Medicare's search for effective obesity treatments: diets are not the answer

The prevalence of obesity and its associated health problems have increased sharply in the past 2 decades. New revisions to Medicare policy will allow funding for obesity treatments of proven efficacy. The authors review studies of the long-term outcomes of calorie-restricting diets to assess whether dieting is an effective treatment for obesity. These studies show that one third to two thirds of dieters regain more weight than they lost on their diets, and these studies likely underestimate the extent to which dieting is counterproductive because of several methodological problems, all of which bias the studies toward showing successful weight loss maintenance. In addition, the studies do not provide consistent evidence that dieting results in significant health improvements, regardless of weight change. In sum, there is little support for the notion that diets lead to lasting weight loss or health benefits.     

Rumination-focused cognitive behaviour therapy for residual depression: a case series

The treatment of chronic and recurrent depression is a priority for the development of new interventions. The maintenance of residual symptoms following acute treatment for depression is a risk factor for both chronic depression and further relapse/recurrence. This open case series provides the first data on a cognitive-behavioural treatment for residual depression that explicitly targets depressive rumination. Rumination has been identified as a key factor in the onset and maintenance of depression, which is found to remain elevated following remission from depression. Fourteen consecutively recruited participants meeting criteria for medication--refractory residual depression [Paykel, E.S., Scott, J., Teasdale, J.D., Johnson, A.L., Garland, A., Moore, R. et al., 1999. Prevention of relapse in residual depression by cognitive therapy--a controlled trial. Archives of General Psychiatry 56, 829-835] were treated individually for up to 12 weekly 60-min sessions. Treatment specifically focused on switching patients from less helpful to more helpful styles of thinking through the use of functional analysis, experiential/imagery exercises and behavioural experiments. Treatment produced significant improvements in depressive symptoms, rumination and co-morbid disorders: 71% responded (50% reduction on Hamilton Depression Rating Scale) and 50% achieved full remission. Treating depressive rumination appears to yield generalised improvement in depression and co-morbidity. This study provides preliminary evidence that rumination-focused CBT may be an efficacious treatment for medication--refractory residual depression.     

Use it or lose it: examining preschoolers' difficulty in maintaining and executing a goal

Individuals with low working memory capacity (e.g. preschoolers) are more prone to goal neglect, or a failure to execute a goal even though it is understood. We examined the role of goal neglect in performance on the Dimensional Change Card Sort by including 'redundant' cards that could be sorted without attending to the rules, as well as the traditional 'conflict' cards that encouraged awareness of the rules. In Experiment 1, 4- and 5-year-old children were administered two card sorts that differed on the proportion of redundant cards presented (20% vs. 80%). Children neglected the goal more often when faced with a preponderance of redundant cards, suggesting that consistent attention to the rules leads to goal maintenance. In Experiment 2, results were replicated even when the post-switch rules were repeated on every trial. Implications for the development of working memory are discussed.     

Listening to language at birth: evidence for a bias for speech in neonates

The nature and origin of the human capacity for acquiring language is not yet fully understood. Here we uncover early roots of this capacity by demonstrating that humans are born with a preference for listening to speech. Human neonates adjusted their high amplitude sucking to preferentially listen to speech, compared with complex non-speech analogues that controlled for critical spectral and temporal parameters of speech. These results support the hypothesis that human infants begin language acquisition with a bias for listening to speech. The implications of these results for language and communication development are discussed. For a commentary on this article see Rosen and Iverson (2007).     

Factor structure of patient and caregiver ratings on the dementia quality of life instrument

Preliminary evidence suggests that quality of life reports from patients diagnosed with mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) are as reliable and valid as data provided by caregivers. To date, no studies compared the factor structure of data provided by caregivers and patients. Factor analyses are important to conduct because they are an indicator of validity. This study compared the factor structure of patient and caregiver reports on the Dementia Quality of Life scale (DQoL). Participants (N=67) were patients diagnosed with amnestic MCI or mild AD and their caregivers. Principal axis factor analyses were run separately on patient and caregiver report data. The three-factor solutions for patient and caregiver data were nearly identical. Three factors corresponding to positive affect, negative affect, and aesthetics emerged reliably from analyses. Thus, data from patients demonstrated a factor structure that was highly consistent with caregiver report data and conformed to meaningful psychological constructs.     

Information structure expectations in sentence comprehension

In English, new information typically appears late in the sentence, as does primary accent. Because of this tendency, perceivers might expect the final constituent or constituents of a sentence to contain informational focus. This expectation should in turn affect how they comprehend focus-sensitive constructions such as ellipsis sentences. Results from four experiments on sluicing sentences (e.g., The mobster implicated the thug, but we can't find out who else) suggest that perceivers do prefer to place focus late in the sentence, though that preference can be mitigated by prosodic information (pitch accents, Experiment 2) or syntactic information (clefted sentences, Experiment 3) indicating that focus is located elsewhere. Furthermore, it is not necessarily the direct object, but the informationally focused constituent that is the preferred antecedent (Experiment 4). Expectations regarding the information structure of a sentence, which are only partly cancellable by means of overt focus markers, may explain persistent biases in ellipsis resolution.     

Phenomenology of Early Childhood Onset Obsessive Compulsive Disorder

This paper describes the phenomenological features of early childhood onset obsessive compulsive disorder (OCD; defined as children meeting DSM-IV criteria for OCD with age of onset <8 years). Fifty-eight children (ages 4–8) were included in the sample. OCD and comorbid diagnoses were determined by structured interview, and OCD severity was measured using the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Mean age of OCD onset was almost five, and mean age of presentation was between 6 and 7. Mean symptom severity was in the moderately severe range. Comorbidity and family history of OCD were common. Contamination and aggressive/catastrophic obsessions and washing and checking compulsions were endorsed most frequently. Results indicate that early childhood onset OCD may have a lower boy to girl ratio and lower rates of depressive disorders, but may be similar to later childhood onset OCD in terms of OCD symptom presentation and severity.     

Inferior Frontal Regions Underlie the Perception of Phonetic Category Invariance

ABSTRACT— The problem of mapping differing sensory stimuli onto a common category is fundamental to human cognition. Listeners perceive stable phonetic categories despite many sources of acoustic variability. What are the neural mechanisms that underlie this perceptual stability? In this functional magnetic resonance imaging study, a short-interval habituation paradigm was used to investigate neural sensitivity to acoustic changes within and between phonetic categories. A region in the left inferior frontal sulcus showed a pattern of activation consistent with phonetic invariance: insensitivity to acoustic changes within a phonetic category and sensitivity to changes between phonetic categories. Left superior temporal regions, in contrast, showed graded sensitivity to both within- and between-category changes. These results suggest that perceptual insensitivity to changes within a phonetic category may arise from decision-related mechanisms in the left prefrontal cortex and add to a growing body of literature suggesting that the inferior prefrontal cortex plays a domain-general role in computing category representations.     

Metacognitive Judgments and Control of Study

ABSTRACT— Recent evidence indicates that people's judgments of their own learning are causally related to their study behavior and not epiphenomenal. I argue here that people use these metacognitions in an effort to selectively study material in their own region of proximal learning. First they attempt to eliminate materials that are already well learned. Then they progress successively from studying easier to more difficult materials. Successful implementation of this metacognitively guided strategy enhances learning. The necessary components are, first, that the metacognitions be accurate, and second, that the appropriate choices are implemented for study. With these parts in place, the individual is in position to effectively take control of his or her own learning.