A cognitive tool to diagnose predominantly inattentive ADHD behavior

Poor performance on tests of reading comprehension could be the result of weak word-recognition skills, inconsistent attention (ADD), or a combination of the two. Identifying the source of the reading disability (RD) reliably has been difficult because inconsistent attention interferes with reading and weak word recognition skill makes attention wander. The situation is further complicated by the fact that there are no objective diagnostic tests for ADD (Breggin, 1998; Diller, 1998). We proposed a new model of differential diagnosis of ADHD-I/RD and field-tested its utility in two studies. The new diagnostic procedure utilizes intra-individual differences seen in the performance of at-risk learners on tasks related to reading that vary in the degree of sustained attention required for successful performance. The hypothesis is that children whose attention is inconsistent would perform more poorly on tests such as listening comprehension, which require sustained attention, than on tests such as reading comprehension, which are more tolerant of inattention. Such differences will not be seen in the test scores of children who have only a reading disability because their performance on reading tests is determined more by the difficulty level of the tests than by the sensitivity of the tests to attention. The validity of this new model was evaluated by determining the relationship between differences seen in the scores of tests that differ in their attention requirement and the degree of inconsistency in sustained attention as measured by Conners' CPT. The results of the two studies indicate this to be a viable approach. The results of the second study are presented in this report.     

Impact of recent findings on study design of future autism clinical trials

There are specific challenges to studying the design of pharmacologic trials in child/adolescent and adult autism, such as subject stratification and parallel versus crossover designs. This article describes how optimal study design is influenced by subject selection and outcome measures chosen. Lessons learned in study design from the Research Units on Pediatric Psychopharmacology Autism Network trial with risperidone, Seaver Center trials with fluoxetine and valproate, Dartmouth trials with amantadine, and National Institutes of Health secretin trials are highlighted. The Internet System for Assessing Autistic Children system for managing multicenter clinical trials in autism and statistical issues in autism research are also described.     

Drug treatment of epilepsy: when does it fail and how to optimize its use?

Although modern community-based studies have shown that a majority of people with newly diagnosed epilepsy will enter long-term remission, seizures remain refractory to treatment in a substantial proportion of this population--perhaps as much as 40%. A consensus is being reached that, for operational purposes, pharmacoresistance can be suspected when two appropriately chosen, well-tolerated, first-line antiepileptic drugs (AEDs) or one monotherapy and one combination regimen have failed due to lack of efficacy. Poor prognostic factors include lack of response to the first AED, specific syndromes, symptomatic etiology, family history of epilepsy, psychiatric comorbidity, and high frequency of seizures. These observations suggest that prognosis can often be determined early in the course of the disorder. We propose a management paradigm that aims to maximize the chance of successful AED therapy, including the early use of "rational polytherapy" for patients not responding to monotherapy, and to identify efficiently patients suitable for "curative" resective surgery, in particular those with mesial temporal lobe epilepsy. An orderly approach to each epilepsy syndrome will optimize the chance of perfect seizure control and help more patients achieve a fulfilling life.     

The clinical efficacy and safety of galantamine in the treatment of Alzheimer's disease

Alzheimer's disease is a progressive, neurodegenerative condition characterized by deficits in cognition, inability to perform activities of daily living, and alterations in behavior. Galantamine hydrobromide is the newest acetylcholinesterase inhibitor (AChEI) approved in the United States for the treatment of mild-to-moderate AD. The safety and efficacy of galantamine has been demonstrated in multiple randomized, Phase III trials of >2,600 patients with mild-to-moderate AD. Studies have found that galantamine improved or maintained performance in all domains of AD (cognition, function, behavior, and caregiver burden) in the short term and slowed the decline in performance or maintained baseline performance through 12 months. The dual mechanism of action may make galantamine a reasonable treatment option for both newly diagnosed patients and patients who have not benefitted from or have poorly tolerated current therapy.     

The morality of weapons research

I ask whether weapons research is ever justified. Weapons research is identified as the business of the engineer. It is argued that the engineer has responsibility for the uses to which the tools that he designs can be put, and that responsibility extends to the use of weapons. It is maintained that there are no inherently defensive weapons, and hence there is no such thing as ‘defensive’ weapons research. The issue then is what responsibilities as a professional the engineer has in regard to such research. An account is given to ground the injunction not to provide the means to harm as a duty for the engineers. This account is not, however, absolutist, and as such it allows justifiable exceptions. The answer to my question is thus not that weapons research is never justified but there must be a strong assurance that the results will only be used as a just means in a just cause.     

Acquisition, learning, or development of language? Skinner's "Verbal Behavior" revisited

In 1957, Skinner, in his "Verbal Behavior", proposed an explanation on how a language is learned. In 1959, Chomsky strongly argued the non-learnability of language, establishing in the field of developmental psycholinguistics the substitution of the term "learning" for that of "acquisition". Currently, the constructivist models describe language acquisition as a process of ontogenetic, gradual, complex, and adaptive change. This new theoretical framework has been especially useful for rereading Verbal Behavior because it facilitates recovering the Skinnerian learning mechanisms. This can be observed in the recent research trends that recapture reinforcement and imitation (echoic responses), although they are now located in the initial phases of the process and are included in a cognitive dynamic that, by gradually increasing its complexity, can achieve grammar. The new constructivist theoretical framework, by retrieving the functional and referential aspects of language, can also take advantage of the classic Skinnerian proposal about the pragmatic types of verbal behavior, providing it with new meaning.     

Illusory conjunctions in the time domain and the resulting time-course of the attentional blink

Illusory conjunctions in the time domain are errors made in binding stimulus features presented In the same spatial position in Rapid Serial Visual Presentation (RSVP) conditions. Botella, Barriopedro, and Suero (2001) devised a model to explain how the distribution of responses originating from stimuli around the target in the series is generated. They proposed two routes consisting of two sequential attempts to make a response. The second attempt (sophisticated guessing) is only employed if the first one (focal attention) fails in producing an integrated perception. This general outline enables specific predictions to be made and tested related to the efficiency of focal attention in generating responses in the first attempt. Participants had to report the single letter in an RSVP stream of letters that was presented in a previously specified color (first target, T1) and then report whether an X (second target, T2) was or was not presented. Performance on T2 showed the typical U-shaped function across the T1-T2 lag that reflects the attentional blink phenomenon. However, as was predicted by Botella, Barriopedro, and Suero's model, the time-course of the interference was shorter for trials with a correct response to T1 than for trials with a T1 error. Furthermore, longer time-courses of interference associated with pre-target and post-target errors to the first target were indistinguishable.     

Marital conflict and acculturation among Mexican American husbands and wives

This study examined the relationship between acculturation and multiple dimensions of marital conflict among Mexican American husbands and wives. Participants were 151 husbands and wives who were recruited from a health maintenance organization in northern California and individually interviewed. More acculturated husbands and wives engaged in less avoidance of conflict and were more expressive of their feelings in an argument. Husbands who were more acculturated reported more conflict concerning sex and consideration for the other. Bicultural and more acculturated husbands reported that their wives were more verbally and physically aggressive, compared with mono-Mexican husbands. The findings provide evidence that more acculturated husbands and wives are involved in more direct expressions of conflict in their marriages, compared with less acculturated husbands and wives.     

A longitudinal study of gender-related cognition and behaviour

Gender schema theory proposes that children's acquisition of gender labels and gender stereotypes informs gender-congruent behaviour. Most previous studies have been cross-sectional and do not address the temporal relationship between knowledge and behaviour. We report the results of a longitudinal study of gender knowledge and sex-typed behaviour across three domains in children tested at 24 and 36 months (N = 56). Although both knowledge and sex-typed behaviour increased significantly between 2 and 3 years, there was no systematic pattern of cross-lagged correlations between the two, although some concurrent relationships were present at 24 months. Future longitudinal work might profitably focus on younger children using reliable preverbal measures of gender knowledge and employing a shorter lag between measurement times.