Contents

Up to one third of the epilepsy population consists of children with cryptogenic localization related epilepsy (CLRE). Unfortunately, the effect of CLRE on the development is still unclear. Behavioral and academic problems have been reported, but no conclusive study concerning the impact of CLRE on neuropsychological functioning is yet published.

This study was a systematic cross-sectional open clinical and nonrandomized investigation, which included 68 children with CLRE. Several neuropsychological tests were analyzed and age-related normative values were used as reference. Differences between CLRE and reference values were tested with Paired-Samples t-tests. Z scores were computed to compare the different neuropsychological tests and to inspect whether a characteristic neuropsychological profile exists for CLRE. The Independent-Samples t-test was used to explore which epilepsy factors (seizure type, seizure frequency, age at onset, duration of epilepsy, and drug load) were influencing the cognitive profile of CLRE.

There seems to be a characteristic cognitive profile for children with CLRE; children with CLRE experience cognitive difficulties on a wide range of areas—in particular, alertness, mental speed, and memory. Seizure type, seizure frequency, duration of epilepsy, and drug load do not influence this neuropsychological profile. Age at onset was an important risk factor; the earlier the age at onset, the worse the cognitive performance. In spite of the influence of age at onset, the revealed profile can be seen as a stable, independent of temporary factors, neuropsychological profile for children with CLRE.     

Reading and Spelling Disabilities in Children with and Without a History of Early Language Delay: A Neuropsychological and Linguistic Study

Language delay is a frequent antecedent of literacy problems, and both may be linked to phonological impairment. Studies on developmental dyslexia have led to contradictory results due to the heterogeneity of the pathological samples. The present study investigated whether Italian children with dyslexia showed selective phonological processing deficits or more widespread linguistic impairment and whether these deficits were associated with previous language delay. We chose 46 children with specific reading deficits and divided them into two groups based on whether they had language delay (LD) or not (NoLD). LD and NoLD children showed similar, severe deficits in reading and spelling decoding, but only LD children showed a moderate impairment in reading comprehension. LD children were more impaired in phonological working memory and phonological fluency, as well as in semantic fluency, grammatical comprehension, and verbal IQ. These findings indicate the presence of a moderate but widespread linguistic deficit (not limited to phonological processing) in a subset of dyslexic children with previous language delay that does not generalize to all children with reading difficulties.     

Multiple stimulus presentation yields larger deficits in children with developmental dyslexia: A study with reading and RAN-type tasks

In this study, we examined the effect of multiple versus single stimulus presentation in typically developing readers and children with developmental dyslexia. The tasks involved either reading single words or arrays of words or naming single or multiple colors and digits (rapid automatized naming or RAN). To be able to compare these sets of conditions, we recorded total response times (i.e., the time between stimulus onset and the end of the participant’s vocal response) in all cases. The study included 43 typically developing readers and 25 children with dyslexia.

Results indicate that typically developing readers have a clear advantage with multiple over single items on both RAN and reading tasks. The children with dyslexia showed a moderate advantage for multiple stimuli in naming colors and digits but presented the opposite pattern in reading.

With regard to reading, the disproportionate impairment of the children with dyslexia in dealing with multiple arrays suggests difficulty in integrating the multiple subcomponents of the reading task over and above the basic nuclear deficit in decoding words. Regarding the RAN tasks, results confirm that the requirement of integrating multiple subcomponents may be critical in mediating the predictive value of these measures on reading.     

Implementation of Cognitive Therapy for PTSD in routine clinical care: Effectiveness and moderators of outcome in a consecutive sample

ObjectiveTrauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area.MethodA consecutive sample of 330 patients with PTSD (age 17–83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects.ResultsCT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M = 280 days, n = 220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience.ConclusionsThe results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.     

Treating PTSD in refugees and asylum seekers within the general health care system. A randomized controlled multicenter study

Objective

There has been uncertainty about whether refugees and asylum seekers with PTSD can be treated effectively in standard psychiatric settings in industrialized countries. In this study, Narrative Exposure Therapy (NET) was compared to Treatment As Usual (TAU) in 11 general psychiatric health care units in Norway. The focus was on changes in symptom severity and in the diagnostic status for PTSD and depression.

Method

Refugees and asylum seekers fulfilling the DSM-IV criteria for PTSD (N = 81) were randomized with an a-priori probability of 2:1 to either NET (N = 51) or TAU (N = 30). The patients were assessed with Clinician Administered PTSD Scale, Hamilton rating scale for depression and the MINI Neuropsychiatric Interview before treatment, and again at one and six months after the completion.

Results

Both NET and TAU gave clinically relevant symptom reduction both in PTSD and in depression. NET gave significantly more symptom reduction compared to TAU as well as significantly more reduction in participants with PTSD diagnoses. No difference in treatment efficacy was found between refugees and asylum seekers.

Conclusions

The study indicated that refugees and asylum seekers can be treated successfully for PTSD and depression in the general psychiatric health care system; NET appeared to be a promising treatment for both groups.

ClinicalTrials.gov registry number

NCT00218959.     

Comprehension of the Referential Intent of Looking and Pointing Between 12 and 15 Months

Butler, Caron, & Brooks (2000) tested the gaze following of 14-and 18-month-olds under 3 conditions: (1) when the adult's view of the targets was blocked by barriers, (2) when the barriers contained open windows, and (3) no barriers. Contrary to a nonmentalist "ecological" model (adult turns serve as cues to the location of interesting events), frequency of gaze following by 14-month-olds was not equivalent across the 3 conditions. Contrary to a mentalist model (infant wants to see what the adult is seeing), gaze following was not substantially less in the barrier than in the window and no-barrier conditions (as was the case for 18-month-olds). To examine whether the barriers posed vector projection problems for essentially nonmentalist, or line-of-sight problems for essentially mentalist younger infants, 3 experiments were conducted. In Experiment 1, a 12-month group was tested in the same 3 conditions to determine if, being younger, they might yield a more clearcut nonmentalist pattern. Contrarily, they behaved like Butler et al.'s 14-month-olds. In Experiment 2, a 14-month group was tested in the barrier and window conditions, but now combining pointing with turning. Infants behaved as predicted by the mentalist model: strong responding in the window condition and minimal in the barrier (where many strained to look inside the partitions). In Experiment 3, an attempt was made to differentiate between mentalist and "geometric" (vector projection) interpretations of the results of Experiment 2 by testing another 14-month group with the adult's eyes closed while pointing. Gaze following now dropped precipitously in the window condition as did looking inside the solid barriers, indicating (1) that infants in Experiment 2 had not simply been guided to target by an extended arm, but construed it as part of a referential act that was as much visual as gestural, and (2) that by 14 months, infants may have acquired a mentalistic concept of seeing.     

Implications of Independent Versus Interdependent Self-knowledge for Motivated Social Cognition: The Semantic Procedural Interface Model of the Self

The Semantic Procedural Interface Model of the Self (SPI) suggests that, depending on the strength of the situational accessibility of independent or interdependent self-knowledge, people will tend to process stimuli either unaffected by context (context-independency) or cognizant of context (context-dependency). In this paper we describe the cognitive processes underlying context-independent or context-dependent information processing. We suggest that degree of context-dependency depends on cognitive control processes (attentional focus on focal or task-relevant information; inhibition of contextual or task-irrelevant information; task-management). Second, we predict motivational effects of the self's independence/interdependence by including assumptions about possible selves.     

Life Events may Contribute to Family Communication About Cancer Risk Following BRCA1/2 Testing

We assessed whether certain life events contributed to the communication about cancer risk within families who have undergone BRCA1/2 testing. We also explored what type of resources participants would have valued to help in supporting family communication about genetic information. Two hundred and forty-six individuals (218 women, 28 men) who received a BRCA1/2 genetic test result 3 to 10 years earlier (mean of 6.4 years) participated in a telephone interview. Participants were asked about the occurrence of a number of life events (cancer diagnosis, death, uptake of prophylactic surgery, and providing care to a family member with cancer) in their family since their BRCA1/2 test result disclosure and, for each occurrence, whether it fostered family communication about cancer risk. A total of 182 participants (74 %) reported that they or one of their relatives received a cancer diagnosis, 176 (72 %) reported that someone died in their family, and 73 (30 %) stated that they or one of their relatives undertook a prophylactic surgery. During this period, 109 participants (44 %) also provided care for a family member who had cancer. Among participants who reported these life events, family communication was fostered by these events in proportions varying from 50 % (death) to 69 % (cancer diagnosis). Our results indicate that life events may contribute to family communication about cancer risk. Further research is needed to determine whether these events provide a “window of opportunity” to reach family members, address their needs and concerns about cancer, update family cancer history, and introduce genetic counseling and risk assessment.     

Letter transpositions within and across morphemic boundaries: Is there a cross-language difference?

Research on the impact of letter transpositions that arise across morpheme boundaries has yielded conflicting results. These results have led to the suggestion that a cross-linguistic difference may exist in the recognition of Spanish and English words. In two masked-priming experiments run on separate groups of Spanish and English speakers, we tested this hypothesis by comparing the impacts of primes with letter transpositions that arose within morphemes or across morpheme boundaries on the recognition of identical or near-identical Spanish–English cognate targets. The results showed transposed-letter benefits in both Spanish and English that were not modulated by the position of the transposed letter in the prime stimulus. Our findings therefore add to the growing body of literature suggesting that the transposed-letter benefit is not affected by the position of the transposed letters relative to the morpheme boundary, and they dispel previous suggestions that there might be a genuine difference in orthographic coding across the Spanish and English writing systems.