Does performance on the standard antisaccade task meet the co-familiality criterion for an endophenotype?

The “co-familiality” criterion for an endophenotype has two requirements: (1) clinically unaffected relatives as a group should show both a shift in mean performance and an increase in variance compared with controls; (2) performance scores should be heritable. Performance on the antisaccade task is one of several candidate endophenotypes for schizophrenia. In this paper we examine whether the various measures of performance on the standard version of the antisaccade task meet the co-familiality criterion for an endophenotype. The three measures of performance—reflexive saccade errors, latency of correct antisaccades, and gain—show a wide range of effect sizes and variance ratios as well as evidence of significant or near significant heterogeneity. The estimated mean effect sizes [Cohen’s d: error rate: 0.34 (SD: 0.29); latency: 0.33 (SD: 0.30); gain: 0.54 (SD: 0.38)] are significantly greater than 0, but the magnitude of the departures from 0 is relatively small, corresponding to modest effect sizes. The width of the 95% confidence intervals for the estimated effect sizes (error rate: 0.2–0.49; latency: 0.17–0.50; gain: 0.23–0.85) and the coefficients of variation in effect sizes (error rate: 85.3%; latency: 90.9%; gain: 68.4%) reflect heterogeneity in effect sizes. The effect sizes for error rate showed statistically significant heterogeneity and those for latency (P = .07) and gain (P = .09) showed a trend toward heterogeneity. These results indicate that the effect sizes are not consistent with a single mean and that the average effect size may be a biased estimate of the magnitude of differences in performance between relatives of schizophrenics and controls. Relatives of schizophrenics show a small but significant increase in variance in error rate, but the confidence interval is broad, perhaps reflecting the heterogeneity in effect size. The variance ratios for latency and gain did not differ in relatives of schizophrenics and controls. Performance, as measured by error rate, is moderately heritable. The data do not provide compelling support for a consistent shift in mean or variance in relatives of schizophrenia patients compared with nonpsychiatric controls, both of which are required for a major gene involved in co-familial transmission. This set of findings suggests that although intra-familial resemblance in antisaccade performance is due in part to genetic factors, it may not be related to a schizophrenia genotype. Based on the current literature, it would be premature to conclude that any of the measures of antisaccade performance unambiguously meets the co-familiality criterion for an endophenotype.     

Forgotten but not gone: context effects on recognition do not require explicit memory for context

Context effects on recognition memory provide an important indirect assay of associative learning and source memory. Neuropsychological studies have indicated that such context effects may obtain even if the contexts themselves are not remembered--for example, in individuals impaired on direct tests of memory for contextual information. In contrast, a recent study indicated that the effects of temporal context reinstatement on visual recognition obtain only when the contextual information itself was explicitly recollected. Here we report that the effects of reinstatement of spatial-simultaneous context on visual object recognition memory obtain irrespective of whether those context stimuli are explicitly recognized. We suggest that spatial-simultaneous context effects might be based on ensemble unitization of target and context stimuli at encoding, whereas temporal context effects may require recollective processes.     

Age-related differences in irrelevant-speech effects

Three experiments examined age-related differences in irrelevant-speech effects. Younger and older adults were required to recall short prose texts or lists of semantically related words presented visually together with distractor speech. In all experiments, older adults made more semantically related intrusion errors from the irrelevant speech than younger adults. Results of a source memory test suggested that these age-related differences in interference are most likely due to both inhibitory deficits and source-monitoring problems. The results lend partial support to the inhibition deficit theory of cognitive aging.     

Can CBT Be Effective for Aboriginal Australians? Perspectives of Aboriginal Practitioners Trained in CBT

The objective of the study was to investigate whether high and low intensity versions of cognitive behaviour therapy (CBT) might be an effective therapeutic approach for enhancing the mental health of Aboriginal Australians. Five university‐educated Aboriginal counsellors received in‐depth training in CBT. Over the following year, they used CBT strategies with their clients, and met 10 times as a participatory action research group. The group addressed three key questions: (a) Does CBT appear to be useful for Aboriginal Australians? (b) If so, what elements of CBT are perceived to be effective? (c) What adaptations might be made to CBT to enhance its effectiveness with Aboriginal Australians? The resulting qualitative data were transcribed and analysed. Counsellors perceived CBT to be very useful for their Aboriginal clients and for themselves. They reported that it enhanced their clients' well‐being, their own clinical skills, and their own well‐being, and it reduced burnout. The qualities of CBT that were perceived to be effective were its adaptability, pragmatic here‐and‐now approach, capacity for low‐intensity interventions, safe containing structure, promotion of self‐agency, and valuable techniques. It was suggested that the prime requirement for adaptations to CBT were that they would need to fit different social and cultural contexts.     

Why do people with an anxiety disorder utilize more nonmental health care than those without?

OBJECTIVE: It is unclear why nonmental healthcare utilization is greater among those with psychological problems. The authors examined healthcare utilization in HMO patients to determine whether greater utilization in anxiety disorder (AD) patients was explained by anxiety symptoms (increasing sensitivity to physical symptoms) or comorbid illness (causing greater need for services). DESIGN: Patients were randomly selected from the database of a multi-specialty practice and 1,041 completed a survey assessing psychological symptoms, health behaviors, and demographics. Anxiety symptoms were assessed by questionnaire and the presence of an AD was determined from the medical chart. Healthcare encounters and medication use were abstracted from medical charts and HMO claims data. MAIN OUTCOME MEASURES: Healthcare utilization. RESULTS: Both AD and anxiety symptoms predicted utilization, but symptoms were not associated with utilization in a model that also included AD. Comorbid illness was significantly associated with utilization independent of AD and somewhat reduced the strength of the AD-utilization association. The results were replicated in comparison of those with any psychiatric disorder to those without. CONCLUSION: Among those with AD, greater utilization is not explained by anxiety symptoms but is partly explained by greater comorbid illness. Further study is needed to understand excess healthcare utilization among AD patients.     

Criteria‐based content analysis of true and suggested accounts of events

Worldwide, the criteria‐based content analysis (CBCA) is probably the most widely used veracity assessment technique for discriminating between accounts of true and fabricated events. In this study, two experiments examined the effectiveness of the CBCA for discriminating between accounts of true events and suggested events believed to be true. In Experiment 1, CBCA‐trained judges evaluated participants' accounts of true and suggestively planted childhood events. In Experiment 2, judges analysed accounts of recent events that were experimentally manipulated to be a (a) true experience, (b) false experience believed to be true and (c) deliberately fabricated experience. In both experiments CBCA scores were significantly higher for accounts of true events than suggested events. However, this difference was not significant for participants classified as experiencing ‘full’ memories for the suggested event. Self‐report memory measures supported the findings of the CBCA analyses. Taken together these results suggest that the CBCA discriminative power is greatly constrained. Copyright © 2008 John Wiley & Sons, Ltd.     

Expectancy bias and the persistence of posttraumatic stress

Anxious individuals tend to overestimate the probability that encounters with anxiogenic stimuli (CS) will be followed by aversive consequences (UCS). This study examined whether such (biased) UCS expectancies predict the persistence of PTSD symptoms. A total of 265 soldiers were recruited before a four-month deployment to Iraq in 2004. About 2-5 months after deployment, 171 (65%) soldiers completed self-report scales about adverse events in Iraq and PTSD symptoms, and a UCS expectancy task. In this task, participants were exposed to a series of deployment-related and deployment-unrelated (control) picture stimuli. For each trial, the participants indicated the subjective probability that a particular slide would be followed by an imminent loud noise. Around 15 months after deployment, 130 (76%) soldiers completed surveys about PTSD symptoms again. Only a small group of participants had high levels of PTSD symptoms. Regression analyses showed that the level of PTSD symptoms at 15 months was predicted by earlier PTSD symptoms, but also and independently by an enhanced UCS expectancy to deployment-related stimuli. The findings support the notion that UCS expectancy bias contributes to the persistence of PTSD symptoms.     

Uncertainty about perception and dissociation after compulsive-like staring: Time course of effects

Repeated and compulsive-like checking reduces confidence in memory for the last check. Obsessive-compulsive (OC) patients are not only uncertain about memory, but may also be uncertain about perception, while this perceptual uncertainty may be associated with prolonged visual fixation on the object of uncertainty. It was reported earlier that, among healthy participants, prolonged staring at light bulbs or gas rings induces OC-like uncertainty about perception and feelings of dissociation [van den Hout, M. A., Engelhard, I. M., de Boer, C., du Bois, A., & Dek, E. (2008). Perseverative and compulsive-like staring causes uncertainty about perception. Behaviour Research and Therapy, 46, 1300–1304]. In that study, staring continued for 10 min. For patients, however, staring intervals seem to be considerably shorter. To test the clinical credibility of the paradigm as a model of the maintenance of OC perceptual uncertainty, we investigated whether the effects of staring materialize long before 10 min. Five groups of 16 undergraduates participated: one group did not stare at a gas stove while the others stared for 7.5, 15, 30 or 300 s. In the absence of staring, no pre-to-post increase in dissociation/uncertainty was reported, but after staring it was. The larger part of the observed dissociation/uncertainty after 5 min had occurred within 30 s, and around 50% of this maximal increase was reported between 7.5 and 15 s. Thus, even relatively short intervals of staring induce uncertainty about perception and dissociative experiences. Perseverative looking at objects may be a counter-productive OC strategy, which increases uncertainty about perception and may serve to maintain the disorder.