Reduction of caregiver burden in Alzheimer's disease by treatment with galantamine

Alzheimer's disease is a progressive condition characterized by a loss of cognition, altered behavior, and a loss of functional ability, such as bathing, dressing, toileting, and organizing finances. Family and friends provide nearly three quarters of all care for patients with Alzheimer's disease. This informal care results in significant burden to caregivers. Caregiver burden is the set of physical, psychological or emotional, social, and financial problems that family members may experience when caring for impaired older adults. Caregivers of Alzheimer's disease patients report higher rates of physical symptoms, mortality, depression, and fatigue, as well as adverse effects on employment compared with those who are not caregivers for Alzheimer's disease patients. In many cases, the same family members are responsible for both out-of-pocket expenditures and caregiving duties. For this article, a MEDLINE search using the key words "caregiver and Alzheimer's disease" and "cost and Alzheimer's disease" was performed. The purpose of this article is to review the literature on caregiver burden, the components of caregiver burden, effects of caregiving on the health of caregivers, the cost of Alzheimer's disease on the caregiver and society, and the benefits attainable with treatment.     

The Role of Hostile and Benevolent Sexism in Women's and Men's Perceptions of the Menstruating Woman

Perceptions of menstruating women were studied in a sample of 244, predominantly European American, college freshmen. Both women and men rated the menstruating woman, as compared with the average woman, as higher on the Neuroticism factor from Lippa's (1991) measure of the Big Five personality factors. Men also rated her as lower on the Openness, Agreeableness, and Conscientiousness factors, and women rated her lower on the Extraversion factor. Women rated her as perceiving herself as less masculine and more feminine. Both women and men rated her as less "energized" and "sexy," but more "irritable,""sad," and "angry." In addition, men rated her as less "clean and fresh,""nurturing," and "reasonable," and more "spacey" and "annoying." Significant relationships were found between negative impressions of the menstruating woman and the Hostile Sexism Scale ( Glick & Fiske, 1996 ). Although most ratings by men and women were negative, women perceived the menstruating woman as more "maternal,""strong," and "trustworthy."     

Thinking Developmentally: Perspectives Following Loewald and Klein

In this article, I explore two perspectives on development that are central to how I think and work as an analyst, one drawn from the work of Hans Loewald and one from Melanie Klein. Loewald turned the usual psychoanalytic way of thinking, rooted in the past, on its head when he theorized that development proceeds by internalization of the parent’s future vision of the child and, by corollary, the analyst’s future vision of the patient. Using a vignette from Klein’s work with 10-year-old Richard, I show how the analyst’s image of the patient’s potential can facilitate growth and development. Melanie Klein also introduced a radical reordering of traditional psychoanalytic theory when she theorized that the mind develops and is structured as positions, not as successive phases. For Klein, the mind is organized in groupings of anxieties, defenses, and object-relations that are in a continuous state of oscillation throughout life independent of chronological age. Through a clinical vignette, I illustrate how one understands a patient differently when development is seen as occuring in momentary shifts between different levels of the personality rather than as stages over time.     

Identity From Variation: Representations of Faces Derived From Multiple Instances

Research in face recognition has tended to focus on discriminating between individuals, or “telling people apart.” It has recently become clear that it is also necessary to understand how images of the same person can vary, or “telling people together.” Learning a new face, and tracking its representation as it changes from unfamiliar to familiar, involves an abstraction of the variability in different images of that person's face. Here, we present an application of principal components analysis computed across different photos of the same person. We demonstrate that people vary in systematic ways, and that this variability is idiosyncratic—the dimensions of variability in one face do not generalize well to another. Learning a new face therefore entails learning how that face varies. We present evidence for this proposal and suggest that it provides an explanation for various effects in face recognition. We conclude by making a number of testable predictions derived from this framework.     

Linking major depression and the neural substrates of associative processing

It has been proposed that mood correlates with the breadth of associative thinking. Here we set this hypothesis to the test in healthy and depressed individuals. Generating contextual associations engages a network of cortical regions including the parahippocampal cortex (PHC), retrosplenial complex, and medial prefrontal cortex. The link between mood, associative processing, and its underlying cortical infrastructure provides a promising avenue for elucidating the mechanisms underlying the cognitive impairments in major depressive disorder (MDD). The participants included 15 nonmedicated individuals with acute major depressive episodes and 15 healthy matched controls. In an fMRI experiment, participants viewed images of objects that were either strongly or weakly associated with a specific context (e.g., a beach chair vs. a water bottle) while rating the commonality of each object. Analyses were performed to examine the brain activation and structural differences between the groups. Consistent with our hypothesis, controls showed greater activation of the contextual associations network than did depressed participants. In addition, PHC structural volume was correlated with ruminative tendencies, and the volumes of the hippocampal subfields were significantly smaller in depressed participants. Surprisingly, depressed participants showed increased activity in the entorhinal cortex (ERC), as compared with controls. We integrated these findings within a mechanistic account linking mood and associative thinking and suggest directions for the future.     

Cognitive and social-communication abilities among young children conceived by assisted reproductive technologies

Assisted reproductive technologies (ART) lack biological filters that are part of the natural fertilization process and thus might enable the presence of abnormal genetic materials. Whereas the findings regarding neonatal and neurological risks among ART-conceived children are rather consistent, data regarding cognitive and social-emotional developmental outcomes are inconsistent. The aim of this study was to examine the association between ART and cognitive and social-communication outcomes among pre-school children. The results indicated that the cognitive and social-communicative abilities of the ART-conceived children were similar to those of the spontaneously conceived children; however, according to parental reports, children in the ART group had higher communicative skills and better motor abilities than spontaneously conceived children. These results should be interpreted with caution as we used measures that assess global cognitive abilities that may not be sensitive to more subtle differences of higher cognitive and social-communication abilities in infancy that may become more prominent later in life. Although infertile couples and professionals in the field of ART can be reassures by the current findings, further research is needed as well as follow-up evaluation of this population during school age.     

Christian Churches and the Prevention of Preadolescent Aggression and Violence in Puerto Rico: Regional Leaders’ Perspective

Journal of Religion and Health - Preadolescents’ involvement in religious congregations may serve as a distal protective factor against aggression. Interviews were conducted to...     

Intuitive Probabilities and the Limitation of Moral Imagination

There is a vast literature that seeks to uncover features underlying moral judgment by eliciting reactions to hypothetical scenarios such as trolley problems. These thought experiments assume that participants accept the outcomes stipulated in the scenarios. Across seven studies (N = 968), we demonstrate that intuition overrides stipulated outcomes even when participants are explicitly told that an action will result in a particular outcome. Participants instead substitute their own estimates of the probability of outcomes for stipulated outcomes, and these probability estimates in turn influence moral judgments. Our findings demonstrate that intuitive likelihoods are one critical factor in moral judgment, one that is not suspended even in moral dilemmas that explicitly stipulate outcomes. Features thought to underlie moral reasoning, such as intention, may operate, in part, by affecting the intuitive likelihood of outcomes, and, problematically, moral differences between scenarios may be confounded with non‐moral intuitive probabilities.     

The effect of motive-goal congruence on adolescents’ academic goal engagement and disengagement

Motivation and Emotion - Academic achievement is an important developmental goal during adolescence. Two independent factors involved in academic motivation are implicit motives and explicit goals....