Explaining delusions: a cognitive perspective

There is now considerable evidence for reasoning, attention, metacognition and attribution biases in delusional patients. Recently, these findings have been incorporated into a number of cognitive models that aim to explain delusion formation, maintenance and content. Although delusions are commonly conceptualized as beliefs, not all models make reference to models of normal belief formation. This review considers those models that explain delusions as a breakdown of normal belief formation (belief-positive models), approaches that explain the pathology only (belief-negative models) and approaches that view delusions as one end of a distribution of anomalous mental phenomena (the continuum view). A cognitive theory that includes the 'pragmatic pathology' of delusions will be able to address both the phenomenology and the treatment of delusion-related distress.     

The Role for Public Funding of Faith-Based Organizations Delivering Behavioral Health Services: Guideposts for Monitoring and Evaluation

The paper reviews policies promoting faith-based organizations' (FBO) participation in publicly-funded programs since the Charitable Choice statute was enacted during the Clinton administration and then additional faith-based initiatives were implemented by the Bush administration. The paper focuses on research findings on FBO participation in publicly-funded human service programs under these policies. It then proposes a framework for evaluation to assess the appropriateness of public funding for behavioral health services delivered by FBOs, in order to address: (1) the programmatic and systemic effects resulting from the infusion of new players from the faith community, and the consequences to the profile of services and who gets served; and (2) the content and effectiveness of faith-infused services as a basis for identifying interventions appropriate for public funding. The analysis considers classification issues, theoretical bases of measured effects of faith-infused services, and the transferability of faith-based interventions across religious and secular applications in order to satisfy constitutional issues and client choice.     

The effects of stimulus size on bisection judgements in near and far space

Primate data suggest that near (peripersonal) and far (extrapersonal) space are coded within distinct representations. Support for this claim has been gained from human studies of line bisection, many of which have focused on neuropsychological, rather than normative, samples. One important aspect of these bisection studies has been to control for the changes in angular extent of stimuli that normally accompany changes in viewing distance. The control of angular information, however, requires alterations in the linear dimensions (actual stimulus size) of stimuli. We report two experiments in which normal subjects made manual bisection judgements on stimuli positioned in near or far space, and which were oriented in either the left-right (Experiment 1) or radial plane (Experiment 2). Both experiments were designed to enable the separable effects of linear and angular extent to be disentangled. Viewing distance effects were obtained when angular information was controlled, but many of these were dependent on changes in linear extent, and were only apparent at the individual subject level. Our data confirm that genuine near/far effects may be observed in normative bisection, but that many previous studies which appeared to support a near/far distinction in both normal and brain-damaged bisection behaviour may reflect a failure to control for changes in stimulus size.     

The Attribution of Hostile Intent in Mothers,Fathers and Their Children

Child externalising symptoms are associated with a bias towards attributing hostile intent to others. We examined the role of parental attributions in the development of this hostile attribution bias in children. The parents of 134 children aged 5-7 years responded to hypothetical social scenarios examining a) their general tendency to attribute hostile intent to the ambiguous behaviour of others, and b) hostile attributions made specifically to their child. Children's own attributions of hostile intent and levels of externalising symptomatology were assessed. The results indicated that child externalising symptoms were positively associated with both a generalised tendency towards the attribution of hostile intent and child-specific hostile attributions in parents. Child externalising symptoms were themselves associated with hostile attributions made by the child. However, no direct associations were observed between parental and child attributions of hostile intent. Thus, although the results suggest a role for parental social information processing biases in the development of child externalising symptoms, a direct transmission of such biases from parent to child was not supported.     

Intra-individual variability in gait and in cognitive performance are not related in the elderly

As humans age, the amount of intra-individual variability (IIV) present in both their gait and their cognitive performance tends to increase. Both gait and cognitive IIV are associated with attentional control and with cerebrovascular disease, suggesting that the IIV in gait and cognitive function should be strongly correlated in the elderly. In this study temporal gait variability was determined from a 60-second period of walking. Cognitive variability was determined from two decision-time tasks assessing inhibition. Despite the presence of substantial amounts of gait and cognitive IIV in 71 elderly individuals, there were no significant correlations between measures of cognitive and gait IIV, suggesting that different factors drive IIV in the motor and cognitive performance of older individuals. These results are not consistent with the common cause theory of aging, which predicts that cognitive and sensorimotor performance should show related declines due to age-related disruption of a common neurological substrate.     

The Relation of White Matter Hyperintensities to Cognitive Performance in the Normal Old: Education Matters

ABSTRACT

This study examined whether the severity of cerebral white matter abnormalities (evident on MR images as white matter hyperintensities (WMH)) was related to the cognitive performance of 141 high-functioning older adults. The elderly showed the typical age decrement on measures of processing speed, working memory, and inhibition; however WMH severity was significantly related only to processing speed. The strength of this relationship was, however, influenced by the educational level of the participants, such that processing speed was more associated with WMH severity in less-educated than in well-educated participants. This is consistent with recent concepts of cognitive reserve, but does raise a question as to the underlying source of the cognitive decrement found in the sort of well-educated elders typically used in cognitive-aging studies.     

Memory Impairment in Elderly Individuals With a Mildly Elevated Serum TSH: The Role of Processing Resources,Depression and Cerebrovascular Disease

This study examined whether a mild elevation in serum Thyroid Stimulating Hormone (TSH) in normal older individuals was associated with a cognitive impairment. Participants consisted of 15 individuals with a high- TSH level and 82 with a normal TSH. The high-TSH group performed significantly worse than the normal- TSH group on tests of immediate and delayed verbal recall and on the Mini-Mental State Exam. This decrement was not due to group differences in processing resources nor was it explained by comorbid cerebrovascular disease, depression or anticholinergic drug usage. These results suggest that undetected mild thyroid dysfunction may contribute to the cognitive decrements found in older adults.     

Vaasudevassarvam: A Journey into the Mystery of the Indian Subcontinent

A pilgrimage to an Indian ashram leaves breath-taking memories of beauty, love and spirituality of the people, as well as profound, yet subtle experience of a message from the Bhagavad Gita: All this is God.     

The relation of white matter hyperintensities to cognitive performance in the normal old: education matters

This study examined whether the severity of cerebral white matter abnormalities (evident on MR images as white matter hyperintensities (WMH)) was related to the cognitive performance of 141 high-functioning older adults. The elderly showed the typical age decrement on measures of processing speed, working memory, and inhibition; however WMH severity was significantly related only to processing speed. The strength of this relationship was, however, influenced by the educational level of the participants, such that processing speed was more associated with WMH severity in less-educated than in well-educated participants. This is consistent with recent concepts of cognitive reserve, but does raise a question as to the underlying source of the cognitive decrement found in the sort of well-educated elders typically used in cognitive-aging studies.