Functional Consequences of HIV-Associated Neuropsychological Impairment

This review focuses on the “real world” implications of infection with HIV/AIDS from a neuropsychological perspective. Relevant literature is reviewed which examines the relationships between HIV-associated neuropsychological impairment and employment, driving, medication adherence, mood, fatigue, and interpersonal functioning. Specifically, the relative contributions of medical, cognitive, psychosocial, and psychiatric issues on whether someone with HIV/AIDS will be able to return to work, adhere to a complicated medication regimen, or safely drive a vehicle will be discussed. Methodological issues that arise in the context of measuring medication adherence or driving capacity are also explored. Finally, the impact of HIV/AIDS on mood state, fatigue, and interpersonal relationships are addressed, with particular emphasis on how these variables interact with cognition and independent functioning. The purpose of this review is to integrate neuropsychological findings with their real world correlates of functional behavior in the HIV/AIDS population.     

Development of categorization in infancy: advancing forward to the animate/inanimate level

Three experiments are reported on the development of object categorization skills during the second year of life. Experiment 1 examined whether 14- and 18-month-old infants were capable of performing categorization at the animate/inanimate (A/I) level using a sequential touching task. The 18-month-olds were significantly above chance and the 14-month-olds were also approaching above-chance significance, which is the highest level of inclusiveness ever tested in infancy. In Experiments 2 and 3, 14-month-old infants participated in a sequential touching task in which the part features of animate and inanimate objects were modified, allowing for a test of partonomic (i.e., legs and wheels) vs. taxonomic (i.e., animates and inanimates) categorization. Infants did not favor partonomic categorization, suggesting that A/I categories are not formed solely based on object parts such as legs and wheels.     

Rationales in children’s causal learning from others’ actions

Shown commensurate actions and information by an adult, preschoolers’ causal learning was influenced by the pedagogical context in which these actions occurred. Four-year-olds who were provided with a reason for an experimenter’s action relevant to learning causal structure showed more accurate causal learning than children exposed to the same action and data accompanied by an inappropriate rationale or accompanied by no explanatory information. These results suggest that children’s accurate causal learning is influenced by contextual factors that specify the instructional value of others’ actions.     

Sosa on scepticism

 In my remarks, I discuss Sosa's attempt to deal with the sceptical threat posed by dreaming. Sosa explores two replies to the problem of dreaming scepticism. First, he argues that, on the imagination model of dreaming, dreaming does not threaten the safety of our beliefs. Second, he argues that knowledge does not require safety, but a weaker condition which is not threatened by dreaming skepticism. I raise questions about both elements of his reply.

Expanded vs. equal interval spaced retrieval practice: exploring different schedules of spacing and retention interval in younger and older adults

The present study was designed to help answer several questions regarding the impact of spacing and expanded retrieval on memory performance in younger and older adults. Three expanded/equal interval schedule pairings, matched in average spacing (1-2-3/2-2-2; 1-3-5/3-3-3; and 1-3-8/4-4-4), were compared, and the effect of retention interval on spaced retrieval benefits was examined by comparing performance on a same day test to a test delayed by 24 h. Both age groups showed a learning phase retrieval success advantage for expanded items compared to equal interval items. Only older adults in the same day test condition showed a significant expansion effect in final recall. After a 24-h delay, the final recall advantage for items in the expanded condition was lost in both groups, and in fact these items were at a significant recall disadvantage for younger adults. Results indicate that younger and older adults benefit from a rehearsal technique that incorporated any type of spaced retrieval whether it is distributed as an expanding schedule or not. Although we did not find robust advantages for expanded retrieval compared to equal interval practice, there could be certain advantages (such as reinforcement due to high success rates) to using expanded retrieval depending on the ultimate goals of an individual memory training program.     

Statistical phonetic learning in infants: facilitation and feature generalization

Over the course of the first year of life, infants develop from being generalized listeners, capable of discriminating both native and non-native speech contrasts, into specialized listeners whose discrimination patterns closely reflect the phonetic system of the native language(s). Recent work by Maye, Werker and Gerken (2002) has proposed a statistical account for this phenomenon, showing that infants may lose the ability to discriminate some foreign language contrasts on the basis of their sensitivity to the statistical distribution of sounds in the input language. In this paper we examine the process of enhancement in infant speech perception, whereby initially difficult phonetic contrasts become better discriminated when they define two categories that serve a functional role in the native language. In particular, we demonstrate that exposure to a bimodal statistical distribution in 8-month-old infants' phonetic input can lead to increased discrimination of difficult contrasts. In addition, this exposure also facilitates discrimination of an unfamiliar contrast sharing the same phonetic feature as the contrast presented during familiarization, suggesting that infants extract acoustic/phonetic information that is invariant across an abstract featural representation.     

State-based versus reward-based motivation in younger and older adults

Recent decision-making work has focused on a distinction between a habitual, model-free neural system that is motivated toward actions that lead directly to reward and a more computationally demanding goal-directed, model-based system that is motivated toward actions that improve one’s future state. In this article, we examine how aging affects motivation toward reward-based versus state-based decision making. Participants performed tasks in which one type of option provided larger immediate rewards but the alternative type of option led to larger rewards on future trials, or improvements in state. We predicted that older adults would show a reduced preference for choices that led to improvements in state and a greater preference for choices that maximized immediate reward. We also predicted that fits from a hybrid reinforcement-learning model would indicate greater model-based strategy use in younger than in older adults. In line with these predictions, older adults selected the options that maximized reward more often than did younger adults in three of the four tasks, and modeling results suggested reduced model-based strategy use. In the task where older adults showed similar behavior to younger adults, our model-fitting results suggested that this was due to the utilization of a win-stay–lose-shift heuristic rather than a more complex model-based strategy. Additionally, within older adults, we found that model-based strategy use was positively correlated with memory measures from our neuropsychological test battery. We suggest that this shift from state-based to reward-based motivation may be due to age related declines in the neural structures needed for more computationally demanding model-based decision making.     

Traditional Roles in a Non-Traditional Setting: Genetic Counseling in Precision Oncology

Next generation sequencing technology is increasingly utilized in oncology with the goal of targeting therapeutics to improve response and reduce side effects. Interpretation of tumor mutations requires sequencing of paired germline DNA, raising questions about incidental germline findings. We describe our experiences as part of a research team implementing a protocol for whole genome sequencing (WGS) of tumors and paired germline DNA known as the Michigan Oncology Sequencing project (MI-ONCOSEQ) that includes options for receiving incidental germline findings. Genetic counselors (GCs) discuss options for return of results with patients during the informed consent process and document family histories. GCs also review germline findings and actively participate in the multi-disciplinary Precision Medicine Tumor Board (PMTB), providing clinical context for interpretation of germline results and making recommendations about disclosure of germline findings. GCs have encountered ethical and counseling challenges with participants, described here. Although GCs have not been traditionally involved in molecular testing of tumors, our experiences with MI-ONCOSEQ demonstrate that GCs have important applicable skills to contribute to multi-disciplinary care teams implementing precision oncology. Broader use of WGS in oncology treatment decision making and American College of Medical Genetics and Genomics (ACMG) recommendations for active interrogation of germline tissue in tumor-normal dyads suggests that GCs will have future opportunities in this area outside of research settings.     

Emotional responding in NSSI: examinations of appraisals of positive and negative emotional stimuli,with and without acute stress

Non-suicidal self-injury (NSSI) is commonly used by young adults to regulate emotional responses. Yet, experimental examination of how people who self-injure appraise and respond to emotional stimuli is limited. We examined appraisals of, and responses to, emotive images in young adults who did and did not self-injure, and assessed whether these were impacted by exposure to a stressor. Study 1 (N?=?51) examined whether participants differed in their appraisals of emotional images. Study 2 (N?=?78) assessed whether appraisals of images changed after exposure to the Trier Social Stress Test. Ratings of emotional valence and arousal were collected in both studies; skin conductance was measured as an indicator of physiological arousal in Study 2. In Study 1 participants reporting NSSI rated positively valenced images as less pleasant than participants not reporting NSSI. In Study 2, after acute stress, participants reporting NSSI displayed dampened physiological reactions to positive images whereas participants who did not self-injure displayed heightened physiological reactions to these and rated them as more pleasant. Individuals who self-injure seem less able to engage in strategic mood repair after exposure to stress compared to people who do not self-injure.