Neuropsychological,Cognitive, and Theoretical Considerations for Evaluation of Bilingual Individuals

As the number of bilinguals in the USA grows rapidly, it is increasingly important for neuropsychologists to be equipped and trained to address the unique challenges inherent in conducting ethical and competent neuropsychological evaluations with this population. Research on bilingualism has focused on two key cognitive mechanisms that introduce differences between bilinguals and monolinguals: (a) reduced frequency of language-specific use (weaker links), and (b) competition for selection within the language system in bilinguals (interference). Both mechanisms are needed to explain how bilingualism affects neuropsychological test performance, including the robust bilingual disadvantages found on verbal tasks, and more subtle bilingual advantages on some measures of cognitive control. These empirical results and theoretical claims can be used to derive a theoretically informed method for assessing cognitive status in bilinguals. We present specific considerations for measuring degree of bilingualism for both clients and examiners to aid in determinations of approaches to testing bilinguals, with practical guidelines for incorporating models of bilingualism and recent experimental data into neuropsychological evaluations. This integrated approach promises to provide improved clinical services for bilingual clients, and will also contribute to a program of research that will ultimately reveal the mechanisms underlying language processing and executive functioning in bilinguals and monolinguals alike.     

Psychological and Somatic Factors in Patients Undergoing Coronary Artery Bypass Graft Surgery: Towards Building a Psychological Framework

The present study explored the relationships between psychological and somatic factors in patients undergoing Coronary Artery Bypass Graft surgery (CABG). The data-analysis of previous work was extended by adding somatic factors, including feelings of disability, somatic complaints and fatigue. The focus was on their relationships with psychological factors, including anxiety, depression and neuroticism. Prior to surgery and six months postoperatively, 217 patients completed self-report questionnaires. Using the method of structural equation modeling (SEM), the structure of relationships between the somatic, psychological and background factors (i.e., gender, age and medical factors) was explored. A model was developed providing a good fit and accounting for a substantial amount of variance. The structure of relationships revealed that somatic factors lead to anxiety and depression in the preoperative period, whereas anxiety and depression lead to somatic factors in the postoperative period. The structure further strengthened the key position of neuroticism and its overall negative prognostic implications.     

TMS suppression of right pars triangularis, but not pars opercularis, improves naming in aphasia

This study sought to discover if an optimum 1 cm² area in the non-damaged right hemisphere (RH) was present, which could temporarily improve naming in chronic, nonfluent aphasia patients when suppressed with repetitive transcranial magnetic stimulation (rTMS). Ten minutes of slow, 1 Hz rTMS was applied to suppress different RH ROIs in eight aphasia cases. Picture naming and response time (RT) were examined before, and immediately after rTMS. In aphasia patients, suppression of right pars triangularis (PTr) led to significant increase in pictures named, and significant decrease in RT. Suppression of right pars opercularis (POp), however, led to significant increase in RT, but no change in number of pictures named. Eight normals named all pictures correctly; similar to aphasia patients, RT significantly decreased following rTMS to suppress right PTr, versus right POp. Differential effects following suppression of right PTr versus right POp suggest different functional roles for these regions.     

Childhood correlates of adult levels of incongruence between implicit and explicit motives

The present study used archival longitudinal data from 5 years old children and their mothers to explore mother and child characteristics associated with motive incongruence 26 years later. Motive incongruence was assessed in terms of discrepancies between implicit and explicit measures of the need for achievement, power and affiliation. Previous research has suggested that trait self-determination, which involves self-awareness and perceived volition in one’s actions, moderates the level of implicit/explicit motive incongruence. We hypothesized that early childhood experiences that interfere with the development of self-determination would be associated with later motive incongruence. Our results showed that childhood factors that reflected mother–child difficulties in the areas of autonomy and relatedness were significantly related to adult levels of motive incongruence. Specifically, adult motive incongruence was significantly associated with strong maternal inhibition of the child’s dependent and sexual impulses, maternal separation during the child’s second year, and mother reports of feeling dominated by the child. Limitations of the data are discussed.     

Detecting conscious awareness from involuntary autonomic responses

Can conscious awareness be ascertained from physiological responses alone? We evaluate a novel learning-based procedure permitting detection of conscious awareness without reliance on language comprehension or behavioural responses. The method exploits a situation whereby only consciously detected violations of an expectation alter skin conductance responses (SCRs). Thirty participants listened to sequences of piano notes that, without their being told, predicted a pleasant fanfare or an aversive noise according to an abstract rule. Stimuli were presented without distraction (attended), or while distracted by a visual task to remove awareness of the rule (unattended). A test phase included occasional violations of the rule. Only participants attending the sounds reported awareness of violations and only they showed significantly greater SCR for noise occurring in violation, vs. accordance, with the rule. Our results establish theoretically significant dissociations between conscious and unconscious processing and furnish new opportunities for clinical assessment of residual consciousness in patient populations.     

Health-Related Quality of Life is Associated with Positive Affect in Patients with Coronary Heart Disease Entering Cardiac Rehabilitation

Health-related quality of life (QoL) is an important and widely used outcome measure in cardiac populations. We examined the relationship between positive affect and health-related quality of life, controlling for traditional cardiovascular risk factors, clinical variables and negative affect. We further investigated the role of gender in this relationship given the well-known gender differences in cardiovascular health. We enrolled 746 patients with coronary heart disease (CHD) before they entered outpatient cardiac rehabilitation. All patients completed the Global Mood Scale and the SF-36 Health Survey. Positive affect was independently associated with mental (p < .001) and physical QoL (p < .001) after controlling for control variables. Gender moderated the relationship between positive affect and physical QoL (p = .009) but not mental QoL (p = .60). Positive affect was positively associated with physical QoL in men (p < .001) but not in women (p = .44). The health-related QoL of patients with CHD is associated with a person’s level of positive affect.