Age of avatar modulates the altercentric bias in a visual perspective-taking task: ERP and behavioral evidence

Despite being able to rapidly and accurately infer their own and other peoples’ visual perspectives, healthy adults experience difficulty ignoring the irrelevant perspective when the two perspectives are in conflict; they experience egocentric and altercentric interference. We examine for the first time how the age of an observed person (adult vs. child avatar) influences adults’ visual perspective-taking, particularly the degree to which they experience interference from their own or the other person’s perspective. Participants completed the avatar visual perspective-taking task, in which they verified the number of discs in a visual scene according to either their own or an on-screen avatar’s perspective (Experiments 1 and 2) or only from their own perspective (Experiment 3), where the two perspectives could be consistent or in conflict. Age of avatar was manipulated between (Experiment 1) or within (Experiments 2 and 3) participants, and interference was assessed using behavioral (Experiments 1–3) and ERP (Experiment 1) measures. Results revealed that altercentric interference is reduced or eliminated when a child avatar was present, suggesting that adults do not automatically compute a child avatar’s perspective. We attribute this pattern to either enhanced visual processing for own-age others or an inference on reduced mental awareness in younger children. The findings argue against a purely attentional basis for the altercentric effect, and instead support an account where both mentalising and directional processes modulate automatic visual perspective-taking, and perspective-taking effects are strongly influenced by experimental context.     

The effects of expected reward on creative problem solving

Creative problem solving involves search processes, and it is known to be hard to motivate. Reward cues have been found to enhance performance across a range of tasks, even when cues are presented subliminally, without being consciously detected. It is uncertain whether motivational processes, such as reward, can influence problem solving. We tested the effect of supraliminal and subliminal reward on participant performance on problem solving that can be solved by deliberate analysis or by insight. Forty-one participants attempted to solve 100 compound remote associate problems. At the beginning of each problem, a potential reward cue (1 or 25 cents) was displayed, either subliminally (17 ms) or supraliminally (100 ms). Participants earned the displayed reward if they solved the problem correctly. Results showed that the higher subliminal reward increased the percentage of problems solved correctly overall. Second, we explored if subliminal rewards preferentially influenced solutions that were achieved via a sudden insight (mostly processed below awareness) or via a deliberate analysis. Participants solved more problems via insight following high subliminal reward when compared with low subliminal reward, and compared with high supraliminal reward, with no corresponding effect on analytic solving. Striatal dopamine (DA) is thought to influence motivation, reinforce behavior, and facilitate cognition. We speculate that subliminal rewards activate the striatal DA system, enhancing the kinds of automatic integrative processes that lead to more creative strategies for problem solving, without increasing the selectivity of attention, which could impede insight.     

Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding,Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS?, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS? report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS? reports were released to 14 families (N?=?28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N?=?24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS? reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS? report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).     

Utilization of the Tablet Application Proband in Pedigree Construction and Assessment

Many medical institutions have converted to a digital model for record keeping due to the Health Information Technology for Economic and Clinical Health Act. This Act provides incentives to health care systems to accelerate and encourage the adoption of electronic health record (EHR) systems. The pedigree as a tool in medicine provides an efficient method to assess and represent an individual’s health and family health risks that may otherwise not be apparent in the medical record in a clearly identifiable way (Schuette, J. L., & Bennett 2009). Many clinicians continue to construct pedigrees using pen and paper method despite findings of improved identification of at risk patients with similar electronic intake tools (Arar et al. in Personalized Medicine 2011 8:523–32). The goal of this study was to explore the patient and practitioner experience with electronic pedigree programs using Proband, an application developed at The Children’s Hospital of Philadelphia for genetic counselors to construct pedigrees during genetic counseling sessions directly on iPads. The first part of this study looked at the patient experience and assessed time to take the pedigree and the impact of using an electronic pedigree tool on the relationship between participant and genetic counselor. This involved 50 participants and was compared with the traditional paper method of taking a pedigree. There was no statistical significance found between the two different mediums in accuracy, speed, and rapport with provider. The second part of the study assessed the usability of Proband by ten genetic counselors. Overall, the application received a system usability score of 90/100 with a majority (7/10) of counselors agreeing that they would use this application in their clinic. The positive outcome of this study encourages future work to assess the impact and usability of programs on a larger scale as they continue to integrate into current electronic health records.     

Change in Maternal Stress for Families in Treatment for their Children with Oppositional Defiant Disorder

Our objective was to predict change in maternal stress over the course of a randomized clinical trial comparing the efficacy of two interventions for Oppositional Defiant Disorder (ODD): Parent Management Training and Collaborative & Proactive Solutions. In a secondary analysis of data collected from this randomized clinical trial, we examined whether children’s self-reported positive relations with their parents impacted responsiveness to treatment, which in turn impacted maternal stress. One hundred thirty-four children and their parents (38.1% female, ages 7–14, M age?=?9.51, SD?=?1.77) were tracked across three time points: pre-treatment; one-week post-treatment; and six-month post-treatment. Hierarchical linear models tested change in children’s reports of positive relations with parents, clinician reports of ODD severity, and maternal reports of parenting stress. Models then tested multilevel mediation from positive relations with parents, through ODD severity, onto maternal stress. Hypothesized indirect effects were supported such that children’s reports of positive views toward parents uniquely predicted reductions in ODD severity over time, which in turn uniquely predicted reductions in maternal stress. Results highlight the promise of potential secondary benefits for parents following interventions for children with oppositional problems. Furthermore, results underscore the importance of the parent–child relationship as both a protective factor and as an additional target to complement interventions for child disruptive behaviors.     

The Longitudinal Impact of a Family-Based Communication Intervention on Observational and Self-Reports of Sexual Communication

Parents can play a vital role in shaping teenagers’ sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent–adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent–adolescent sexual communication was examined at 12 months among adolescents with mental health problems. Of the 721 parent–adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent–adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent body language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11?h of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12 months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent–adolescent sexual communication among a mental health sample.     

From Application to Approach: A Systematic Review of 50 Years of Psychoanalytic Couple Therapy

ABSTRACT

This systematic review of contributions to peer-reviewed journals in the area of couple interventions aims to provide a comprehensive and intensive overview of this evolving field, within psychoanalysis. Using a pan theoretical systematic review methodology, 113 peer-reviewed journal articles were reviewed, dated between 1963 and 2014, addressing the topic of couple therapy and psychoanalysis. This article addresses a number of specific questions including, where authors have published their work, what methodologies they have used, with which couples psychoanalysts have been working, how writers from within different theoretical orientations talk about their work with couples, and how the field has changed over time. It also explores emerging themes of the relationship between couple and individual therapy, sex, and co-therapy. This review of writing over the past 50 years suggests that although Classical contributions have waned over time, couple psychoanalysts from within Object Relations, Self Psychology, Intersubjectivity, and Relational orientations have evolved in their discourse about couple distress, from an application of psychoanalytic concepts to full-bodied, well-articulated, clear, and concise approaches to diagnosis and treatment. The first 50 years of writing in the field of couple psychoanalysis has brought us distinct treatment models, which have opened the door for greater communication and sharing within and between orientations.