Multimethod assessment of treatment process in chronic low back pain: comparison of reported pain-related anxiety with directly measured physical capacity

Although cognitive behavioural treatments (CBT) have proven efficacy in improving symptom management, pain-related distress, physical performance and return to work. few studies have examined the relationship between changes in behavioural process variables during treatment and improvement in outcome variables following treatment. We designed a multimethod assessment strategy to test the relative contribution of changes in physical capacity and pain-related anxiety to treatment outcome variables. Low back pain patients (n = 59) were treated with an intensive programme of physical exercise and CBT. Comparisons from pre- to post-treatment showed significant improvement in pain severity, interference, affective distress, activity level, and depression. Improvements in pain-related anxiety were associated with improvements in all outcome variables except interference. Of three physical capacity composite scores, improvement in only one (lumbar extension and flexion capacity) was associated with improvements in all outcome variables except interference. Further analyses demonstrated that the relationship between changes in pain-related anxiety and treatment outcome were independent of changes in physical capacity performance. Changes during treatment in pain-related anxiety may be more important than changes during treatment in physical capacity when predicting the effect of treatment on behavioural outcome measures. These results are discussed in the context of how to improve assessment of the chronic pain patient and improve the effectiveness of multidisciplinary CBT.     

Overhearing a language during childhood

Despite its significance for understanding of language acquisition, the role of childhood language experience has been examined only in linguistic deprivation studies focusing on what cannot be learned readily beyond childhood. This study focused instead on long-term effects of what can be learned best during childhood. Our findings revealed that adults learning a language speak with a more nativelike accent if they overheard the language regularly during childhood than if they did not. These findings have important implications for understanding of language-learning mechanisms and heritage-language acquisition.     

Holding on to childhood language memory

While early language experience seems crucial for mastering phonology, it remains unclear whether there are lasting benefits of speaking a language regularly during childhood if the quantity and quality of speaking drop dramatically after childhood. This study explored the accessibility of early childhood language memory. Specifically, it compared perception and production of Korean speech sounds by childhood speakers who had spoken Korean regularly for a few years during childhood to those of two other groups: (1) childhood hearers who had heard Korean regularly during childhood but had spoken Korean minimally, if at all; and (2) novice learners. All three groups were enrolled in first-year college Korean language classes. Childhood speakers were also compared to native speakers of Korean to see how native-like they were. The results revealed measurable long-term benefits of childhood speaking experience, underscoring the importance of early language experience, even if such experience diminishes dramatically beyond childhood.     

Voluntary assent in biomedical research with adolescents: a comparison of parent and adolescent views

An informed consent and voluntary assent in biomedical research with adolescents is contingent on a variety of factors, including adolescent and parent perceptions of research risk, benefit, and decision-making autonomy. Thirty-seven adolescents with asthma and their parents evaluated a high or low aversion form of a pediatric asthma research vignette and provided an enrollment decision; their perceptions of family influence over the participation decision; and evaluations of risk, aversion, benefit, and burden of study procedures. Adolescents and their parents agreed on research participation decisions 74% of the time, yet both claimed ultimate responsibility for the participation decision. Both rated most study procedures as significantly more aversive than risky. Parents were more likely to rate aspects of the hypothetical study as beneficial and to provide higher risk ratings for procedures. Disagreements concerning research participation decisions and decision-making autonomy have implications for the exercise of voluntary assent in biomedical research.     

The role of motion direction selective extrastriate regions in reading: a transcranial magnetic stimulation study

Why reading ability is correlated with motion processing ability is perplexing. Activity in motion direction processing regions (Area V5/MT+) was perturbed by means of repetitive transcranial magnetic stimulation (rTMS) to examine its effect on reading. A functional probe (significant shortening of the motion aftereffect) was used to identify Area V5/MT+. Right-handed participants (8 m, 8 f) received three 7.5 min blocks of rTMS, after which two phonological and one orthographic reading tasks were administered. Application of rTMS to Area V5/MT+ (as compared to a non-rTMS baseline) significantly decreased performance only during non-word naming. The pattern of naming errors and the absence of deficits on the second phonological task were not consistent with a role for Area V5/MT+ in phonological decoding. Instead, its role in reading may be limited to image stabilization and/or letter localization.     

Motor timing deficits in community and clinical boys with hyperactive behavior: the effect of methylphenidate on motor timing

In a previous paper we showed that community children with hyperactive behavior were more inconsistent than controls in the temporal organization of their motor output. In this study we investigated: (1) various aspects of motor timing processes in 13 clinically diagnosed boys with attention deficit hyperactivity disorder (ADHD) who were compared to 11 community boys with hyperactive behavior and to a control group and (2) the effect of methylphenidate on the motor timing processes in the clinical group with ADHD in a double blind, cross-over, medication-placebo design, including 4 weeks of medication. The clinical group with ADHD, like the community group with hyperactivity, showed greater variability in sensorimotor synchronization and in sensorimotor anticipation relative to controls. The clinical group was also impaired in time perception, which was spared in the community group with hyperactivity. The persistent, but not the acute dose, of methylphenidate reduced the variability of sensorimotor synchronization and anticipation, but had no effect on time perception. This study shows that motor timing functions are impaired in both clinical and community children with hyperactivity. It is the first study to show the effectiveness of persistent administration of methylphenidate on deficits in motor timing in ADHD children and extends the use of methylphenidate from the domain of attentional and inhibitory functions to the domain of executive motor timing.     

Self-reported parental abuse relates to autobiographical memory style in patients with eating disorders

Previous research has shown a relationship between levels of self-reported childhood abuse and overgeneral memory style. This relationship was further clarified in patients with an eating disorder (ED). Patients and healthy controls completed a task in which they had to generate specific autobiographical memories to emotional cue words. The results showed that first, the ED group, relative to the controls, produced more first memories that were "overgeneral" and fewer first memories that were specific. Second, in the ED group, the level of self-reported parental abuse was positively correlated with the tendency to produce overgeneral memories to negative cues. This effect remained significant even after levels of depressed mood were controlled for.