Accuracy of Clinician Predictions of Future Self‐Harm: A Systematic Review and Meta‐Analysis of Predictive Studies

Assessment of a patient after hospital‐treated self‐harm or psychiatric hospitalization often includes a risk assessment, resulting in a classification of high risk versus low risk for a future episode of self‐harm. Through systematic review and a series of meta‐analyses looking at unassisted clinician risk classification (eight studies; N = 22,499), we found pooled estimates for sensitivity 0.31 (95% CI: 0.18–0.50), specificity 0.85 (0.75–0.92), positive predictive value 0.22 (0.21–0.23), and negative predictive value 0.89 (0.86–0.92). Clinician classification was too inaccurate to be clinically useful. After‐care should therefore be allocated on the basis of a needs rather than risk assessment.     

Repetition priming across the adult lifespan--the long and short of it

Previous reports suggest that repetition priming (i.e., enhanced processing of a stimulus after experience with that stimulus) is long lasting and impervious to the effects of age, in contrast to the pattern found with explicit memory. However, the nature of repetition priming in aged individuals remains unclear, as conflicting findings have also been reported. We used a longitudinal design to examine how repetition priming is affected by multiple stimulus repetitions (three presentations) and different delay intervals (no delay, 1 day, 1 week, and 1 month) in young adults, as well as in two groups of aging adults (young-elderly and old-elderly). Our findings extend previous reports that priming is long lasting, even when 1 month intervenes between the initial experience with an item and the subsequent priming test of that item (Cave, 1997), and is relatively impervious to the effects of age (Mitchell, et al., 1990). In addition, a more detailed characterization of priming and the effects of aging was revealed. Although priming is long lasting, remaining significant even at the month delay for all groups, it did decline over time and the rate of that decline differed with age. Both young-elderly and old-elderly groups showed a marked drop-off at 1 day, whereas young adults did not show a decline until 1 week. All groups benefited from multiple repetitions; however, this benefit disappeared at the month delay (in contrast to recognition memory, where the benefit remained significant). These findings support the assertion that repetition priming and explicit memory reflect the operation of distinct systems, and that these systems may undergo different rates of change in aging.     

A New Caledonian crow (Corvus moneduloides) creatively re-designs tools by bending or unbending aluminium strips

Previous observations of a New Caledonian crow (Corvus moneduloides) spontaneously bending wire and using it as a hook [Weir et al. (2002) Science 297:981] have prompted questions about the extent to which these animals 'understand' the physical causality involved in how hooks work and how to make them. To approach this issue we examine how the same subject ("Betty") performed in three experiments with novel material, which needed to be either bent or unbent in order to function to retrieve food. These tasks exclude the possibility of success by repetition of patterns of movement similar to those employed before. Betty quickly developed novel techniques to bend the material, and appropriately modified it on four of five trials when unbending was required. She did not mechanically apply a previously learned set of movements to the new situations, and instead sought new solutions to each problem. However, the details of her behaviour preclude concluding definitely that she understood and planned her actions: in some cases she probed with the unmodified tools before modifying them, or attempted to use the unmodified (unsuitable) end of the tool after modification. Gauging New Caledonian crows' level of understanding is not yet possible, but the observed behaviour is consistent with a partial understanding of physical tasks at a level that exceeds that previously attained by any other non-human subject, including apes.     

Psychological management and body image issues in facial transplantation

Facial transplantation, although controversial, is proposed as a major advance in facial reconstructive surgery, with the first partial transplant having taken place in France in November 2005. Although the psychological impact of facial transplantation will not be understood until several procedures have been carried out, this article examines the psychological issues likely to arise with particular reference to body image. A detailed framework for anticipation and management of psychological change is proposed. Pre-operative preparation must include thorough psychological preparation for the patient and their family. The immediate post-operative period is likely to be challenging, and a detailed management plan is proposed emphasising early return to function; subsequent psychological issues including altered body image, anxiety, shame, depression, communication and behavioural avoidance are discussed and a management strategy based on cognitive behavioural principles is proposed for the first post-operative year. Previous discussion frames psychological outcome in terms of complication and risk, tending to downplay the potential advantages of a successful procedure; the focus of this paper is on ensuring psychological adjustment as an inevitable consequence of change.     

The nature of residual cost in regular switch response factors

Two experiments are presented that compare the residual cost found when switching from one task to another under predictable conditions. The aim of the study was to explore the roles played by the stimulus, the response, or both in the process of the mental set reconfiguration necessary to switch between two tasks. The experiments tested [Rogers, R. D., & Monsell, S. (1995). Cost of a predictable switch between simple cognitive tasks. Journal of Experimental Psychology: General, 124, 207-231] stimulus-cued-completion hypothesis and [Schuch, S., & Koch, I. (2003). The role of response selection for inhibition of task sets in task shifting. Journal of Experimental Psychology: Human Perception and Performance, 29, 92-105] hypothesis of response selection as the key factor in the nature of switch cost. In the first experiment, two conditions were created that varied in terms of a Go/No-Go signal: The Go trials were a replication of [Tornay, F. J., & Milán, E. G. (2001). A more complete task-set reconfiguration in random than in predictable task switch. The Quarterly Journal of Experimental Psychology, 54A, 785-803 Experiment 3]; The No-Go trials were identical to the first condition, except that participants did not execute a response in the trial n-1 (Schuch & Koch, 2003). In addition, the percentage of Go and No-Go trials was manipulated. The results showed that the cost was significant only in the high Go signal-frequency case (Experiment 2), with an abrupt offset in Go trials and a gradual offset in No-Go trials. Based on the results of these experiments, it was concluded that the crucial factor to complete a mental set reconfiguration is response-related and not stimulus-related.     

Attentional dysfunction, social perception, and social competence: what is the nature of the relationship?

The aim of this study was to examine the nature of the relationship between attentional dysfunction and social competence deficits in patients with schizophrenia. Attentional functioning, social perception, and social competence were assessed in 56 inpatients. Measures of vigilance and span of apprehension were administered to assess attentional functioning. Social perception was assessed with an audiovisual measure of affect recognition. Social competence was rated from a role-play task. Span of apprehension and auditory vigilance emerged as specific predictors of social competence. Affect recognition was tested as a mediator and a moderator of the relationship between attentional dysfunction and social competence. Affect recognition was found to moderate the relationship between span of apprehension and social competence.     

Expressed emotion and sociocultural moderation in the course of schizophrenia

This study examined whether the sociocultural context moderates the relationship between families' expressed emotion (EE) and clinical outcomes in schizophrenia. In a sample of 60 Mexican American caregivers and their ill relatives, we first assessed whether EE and its indices (criticism, emotional overinvolvement [EOI], and warmth) related to relapse. Second, we extended the analysis of EE and its indices to a longitudinal assessment of symptomatology. Last, we tested whether bidimensional acculturation moderated the relationship between EE (and its indices) and both relapse and symptom trajectory over time. Results indicated that EOI was associated with increased relapse and that criticism was associated with increased symptomatology. Additionally, as patients' Mexican enculturation (Spanish language and media involvement) decreased, EE was increasingly related to relapse. For symptomatology, as patients' U.S. acculturation (English language and media involvement) increased, EE was associated with increased symptoms longitudinally. Our results replicate and extend past research on how culture might shape the way family factors relate to the course of schizophrenia.     

An exploratory examination of the associations among racial and ethnic discrimination, racial climate, and trauma-related symptoms in a college student population

In this study, we examined the association among perceptions of racial and/or ethnic discrimination, racial climate, and trauma-related symptoms among 289 racially diverse college undergraduates. Study measures included the Perceived Stress Scale, the Perceived Ethnic Discrimination Questionnaire, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Racial Climate Scale. Results of a multivariate analysis of variance (MANOVA) indicated that Asian and Black students reported more frequent experiences of discrimination than did White students. Additionally, the MANOVA indicated that Black students perceived the campus racial climate as being more negative than did White and Asian students. A hierarchical regression analysis showed that when controlling for generic life stress, perceptions of discrimination contributed an additional 10% of variance in trauma-related symptoms for Black students, and racial climate contributed an additional 7% of variance in trauma symptoms for Asian students.     

The medium or the message? Communication relevance and richness in trust games

Subjects communicated prior to playing trust games; the richness of the communication media and the topics of conversation were manipulated. Communication richness failed to produce significant differences in first-mover investments. However, the topics of conversation made a significant difference: the amounts sent were considerably higher in the unrestricted communication conditions than in the restricted communication and no-communication conditions. Most importantly, we find that first-movers’ expectations of second-movers’ reciprocation are influenced by communication and strongly predict their levels of investment.