The Relation of White Matter Hyperintensities to Cognitive Performance in the Normal Old: Education Matters

ABSTRACT

This study examined whether the severity of cerebral white matter abnormalities (evident on MR images as white matter hyperintensities (WMH)) was related to the cognitive performance of 141 high-functioning older adults. The elderly showed the typical age decrement on measures of processing speed, working memory, and inhibition; however WMH severity was significantly related only to processing speed. The strength of this relationship was, however, influenced by the educational level of the participants, such that processing speed was more associated with WMH severity in less-educated than in well-educated participants. This is consistent with recent concepts of cognitive reserve, but does raise a question as to the underlying source of the cognitive decrement found in the sort of well-educated elders typically used in cognitive-aging studies.     

Memory Impairment in Elderly Individuals With a Mildly Elevated Serum TSH: The Role of Processing Resources,Depression and Cerebrovascular Disease

This study examined whether a mild elevation in serum Thyroid Stimulating Hormone (TSH) in normal older individuals was associated with a cognitive impairment. Participants consisted of 15 individuals with a high- TSH level and 82 with a normal TSH. The high-TSH group performed significantly worse than the normal- TSH group on tests of immediate and delayed verbal recall and on the Mini-Mental State Exam. This decrement was not due to group differences in processing resources nor was it explained by comorbid cerebrovascular disease, depression or anticholinergic drug usage. These results suggest that undetected mild thyroid dysfunction may contribute to the cognitive decrements found in older adults.     

HOLOCAUST COMMEMORATIONS IN LONDON AND ANGLO‐JEWISH (DIS‐)UNITY

This study of selected episodes of Holocaust commemorations in London (UK) sheds light on the tense and ambiguous relationship between commemoration of the Holocaust and Anglo‐Jewish unity. Many have shared the aspiration for Anglo‐Jewish unity at Holocaust commemorations, but a narrow definition of “unity”, as taken to mean centralization, uniformity and consensus, has been restrictive and has not served the desired end. As these case studies demonstrate, despite the high level of cohesion achieved by the rituals of the ceremony and the collective mourning, Holocaust commemorations have also been occasions of conflict and disunity. It is the recent proliferation of commemorations in the 1990s, taking place in a diverse range of Jewish organizations and institutions rather than one combined memorial gathering, that has led to Anglo‐Jewry’s uniting in common moments of remembrance. These differing approaches to the nature, form and content of Holocaust commemorations should be perceived not only as a positive development for the future of Holocaust remembrance in Britain but also an indication of an increasingly healthy Anglo‐Jewry.     

Neonatal Intensive-Care Unit Graduates Show Persistent Difficulties in an Intradimensional Shift Card Sort

Neonatal intensive-care unit (NICU) graduates, a group at risk for attention problems and attention-deficit hyperactivity disorder, performed an intradimensional shift card sort at 34, 42, 51, and 60 months to assess executive function and to examine effects of individual risk factors. In the “silly” game, children sorted cards (airplanes and dogs) so they were not the same as targets. In the “same” game, they did the opposite. Performance on the “silly” game was poor, especially when it was presented first. Success in following “silly” game rules improved with age and was significantly linked to maternal education and birth weight for gestational age, a measure of intrauterine stress. Degree of central nervous system injury differentiated children who completed the task from children who did not, and it also affected the need to repeat instructions in the “same” game. These results confirm an increased likelihood of impairments in executive function during preschool years in NICU graduates.     

COMMUNICATING WITH THE COMMUNITY ABOUT GRIEVING: A DESCRIPTION AND REVIEW OF THE FOUNDATIONS OF A BROKEN LEG ANALOGY OF GRIEVING

With loss permeating the lives of all people throughout the entire life span and its potential for serious long-term deleterious effects, providing effective care for those experiencing situations of loss would be an important element of any preventive community-based mental health promotion approach.The low use of mental health services by those confronted with loss, and the lack of such services in many areas, makes it imperative to enhance the competency of the broader community to provide appropriate care during times of loss. Contributory to such care is a sound knowledge of the literature concerning loss and grieving. The broken leg analogy of grief presented in this article integrates the traditional and emerging grief theories and empirical evidence into an analogy of grieving that can be easily communicated to the general community, is relevant to many losses, and yet upholds the differing positions concerning grieving held by various schools of psychiatric thought.     

Development of a Children's Version of the SCORE Index of Family Function and Change

The Systemic Clinical Outcome and Routine Evaluation (SCORE) Index of Family Function and Change is a recently developed outcome measure. It was designed to be acceptable to adults and children aged 12 and over. Thus far no research has been conducted using the SCORE in children under the age of 12. The aim of this study was to pilot a children's version of the SCORE. An existing 29‐item version of the SCORE was completed by a sample of seven children aged 8–10. Time was allowed for group discussion with the children. Feedback from this stage of the study was used to develop a draft version of the SCORE for children. An expert panel of clinicians and researchers were also consulted. A pilot version of the Child SCORE was administered to 80 children aged 7–10 in an inner London primary school. Thirty‐five children also completed the measure for a second time, 1 week later. Findings suggested that the Child SCORE was acceptable to children in the 8–11 age range. Values for internal reliability and test–retest reliability were good. The Child SCORE appears to be a promising instrument. Further research is required to confirm its acceptability to clinical populations, and to demonstrate sensitivity to change.     

Internal attention to features in visual short-term memory guides object learning

Attending to objects in the world affects how we perceive and remember them. What are the consequences of attending to an object in mind? In particular, how does reporting the features of a recently seen object guide visual learning? In three experiments, observers were presented with abstract shapes in a particular color, orientation, and location. After viewing each object, observers were cued to report one feature from visual short-term memory (VSTM). In a subsequent test, observers were cued to report features of the same objects from visual long-term memory (VLTM). We tested whether reporting a feature from VSTM: (1) enhances VLTM for just that feature (practice-benefit hypothesis), (2) enhances VLTM for all features (object-based hypothesis), or (3) simultaneously enhances VLTM for that feature and suppresses VLTM for unreported features (feature-competition hypothesis). The results provided support for the feature-competition hypothesis, whereby the representation of an object in VLTM was biased towards features reported from VSTM and away from unreported features (Experiment 1). This bias could not be explained by the amount of sensory exposure or response learning (Experiment 2) and was amplified by the reporting of multiple features (Experiment 3). Taken together, these results suggest that selective internal attention induces competitive dynamics among features during visual learning, flexibly tuning object representations to align with prior mnemonic goals.     

The development of an institute for the caring professions

This paper was originally given in Durham in March 1988 at a conference of the Association for Psychoanalytic Psychotherapy in the NHS, the Scottish Association of Analytical Psychotherapists and the Northern Association for Analytic Psychotherapy. It explores the processes of development of a single organisation, the Scottish Institute of Human Relations, since its inception twenty years ago. The three authors have worked together in different roles throughout this period, and they write from their separate subjective experiences as well as indicating areas of joint concern.

First, an overview of the history of the Institute is offered by the Director, with comment on some of the achievements and vicissitudes and the learning which resulted. Secondly, the Institute's responses to a particular group of users, the clergy, is described and illustrated. Finally, the change process is discussed, both theoretically and with reference to various aspects of the Institute's life, especially relationships within and between internal groupings and with the outside world.     

In the eye of the beholder: subjective and observer ratings of middle-class African American mother-adolescent interactions

Middle-class African American mothers and adolescents (n=81) participated in a dyadic interaction task in early adolescence (M=13.06 years, SD=1.27) and then again 2 years later (M=15.01 years, SD=1.27). Following the task, mothers and adolescents rated their own and their partner's support and involvement in the task; observers rated videotaped interactions for the same dimensions. African American mothers perceived adolescents' behavior in the interactions more positively than did observers, and both mothers and observers viewed mothers' behavior as more positive than adolescents' behavior. With observers' ratings controlled, early adolescents' more negative perceptions of their mothers' interactions led to less trust and communication with mothers 2 years later, but subjective understanding did not influence later ratings of conflict intensity.