Substance use and partner violence among urban women seeking emergency care

Growing evidence suggests intimate partner violence (IPV) and substance misuse are co-occurring problems that disproportionately affect low income urban women seeking care in emergency departments (EDs) and represent leading causes of injuries that result in ED visits. This paper examines temporal bidirectional associations between different types of drug and alcohol use and different types of IPV in a longitudinal study of a representative sample of 241 low-income urban women receiving emergency care from an ED in the Bronx, New York. After adjusting and matching for sociodemographics and potentially confounding multilevel risk and protective covariates, women who reported using heroin in the prior 6 months at Wave 1 were twice as likely as nonheroin-using women to indicate any physical, injurious, or sexual IPV at subsequent waves and were 2.7 times more likely to indicate experiencing an injury from IPV at subsequent waves. Crack or cocaine use in the past 6 months at Wave 1 was associated with an increased likelihood of injurious IPV and severe verbal abuse at subsequent waves. Findings also suggested that sexual IPV was significantly associated with subsequent use of crack or cocaine. The multiple bidirectional associations found linking these problems underscore the need for conducting routine screening for IPV and substance misuse among women in low-income urban EDs, and for improving linkages to services that will ultimately reduce the risk of morbidity, disability, and mortality related to these co-occurring problems.     

Substance-related disorders among juvenile offenders: what role do psychopathic traits play?

Substance use disorders are associated with psychopathy, a personality disorder that is heterogeneous in both adults and youth; secondary variants of psychopathy with comorbid psychopathology and primary variants without comorbidity show distinct correlates and outcomes. In adult criminal populations, secondary variants report greater substance abuse compared with primary variants. The primary aim of this study is to replicate and extend these findings to a juvenile offender population. Compared with primary variants of juvenile psychopathy, secondary variants (a) reported significantly more frequent substance use--particularly alcohol--within the 6 months prior to incarceration (d = .43), (b) were almost twice as likely to abuse substances while incarcerated, and (c) were more likely to be diagnosed with a current Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV; American Psychiatric Association, 2000) substance use disorder. Practical implications for working with justice-involved youth are discussed.     

Multisystemic therapy for young offenders: families' experiences of therapeutic processes and outcomes

Multisystemic Therapy (MST) has been found to be effective in reducing youth antisocial behavior, but little is known about the process and impact of MST from the perspective of families themselves. This qualitative study explored parents' and young people's experiences of MST, focusing on aspects of the intervention that promoted or limited change. Thirty-seven semistructured interviews were conducted with a consecutive sample of 21 families (21 parent interviews, 16 young people) who had participated in a randomized controlled trial of MST for young offenders in the United Kingdom. Thematic analysis yielded 10 themes, organized into two domains: (a) engagement in MST and initial processes of change captures the central importance of the therapeutic relationship and the MST engagement model in families' positive experiences of MST; and (b) outcomes are complex reflects the range of positive outcomes reported (notably increased parental confidence and skills, improved family relationships, a return to education, and greater reflection and aspiration on the part of the young person) and mixed behavior outcomes. Even when the young person had reoffended, respondents indicated a range of other benefits for the family. The findings support the MST theory of change as well as point to some outcomes not usually measured in MST outcome studies. They also suggest some adaptations that may increase the impact of the intervention, including more attention to the influence of deviant peers, and ongoing support for families struggling to maintain strategies beyond the prescribed treatment period.     

Eye of the beholder: the individual and dyadic contributions of empathic accuracy and perceived empathic effort to relationship satisfaction

This study examined links between two distinct facets of empathy-empathic accuracy and perceived empathic effort-and one's own and one's partner's relationship satisfaction. Using a video recall procedure, participants (n = 156 couples in committed relationships) reported on their own emotions and their perceptions of partners' emotions and partners' empathic intentions during moments of high affect in laboratory-based discussions of upsetting events. Partners' data were correlated as a measure of how accurately they were able to read what the other was feeling and to what degree they felt the other was trying to be empathic at those moments. The perception of empathic effort by one's partner was more strongly linked with both men's and women's relationship satisfaction than empathic accuracy. Men's relationship satisfaction was related to the ability to read their partners' positive emotions accurately, whereas women's relationship satisfaction was related to their partners' ability to read women's negative emotions accurately. Women's ability to read their husbands' negative emotions was positively linked to both men's and women's relationship satisfaction. Findings suggest that the perception of a partner's empathic effort-as distinct from empathic accuracy-is uniquely informative in understanding how partners may derive relationship satisfaction from empathic processes. When working with couples in treatment, heightening partners' perceptions of each other's empathic effort, and helping partners learn to demonstrate effort, may represent particularly powerful opportunities for improving satisfaction in relationships.     

Unpicking the semantic impairment in Alzheimer's disease: qualitative changes with disease severity

Despite a vast literature examining semantic impairment in Alzheimer's disease (AD), consensus regarding the nature of the deficit remains elusive. We re-considered this issue in the context of a framework that assumes semantic cognition can break down in two ways: (1) core semantic representations can degrade or (2) cognitive control mechanisms can become impaired. We hypothesised and confirmed that the nature of semantic impairment in AD changes with disease severity. Patients at mild or severe stages of the disorder exhibited impairment across various semantic tasks but the nature of those deficits differed qualitatively for the two groups. Commensurate with early dysfunction of the cognitive control, temporoparietal-frontal-cingulate network, characteristics of deregulated semantic cognition were exhibited by the mild AD cases. In contrast, the severe AD group reproduced features of additional degradation of core semantic representations. These results suggest that spread of pathology into lateral anterior temporal lobes in later stage AD produces degradation of semantic representations, exacerbating the already deregulated system. Moreover, the dual nature of severe patients' impairment was highlighted by disproportionately poor performance on tasks placing high demand on both conceptual knowledge and control processes--e.g., category fluency.     

Specificity in rehabilitation of word production: a meta-analysis and a case study

Speech production impairment is a frequent deficit observed in aphasic patients and rehabilitation programs have been extensively developed. Nevertheless, there is still no agreement on the type of rehabilitation that yields the most successful outcomes. Here, we ran a detailed meta-analysis of 39 studies of word production rehabilitation involving 124 patients. We used a model-driven approach for analyzing each rehabilitation task by identifying which levels of our model each task tapped into. We found that (1) all rehabilitation tasks are not equally efficient and the most efficient ones involved the activation of the two levels of the word production system: the phonological output lexicon and the phonological output, and (2) the activation of the speech perception system as it occurs in many tasks used in rehabilitation is not successful in rehabilitating word production. In this meta-analysis, the effect of the activation of the phonological output lexicon and the phonological output cannot be assessed separately. We further conducted a rehabilitation study with DPI, a patient who suffers from a damage of the phonological output lexicon. Our results confirm that rehabilitation is more efficient, in terms of time and performance, when specifically addressing the impaired level of word production.     

Colorless green ideas (can) prime furiously

That similar words can prime one another is not news. However, this phenomenon can be exploited to make inferences about the organization of conceptual representations. What types of similarity matter? Although there is evidence that similarity of function, shape, and even manner of manipulation is reflected in semantic memory, evidence for organization on the basis of color similarity is sparse. This lack of evidence is surprising: Intuition suggests that color is a prominent feature of many object concepts. The research reported here clarifies this puzzle and illustrates the dynamic nature of conceptual representations. Our research demonstrates color-based priming (e.g., "emerald" primes "cucumber") in participants who completed a Stroop color-naming task before a priming task. Notably, the size of the Stroop effect predicted the size of the priming effect. When the order of tasks was reversed, priming effects were eliminated. By demonstrating that both extrinsic and intrinsic factors can influence conceptual activation, our findings have implications for theories of semantic memory.     

Witnesses in action: the effect of physical exertion on recall and recognition

Understanding memory performance under different operational conditions is critical in many occupational settings. To examine the effect of physical exertion on memory for a witnessed event, we placed two groups of law-enforcement officers in a live, occupationally relevant scenario. One group had previously completed a high-intensity physical-assault exercise, and the other had not. Participants who completed the assault exercise showed impaired recall and recognition performance compared with the control group. Specifically, they provided significantly less accurate information concerning critical and incidental target individuals encountered during the scenario, recalled less briefing information, and provided fewer briefing updates than control participants did. Exertion was also associated with reduced accuracy in identifying the critical target from a lineup. These results support arousal-based competition accounts proposing differential allocation of resources under physiological arousal. These novel findings relating to eyewitness memory performance have important implications for victims, ordinary citizens who become witnesses, and witnesses in policing, military, and related operational contexts.     

Neural control of voluntary eye closure: a case study and an fMRI investigation of blinking and winking

The current paper describes a rare case of a patient who suffered from unilateral apraxia of eye closure as a result of a bilateral stroke. Interestingly, the patient's ability to voluntarily close both eyelids (i.e. blinking) was not affected, indicating that different neural mechanisms control each type of eye closure. The stroke caused damage to a large part of the right frontal cortex, including the motor cortex, pre-motor cortex and the frontal eye field (FEF). The lesion in the left hemisphere was restricted to the FEF. In order to further study the neural mechanisms of eye closure, we conducted an fMRI study in a group of neurological healthy subjects. We found that all areas of the oculomotor cortex were activated by both left and right winking, including the FEF, supplementary eye field (SEF), and posterior parietal cortex (PPC). Blinking activated FEF and SEF, but not PPC. Both FEF and PPC were significantly more active during winking than blinking. Together, these results provide evidence for a critical role of the FEF in voluntary unilateral eye closure.