Comparing Holographic Reprocessing and Prolonged Exposure for Women Veterans with Sexual Trauma: A Pilot Randomized Trial

This pilot study compares an emerging evidence-based treatment, holographic reprocessing (HR) to prolonged exposure (PE) versus a person-centered (PC) control group to treat symptoms of distress in female Veterans with sexual trauma. In contrast to PE, HR does not include exposure to a target event of trauma. Instead, HR focuses on healing the internal working model or type of attachment style that may form as a result of interpersonal trauma or maltreatment. The model reveals how people perceive themselves and others. These perceptions set in motion emotional, cognitive, and behavioral tendencies wherein people unconsciously replicate similar types of relationships that reinforce their worldview. Fifty-one female Veterans with sexual trauma were randomly assigned to one of three treatments and completed pre- and post-treatment measures of psychiatric symptoms (anxiety, depression, and PTSD) and post-traumatic cognitions. ANOVAs found significant decreases on all variables. Post-hoc comparisons revealed that HR and PE treatments demonstrated significantly greater decreases in symptoms compared to the PC control group. Chi square analyses revealed that HR produced a significantly lower dropout rate 1 (6 %) compared to PE 7 (41 %) and PC 6 (35 %). These initial results are promising and further investigation of HR is warranted.     

Punishment and the potential for negative reinforcement with histamine injection

The present study examined punishment of responding with histamine injection, and its potential to generate avoidance of punishment. Sprague–Dawley rats were trained under concurrent schedules in which responses on one lever (the punishment lever) produced food under a variable‐interval schedule, and under some conditions intermittent injections of histamine, which suppressed behavior. Responses on a second (avoidance) lever prevented histamine injections scheduled on the punishment lever. After stabilization of punished responding, a variable‐interval 15‐s schedule of cancellation of histamine (avoidance) was added for responding on the second/avoidance lever, without subsequent acquisition of responding on that lever. Progressive decreases in the length of the punishment variable‐interval schedule increased suppression on the punishment lever without increases in response rates on the avoidance lever. Exchanging contingencies on the levers ensured that response rates on the avoidance lever were sufficiently high to decrease the histamine injection frequency; nonetheless response rates on the avoidance lever decreased over subsequent sessions. Under no condition was responding maintained on the avoidance lever despite continued punishing effectiveness of histamine throughout. The present results suggest that avoidance conditioning is not a necessary condition for effective punishment, and confirm the importance of empirical rather than presumed categorization of behavioral effects of stimulus events.     

Neuroprotection and stroke rehabilitation: modulation and enhancement of recovery

Recent advances in research are modifying our view of recovery after nervous system damage. New findings are changing previously held concepts and providing promising avenues for treatment of patients after stroke. This review discusses mechanisms of neuronal injury after brain ischemia and the attempts to study neuroprotection options based on such mechanisms. It also considers measures available at present to improve outcome after stroke and presents new areas of research, particularly stimulation techniques, neurogenesis and trophic factors to enhance recovery. In order to improve outcomes, medications that may be detrimental to recovery should be avoided, while symptomatic therapy of problems such as depression, pain syndromes and spasticity may contribute to better results. Continued surveillance and early treatment of complications associated with acute stroke, along with supportive care remain the mainstay of treatment for stroke patients in the recovery phase. Present research on limiting brain damage and improving recovery and plasticity enhance the prospects for better clinical treatments to improve recovery after stroke.     

When meaning matters,look but don’t touch: The effects of posture on reading

Much of the reading that we do occurs near our hands. Previous research has revealed that spatial processing is enhanced near the hands, potentially benefiting several processes involved in reading; however, it is unknown whether semantic processing—another critical aspect of reading—is affected near the hands. While holding their hands either near to or far from a visual display, our subjects performed two tasks that drew on semantic processing: evaluation of the sensibleness of sentences, and the Stroop color-word interference task. We found evidence for impoverished semantic processing near the hands in both tasks. These results suggest a trade-off between spatial processing and semantic processing for the visual space around the hands. Readers are encouraged to be aware of this trade-off when choosing how to read a text, since both kinds of processing can be beneficial for reading.     

Structural properties of spatial representations in blind people: Scanning images constructed from haptic exploration or from locomotion in a 3-D audio virtual environment

When people scan mental images, their response times increase linearly with increases in the distance to be scanned, which is generally taken as reflecting the fact that their internal representations incorporate the metric properties of the corresponding objects. In view of this finding, we investigated the structural properties of spatial mental images created from nonvisual sources in three groups (blindfolded sighted, late blind, and congenitally blind). In Experiment 1, blindfolded sighted and late blind participants created metrically accurate spatial representations of a small-scale spatial configuration under both verbal and haptic learning conditions. In Experiment 2, late and congenitally blind participants generated accurate spatial mental images after both verbal and locomotor learning of a full-scale navigable space (created by an immersive audio virtual reality system), whereas blindfolded sighted participants were selectively impaired in their ability to generate precise spatial representations from locomotor experience. These results attest that in the context of a permanent lack of sight, encoding spatial information on the basis of the most reliable currently functional system (the sensorimotor system) is crucial for building a metrically accurate representation of a spatial environment. The results also highlight the potential of spatialized audio-rendering technology for exploring the spatial representations of visually impaired participants.     

From the Galleries to the Clinic: Applying Art Museum Lessons to Patient Care

Increasingly, medical educators integrate art-viewing into curricular interventions that teach clinical observation—often with local art museum educators. How can cross-disciplinary collaborators explicitly connect the skills learned in the art museum with those used at the bedside? One approach is for educators to align their pedagogical approach using similar teaching methods in the separate contexts of the galleries and the clinic. We describe two linked pedagogical exercises—Visual Thinking Strategies (VTS) in the museum galleries and observation at the bedside—from “Training the Eye: Improving the Art of Physical Diagnosis,” an elective museum-based course at Harvard Medical School. It is our opinion that while strategic interactions with the visual arts can improve skills, it is essential for students to apply them in a clinical context with faculty support—requiring educators across disciplines to learn from one another.