g., owner of a store one frequents), (c) lower levels of good will and cooperativeness in attitudinally heterogeneous groups, and (d) a greater inability to generate procedural solutions to resolve disagreements.