The Association Between Delirium and Cognitive Decline: A Review of the Empirical Literature

Delirium is a common neurobehavioral syndrome that occurs across health care settings which is associated with adverse outcomes, including death. There are limited data on long-term cognitive outcomes following delirium. This report reviews the literature regarding relationships between delirium and cognitive impairment. Psych Info and Medline searches and investigation of secondary references for all English language articles on delirium and subsequent cognitive impairment were carried out. Nine papers met inclusion criteria and documented cognitive impairment in patients following delirium. Four papers reported greater cognitive impairment among patients with delirium than matched controls. Four papers reported higher incidence of dementia in patients with a history of delirium. One study found 1 of 3 survivors of critical illness with delirium developed cognitive impairment. The evidence suggests a relationship between delirium and cognitive impairment, although significant questions remain regarding the nature of this association. Additional research on delirium-related effects on long-term cognitive outcome is needed.     

Depression,restraint and eating behavior

Contrary to the belief that weight loss is a principal symptom of depression, several recent studies have suggested that certain people gain rather than lose weight when depressed. The present experiment concerned the effects of experimentally induced mood states on the eating behavior of high- and low-restraint persons. Sixty-eight female undergraduates were randomly assigned to one of three groups each designed to induce a different mood state (depressed, neutral or elated), and were classified as high or low restraint based on their responses to a questionnaire. During the mood induction procedure subjects were provided with the opportunity to eat. High-restraint persons induced into a depressed mood ate significantly more than high-restraint persons induced into neutral or elated moods, and more than low-restraint persons induced into a depressed mood. This effect was most prominent among subjects who scored high on the weight-fluctuation factor of the restraint scale. There was no evidence that this effect occurred among subjects who scored high on the concern for dieting factor. The role of emotional arousal on the self-control over eating behavior of high weight-fluctuation persons, and the implications of these findings for the evaluation of depression were discussed.     

Re-examination of Motivation in Learning Contexts: Meta-analytically Investigating the Role Type of Motivation Plays in the Prediction of Key Training Outcomes

Purpose

The extant research has not been consistent in the way motivation is conceptualized and measured in learning contexts, with prior research utilizing five different types of motivation derived from three theoretical frameworks—self-determination theory, expectancy theory, and the expectancy-value model. The purpose of the present study was to examine whether type of motivation impacts the motivation–training outcome relationships.

Design/Methodology

We conducted a meta-analysis investigating the impact of motivation type (i.e., intrinsic motivation, motivation to learn, motivation to transfer, expectancy motivation, and task value) on four training outcomes. The review of the literature yielded 136 independent samples and a total of 25,012 trainees. Relative weights analysis was also used.

Findings

Results suggest that all types of motivation had stronger relationships with trainee reactions than with declarative knowledge, initial skill acquisition, or transfer. Yet, there was variability in the strength of the motivation–training outcome relationships across motivation type.

Implications

We recommend that motivation to learn be used to predict trainee reactions, declarative knowledge, and initial skill acquisition; motivation to transfer should be measured when predicting distal post-training outcomes (i.e., transfer of training). Although this recommendation may seem intuitive, clearly prior research/practice has used other motivation types in the prediction of these training outcomes. Accordingly, we advise that measures of motivation to learn and motivation to transfer be used more uniformly.

Originality/Value

This is the first study to meta-analytically test whether the relationship between motivation and training outcomes varies based on the type of motivation utilized.

     

Neuropsychological functioning in preschool-age children with sickle cell disease: the role of illness-related and psychosocial factors.

Cognitive and academic deficits have been identified in school-aged children with sickle cell disease (SCD). However, there have been very few identified studies that examine neuropsychological functioning in preschool-age children with SCD. It is important to understand effects of SCD from a developmental perspective and to consider the contribution of environmental factors in this at-risk population. Neuropsychological functioning of preschool-age children with SCD and no history of overt stroke (n = 26) was examined across several domains (language, immediate memory/brief attention, visuospatial/visuoconstructional, motor/visuomotor). The mean Full Scale IQ for the sample was 89.0. Performance on the Immediate Memory/ Brief Attention domain was significantly higher than the other domains, although the pattern of performance was relatively consistent, with mean standard scores ranging from 88.0 to 95.0. Disease severity was not significantly related to cognitive functioning in this group of young children with SCD. Socioeconomic status (SES) was significantly correlated with most domain scores and, based on regression analyses, accounted for 18% to 47% of the variance in functioning. Psychosocial factors, such as number of children living in the home and parental stress levels, were negatively associated with Motor/Visuomotor skills, and weekly hours in school/day care was positively associated with language-related skills. Results suggest that, at this young age, psychosocial risk factors appear to be appropriate targets for intervention, with the goal of improving long-term outcome in children with SCD. Further investigations should include comparison to a matched control group.     

Comparing music- and food-evoked autobiographical memories in young and older adults: A diary study

Previous research has found that music brings back more vivid and emotional autobiographical memories than various other retrieval cues. However, such studies have often been low in ecological validity and constrained by relatively limited cue selection and predominantly young adult samples. Here, we compared music to food as cues for autobiographical memories in everyday life in young and older adults. In two separate four-day periods, 39 younger (ages 18–34) and 39 older (ages 60–77) adults recorded their music- and food-evoked autobiographical memories in paper diaries. Across both age groups, music triggered more frequent autobiographical memories, a greater proportion of involuntary memories, and memories rated as more personally important in comparison to food cues. Age differences impacted music- and food-evoked memories similarly, with older adults consistently recalling older and less specific memories, which they rated as more positive, vivid, and rehearsed. However, young and older adults did not differ in the number or involuntary nature of their recorded memories. This work represents an important step in understanding the phenomenology of naturally occurring music-evoked autobiographical memories across adulthood and provides new insights into how and why music may be a more effective trigger for personally valued memories than certain other everyday cues.     

Remembering talk: individual and gender differences in reported speech

This study examined individual and group differences in the nature and frequency of reports of past speech in the autobiographical memories of young adults. A sample of 108 participants (60 females, 48 males) responded in writing to six memory prompts. They also completed the Five Factor Inventory (Costa & McCrae, 1992) and the Personal Attributes Questionnaire (Spence & Helmreich, 1978). The frequency with which participants used reported speech was correlated with agreeableness, openness, and expressivity; however, regression analyses indicated that narrators' gender alone was the best predictor. Females used more reported speech than did males. The findings suggest that recollections of past speech are an under-appreciated yet important component of autobiographical memory.     

Behavior Therapy for Stereotypic Movement Disorder in Typically Developing Children: A Clinical Case Series

Stereotypic movement disorder (SMD) is characterized by repetitive, rhythmic, episodic movement and is associated with distress and functional impairment. A range of behavioral strategies have been implemented for the treatment of stereotypies, but research on the effectiveness of behavior therapy in typically developing children is limited. The following case series describes the implementation of behavior therapy for 3 typically developing children (ages 12 to 14) with SMD. Results showed significant reductions in the frequency and intensity of the stereotypies. Future refinement and testing of a behavior therapy protocol is recommended.     

A Cyclical Model of Motivational Constructs in Web-Based Courses

The current study investigates antecedents and outcomes of motivation to learn across nine Web-based courses. The results supported a cyclical model of motivational processes across courses in a training curriculum. Trainees' course expectations had a positive effect on motivation to learn, motivation to learn had a positive effect on trainee reactions, and trainee reactions predicted expectations for subsequent courses in the curriculum. In addition, motivation to learn decreased across the nine courses such that the average level of motivation was 0.30 points lower (on a 5-point scale) for the ninth than the first course. Agreeableness predicted changes in motivation to learn such that motivation decreased at a steeper rate for highly agreeable trainees across courses. The results suggest that there is a dynamic interplay among motivational constructs over time, and motivation should be examined from a systems perspective to understand carryover effects across training courses.