Neuropsychological course after surgery for intracranial aneurysms. A prospective study and a critical review

Previously, only three studies with representative samples of patients with ruptured intracranial aneurysms have provided detailed results of prospective, repeated, neuropsychological assessments after surgery. These studies apparently disagree with regard to occurrence of cognitive deficits and to degree of improvement between early and delayed follow-ups. The present paper attempts to analyze the conditions underlying these differences in results. As a first step in this analysis we present a comprehensive, prospective, neuropsychological investigation of a consecutive sample of 41 patients with rupture of a supratentorial aneurysm, assessed 4 and 12 months after surgery. It is concluded that a prorated course of improvement of a wide specter of psychological functions may be revealed, but that sensitive tests and large samples are needed to establish the range of deficits and improvements with time. Differences in patient selection with respect to severity of the acute clinical state and delayed deterioration apparently contribute importantly to the discrepance in previously reported outcome.     

Pain perception in irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic abdominal discomfort or pain in the absence of detectable organic disease. IBS is common and is associated with a significant impairment in health-related quality of life. Enhanced perception of visceral stimuli ("visceral hypersensitivity") appears to be an important pathophysiological mechanism. Early IBS studies using functional brain imaging techniques suggest an alteration in central pain modulation circuits, rather than an increased sensitivity of peripheral visceral pain pathways. The frequent comorbidity with psychiatric disorders suggests the possibility of shared pathophysiological mechanisms and etiologic factors.     

Childhood play and adolescent leisure preferences: Associations with gender typing and the presence of siblings

Childhood play and adolescent leisure preferences were solicited from a sample of 168 predominately white undergraduate students, who also completed the Bem Sex Role Inventory (BSRI; Bem, 1974) and provided ratings of the amount of time spent in play and leisure with same- and opposite-sex siblings. Higher Femininity (F) scores were found among those females who gave higher ratings of interaction with female siblings. The BSRI measures were also predicted by play and leisure preferences for strongly gender-stereotyped activities. Amount of interaction with same- and opposite-sex siblings was associated with activity preferences for both sexes. There was evidence of more sex-stereotyped preferences being given by those with same sex siblings and fewer by those with opposite sex siblings. The results are discussed in terms of the possible influences of siblings upon play and leisure preferences and the differing developmental pathways of male and female sex roles.     

Different and similar at the same time: when the activation of dissimilarity makes people look more similar

Whether two people are presented as similar or different may have a strong impact on the outcome of their comparison. In the present research, we examined the counterintuitive hypothesis that activating dissimilarity increases the perception of similarities between people, in other words increases perceived feature overlap, during the comparison process. We investigated this prediction by asking people to judge the perceived similarity between two faces with a suboptimally related or unrelated morph inserted in between (to influence joint categorization), and with similar or different facial expressions (to vary the salience of similar or different features). The results confirmed our expectations: In the similarity (joint categorization) condition, two faces that differed in expression were perceived as more dissimilar than faces with the same expression. More important for our prediction, in the dissimilarity condition two faces with different expressions were no longer perceived as more dissimilar than two faces with the same expression. We discuss implications of these findings for the mechanisms underlying comparisons between people. Copyright © 2007 John Wiley & Sons, Ltd.     

Using a Learning Collaborative Model to Disseminate Cognitive Processing Therapy to Community-Based Agencies

Although effective treatments for posttraumatic stress disorder exist, their use in community settings is disappointingly low. Training alone does not necessarily lead to adoption. To address this problem, we trained community clinicians in cognitive processing therapy, an evidence-based treatment for posttraumatic stress disorder, using a Learning Collaborative, an intensive training methodology focused on both clinical training and developing sustainability. Sixty clinicians within 18 agencies began the year-long, team-based Learning Collaborative. Clinicians attended three in-person Learning Sessions, received weekly consultation, and submitted audio-recorded sessions to be rated for fidelity. Clinicians were rostered as approved treatment providers if they completed all training requirements. Additionally, we engaged leadership from each agency to build a sustainable practice. Clinicians trained through the Learning Collaborative demonstrated a high degree of fidelity to the treatment (average competence ratings “satisfactory” to “good”), and most (68%) were rostered as approved treatment providers. Patients treated by clinician trainees exhibited significant symptom reductions (d = 1.68 and 1.28 for posttraumatic stress and depression symptoms, respectively, among treatment completers). At a 6-month follow-up, 95% of rostered clinicians and 100% of agencies with rostered clinicians were still providing the treatment. These results suggest that the Learning Collaborative model is a promising approach for the dissemination and implementation of evidence-based treatments for adult posttraumatic stress disorder.     

Skill‐based versus effort‐based task difficulty: A task‐analysis approach to the role of specific emotions in motivating difficult actions

We make a distinction between primarily effort-based and skilled-based tasks and examine the correspondence between emotion and task. We reverse attribution theory results wherein failure to expend effort engenders regret and accomplishing tasks with skill engenders pride, and propose these emotions as antecedents to effort-based and skill-based behaviors. Specifically, pride (regret) produces higher self-efficacy, behavioral intentions and sign-ups when the task (CPR training) is portrayed as skill-intensive (effort-intensive) compared to effort-intensive (skill-intensive) or easy. Our research highlights the value of integrating an attributional analysis of tasks into an appraisal theory of emotions and suggests mechanisms that might underlie this relationship.     

Age at menarche and digit ratio (2D:4D): relationships with body dissatisfaction, drive for thinness, and bulimia symptoms in women

This study examined the hypothesis that lower prenatal androgen exposure and earlier puberty are associated with more dysfunctional eating attitudes and behaviors. Relationships between both age at menarche (AAM) and 2D:4D (a marker of prenatal androgen exposure), and EDI-2-Body Dissatisfaction, EDI-2-Drive for Thinness, and EDI-2-Bulimia scores, were examined in women using correlations and regressions. Earlier menarche was associated with higher drive for thinness after controlling for BMI and negative affect, but only in women who were not exclusively heterosexual. Higher 2D:4D was associated with higher Bulimia and Body Dissatisfaction scores, but only in exclusively heterosexual women, and relationships disappeared when covariates were controlled. Later AAM and higher 2D:4D were unique predictors of higher Bulimia scores for exclusive heterosexuals when BMI was controlled. These findings suggest future research should examine sexual orientation as a mediator or moderator of prenatal and postnatal organizational hormonal effects on women's disordered eating attitudes and behaviors.     

Inanspruchnahme psychosozialer Versorgungsstrukturen

In spite of the high proportion of persons with a migration background in Germany, professional mental health care utilization by this population group still seems to be insufficient. This could be due to social as well as structural and individual barriers which impede the professional mental health care-seeking process. The heuristic Mental Health Action Process Approach (M-HAPA) model was developed in order to be able to empirically investigate the specific mechanism of action as well as the specific time of influence of these factors. An empirically supported model should possibly be able to justify targeted interventions. The M-HAPA model describes mental health care utilization behavior, combines the basic ideas of already existing models describing health behavior and health care utilization behavior as well as factors which are specifically relevant for the health care utilization behavior of persons with a migration background. This combination may serve as a basis for future research in the field of mental health care utilization behavior of persons with a migration background.     

Dissociations between vision for perception and vision for action depend on the relative availability of egocentric and allocentric information

In three experiments, we scrutinized the dissociation between perception and action, as reflected by the contributions of egocentric and allocentric information. In Experiment 1, participants stood at the base of a large-scale one-tailed version of a Müller-Lyer illusion (with a hoop) and either threw a beanbag to the endpoint of the shaft or verbally estimated the egocentric distance to that location. The results confirmed an effect of the illusion on verbal estimates, but not on throwing, providing evidence for a dissociation between perception and action. In Experiment 2, participants observed a two-tailed version of the Müller-Lyer illusion from a distance of 1.5 m and performed the same tasks as in Experiment 1, yet neither the typical illusion effects nor a dissociation became apparent. Experiment 3 was a replication of Experiment 1, with the difference that participants stood at a distance of 1.5 m from the base of the one-tailed illusion. The results indicated an illusion effect on both the verbal estimate task and the throwing task; hence, there was no dissociation between perception and action. The presence (Exp. 1) and absence (Exp. 3) of a dissociation between perception and action may indicate that dissociations are a function of the relative availability of egocentric and allocentric information. When distance estimates are purely egocentric, dissociations between perception and action occur. However, when egocentric distance estimates have a (complementary) exocentric component, the use of allocentric information is promoted, and dissociations between perception and action are reduced or absent.