Characterizing the ADHD phenotype for genetic studies

The genetic study of ADHD has made considerable progress. Further developments in the field will be reliant in part on identifying the most appropriate phenotypes for genetic analysis. The use of both categorical and dimensional measures of symptoms related to ADHD has been productive. The use of multiple reporters is a valuable feature of the characterization of psychopathology in children. It is argued that the use of aggregated measures to characterize the ADHD phenotype, particularly to establish its pervasiveness, is desirable. The recognition of the multiple comorbidities of ADHD can help to isolate more specific genetic influences. In relation to both reading disability and conduct disorder there is evidence that genes may be involved in the comorbid condition that are different from pure ADHD. To date, progress with the investigation of endophenotypes for ADHD has been disappointing. It is suggested that extending such studies beyond cognitive underpinnings to include physiological and metabolic markers might facilitate progress.     

Relational learning with and without awareness: Transitive inference using nonverbal stimuli in humans

Learning complex relationships among items and representing them flexibly have been shown to be highly similar in function and structure to conscious forms of learning. However, it is unclear whether conscious learning is essential for the exhibition of flexibility in learning. Successful performance on the transitive inference task requires representational flexibility. Participants learned four overlapping premise pairs (A > B, B > C, C > D, D > E) that could be encoded separately or as a sequential hierarchy (A > B > C > D > E). Some participants (informed) were told prior to training that the task required an inference made from premise pairs. Other participants (uninformed) were told simply that they were to learn a series of pairs by trial and error. Testing consisted of unreinforced trials that included the non-adjacent pair, B versus D, to assess capacity for transitive inference. Not surprisingly, those in the informed condition outperformed those in the uninformed condition. After completion of training and testing, uninformed participants were given a postexperimental questionnaire to assess awareness of the task structure. In contrast with expectations, successful performance on the transitive inference task for uninformed participants does not depend on or correlate with postexperimental awareness. The present results suggest that relational learning tasks do not necessarily require conscious processes.     

Improving Attention in Old Age

The aim of this study was to examine whether a mindful intervention, based on noticing distinctions, could be used to improve the attention of older individuals. Participants were randomly assigned to one of four attention interventions. In the mindfulness groups, participants studying a set of pictures were told to notice either three or five distinctions. In the control groups, participants were either told to pay attention or were not given any directions related to attention before exposure to the set of pictures. The results indicated that those who viewed the stimuli in terms of distinctions were able to remember significantly more pictures than did those in the control groups. Distinction drawing also increased liking for the stimuli. The findings suggest that if older individuals want to increase attention and recall, rather than focus their attention, they may want to find ways to vary their attention.     

Prolonged exposure therapy for chronic combat-related PTSD: a case report of five veterans

Prolonged exposure (PE) therapy has been found efficient in reducing posttraumatic stress disorder (PTSD) symptoms mostly among rape victims, but has not been explored in combat-related PTSD. Five patients with severe chronic PTSD, unresponsive to previous treatment (medication and supportive therapy) are described. Patients were evaluated with the PTSD Symptom Scale-Interview, and Beck Depression Inventory, before and after 10-15 sessions of PE therapy. All five patients showed marked improvement with PE, with a mean decrease of 48% in PTSD Symptom Scale-Interview score and 69% in Beck Depression Inventory score. Moreover, four patients maintained treatment gains or kept improving 6-18 months after the treatment. The results suggest that PE was effective in reducing combat-related chronic PTSD symptoms.     

Aboriginal Practitioners Offer Culturally Safe and Responsive CBT: Response to Commentaries

We appreciate the valuable commentaries that have been provided for our paper “Can CBT be effective for Aboriginal Australians? Perspectives of Aboriginal practitioners trained in CBT.” The international authors identify how CBT, with adaptations by culturally responsive practitioners can be of value for non‐Western and Indigenous peoples. The commentary by Australian psychologists Dudgeon and Kelly questions the value of CBT for Indigenous Australians, terming it a “Western therapy” that is “culturally unresponsive” and “culturally blind.” They also critique the methodology of the study. We argue that CBT can be adapted by culturally competent practitioners to be culturally safe in Australia, as elsewhere. Cultural safety is mostly a function of the therapist, not the therapy. In the Bennett‐Levy et al. (2014) study, CBT was delivered in a culturally responsive way by Aboriginal counsellors within their own communities. CBT is a particularly adaptable and versatile therapy, and embodies principles of empowerment and self‐determination that are central to Indigenous social and emotional well‐being. We are concerned that CBT, which has strong empirical support and has been adapted elsewhere for a range of cultures, including Indigenous cultures, may be being denied to Indigenous Australian clients. There is considerable opportunity to evaluate the effectiveness and versatility of CBT, and variations of its mode of delivery, for all Australians.     

Frankfurt in Fake Barn Country

It is very widely held that Frankfurt‐style cases—in which a counterfactual intervener stands by to bring it about that an agent performs an action but never actually acts because the agent performs that action on her own—show that free will does not require alternative possibilities. This essay argues that that conclusion is unjustified, because merely counterfactual interveners may make a difference to normative properties. It presents a modified version of a fake barn case to show how a counterfactual intervener can make the difference between an agent knowing a fact or merely truly believing that fact, by eliminating veretic epistemic luck. If counterfactual interveners can make this kind of difference to the epistemic status of agents, the essay argues, there is no reason why they can't make an analogous difference to agents' moral responsibility. It concludes that reflection on these cases reveals that despite the mountains of words spilled on the topic, we still don't fully understand what role access to alternative possibilities plays in whether or not agents are morally responsible for their actions.