Research on familial Creutzfeldt-Jakob disease (FCJD) resulting in presymptomatic testing: Implications for the human genome project

A research study to identify the priori gene mutation in a family with familial Creutzfeldt-Jakob disease (FCJD) evolved into presymptomatic diagnostic testing. Our experience with one case raises concerns regarding similar studies that will ensue as a result of the Human Genome Project. Technological advances in human molecular genetics make it difficult for Institutional Review Boards (IRB) to adequately evaluate proposed studies. Additionally, changes in the implications of the study may occur after initial IRB approval, due to technological progress. While FCJD, like Huntington's disease (HD), has adult onset and causes progressive dementia and ataxia, protocols established for presymptomatic testing of HD were not included in the FCJD study design. It is thus recommended that IRB committees include a genetics professional and that IRB-approved research studies be reevaluated on a regular basis to monitor the impact that technological advances may have on participating human subjects.     

The refractory headache patient--II. High medication consumption (analgesic rebound) headache

'Analgesic rebound headache' is identified by habituation of an individual to pain reducing medication, the exacerbation of headache pain a few hours after medication consumption and a marked increase in headache frequency and intensity for several weeks after medication is discontinued. We describe three studies undertaken to clarify the existence and characteristics of this proposed headache syndrome. In Study 1 we compared a group of headache sufferers who consume large amounts of analgesic medications to headache sufferers who did not consume excessive analgesics. It was found that the two groups did not differ on age, duration of headache problem or gender. However, the groups did differ on subjective headache pain (with the high medicators experiencing more headache pain than low medicators) and diagnosis (with high medicators being more likely to have a muscle contraction component to their headaches). In an analysis of drug use within the high medication group, it was found that 91% were taking some kind of analgesic and that a majority (84%) were taking more than one type of medication. In Study 2 we found that the group of high medicators were not as successful in reducing headache activity as a result of a self-regulatory behavioral treatment as the matched controls. Furthermore, there was a direct relationship between reduction and treatment success in the high medication consuming population. Lastly, in Study 3 we examined the current psychological functioning of the two groups; no differences were found between the two groups indicating the lack of 'addictive' personality characteristics as an explanation for the high medicating population. These findings all support the existence of a sub-population of headache sufferers who consume excessive amounts of analgesic medication and who are relatively refractory to behavioral treatment.     

Cognitive reactivity, dysfunctional attitudes, and depressive relapse and recurrence in cognitive therapy responders

Dysfunctional attitudes can foreshadow depressive relapse/recurrence. Priming mood, through induction paradigms, is hypothesized to activate dysfunctional attitudes. Cognitive reactivity (CR) refers to mood-linked increases in dysfunctional attitudes after priming. Here we explored the extent to which CR as well as residual, unprimed, dysfunctional attitudes predicted depressive relapse/recurrence among depressed patients who responded to acute phase cognitive therapy (CT). Consenting adults, aged 18–70, with recurrent major depressive disorder (n = 523) participated in a two-site randomized controlled trial examining the durability of continuation phase treatments. Patients received 16–20 sessions of CT. Among the 245 incompletely remitted responders, 213 agreed to undergo a mood induction paradigm. After 8 months of continuation phase treatments, participants were followed an additional 24 months. Although the mood induction significantly lowered mood in 80% of responders, the expected CR was not evident. By contrast, higher unprimed dysfunctional attitudes following CT did predict relapse/recurrence over 20 and 32 months post-randomization. The findings of this large longitudinal study of incompletely remitted CT responders challenge the notion that it is necessary to prime mood in order to maximize dysfunctional attitudes’ prediction of relapse and/or recurrence. While findings cannot be generalized beyond CT responders, they emphasize the clinical importance of reducing dysfunctional attitudes in preventing depression.     

Training experts: individuation without naming is worth it

There is growing evidence that individuation experience is necessary for development of expert object discrimination that transfers to new exemplars. Individuation training in human studies has primarily used label association tasks where labels are learned at both the individual and more abstract (basic) level, and expertise criterion requires that individual-level judgments become as fast as basic-level judgments. However, there are training situations when the use of labels is not practical (e.g., with animals or some clinical populations). Moreover, labeling itself can facilitate object discrimination, thus it is unclear what role labels play in the acquisition of expertise in such training paradigms. Here, participants completed an online game that did not require labels in which they interacted with novel objects (Greebles) or control objects (Yufos). Games either required individuation or categorization. We then assessed the impact of this exposure on an abridged Greeble training paradigm. As expected, participants who played Yufo games or Greeble categorization games showed a significant basic-level advantage for Greebles in the abridged training paradigm, typical of novices. However, participants who played the Greeble identity game showed a reduced basic-level advantage, suggesting that individuation without labels may be sufficient to acquire perceptual expertise.     

Inhibitory control over the present and the past

From the perspective of the Hasher, Zacks, and May (1999) inhibitory framework, optimal performance occurs only when there is control over nonrelevant information. Relative to a current, goal-directed task, there are at least two potential sources of nonrelevant information that need to be controlled. The first is no longer relevant information. Such information would include, for example, a previous topic of conversation, or, in our work, a previous list of materials presented for study and recall. The second source of nonrelevant information is currently present (in thought or in the world) stimuli that are not relevant to the task at hand. Inhibitory processes are critical to the effective control of both sources of information?the no longer relevant past and the irrelevant present. If inhibitory processes are inefficient, irrelevant information from both the past and the present will disrupt performance on the current task. We illustrate this with studies showing the role of irrelevant information in reducing the working memory capacity of older adults and in slowing them down as they do even reasonably simple tasks.     

Local Dialogue Heard Around the World

The authors of this article examine deliberative democracy and the value of dialogue in promoting the engagement of communities in deliberation and involvement in public issues. Focusing on the Texas Forum (TF), a member of the National Issues Forum (NIF), the authors discuss how diverse individuals are brought together with the purpose of cultivating public dialogue and discourse about significant policy issues, with a focus on the public's participation in the democratic process. The article addresses changes in civic engagement, dialogue, and the use of technology to mediate civic discourse and create virtual civic communities. The TF and NIF provide practical examples of the work needed in promoting deliberative democracy and civic engagement.     

Examining attentional biases underlying trait anxiety in younger and older adults

Previous research has not adequately assessed the independent contributions of component attentional processes to anxiety-linked biases. MacLeod and Sadler developed a novel, lexical decision task using negative and neutral word stimuli, to enable the independent measurement of attentional engagement and disengagement. Their results suggest that anxiety-linked attentional biases are associated with facilitated attentional engagement with negative information. The present study aimed to determine the replicability of these findings, with two important extensions. First, this study included positive word stimuli in the lexical decision task, to determine whether anxiety-linked attentional biases exist only towards negative information, or toward emotionally arousing information in general. Second, this study explored age-related differences in anxiety-linked attentional biases. Younger (N=32) and older adults (N=32) with both high and low trait anxiety completed the lexical decision task. The results suggest that heightened anxiety may be associated with a deficit in engaging with positive words. No age-related differences in anxiety-linked attentional biases were apparent.     

Social exchange from the supervisor’s perspective: Employee trustworthiness as a predictor of interpersonal and informational justice

Using social exchange theory, we argue that because supervisors tend to value employee trustworthiness, they will be more likely to adhere to interpersonal and informational justice rules with trustworthy employees. Given social exchange theory’s assumption that benefits are voluntary in nature, we propose that the benevolence and integrity facets of trustworthiness will be more likely to engender social exchange relationships than the ability facet. Specifically, we propose that employees seen as having high benevolence and integrity engender feelings of obligation and trust from their direct supervisors, increasing the likelihood that these supervisors will adhere to interpersonal and informational justice rules, which in turn influences employee perceptions of justice. We find partial support for our mediated model using a field sample.     

Knowledge of Memory Aging Across the Lifespan

ABSTRACT. The authors examined knowledge of normal and pathological memory aging in a lifespan sample of 198 individuals who ranged in age from 13 to 88 years. Participants completed the Knowledge of Memory Aging Questionnaire (Cherry, Brigman, Hawley, & Reese, 2003). The authors hypothesized that high school students would be less knowledgeable about memory aging issues than college students, middle-aged, and community-dwelling older adults. Consistent with this hypothesis, response accuracy was lower for high school students compared to their older counterparts. Follow-up analyses revealed that high school students’ responses to a subset of questions that tap ageist views of adult cognition were less accurate than the other age groups, implying a response bias toward stereotypical images of memory aging. Implications for research and the design of instructional materials to increase people's knowledge about normative changes in adult cognition are discussed.