Cognitive behaviour therapy with adults with intractable epilepsy and psychiatric co-morbidity: preliminary observations on changes in psychological state and seizure frequency

Cognitive behaviour therapy (CBT) was undertaken with six adults with chronic, poorly controlled seizures and co-existing psychiatric and/or psychosocial difficulties. During 12 sessions of CBT from an experienced CBT Nurse Specialist, treatment focused concurrently on epilepsy-related problems, associated psychopathology and on the development of psychological strategies to reduce seizure occurrence. At the end of treatment participants rated their initial epilepsy-related problem as having less impact on their daily lives and at one-month follow-up reported less deleterious impact on everyday life in terms of their psychological difficulties. In addition participants demonstrated significant improvements in terms of their self-rated work and social adjustment, and in their decreased use of escape-avoidance coping strategies. These positive findings occurred despite the absence of a significant decrease in seizure frequency. Issues raised by the complexity and severity, both of these patients' psychological/psychosocial difficulties and their epilepsy, are discussed in relation to the optimal length of treatment that may be required when adopting a CBT model in this patient group.     

Juvenile offenders' Miranda rights comprehension and self-reported likelihood of offering false confessions

This study examined whether age, IQ, and history of special education predicted Miranda rights comprehension and the self-reported tendency to falsely confess to a crime among 55 delinquent boys. The Miranda Rights Comprehension Instruments-II, a revised version of Grisso's Instruments for Assessing Understanding and Appreciation of Miranda Rights, were developed for this study and are described in detail in this article. Results revealed that age, IQ, and special education were related to comprehension of Miranda rights. When Miranda comprehension, age, and IQ were simultaneously tested as predictor variables of the self-reported likelihood of false confessions, only age served as an independent predictor. Research and policy implications of this study are presented, and recommendations for use of the original and revised instruments are reviewed.     

Adolescents’ Disclosure and Secrecy About Peer Behavior: Links with Cyber Aggression,Relational Aggression,and Overt Aggression

The current study examines links between parent–adolescent relationship characteristics, friendship risk, and adolescent aggressive behavior. Adolescents (N = 110; M age = 17.05 years) were surveyed about their aggressive behavior (including cyber, relational, and overt) and the extent to which they disclosed aspects about their social lives (online and offline) to their parents. Participants also reported on the extent to which they hid or concealed components of their online and offline social lives from their parents, and about their exposure to a risky friendship context. Results indicate that high amounts of adolescent secrecy coupled with either (1) cyber aggressive friends, or (2) high levels of unsupervised socializing, increases adolescents’ risk for cyber aggression. Interactions between the parenting and peer contexts were also found with regard to relationally aggressive behavior. Implications of these results are discussed in the context of the parent–adolescent relationship.     

Not the End of the Odyssey: Parental Perceptions of Whole Exome Sequencing (WES) in Pediatric Undiagnosed Disorders

Due to the lack of empirical information on parental perceptions of primary results of whole exome sequencing (WES), we conducted a retrospective semi-structured interview with 19 parents of children who had undergone WES. Perceptions explored during the interview included factors that would contribute to parental empowerment such as: parental expectations, understanding of the WES and results, utilization of the WES information, and communication of findings to health/educational professionals and family members. Results of the WES had previously been communicated to families within a novel framework of clinical diagnostic categories: 5/19 had Definite diagnoses, 6/19 had Likely diagnoses, 3/19 had Possible diagnosis and 5/19 had No diagnosis. All parents interviewed expressed a sense of duty to pursue the WES in search of a diagnosis; however, their expectations were tempered by previous experiences with negative genetic testing results. Approximately half the parents worried that a primary diagnosis that would be lethal might be identified; however, the hope of a diagnosis outweighed this concern. Parents were accurately able to summarize their child’s WES findings, understood the implications for recurrence risks, and were able to communicate these findings to family and medical/educational providers. The majority of those with a Definite/Likely diagnosis felt that their child’s medical care was more focused, or there was a reduction in worry, despite the lack of a specific treatment. Irrespective of diagnostic outcome, parents recommended that follow-up visits be built into the process. Several parents expressed a desire to have all variants of unknown significance (VUS) reported to them so that they could investigate these themselves. Finally, for some families whose children had a Definite/Likely diagnosis, there was remaining frustration and a sense of isolation, due to the limited information that was available about the diagnosed rare disorders and the inability to connect to other families, suggesting that for families with rare genetic disorders, the diagnostic odyssey does not necessarily end with a diagnosis. Qualitative interviewing served a meaningful role in eliciting new information about parental motivations, expectations, and knowledge of WES. Our findings highlight a need for continued communication with families as we navigate the new landscape of genomic sequencing.     

You Wear Me Out: The Vicarious Depletion of Self-Control

ABSTRACT— Acts of self-control may deplete an individual's self-regulatory resources. But what are the consequences of perceiving other people's use of self-control? Mentally simulating the actions of others has been found to elicit psychological effects consistent with the actual performance of those actions. Here, we consider how simulating versus merely perceiving the use of willpower can affect self-control abilities. In Study 1 , participants who simulated the perspective of a person exercising self-control exhibited less restraint over spending on consumer products than did other participants. In Study 2 , participants who took the perspective of a person using self-control exerted less willpower on an unrelated lexical generation task than did participants who took the perspective of a person who did not use self-control. Conversely, participants who merely read about another person's self-control exerted more willpower than did those who read about actions not requiring self-control. These findings suggest that the actions of other people may either deplete or boost one's own self-control, depending on whether one mentally simulates those actions or merely perceives them.     

Attention to faces modulates early face processing during low but not high face discriminability

In the present study, we investigated whether attention to faces results in sensory gain modulation. Participants were cued to attend either to faces or to scenes in superimposed face—scene images for which face discriminability was manipulated parametrically. The face-sensitive N170 event-related potential component was used as a measure of early face processing. Attention to faces modulated N170 amplitude, but only when faces were not highly discriminable. Additionally, directing attention to faces modulated later processing (~230—300 msec) for all discriminability levels. These results demonstrate that attention to faces can modulate perceptual processing of faces at multiple stages of processing, including early sensory levels. Critically, the early attentional benefit is present only when the “face signal” (i.e., the perceptual quality of the face) in the environment is suboptimal.