Assessment and treatment of adult acute responses to traumatic stress following mass traumatic events

Assessment and treatment of acute responses to traumatic stress has received much attention since September 11, 2001. This article elucidates principles of early intervention with adults in the immediate (within 48 hours) and early recovery phase (within the first week). The principles have been drawn from research on risk and recover factors, stress and traumatic stress theory, and expert consensus recommendations. The debriefing model is discussed, and principle interventions of psychological first aid, pharmacology, and mass trauma systems are described. This article concludes with brief guidelines for longer-term interventions and recommendations for future research.     

Intuition and autism: a possible role for Von Economo neurons

Von Economo neurons (VENs) are a recently evolved cell type which may be involved in the fast intuitive assessment of complex situations. As such, they could be part of the circuitry supporting human social networks. We propose that the VENs relay an output of fronto-insular and anterior cingulate cortex to the parts of frontal and temporal cortex associated with theory-of-mind, where fast intuitions are melded with slower, deliberative judgments. The VENs emerge mainly after birth and increase in number until age 4 yrs. We propose that in autism spectrum disorders the VENs fail to develop normally, and that this failure might be partially responsible for the associated social disabilities that result from faulty intuition.     

Adjustment to chronic low back pain--the relative influence of fear-avoidance beliefs, catastrophizing, and appraisals of control

The present study investigated the relative extent to which patients' adjustment to chronic low back pain (CLBP) was influenced by their fear-avoidance beliefs, their tendency to catastrophize, and their appraisals of control. Eighty-three CLBP patients completed a series of self-report measures before participating in a physical therapist-led intervention. Hierarchical multiple regression analyses revealed that patients' perceptions of their ability to decrease pain explained a small, but statistically significant, proportion of the variance in pain intensity. In addition, patients' levels of catastrophizing, as well as their fear-avoidance beliefs about both work and physical activity, were independently associated with levels of disability. Interestingly, however, when exploring the relative predictive utility of these three psychological factors, it became evident that fear-avoidance beliefs about physical activity (FABs-PA) were the only significant predictor of patients' disability. Specifically, those patients who exhibited higher levels of FABs-PA tended to report greater levels of disability, even after adjusting for age, sex and pain intensity.     

Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study

The intentional nature of tics provides the opportunity to apply behavioural interventions aimed at tic reduction through interruption of stimulus-response sequences. The aim of this study has been to evaluate the effect of exposure and response prevention (ER) versus habit reversal (HR) in 43 Tourette's syndrome (TS) patients. The three outcome measures were: the Yale Global Tic Severity Scale (YGTSS), 15-min tic frequency registrations monitored at the institute and 15-min home tic frequency registrations. Both treatment conditions resulted in statistically significant improvements on all outcome measures (p < 0.001). No significant differences were found between the treatment conditions on any of the outcome measures, although there was a tendency in favour of ER on the YGTSS (p = 0.05). These results suggest that, at least in the short term, TS tic symptoms can be treated effectively with both types of treatment.     

Relating distinctive orthographic and phonological processes to episodic memory performance

Three experiments examined the role of three distinctive perceptual factors in recognition and recall memory. Using a subject-paced presentation rate, the first two experiments (recognition and recall) examined (1) the number of phonological-to-orthographic neighbors, (2) phonological-to-orthographic consistency, and (3) orthographic-to-phonological consistency. The third experiment (recall) reexamined the number of phonological-to-orthographic neighbors, using an experimenter-paced presentation rate of 2 sec per item. In both recognition and recall memory tasks, the number of phonological-to-orthographic neighbors influenced memory performance, whereas the two types of consistency did not. The results indicate that having fewer phonological-to-orthographic neighbors (i.e., having distinct mappings between orthography and phonology, and between phonology and orthography, e.g., pulp) relieve words from interference in episodic memory tests for such words. Furthermore, words that are indistinct in terms of these mappings (e.g., tuck) are subject to interference from words with similar representations (e.g., luck, buck, stuck), and this weakens the memory trace for a particular word.     

Age differences in rereading

Younger and older adults read a series of expository and narrative passages twice in order to answer comprehension questions. Reading time was used to index attentional allocation to word, textbase, and situation model processing and to assess shifts in the allocation policy from the first to the second reading. Older readers' comprehension was at least as good as that of younger readers. Analysis of reading times suggested that for both genres, older adults allocated more attention to situation model features than younger adults did on the first reading, whereas young and old allocated attention similarly to this level of representation on the second reading, suggesting that mature readers may give greater priority to situation model construction when first encountering text. Also, for both genres, older adults showed relatively less facilitation than the young in word-level processing in rereading, suggesting that representation at this level is not as firmly established during reading or decays more quickly for older readers. For narrative texts only, this pattern also obtained for textbase processing. Collectively, these data show that age equivalence in text comprehension at the molar level may be accomplished through different processing routes at the molecular level.     

Attempting to avoid false memories in the Deese/Roediger—McDermott paradigm: Assessing the combined influence of practice and warnings in young and old adults

On each of five study-test trials, young and old adults attempted to memorize the same list of 60 words (e.g., bed, rest, awake), which were blocked according to their convergence on four corresponding associates. Half of the participants in each age group were given an explicit warning about the DRM paradigm prior to encoding and were asked to attempt to avoid recalling any associated but nonpresented words (e.g., sleep). Lists were presented auditorily at either a fast (1,250 msec/word) or a slow (2,500 msec/word) rate. Without a warning, the probability of veridical recall across trials increased for both age groups; however, the probability of false recall across trials decreased only for young adults. When a warning about false recall was provided, young adults virtually eliminated false recall by the second trial. Even though old adults also used warnings to reduce false recall on Trial 1, they were still unable to decrease false memories across the remaining four study-test trials. Old adults also reduced false recall more with slow than with fast presentation rates. Taken together, these findings suggest that old adults have a breakdown in spontaneous, self-initiated source monitoring as reflected by little change in false recall across study-test trials but a preserved ability to use experimenter-provided warnings or slow presentation rates to reduce false memories.     

Holography does not account for goodness: a critique of van der Helm and Leeuwenberg (1996)

P. A. van der Helm and E. L. J. Leeuwenberg (1996) outlined a holographic account of figural goodness of a perceptual stimulus. The theory is mathematically precise and can be applied to a broad spectrum of empirical data. The authors argue, however, that the account is inadequate on both theoretical and empirical grounds. The theoretical difficulties concern the internal consistency of the account and its reliance on unspecified auxiliary assumptions. The account also makes counterintuitive empirical predictions, which do not fit past data or the results of a series of new experimental studies.     

Emergence of joint attention: relationships between gaze following,social referencing,imitation, and naming in infancy

The authors investigated the extent to which the joint-attention behaviors of gaze following, social referencing, and object-directed imitation were related to each other and to infants' vocabulary development in a sample of 60 infants between the ages of 8 and 14 months. Joint-attention skills and vocabulary development were assessed in a laboratory setting. Split-half reliability analyses on the joint-attention measures indicated that the tasks reliably assessed infants' capabilities. In the main analysis, no significant correlations were found among the joint-attention behaviors except for a significant relationship between gaze following and the number of names in infants' productive vocabularies. The overall pattern of results did not replicate results of previous studies (e.g., M. Carpenter, K. Nagell, & M. Tomasello, 1998) that found relationships between various emerging joint-attention behaviors.     

Aging,memory load,and resource allocation during reading

To test the notion that aging brings an inability to self-initiate processing, the authors investigated the effects of memory load on online sentence understanding. Younger and older adults read a series of short passages with or without a simultaneous updating task, which would be expected to deplete resources by consuming memory capacity. Regression analyses of word-by-word reading times onto text variables within each condition were used to decompose reading times into resources allocated to the array of word-level and textbase-level processes needed for comprehension. Among neither the young nor the old were word-level processes disrupted by a simultaneous memory load. However, older readers showed relatively greater levels of resource allocation to conceptual integration than the younger adults when under load, regardless of working-memory span or task priority. These results suggest that the ability to self-initiate the allocation of processing resources during reading is preserved among older readers.