Increased regional cerebral glucose metabolism and semantic memory performance in Alzheimer's disease: A pilot double blind transdermal nicotine positron emission tomography study

Nicotinic receptor dysfunction and impaired semantic memory occur early in Alzheimer's disease patients (AD). Previous research implied that nicotine's ability to enhance alertness, arousal, and cognition in a number of nonclinical populations was a function of its ability to stimulate CNS nicotinic cholinergic receptors. In this study it was hypothesized that transdermal administration of nicotine would increase both regional cerebral glucose metabolism (rCMRglc) and semantic memory (as assessed by verbal fluency). Two mild AD and two elderly controls underwent positron emission tomography scanning during a double blind nicotinic agonist verbal fluency challenge procedure. rCMRglc increases occurred in both AD patients, but not controls. In the two AD patients, verbal fluency scores increased by an average of 17%. One elderly control's verbal fluency increased, and the other decreased. These findings suggest that nicotine's effect on metabolism and verbal fluency is due to its ability to stimulate the cholinergic system.     

Topographically distinct cortical activation in episodic long-term memory: The retrieval of spatial versus verbal information

Two experiments are reported to study slow potentials in the EEG during reactivation of spatial and verbal information. Subjects had to learn associations between drawings and one, two, or three mediators (locations in Experiment 1, nouns in Experiment 2). During recall, subjects had to decide whether or not two drawings were linked to each other by a common mediator. EEG was recorded during learning and recall. Both experiments were completely equivalent. Irrespective of the quality of the mediators, response time proved to be a linear function of the numbers of mediators to be recalled. Negative slow potentials that accompanied the reactivation of information during anticipation learning and cued recall had a material-specific topography: The maximum was found over the parietal cortex for spatial information and over the left frontal cortex for verbal information. Moreover, the amplitude at these scalp locations varied with the amount of the to-be-retrieved information. The results support the claim of topographically distinct cell assemblies specialized for storage and retrieval of distinct kinds of information.     

Psychoeducation: A promising intervention strategy for families of children and adolescents with mood disorders

Mood disorders and suicide in youth represent major health concerns requiring effective intervention strategies. This paper briefly summarizes the literature on childhood mood disorders and discusses expressed emotion (EE) and the link between lowering EE and improved outcome for mood disordered individuals. Family psychoeducation is discussed as a means of reducing EE and similarities and differences between psychoeducation and other therapeutic interventions explored. The authors' adaptations that made psychoeducation developmentally appropriate for families of children and adolescents are reviewed. Psychoeducation for families of mood disordered youth is suggested as worthy of further clinical and empirical effort.     

A structured approach to disengagement in family therapy with child-focused problems

The aim of this paper is to describe a structured approach to managing the disengagement process. Six distinct disengagement scenarios are first outlined. Thereafter, phasing out therapy, dealing with family belief systems concerning the permanence of improvements and relapse management are discussed. Ways in which disengagement from specific episodes of therapy may be construed as part of an ongoing therapeutic relationship and the practicalities of recontracting for further episodes of therapy, handing over cases, and referring cases on to other professionals are considered. An approach to therapeutic failure analysis is presented. Finally, ways in which disengagement may lead to significant loss experiences are discussed.     

participating in a couples therapy outcome study: Participants' views

Discovering that participants who received therapy in a research project and were being debriefed in a therapy outcome study considered those assessment sessions therapeutic, the authors conclude that participants: (a) are aware of the research context, (b) have some idea about how it affected the treatment they got, and (c) see positive outcomes for taking part in the study. Assessment and treatment were not separated in the minds of some participants, as they had been in the mind of the researchers.This study was supported in part by National Institute on Drug Abuse grant #1R 18DA 1069232001.     

Family history and gender roles: Critical factors in practitioners' views of family interactions

This study examined practitioners' perceptions of family and individual family member functioning in relationship to family roles, gender of family leadership, beliefs about the consequences of maternal employment, and paternal division of responsibility in practitioner family of origin. Practicing counselors and mental health therapists rated two videotaped family interviews, one demonstrating a matriarchal style of family interaction and the second a patriarchal style. Findings indicated that practitioners were vulnerable to view a patriarchal style of family interaction as more healthy in comparison to a matriarchal style and that their perceptions of family members were related to personal beliefs about the consequences of maternal employment and to personal family history. These and other findings suggest that practitioners may be prone to errant perceptions and misguided intervention related to personal history and attitudes.     

Reducing work/home conflicts in employed couples: A proposed program to balance job and family demands

Work/home conflict is a dominant stress for workers in industrialized countries, particularly in dual-employment families. Interindividual (husband/wife) and interrole (work/home) conflicts in such families are a unique source of stress and adversely affect family and marital relationships as well as performance at work. Neither family therapy nor the stress literature have reported any interventions directed specifically at reducing work/home conflicts in employed couples or parents, although many workplaces today offer stress prevention programs aimed at individual workers. This paper discusses the underlying theoretical rationale for a marital enhancement intervention currently being developed for prevention of distress associated with work/home conflicts. The program combines marital enrichment and training principles with stress management techniques and aims at reinforcing shared coping resources. It focuses on four main variables associated with interpersonal processes: unrealistic expectations based on irrational beliefs, social undermining, shared decision control, and social support.     

Increasing husbands' involvement in domestic labor: Issues for therapists

As a result of the dramatic increase in women's participation in the work force, more relationship therapists are seeing couples who are dissatisfied with how domestic labor is divided in their homes. Although, this issue may seem therapeutically straightforward, there are many aspects which make its renegotiation surprisingly problematic and complex. This article is an effort to delineate some of these issues such as engaging men in therapy, exploring emotional issues connected with housework, and the mechanism of gatekeeping. Also included is a therapeutic framework for addressing client concerns about domestic responsibilities.     

Creating a safe place for growth in supervision

When people are afraid, learning is inhibited. In too many disturbed families, institutional settings, rigid organizations, and some supervision groups, a feeling of emotional safety is missing. The first step in teaching, supervising, or therapy is the necessity to provide a safe environment. The author suggests a model applicable to any supervision group, work group, organization, classroom, or family. A group model, specifically applied to the relationship between family therapy students or interns and supervisors, suggests ways to enhance growth by minimizing fear.     

The use of interpreters in family therapy with deaf persons

The paper discusses the use of interpreters in family therapy with deaf person families. Issues from the perspective of the therapist, the interpreter, and the family are presented.Portions of this paper were presented at the annual meeting of the Texas Association for Marriage and Family Therapy in San Antonio, TX.