The neuroendocrinology of posttraumatic stress disorder: new directions

Studies of the hypothalamic-pituitary-adrenal (HPA) axis in persons with posttraumatic stress disorder (PTSD) have produced variable findings. This review focuses on the factors likely to have affected the outcome of these studies, including population characteristics and experimental design. Also discussed is a possible role for the adrenal neurosteroid dehydroepiandrosterone (DHEA) as a mediator of HPA axis adaptation to extreme stress and the psychiatric symptoms associated with PTSD. The antiglucocorticoid properties of DHEA may contribute to an upregulation of HPA axis responses as well as mitigate possible deleterious effects of high cortisol levels on the brain in some PTSD subpopulations. The neuromodulatory effects of DHEA and its metabolite DHEAS at gamma-aminobutyric acid and N-methyl-D-aspartate receptors in the brain may contribute to psychiatric symptoms associated with PTSD. The possible importance of other neurohormone systems in modulating HPA axis and symptom responses to traumatic stress is also discussed. Understanding the complex interactions of these stress-responsive neurosteroid and peptide systems may help explain the variability in patterns of HPA axis adaptation, brain changes, and psychiatric symptoms observed in PTSD and lead to better targeting of preventive and therapeutic interventions.     

Computerizing reading training: Evaluation of a latent semantic analysis space for science text

The effectiveness of a domain-specific latent semantic analysis (LSA) in assessing reading strategies was examined. Students were given self-explanation reading training (SERT) and asked to think aloud after each sentence in a science text. Novice and expert human raters and two LSA spaces (general reading, science) rated the similarity of each think-aloud protocol to benchmarks representing three different reading strategies (minimal, local, and global). The science LSA space correlated highly with human judgments, and more highly than did the general reading space. Also, cosines from the science LSA spaces can distinguish between different levels of semantic similarity, but may have trouble in distinguishing local processing protocols. Thus, a domain-specific LSA space is advantageous regardless of the size of the space. The results are discussedin the context of applying the science LSA to a computer-based version of SERT that gives online feedback based on LSA cosines.     

Children as carers: the impact of parental illness and disability on children's caring roles

The nature and extent of young caring in the UK continue to be a feature of a growing number of research programmes motivated by a children and carers' rights philosophy. However, the context in which young caring occurs as a result of parental ill-health or disability can only be fully understood by examining the findings and implications of medical research into parental impairment, and the social movements that have served to re-define the concept of 'disability' in society. This paper examines the arguments put forward by medical researchers, by those proposing a social model of disability and by those who have specifically investigated the conditions and experiences of young carers. It argues that children's caring roles within families where there is parental illness or disability need to be understood not only as a reflection of the nature of the medical condition itself, but as a consequence of complex family, social and economic processes. A 'whole family' approach is proposed, where the needs of children and parents are respected and responded to.     

Fluency disruption in speech and in wind instrument playing

A case of an adult who stutters and complains of a similar fluency problem when playing the trombone is reported. This is the fourth such report, with previous cases involving trumpet, flute, and horn playing.     

Neurocognitive Performance in Alcoholics: Is Polysubstance Abuse Important?

The neurocognitive effects of alcohol have been frequently examined. Studies reveal a wide array of cognitive deficits. Attempts to develop a parsimonious model for these effects have been difficult because of the intra- and intersubject variability. Complicating the development of a model of cognitive deficits in substance abusers is the common practice of polysubstance abuse. The use of theoretical models that focus on the underlying cognitive processes offers flexibility while maintaining sufficient theoretical precision. This article briefly reviews the literature on neurocognitive changes associated with substance abuse as well as the various theoretical models that have been studied. It also provides an overview of recovery of function. Its primary objective is to evaluate cognitive function among alcoholic subtypes, defined by patterns of other drug use. This analysis suggests there are significant differences in neurocognitive function among these subtypes.     

Fleeting Signs of the Course of Life: Facial Expression and Personal Adjustment

In this article, we consider whether facial expressions of emotion relate in theoretically interesting ways to personal adjustment. We first consider the conceptual benefits of this line of inquiry. Then, to anticipate why brief samples of emotional behavior should relate to personal adjustment, we review evidence indicating that facial expressions of emotion correspond to intrapersonal processes and social outcomes. We then review studies showing that facial expressions relate in theoretically significant ways to adjustment after the death of a spouse, in long-term relationships, and in the context of chronic psychological disorders.     

Pain and Pain-Related Impairment in Adults with Cystic Fibrosis

The Multidimensional Pain Inventory (MPI) was utilized in a sample of adult outpatients with cystic fibrosis (CF) to assess their perception of pain and its psychosocial consequences. Subsequently, the data were compared to the ratings of pain and pain-related impairment in these patients as perceived by two nurses from the CF treatment team, as well as to a quantitative measure of illness severity. The results of these comparisons demonstrate that the majority of adult outpatients with CF reported experiencing lower levels of pain and pain-related impairment than expected, although the male patients tend to report experiencing significantly less impact in these domains than do the female patients. Additionally, the nurses do not underestimate the degree to which patients, especially males, experience pain and pain-related interference from chronic illness. Finally, there was no significant relationship between patients' self-report of pain severity or pain-related interference and an objective measure of disease severity.     

Training Japanese listeners to identify English /r/and /l/: Long-term retention of learning in perception and production

Previous work from our laboratories has shown that monolingual Japanese adults who were given intensive high-variability perceptual training improved in both perception and production of English /r/-/l/ minimal pairs. In this study, we extended those findings by investigating the long-term retention of learning in both perception and production of this difficult non-native contrast. Results showed that 3 months after completion of the perceptual training procedure, the Japanese trainees maintained their improved levels of performance on the perceptual identification task. Furthermore, perceptual evaluations by native American English listeners of the Japanese trainees’ pretest, posttest, and 3-month follow-up speech productions showed that the trainees retained their long-term improvements in the general quality, identifiability, and overall intelligibility of their English /r/-/l/ word productions. Taken together, the results provide further support for the efficacy of high-variability laboratory speech sound training procedures, and suggest an optimistic outlook for the application of such procedures for a wide range of “special populations.” nt]mis|This work was supported by NIDCD Training Grant DC-00012 and by NIDCD Research Grant DC-00111 to Indiana University.