Reflections on the process of psychotherapeutic change as applied to medical situations

This article takes the basic ideas on the process of changing implicit knowledge put forward in this special issue, and extends them beyond psychotherapy to include other therapeutic relationships that occur in medicine. One vignette, from an encounter between a medical student and a dying patient, illustrates how a “moment of meeting” changes the student as well as the patient. The second shows how therapeutic interventions for new mothers with their newborn infants involve “moments of meeting” that alter the mother's implicit knowledge of her baby and of herself as a mother. © 1998 Michigan Association for Infant Mental Health     

Effects of perceived disability on persuasiveness of computer-synthesized speech

Are perceptions of computer-synthesized speech altered by the belief that the person using this technology is disabled? In a 2 x 2 factorial design, participants completed an attitude pretest and were randomly assigned to watch an actor deliver a persuasive appeal under 1 of the following 4 conditions: disabled or nondisabled using normal speech and disabled or nondisabled using computer-synthesized speech. Participants then completed a posttest survey and a series of questionnaires assessing perceptions of voice, speaker, and message. Natural speech was perceived more favorably and was more persuasive than computer-synthesized speech. When the speaker was perceived to be speech-disabled, however, this difference diminished. This finding suggests that negatively viewed assistive technologies will be perceived more favorably when used by people with disabilities.     

Acute hunger of rat pups elicits increased kyphotic nursing and shorter intervals between nursing bouts: implications for changes in nursing with time postpartum

Earlier findings, based on limited behavioral observations, indicate that nursing behavior in rats declines dramatically in duration over time postpartum-despite increasing ingestion of milk by rat pups to meet their growth and metabolic needs-although hungry pups elicit more nursing than do well-nourished pups. The authors compared the nursing pattern in detail for 6 hr on Days 7 and 14 and induced hunger in pups acutely with mammary-duct-ligated dams unable to provide milk. Compared with Day 7, on Day 14, supine nursing and the interval between nursing bouts increased, whereas hovering over pups and kyphotic nursing decreased. When pups were increasingly hungry, these age-related changes were counteracted. Thus, the ingestive motivation of pups largely regulates the nursing pattem over time.     

Paying Attention to Time as One Gets Older

Age-related changes in attention and interval timing as a function of time of day were examined using a temporal bisection task with single and compound auditory and visual stimuli. Half of the participants in each age group were tested in the morning, and half were tested in the afternoon. Duration judgments were found to be shorter for visual signals than for auditory signals. This discrepancy was greater in the morning than in the afternoon and larger for the older than for the younger adults. Young adults showed equal sensitivity to signal duration for single and compound trials and higher sensitivity in the afternoon than in the morning for both signal modalities. In contrast, older adults showed impaired sensitivity on compound trials and the greatest sensitivity overall to single visual trials in the morning. These results suggest that age-related reductions in attentional resources may cause older adults to focus on signals that require controlled attention during specific phases of the circadian cycle.     

Mild memory deficits differentially affect 6-year changes in compensatory strategy use

The authors examined memory compensation techniques used by older adults from 2 memory status groups, not impaired control (NIC) and mild memory deficit (MMD), both at baseline and across a 6-year (3-wave) interval. The groups were derived from a parent sample of 55- to 85-year-old adults from the Victoria Longitudinal Study (NIC baseline, n = 276; memory > parent sample mean; MMD baseline, n = 79; memory > 1 standard deviation below parent sample mean). Multilevel modeling was used to test 3 research questions concerning differences in initial use of, and 6-year changes and variability in, memory compensation. Initial group differences were observed for both a memory compensation technique and a general compensation indicator. Significant differences in 6-year change patterns were observed for 2 memory compensation techniques (recruitment of human memory assistance, investment of extra effort in memory tasks). Interactions of group status and wave showed that older adults with MMD declined in their use of memory compensation strategies, whereas initially NIC older adults increased their use of compensatory techniques over the 6 years.     

Distortions in the memory of the pitch of speech

Corneille, Huart, Becquart, & Brédart (2004) found that people remember ambiguous race faces as closer to a race prototype than they actually are. In three studies, we examined whether this memory bias generalizes to voice memory. In Studies 1 and 2, participants listened to synthesized male and female speech samples (high, moderate, or low pitch) and were asked to identify a voice target when paired against distracters higher or lower in pitch. The results showed that pitch distortions occurred, with the pattern consistent with assimilation toward low and high ends of the pitch continuum. Study 3 replicated this result with a wider voice pitch range. The results parallel those of Corneille et al. (2004). The implications of this work are discussed.     

Inferior Parietal Perfusion, Lateralization, and Neuropsychological Dysfunction in Alzheimer's Disease

The severity of inferior parietal perfusion deficits in Alzheimer's disease (AD) is strongly associated with global intellectual decline. The relationship to specific losses of neuropsychological functioning, however, is less clear, as is the relative importance of the side (left vs. right) of hemispheric deficit. In this study, 53 patients with probable AD and 35 elderly controls received both a resting¹³³Xe rCBF measurement and neuropsychological examination. AD patients demonstrated the expected bilateral deficits in inferior parietal perfusion, as well as impairment on measures of mental status, intelligence, verbal and visual memory, attention, language, and construction abilities. The severity of this bilateral parietal deficit, in turn, was associated with virtually all of these AD-related neuropsychological impairments, most strongly with declining Performance IQ. Left-sided deficits correlated better with overall declines in IQ, as well as with declining attention and language fluency. Right-sided deficits, on the other hand, correlated best with declines in mental status and—paradoxically—verbal memory and contributed independently to declines in Full Scale and Performance IQ. In terms of the number and strength of their association to neuropsychological measures, left-sided deficits appear much more predictive of cognitive decline in AD. Right-sided deficits, however, may be most important for predicting aspects of performance skill that are only indirectly assessed in standard paper-and-pencil format. Overall, it appears that both sides make significant, but independent contributions to general functional decline in AD, but that left-sided deficits are more closely associated with cognitive decline as measured by most standard neuropsychological measures.     

Psychological interventions for arthritis pain management in adults: a meta-analysis.

CONTEXT: The psychosocial impact of arthritis can be profound. There is growing interest in psychosocial interventions for managing pain and disability in arthritis patients. OBJECTIVE: This meta-analysis reports on the efficacy of psychosocial interventions for arthritis pain and disability. DATA SOURCES: Articles evaluating psychosocial interventions for arthritis were identified through Cochrane Controlled Trials, EMBASE, Ovid MEDLINE, and Ovid PsycINFO data sources. STUDY SELECTION: Randomized controlled trials testing the efficacy of psychosocial interventions in arthritis pain management were reviewed. DATA EXTRACTION: Twenty-seven randomized controlled trials were analyzed. Pain intensity was the primary outcome. Secondary outcomes included psychological, physical, and biological functioning. DATA SYNTHESIS: An overall effect size of 0.177 (95% CI=0.256-0.094) indicated that patients receiving psychosocial interventions reported significantly lower pain than patients in control conditions (combined p=.01). Meta-analyses also supported the efficacy of psychosocial interventions for the secondary outcomes. CONCLUSIONS: These findings indicate that psychosocial interventions may have significant effects on pain and other outcomes in arthritis patients. Ample evidence for the additional benefit of such interventions over and above that of standard medical care was found.