The Home-Based Occupational Therapy Intervention in the Alzheimer's Disease Multiple Intervention Trial (ADMIT)

There is no way to prevent functional declines related to Alzheimer's Disease (AD). The use of occupational therapy (OT) has been shown to be successful in managing some aspects of AD. We added home-based OT to evidence-based best practice for AD with the aim of delaying functional decline in people with AD. OT was delivered in the home to a caregiver dyad including the person with AD and her/his caregiver. This article describes the OT intervention for the AD Multiple Intervention Trial, a parallel randomized controlled trial. We include baseline data on the 180 caregiver dyads.     

Opposite effects of anxiety and depressive symptoms on executive function: The case of selecting among competing options

People constantly face the need to choose one option from among many, such as when selecting words to express a thought. Selecting between many options can be difficult for anyone, and can feel overwhelming for individuals with elevated anxiety. The current study demonstrates that anxiety is associated with impaired selection across three different verbal tasks, and tests the specificity of this finding to anxiety. Anxiety and depression frequently co-occur; thus, it might be assumed that they would demonstrate similar associations with selection, although they also have distinct profiles of symptoms, neuroanatomy and neurochemistry. Here, we report for the first time that anxiety and depressive symptoms counter-intuitively have opposite effects on selection among competing options. Specifically, whereas anxiety symptoms are associated with impairments in verbal selection, depressive symptoms are associated with better selection performance. Implications for understanding the mechanisms of anxiety, depression and selection are discussed.     

Rates of Subthreshold PTSD Among U.S. Military Veterans and Service Members: A Literature Review

The current study’s goal was to provide a comprehensive review of current subthreshold posttraumatic stress disorder (PTSD) rates among U.S. military veterans and service members. PubMed, PsycInfo, ProQuest, Web of Knowledge, Google Scholar, and any relevant articles’ reference lists identified studies of subthreshold PTSD in the U.S. military. Search terms included PTSD in combination with partial, subthreshold or sub-threshold, subsyndromal or sub-syndromal, subclinical or sub-clinical, and military or veteran. Sixteen articles met criteria for review. Current subthreshold PTSD rates ranged from 2.3% to 22.3%, with a weighted mean rate of 7.6%. Definitional variation within and across the “below threshold” terms produced some variability in rates reported. Few studies consistently reported on impairment and comorbidity in the subthreshold PTSD population. Variability of current subthreshold PTSD rates may be due to methodological issues such as sampling methods, sample sizes, and how below threshold PTSD was assessed and defined. Based on our findings, we provide a number of recommendations that can be used to inform future research of subthreshold PTSD among U.S. military veterans and service members. These recommendations include having a standardized term and definition, determining how to more properly assess subthreshold PTSD symptomatology, clarifying subthreshold PTSD diagnostic stability, and identifying appropriate sampling methods.     

Signs of Resistance: Peer Learning of Sign Languages Within ‘Oral’ Schools for the Deaf

This article explores the role of the Deaf child as peer educator. In schools where sign languages were banned, Deaf children became the educators of their Deaf peers in a number of contexts worldwide. This paper analyses how this peer education of sign language worked in context by drawing on two examples from boarding schools for the deaf in Nicaragua and Thailand. The argument is advanced that these practices constituted a child-led oppositional pedagogy. A connection is drawn to Freire’s (1972) theory of critical pedagogy. Deaf children’s actions as peer educators are framed as an act of resistance towards the oppression of their language and culture. A contrast is drawn between oralist pedagogy that is historically associated with punitive practices and didactic methods and the experiential and dialogic interaction that characterised peer learning of sign languages. The argument is made that the peer teaching and learning processes enabled the self-actualisation of the Deaf children whereas the oralist methods were based on a deficit model that focused on modifying deaf children according to the norms of hearing society. The implications of this for current policy and practice are inferred to be about access to sign languages and the importance of Deaf communities in deaf children’s education. The argument is made that space needs to be created for deaf children to engage in peer learning.     

Women's experience of brain injury: An interpretative phenomenological analysis

Acquired traumatic brain injury (TBI) can leave the survivor with a complex range of psychological sequalae. This study aims to investigate the experience from the perspective of women with acquired TBI. Using a qualitative research method, six women with a TBI were interviewed about their experience, and the interviews were transcribed verbatim and analysed according to Interpretative Phenomenological Analysis (IPA). The major themes that emerged were: awareness of change; the emotional reaction; struggling to make sense; adaptation and acceptance. This article describes the process of adaptation, and the implications for rehabilitation are discussed. It is suggested that an intervention based on these themes might be an effective tool in rehabilitation.     

Paternal Postnatal and Subsequent Mental Health Symptoms and Child Socio‐Emotional and Behavioural Problems at School Entry

Research on the effect of paternal mental health problems, particularly on young children, is based predominantly on clinical levels of depression. Furthermore, potential mediators such as marital discord have often been overlooked. This longitudinal community study assessed the association between paternal mental health symptoms in a community sample (N = 705) assessed at 3 months postnatally (Edinburgh Postnatal Depression Scale) and 36 months (General Health Questionnaire) and children's socio‐emotional and behavioural problems at 51 months (Strengths and Difficulties Questionnaire) as reported by mother, father and teacher. Controlling for socioeconomic status and maternal mental health symptoms at 3 and 36 months, paternal postnatal depressive symptoms predicted more father‐reported child problems at 51 months but, in contrast to previous findings, not mother‐reported problems. Paternal mental health symptoms at 36 months predicted both maternal and paternal reports of child problems at 51 months controlling for both paternal and maternal postnatal symptoms. Paternal mental health symptoms at 3 and 36 months were not significant predictors of teacher‐reported child problems. Postnatal marital discord and paternal mental health problems at 36 months both mediated the relationship between paternal postnatal symptoms and later child emotional and behavioural problems. Child gender did not moderate the relationship. Implications for interventions are discussed. Copyright © 2013 John Wiley & Sons, Ltd.     

Environmental enrichment results in cortical and subcortical changes in levels of synaptophysin and PSD-95 proteins

Experience-dependent plasticity is thought to involve selective change in pre-existing brain circuits, involving synaptic plasticity. One model for looking at experience-dependent plasticity is environmental enrichment (EE), where animals are exposed to a complex novel environment. Previous studies using electron microscopy showed that EE resulted in synaptic plasticity in the visual cortex and hippocampus. However, the areas in the brain that have been examined following EE have been limited. The present study quantified potential synaptic plasticity throughout the brains of C57BL/6 mice using an enzyme-linked immunosorbent assay (ELISA) for two synaptic proteins, synaptophysin and PSD-95. EE resulted in increased synaptophysin and PSD-95 levels through major brain regions, including anterior and posterior areas of the forebrain, hippocampus, thalamus, and hypothalamus. However, no changes in synaptophysin were detected in the cerebellum. These results demonstrate that EE results in an increase in levels of both pre- and post-synaptic proteins in multiple regions of the brain, and it is possible that such changes represent the underlying synaptic plasticity occurring in EE.     

The Role of School-based Group Mentoring in Promoting Resilience among Vulnerable High School Students

This study examined the role of participation in a year-long school-based group mentoring program, Project Arrive (PA), on increasing resilience during the first year of high school among students identified as being at high risk for school dropout. Participants were 114, ninth grade students taking part in one of 32 PA mentoring groups, and 71 statistically matched comparison students (53% male, 75% eligible for free/reduced-price lunch, 62% Latinx). Using a propensity score with inverse probability of treatment weighting (IPTW) to reduce selection bias, and a multi-level model to account for non-independence of data within mentoring groups, we examined changes from pre-test to program exit on seven external resilience resources (developmental supports and opportunities) and four internal resilience assets (personal strengths). At program exit, PA participants had higher adjusted means than comparisons on six external resources, including school support, school belonging, school meaningful participation, peer caring relationships, prosocial peers, and home meaningful participation. PA participants also had higher adjusted means on one internal asset, problem solving. Results point to the promise of group mentoring as an approach for increasing resilience among academically vulnerable adolescents.     

I thought that I heard you laughing: Contextual facial expressions modulate the perception of authentic laughter and crying

It is well established that categorising the emotional content of facial expressions may differ depending on contextual information. Whether this malleability is observed in the auditory domain and in genuine emotion expressions is poorly explored. We examined the perception of authentic laughter and crying in the context of happy, neutral and sad facial expressions. Participants rated the vocalisations on separate unipolar scales of happiness and sadness and on arousal. Although they were instructed to focus exclusively on the vocalisations, consistent context effects were found: For both laughter and crying, emotion judgements were shifted towards the information expressed by the face. These modulations were independent of response latencies and were larger for more emotionally ambiguous vocalisations. No effects of context were found for arousal ratings. These findings suggest that the automatic encoding of contextual information during emotion perception generalises across modalities, to purely non-verbal vocalisations, and is not confined to acted expressions.