A DBT Skills training group for family caregivers of persons with dementia

A Dialectical Behavior Therapy Skills training manual (DBT Skills) was adapted for use with caregivers of individuals with dementia. Implementation occurred in a community clinic with a heterogeneous caregiver group at risk for elder abuse. Sixteen caregivers completed the 9-week group. The results point to improved psychosocial adjustment, particularly increased problem-focused coping, enhanced emotional well-being, and less fatigue. Caregivers tended to utilize individual therapeutic services at a higher rate during the period of group attendance, indicative of appropriate help-seeking behavior in highly demanding situations. Six of the 16 caregivers repeated the training sequence in “booster” groups. Follow-up data from the booster groups suggest that high-risk caregivers may require continuing support to maintain treatment gains. In addition to demonstrating the feasibility of DBT Skills with caregivers, the results warrant a controlled outcome evaluation.     

Language comprehension and dominant hand motion simulation

In five experiments participants were presented with pairs of nouns and verbs. They were asked to decide whether the combinations made sense or not. Half of the participants responded "yes" with the dominant hand, half with the left hand. When pairs referred to manual and mouth actions, participants responded faster with the dominant than with the left hand with sensible sentences. When pairs referred to manual and foot actions the result was opposite. Results suggest that language processing activates an action simulation that is sensitive to both the effector involved and the goal expressed by the sentence.     

Cognitive models of choice: comparing decision field theory to the proportional difference model

People often face preferential decisions under risk. To further our understanding of the cognitive processes underlying these preferential choices, two prominent cognitive models, decision field theory (DFT; Busemeyer & Townsend, 1993 ) and the proportional difference model (PD; González-Vallejo, 2002 ), were rigorously tested against each other. In two consecutive experiments, the participants repeatedly had to choose between monetary gambles. The first experiment provided the reference to estimate the models' free parameters. From these estimations, new gamble pairs were generated for the second experiment such that the two models made maximally divergent predictions. In the first experiment, both models explained the data equally well. However, in the second generalization experiment, the participants' choices were much closer to the predictions of DFT. The results indicate that the stochastic process assumed by DFT, in which evidence in favor of or against each option accumulates over time, described people's choice behavior better than the trade-offs between proportional differences assumed by PD.     

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.     

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.     

Lifestyle changes are related to reductions in depression in persons with elevated coronary risk factors

This observational study investigates whether persons with elevated coronary risk factors (CRFs >3 and/or diabetes) and depression [i.e., ≥16 on the Center for Epidemiological Scale – Depression (CES-D)] can make changes in health behaviours over 3 months and improve depressive symptoms and other CRFs. Analyses were based on data from 310 men and 687 women enrolled in the high-risk arm of the Multisite Cardiac Lifestyle Intervention Program, targeting diet (10% fat), exercise (3 h per week) and stress management (7 h per week). As expected, at study entry, depressed persons had a more adverse medical status, consumed more dietary fat and practiced less stress management than non-depressed persons. To examine 3-month changes, participants were grouped into (1) depressed persons who became non-depressed (CES-D ≤ 16, n = 248; 73%), (2) persons who remained or became depressed (CES-D >16, n = 76) and (3) non-depressed persons who remained non-depressed (n = 597). All persons, regardless of group, met program goals. The greatest improvements (i.e., diet, exercise, perceived stress, hostility and mental health) were observed in Group 1 relative to Groups 2 and 3, which did not differ from each other. Comprehensive lifestyle changes appear to be feasible and beneficial for initially depressed persons with elevated CRFs.     

Fractal Structure of Event Segmentation: Lessons From Reel and Real Events

We investigated fractality in the segmentation of cinematic and live events. Four movies from distinct genres were first analyzed and found to be fractal, albeit in different regions of the fractal range. In Experiment 1, viewers parsed the films' events, attending to short or long timescales, using a button box to indicate break points. The temporal structure of film viewing was found to be fractal regardless of the scale of attention and to reflect the differing fractal editing structure of the films. Experiment 2 found event segmentation to be fractal in a natural setting, a basketball game, as well. An additional parallel between reel and real events was uncovered: fractal indices were at the higher end of the range for both the film genre intended to be anxiogenic and the more suspenseful portion of the basketball game. We argue that the fractal structure of perception reflects the fractal structure of events whether the events are in film or in nature. We speculate that fractal structure has implications for understanding subjective experience and, ultimately, the correspondence between films and the world.     

Treatment of bipolar depression

Bipolar disorder is underdiagnosed and often mistaken for unipolar depression. Bipolar patients spend 33% of their time in a state of depression compared to 11% of time spent in a manic state. Duration of time depressed and severity of depression are associated with increased risk for suicide, which occurs in 10% to 20% of bipolar patients. Antidepressants are increasingly being used as adjuncts in the depressed phase of bipolar disorder, although they provide a moderate risk for switch into mania. Lithium and some antiepileptics and atypical antipsychotics have shown antidepressant effects in the treatment of bipolar disorder. Other adjuncts for treatment-refractory patients include monoamine oxidase inhibitors and electroconvulsive therapy.     

Two measures of affect and emotion in Italian children aged 6 to 11 years

The authors investigated the relation between affective and cognitive processes in fantasy play and emotional understanding of 50 Italian children (25 boys and 25 girls) enrolled in regular elementary school in Northern Italy. Children were administered a standardized play task, the Affect in Play Scale, and answered questions about their understanding of emotions. Consistent, yet modest, relationships were found between dimensions of fantasy play and emotional understanding.