Visual associations to retrieve episodic memory across healthy elderly,mild cognitive impairment,and patients with Alzheimer’s disease

Episodic memory tests need to determine the degree to which patients with moderate to severe memory deficits can still benefit from retrieval support. Especially in the case of Alzheimer’s disease (AD), this may support health care to be more closely aligned with patients’ memory capacities. We investigated whether the different measures of episodic memory of the Visual Association Test-Extended (VAT-E) can provide a more detailed and informative assessment on memory disturbances across a broad range of cognitive decline, from normal to severe impairment as seen in AD, by examining differences in floor effects. The VAT-E consists of 24 pairs of black-and-white line drawings. In a within-group design, we compared score distributions of VAT-E subtests in healthy elderly controls, mild cognitive impairment (MCI), and AD (n = 144), as well as in relation to global cognitive impairment. Paired associate recall showed a floor effect in 41% of MCI patients and 62% of AD patients. Free recall showed a floor effect in 73% of MCI patients and 84% of AD patients. Multiple-choice cued recognition did not show a floor effect in either of the patient groups. We conclude that the VAT-E covers a broad range of episodic memory decline in patients. As expected, paired associate recall was of intermediate difficulty, free recall was most difficult, and multiple-choice cued recognition was least difficult for patients. These varying levels of difficulty enable a more accurate determination of the level of retrieval support that can still benefit patients across a broad range of cognitive decline.     

Take a Job,Any Job: Exploring the Importance of Matched Interests to Career Paths and Work Satisfaction

Employment counselors often face the conundrum of whether to advise people to take a job or to hold out for something that better matches their interests. This study investigated whether matched interests in an initial job predicted the subsequent career journey of 336 sales engineers and whether this made a difference to longer term work satisfaction and tenure. Results showed that although the first job significantly influenced people's future career journey, personality and job characteristics were likely to be more influential than matched interests in predicting work satisfaction. Thus, people may be better off taking well‐designed jobs than holding out for matched interests.     

Analytische und tiefenpsychologisch fundierte Psychotherapien im Gutachterverfahren

Zusammenfassung. Ein Vergleich von 94 Erstberichten der analytischen Psychotherapie und 339 Erstberichten zur tiefenpsychologisch fundierten Psychotherapie im Rahmen der Richtlinienpsychotherapie mit Hilfe der Gutachtenkriterienliste (Rudolf et al. 2002) zeigt in beiden Verfahren sehr ?hnliche Quoten der gutachterlichen Befürwortung oder Nichtbefürwortung. Vergleichbares gilt für eine Gegenüberstellung von 61 analytischen und 147 tiefenpsychologisch fundierten Fortführungsberichten. Zweifel und Bedenken der Gutachter, die sich jedoch nicht auf die Entscheidung von Befürwortung/Nichtbefürwortung der Kostenübernahme auswirken, betreffen in der tiefenpsychologisch fundierten Psychotherapie Merkmale der prognostischen Einsch?tzung bezüglich des gew?hlten Verfahrens und der erkrankten Pers?nlichkeit sowie das Thema der Differentialindikation; bei Fortführungsberichten gelten die Zweifel der bearbeiteten Konfliktdynamik und prognostischen Einsch?tzung. Eine Ungleichbehandlung der beiden Verfahren durch die Gutachter kann aus diesen Daten nicht abgeleitet werden. In der Richtlinienpsychotherapie begründen die Therapeuten den Antrag der Patienten auf Psychotherapie durch einen ausführlichen anonymisierten Bericht über die Erkrankung der Patienten und die geplante Behandlung.

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Comparison of psychoanalytic and psychodynamic expertizes

Summary. On the basis of the criteria for expertizes (Rudof et al. 2002) we compared 94 therapy recommendations after the first assessment for psychoanalytic and 339 first recommendations for psychodynamic therapy, corresponding the psychotherapy guidelines. We found very similar proportions of approving and disapproving psychotherapy. The same result was found when comparing 61 psychoanalytic and 147 psychodynamic reports in the course of the therapies. Doubts and reservations of experts in the case of psychodynamic psychotherapy are first of all related to prognostic assessment of the chosen method and of the disturbed personality including the topic of differential indication. Expertizes about the course of therapies include first of all results about the dynamics of the conflict and prognostics. Our results do not support the opinion, that experts would make a difference along the two methods.

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Anschrift: Prof. Dr. med. G. Rudolf, Psychosomatische Universit?tsklinik, Thibautstra?e 2, 69115 Heidelberg, E-Mail: gerd_rudolf@med.uni-heidelberg.de     

Musiktherapie bei Kindern mit Migräne

Migraine in childhood is a serious health problem with a tendency for chronification. According to the bio-psycho-social model migraine is considered as a disorder generated by multiple factors and requiring an interdisciplinary treatment concept consisting of both medical and psychotherapeutic interventions. Music therapy as a nonverbal, creative arts therapy is especially apt for the treatment of children. A specific treatment concept in music therapy for children with migraine, to be applied within a multidisciplinary framework, and its theoretical background are presented in this article. Music therapy is firmly established within the context of stationary infant psychiatric care. Also, it is presently used as a method of outpatient psychotherapy mainly for children and adolescents. Additionally, music therapy finds frequent use in medical care, special needs education and curative education for children. This article will be limited to the presentation of music therapy as artistic psychotherapy.     

2001 INVITED ADDRESS: The Mystery of Human Context and Coping: An Unraveling of Clues

Community and clinical psychology share a fundamental focus: to understand the interplay between human contexts, coping, and adaptation. To highlight recent progress in this area, I offer a guiding conceptual framework and discuss 8 propositions about environment and coping. The propositions consider such issues as patterns of social climate and coping and their links to personal development and dysfunction, the connections between ongoing life circumstances and intervention programs, the role of personal characteristics in matching individuals and environments, and the value of placing specific settings in an ecological context. I then focus on 8 enigmas, such as how to identify conceptually unifying dimensions of diverse social contexts, how to model the processes involved in person–environment transactions, how to understand the link between adversity and personal growth, how to examine the generality of models across ethnic and cultural groups, and how to enhance positive carryover from intervention programs to ongoing life contexts. I close by addressing some implications of these issues for a vision of a dynamic community psychology.     

Drinking to cope and alcohol use and abuse in unipolar depression: a 10-year model

This study examined drinking to cope with distress and drinking behavior in a baseline sample of 412 unipolar depressed patients assessed 4 times over a 10-year period. Baseline drinking to cope operated prospectively as a risk factor for more alcohol consumption at 1-, 4-, and 10-year follow-ups and for more drinking problems at 1- and 4-year follow-ups. Findings elucidate a key mechanism in this process by showing that drinking to cope strengthened the link between depressive symptoms and drinking behavior. Individuals who had a stronger propensity to drink to cope at baseline showed a stronger connection between depressive symptoms and both alcohol consumption and drinking problems.     

Body-image evaluation and body-image investment among adolescents: a test of sociocultural and social comparison theories

Sociocultural theory and social comparison theory were used to account for variations in body-image evaluation and body-image investment among male and female adolescents (N = 1,543). Exposure to magazines and television programs containing idealistic body imagery as well as frequency of self-comparison to universalistic targets (e.g., fashion models) were measured. Results provided minimal support for sociocultural theory, but fairly strong support for social comparison theory. Specifically, the extent to which males engaged in universalistic social comparison predicted appearance self-esteem, number of diets to gain weight, use of pathogenic weight control practices, and use of steroids to increase muscle mass. For females, universalistic social comparison predicted appearance self-esteem, body dissatisfaction, number of diets to lose weight, and use of pathogenic weight control practices. The possibility that the null effects for sociocultural theory were an artifact of dummy coding for missing data or theoretical interdependence were explored, but did not appear to be valid. Limitations of the present study and directions for future research are outlined.     

A Model of Jury Decisions where all Jurors have the same Evidence

Under the independence and competence assumptions of Condorcet’s classical jury model, the probability of a correct majority decision converges to certainty as the jury size increases, a seemingly unrealistic result. Using Bayesian networks, we argue that the model’s independence assumption requires that the state of the world (guilty or not guilty) is the latest common cause of all jurors’ votes. But often – arguably in all courtroom cases and in many expert panels – the latest such common cause is a shared ‘body of evidence’ observed by the jurors. In the corresponding Bayesian network, the votes are direct descendants not of the state of the world, but of the body of evidence, which in turn is a direct descendant of the state of the world. We develop a model of jury decisions based on this Bayesian network. Our model permits the possibility of misleading evidence, even for a maximally competent observer, which cannot easily be accommodated in the classical model. We prove that (i) the probability of a correct majority verdict converges to the probability that the body of evidence is not misleading, a value typically below 1; (ii) depending on the required threshold of ‘no reasonable doubt’, it may be impossible, even in an arbitrarily large jury, to establish guilt of a defendant ‘beyond any reasonable doubt’.     

Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors

Background/ObjectiveLong-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients’ re-integration into society is successful could thus have important implications for well-being in adulthood.     

Evaluating Triple P Online: A Digital Parent Training Program for Child Behavior Problems

Triple P Online (i.e., TPOL; www2.tripleponline.net) is an online self-help parent training program aimed at reducing child behavior problems through “positive parenting practices”—available at time of review for $79.95. TPOL is comprised of 8 video-based modules that also incorporate in-session activities and homework. Randomized control trials have shown that TPOL effectively reduces child behavior problems. The program’s main strengths include very high-quality content with an abundance of relevant and easily locatable resources, an easy-to-use interface, and a professional look and feel. The program’s main weakness lies in its lack of monitoring and adaptation to the user’s state (e.g., child’s and parent’s behaviors), and real-time reminders for desired actions. Altogether, TPOL is an extremely valuable and important resource for families seeking evidence-based treatment for child behavior problems.