Pilot study for assessing the behaviors of patients with schizophrenia towards a virtual avatar.

This study examined whether a virtual avatar could be perceived as a real human by patients with mental disease, especially schizophrenia, as well as whether a virtual avatar could be applied to acquiring patients' behavior characteristics in a short conversation situation. The virtual avatar has been used for various applications which need to communicate with other person or to train or educate by showing humanlike behavior. Recently, many researches have shown that the virtual avatar technology has been enhanced and the avatar could be perceived like real human. A virtual avatar, standing in a virtual room, was designed for this study. Tasks to approach, initiate a talk, and answer to avatar's questions was assigned to the 11 patients with schizophrenia. As behavioral parameters in the virtual environment, the interpersonal distance and the verbal response time were acquired. In addition, the Positive and Negative Syndrome Scale (PANSS) for patients was administered in order to investigate the relationship between patients' symptomatic characteristics and behavior parameters. The interpersonal distance was negatively correlated with the negative syndrome scale, a subscale of PANSS, which is consistent with previous research reporting the relationship between interpersonal distance and a real person's image. The verbal response time, however, was not correlated with any other subscale of PANSS. After analyzing subitems of the negative syndrome of PANSS, two positive correlations were found: one was with blunted affect and the other was with poor rapport. We concluded that the virtual avatar could be perceived as a real human by schizophrenic patients and the avatar could draw the schizophrenic patients' behavior characteristics.     

Dyadic predictors of outcome in a cognitive-behavioral program for patients with generalized anxiety disorder in committed relationships: a "spoonful of sugar" and a dose of non-hostile criticism may help

The present study tested whether pre-treatment levels of partner hostility and non-hostile criticism predicted outcome in an individual cognitive-behavioral therapy package for generalized anxiety disorder (GAD). Eighteen patients with a principal or co-principal diagnosis of GAD were randomly allocated to a treatment condition (n=8) or a delayed treatment condition (n=10). In addition, the patients and their partners were videotaped discussing the patients’ worries. These videotapes were later coded for levels of partner hostility and non-hostile criticism directed at the patients. Treatment resulted in statistically and clinically significant change at post-test. Finally, partner hostility predicted worse end-state functioning whereas partner non-hostile criticism predicted better end-state functioning.     

VR-based conversation training program for patients with schizophrenia: a preliminary clinical trial.

Schizophrenia is a devastating mental illness and is characterized by hallucinations and delusions as well as social skills deficits. Generally, social skills training designed to help patients develop social skills includes role-playing, but this form of training has typical shortcomings, which are largely due to a trainer's difficulties to project emotion. Virtual reality (VR)-based techniques have the potential to solve these difficulties, because they provide a computer-generated but realistic three-dimensional world and humanlike avatars that can provide emotional stimuli. In this paper, we report on a method of implementing virtual environments (VEs) in order to train people with schizophrenia to develop conversational skills in specific situations, which could overcome the shortcomings of or complement conventional role-playing techniques. The paper reports the efficacy of the proposed approach in a preliminary clinical trial with 10 patients with schizophrenia.     

Characteristics of social perception assessed in schizophrenia using virtual reality.

Impairment in social skills is one of the few criteria that all individuals diagnosed with schizophrenia must meet. Successful social skills require the coordination of many abilities, including social perception, which involves the decoding and interpretation of social cues from others. In this study, we examined the potential for virtual reality (VR) in social skill training. We attempted to determine if VR can be used to measure social skills and social perception, and to determine which VR parameters are related to schizophrenic symptoms. Some of these results have clear clinical relevance, while other observations need further study. The VR system appears to be useful in assessing the social perception of schizophrenics and normal people, and could be more widely used in the future for social training and in the assessment of social problem-solving abilities, assertiveness skills, and general social skills.     

Changes in brain activation induced by the training of hypothesis generation skills: an fMRI study

The aim of the present study is to investigate the learning-related changes in brain activation induced by the training of hypothesis generation skills regarding biological phenomena. Eighteen undergraduate participants were scanned twice with functional magnetic resonance imaging (fMRI) before and after training over a period of 2 months. The experimental group underwent eight biological hypothesis generation training programs, but the control group was not given any during the 2-month period. The results showed that the left frontal gyri, the cingulate gyrus, and the cuneus were activated during hypothesis generation. In addition, the brain activation of the trained group increased in the left inferior and the superior frontal gyri, which are related to working memory load and higher-order inferential processes. However, the activation after training decreased in the occipito-parietal route, which is associated with the perception and the analysis processes of visual information. Furthermore, the results have suggested that the dorsolateral prefrontal cortex (DLPFC) region is the critical area in the training of hypothesis generation skills.     

A performance comparison between the two language versions of the Affective Go/No‐Go test: A randomised crossover study

The purpose of this randomised crossover study is to validate the Korean version of the Affective Go/No‐go (AGN) test. The Korean words for the AGN test were selected after careful evaluation of emotional valences, word length and frequency. Fifteen Korean advanced learners of English were administered both Korean and English versions, yielding 30 data points. The performance of both language versions was compared for each of the AGN test parameters (response latency, commission error and omission error) using two‐way analysis of variance (ANOVA). Intraclass correlation coefficients (ICCs) were estimated to evaluate associations between the two versions. The ICCs were high for response latencies of all valences and commission errors of positive and neutral words, but not for that of negative words and omission errors of all valences. A similar pattern of test results, as revealed by the high ICCs and non‐significant interaction effects between language and word valence, suggests that the psychometric properties of the AGN test may be comparable over different language versions.     

Reach tracking reveals dissociable processes underlying inhibitory control in 5‐ to 10‐year‐olds and adults

Researchers have proposed that two processes featuring distinct types of inhibition support inhibitory control: a response threshold adjustment process involving the global inhibition of motor output and a conflict resolution process involving competitive inhibition among co‐active response alternatives. To target the development of these processes, we measured the reaching behavior of 5‐ to 10‐year‐olds (Experiment 1) and adults (Experiment 2) as they performed an Eriksen flanker task. This method provided two key measures: initiation time (the time elapsed between stimulus onset and movement onset) and reach curvature (the degree to which a movement deviates from a direct path to the selected target). We suggest that initiation time reflects the response threshold adjustment process by indexing the degree of motoric stopping experienced before a movement is started, while reach curvature reflects the conflict resolution process by indexing the degree of co‐activation between response alternatives over the course of a movement. Our results support this claim, revealing different patterns effects in initiation time and curvature, and divergent developmental trajectories between childhood and adulthood. These findings provide behavioral evidence for the dissociation between global and competitive inhibition, and offer new insight into the development of inhibitory control.     

When adolescents "mismanage" their chronic medical conditions: an ethical exploration

Many adolescent patients with chronic medical conditions do not manage their illnesses very closely and often put themselves at risk for serious health complications. Setting aside cases of nonadherence that are due to practical difficulties involving the implementation of a management plan, a deeply problematic question remains. How should health care providers respond to adolescent patients who express a conscious and value-driven decision to pursue other goals and interests that are incompatible with their doctors' recommended directives? Using two guiding ethical principles, the "relevant difference principle" and the "principle of noninterference," as well as available empirical data on adolescent decision making and risk perception, the paper concludes that most adolescents ages 14 and older should be allowed to make self-determining decisions regarding the management of their chronic medical conditions.     

The Relation Between Sluggish Cognitive Tempo and DSM-IV ADHD

To test the relation between sluggish cognitive tempo (SCT) and DSM-IV ADHD symptoms, parent and teacher ratings of the 18 DSM-IV ADHD items and five potential SCT items were obtained in a community sample of 8-18 year-old twins that was overselected for ADHD and learning disabilities (n = 296). Confirmatory factor analyses revealed that a three-factor model provided the best fit to the data for both parent and teacher ratings. DSM-IV inattention and hyperactivity-impulsivity symptoms loaded on two factors consistent with the DSM-IV model, and five SCT symptoms loaded primarily on a third factor. The SCT and inattention factors were highly correlated, whereas SCT and hyperactivity-impulsivity were weakly related. Both raters indicated that children meeting symptom criteria for the combined and inattentive subtypes exhibited significantly more SCT symptoms than those meeting symptom criteria for hyperactive-impulsive type and the comparison group without ADHD. Children meeting symptom criteria for the inattentive type exhibited significantly more SCT symptoms than those meeting criteria for the combined type, based on teacher ratings. These results suggest that SCT is an internally consistent construct that is significantly associated with DSM-IV inattention.