Applications of cognitive testing to group therapies with the chronically mentally ill

Appreciation of the various cognitive deficits displayed by many chronic patients offers an alternative way of understanding each patient's predicament and an alternative way of approaching group and milieu therapies with chronic patients. Case examples taken from a test protocol based on neuropsychological testing procedures illustrate the clinical information that can be obtained in this important, but relatively unexplored area.     

Perceptual equivalence of two acoustic cues for stop-consonant manner

The first experiment examined the effects of orthogonal variation in two acoustic cues that are both produced by the articulation of a stop consonant. One component of the articulation produces a temporal cue, the other a spectral cue. In a phonetic identification task, these quite different cues were found to engage in a trading relation: One cue could, within limits, substitute for the other. In a second experiment, the perceptual equivalence implied by that trading relation was put to a stricter test. If the cues are truly equivalent in perception, then they should have their effects on the same perceptual dimension. That being so, it should be possible to combine them in such a way that, working at cross purposes in the perceptual domain, they effectively cancel each other. Pairs of patterns so produced should, then, be harder to discriminate than pairs produced by either cue alone, and still harder than those produced when the (same) two cues are combined in the opposite way and so cooperate. That expectation was confirmed. We suggest that the equivalence thus demonstrated comes about because the two cues are processed by a system specialized to take account of their common origin in speech production. So interpreted, the equivalence may be viewed as an instance of distinctively phonetic perception.     

The effect of generic statements on children's causal attributions: questions of mechanism

Generic statements, or generics, express generalizations about entire kinds (e.g., "Girls are good at a game called 'tooki'"). In contrast, nongeneric statements express facts about specific (sets of) individuals (e.g., "Jane is good at tooki"). Aside from simply conveying information, generics and nongenerics also instill different causal perspectives on the facts expressed, implying that these facts stem from deep, inherent causes (e.g., talent) or from external, mechanistic causes (e.g., instruction), respectively. In the present research (with samples of 4- to 7-year-olds and undergraduates, N = 220), we proposed that children's causal attributions for the facts learned through these statements are determined not by the generic/nongeneric format of the statements themselves but rather by the generic/nongeneric format of the beliefs relevant to these statements. This proposal led to two specific predictions. First, the influence of the generic belief induced by a novel generic statement should be detected in any subsequent context that falls under its scope--even in circumstances that involve particular individuals. Confirming this prediction, participants often attributed a fact conveyed in a nongeneric statement (e.g., a particular girl's tooki ability) to deep, inherent causes if they had previously formed a relevant generic belief (e.g., by hearing that girls are good at tooki). Second, we predicted that nongeneric statements such as "Most girls are good at tooki" should also promote attributions to deep causes because they often ultimately give rise to generic beliefs, as suggested by recent evidence. This prediction was confirmed as well. These results clarify and expand our knowledge of the influence of language on children's understanding of the world.     

Multilevel Measurement of Dimensions of Collaborative Functioning in a Network of Collaboratives that Promote Child and Family Well-Being

Evaluating collaboration between community partners presents a series of methodological challenges (Roussos and Fawcett in Annu Rev Public Health 21:369-402, 2000; Yin and Kaftarian 1997), one of which is selection of the appropriate level of analysis. When data are collected from multiple members of multiple settings, multilevel analysis techniques should be used. Multilevel confirmatory factor analysis (MCFA) is an analytic approach that incorporates the advantages of latent variable measurement modeling and multilevel modeling for nested data. This study utilizes MCFA on data obtained from an evaluation survey of collaborative functioning provided to members of 157 community collaboratives in Georgia. This study presents a well-fitting measurement model that includes five dimensions of collaborative functioning, and a structural component with individual- and collaborative-level covariates. Findings suggest that members' role and meeting attendance significantly predicted their assessment of collaboration at the individual level, and that tenure of collaborative leaders predicted the overall functioning of the collaborative at the collaborative level. Dimensionality of collaborative functioning and implications of potentially substantial measurement biases associated with selection of respondents are addressed.     

Genetic Testing of Children for Predisposition to Mood Disorders: Anticipating the Clinical Issues

Large-scale sequencing information may provide a basis for genetic tests for predisposition to common disorders. In this study, participants in the Coriell Personalized Medicine Collaborative (N?=?53) with a personal and/or family history of Major Depressive Disorder or Bipolar Disorder were interviewed based on the Health Belief Model around hypothetical intention to test one’s children for probability of developing a mood disorder. Most participants (87 %) were interested in a hypothetical test for children that had high (“90 %”) positive predictive value, while 51 % of participants remained interested in a modestly predictive test (“20 %”). Interest was driven by beliefs about effects of test results on parenting behaviors and on discrimination. Most participants favored testing before adolescence (64 %), and were reluctant to share results with asymptomatic children before adulthood. Participants anticipated both positive and negative effects of testing on parental treatment and on children’s self-esteem. Further investigation will determine whether these findings will generalize to other complex disorders for which early intervention is possible but not clearly demonstrated to improve outcomes. More information is also needed about the effects of childhood genetic testing and sharing of results on parent–child relationships, and about the role of the child in the decision-making process.