The nature and treatment of stuttering as revealed by fMRI A within- and between-group comparison

This article reviews some of our recent functional magnetic resonance imaging (fMRI) studies of stuttering. Using event-related fMRI experiments, we investigated brain activation during speech production. Results of three studies comparing persons who stutter (PWS) and persons who do not stutter (PWNS) are outlined. Their findings point to a region in the right frontal operculum (RFO) that was consistently implicated in stuttering. During overt reading and before fluency shaping therapy, PWS showed higher and more distributed neuronal activation than PWNS. Immediately after therapy differential activations were even more distributed and left sided. They extended to frontal, temporal, and parietal regions, anterior cingulate, insula, and putamen. These over-activations were slightly reduced and again more right sided two years after therapy. Left frontal deactivations remained stable over two years of observation, and therefore possibly indicate a dysfunction. After therapy, we noted higher activations in persons who stutter moderately than in those who stutter severely. These activations might reflect patterns of compensation. We discuss why these findings suggest that fluency-inducing techniques might synchronize a disturbed signal transmission between auditory, speech motor planning, and motor areas.

Educational objectives: The reader will learn about and be able to: (1) identify regions of brain activations and deactivations specific for PWS; (2) describe brain activation changes induced by fluency shaping therapy; and (3) discuss the correlation between stuttering severity and brain activation.     

The Guilty Knowledge Test and the modified Stroop task in detection of deception: an exploratory study

The current study tested whether a simple Stroop paradigm can be used to detect deceptive behavior. 40 university students (34 women), half of whom committed a mock crime, were administered a Guilty Knowledge Test and modified Stroop task to detect guilt or innocence. The Guilty Knowledge Test is a well-known psychophysiological detection method, which consists of multiple-choice questions about details of the crime while skin conductance is recorded. Subjects possessing guilty knowledge are expected to show enhanced differential responses to the relevant stimuli. The modified Stroop task required color-naming of colored words related to the mock crime or an irrelevant crime. Each version of the Stroop task was presented in story form. Subjects possessing guilty knowledge were expected to produce larger reaction times to the relevant version relative to the irrelevant version. The test correctly identified 100% of innocent participants and 78% of guilty participants. In contrast, Stroop interference. i.e., reaction times for irrelevant crime details subtracted from those for mock crime details, did not differentiate between the two groups, suggesting that the story form of the Stroop paradigm is not suitable for lie detection.     

Day treatment of patients with personality disorders: experiences from a Norwegian treatment research network

This study sought to investigate the following research questions: Are time-limited day treatment programs for patients with personality disorder (PD) effective outside resourceful university settings, and what are the overall treatment results when the program is implemented on a larger scale? Do all categories and subtypes of PDs respond favorably to such treatment? How intensive should such day treatment programs be? All patients (n = 1,244) were consecutively admitted to eight different treatment programs in the Norwegian Network of Psychotherapeutic Day Hospitals from 1993 to 2000. Altogether, 1,010 patients were diagnosed with PD. Avoidant, borderline, not otherwise specified (NOS), and paranoid PD were the most common conditions. SCID-II and MINI were used as diagnostic instruments. Outcome measures included GAF Global Assessment of Functioning, (GAF; American Psychiatric Association, 1994), SCL-90R, CIP, Quality of Life, work functioning and parasuicidal behavior, measured at admittance, discharge and 1-year follow up. The attrition rate was 24%. The number of dropouts did not improve over time. As a group, completers with PD improved significantly on all outcome variables from admittance to discharge and improvement was maintained or increased at follow up. Treatment results were best for borderline PD, cluster C patients, PD NOS and No PD, and poorer for cluster A patients. Units with a high treatment dosage did not experience better outcomes than those with a low treatment dosage (10 hours per week). Results from the University unit were not better than those from units at local hospitals or mental health centers.     

Boundary distortions for neutral and emotional pictures

In two experiments, we examined Safer, Christianson, Autry, and Osterlund's (1998) claim that when emotional material is remembered, tunnel memory (i.e., the tendency to remember less of a scene than was actually shown) occurs. In Experiment 1, 81 undergraduate students drew photographs from memory after having briefly seen either four neutral or four emotional photographs. Both neutral and emotional drawings revealed boundary extension (i.e., the tendency to remember more of a scene than was actually shown). Experiment 2 relied on the camera distance paradigm (Intraub, Bender, & Mangels, 1992). In a recognition test, 60 undergraduate students judged the camera distance of previously seen neutral or emotional photographs. The majority of them demonstrated accurate judgments and neither extended nor restricted picture boundaries. Those participants who made an error more often displayed a boundary extension than a tunnel memory error. Taken together, our results suggest that boundary extension for neutral and emotional photographs is a more robust phenomenon than its counterpart, tunnel memory.     

Two-year follow-up of an interdisciplinary cognitive-behavioral intervention program for obese adults

Intervention programs for treating adiposity which focus on dietary change and physical exercise often do not lead to the desired long-term reduction in weight. This article reports on the effectiveness of M.O.B.I.L.I.S., a standardized theory-driven intervention program. Participants are taught cognitive-behavioral strategies of goal setting, action planning, barrier management, and self-monitoring. Persons with obesity (N=316) responded to a public advertisement to participate in the intervention program (IG) or comparison group (CG; quasi-experimental design). Assessments were conducted at four time points, with the last assessment being conducted two years after baseline. At the 24-month follow-up, the IG showed weight loss of 5.57%, whereas the CG lost 1.12% of their weight (t1-t4, p < .01). The results yielded significant interaction terms (group x time), indicating that the intervention had a substantial effect on food choice and level of physical exercise (p < .01). The IG showed significantly enhanced self-efficacy, stronger goal intentions, and more detailed implementation intentions than the CG at follow-ups. The intervention program has the potential to evoke enduring changes in the cognitions we hypothesized to be responsible for inducing obese adults to begin and continue regular exercise and healthy eating behavior, resulting in substantial weight loss.     

Anterior cingulate cortex activation is related to learning potential on the WCST in schizophrenia patients

The remediation of executive function in patients with schizophrenia is important in rehabilitation because these skills affect the patient's capacity to function in the community. There is evidence that instructional techniques can improve deficits in the Wisconsin Card Sorting Test (WCST) in some schizophrenia patients. We used a standard test/training phase/standard test format of the WCST to classify 36 schizophrenia patients as high-achievers, learners or non-retainers. All healthy controls performed as high-achievers. An event-related fMRI design assessed neural activation patterns during post-training WCST performance. Patients showed a linear trend between set-shifting related activation in the anterior cingulate cortex and learning potential, i.e. increased activation in high-achievers, a trend for increased activation in learners, and no activation in non-retainers compared to controls. In addition, activation in the temporoparietal cortex was highest in patients classified as learners, whereas in non-retainers activation was increased in the inferior frontal gyrus compared to controls and high-achieving patients. These results emphasize the relevance of the ACC's neural integrity in learning set-shifting strategies for patients with schizophrenia. Also, our results support the hypothesis that compensatory neural activation in patients with schizophrenia helps them to catch up with healthy controls on cognitive tasks.     

Adaptive memory: Stereotype activation is not enough

Studies have shown that survival processing leads to superior memorability. The aim of the present study was to examine whether this survival recall advantage might result from stereotype activation. To test this hypothesis, we conducted a pilot study and two experiments in which participants were primed with stereotypes (Experiment 1, professor and elderly person; Experiment 2, survival-stereotype). In Experiment 1, 120 undergraduates were randomly assigned to a survival, professor stereotype, elderly person stereotype, or moving scenario and rated words for their relevance to the imagined scenario. In Experiment 2, 75 undergraduates were given a survival, survival-stereotype (based on our pilot study), or moving scenario. Both experiments showed that survival processing leads to a greater recall advantage over the stereotype groups and control group. These data indicate that the mere activation of stereotypes cannot explain the survival recall advantage.     

Levels of unconsciousness and their formal structure

This brief essay replies to Carvalho's exposition of a formal approach to the concept of the unconscious which is originally due to Ignacio Matte Blanco (1908–1995), a psychoanalyst from Chile. It's a challenge – first because I have been largely unfamiliar with the details of Matte Blanco's approach, and second because the space available for this reply does not allow me to be as precise as Carvalho's essay no doubt deserves. I will start with some remarks about how I see Matte Blanco's system from a mathematical perspective and then try to relate it to some of the core features of Pauli's and Jung's thinking. I will conclude with a tentative proposal of how Matte Blanco's strata between full consciousness and most undifferentiated unconscious can be related to the tension between ontic and epistemic accounts.