A controlled evaluation of group cognitive therapy in the treatment of irritable bowel syndrome

We randomized, at two sites, 210 patients with Rome II diagnosed irritable bowel syndrome (IBS), of at least moderate severity, to one of three conditions: group-based cognitive therapy (CT; n=120), psychoeducational support groups (n=46) as an active control, or intensive symptom and daily stress monitoring (n=44). One hundred eighty-eight participants completed the initial treatment. Those in symptom monitoring were then crossed over to CT. For an intent to treat analysis on a composite GI symptom measure derived from daily symptom diaries, both CT and the psychoeducational support groups were significantly more improved than those in the intensive symptom monitoring condition, but the CT and psychoeducational support group did not differ. Among treatment completers on the same composite measure of GI symptoms, again, both CT and psychoeducational support groups were statistically superior to symptom monitoring but did not differ on the symptom composite, or on any other measure. On individual IBS symptoms, both CT and psychoeducational support were statistically superior to symptom monitoring on reductions in abdominal pain and tenderness and for flatulence. Patient global ratings at the end of treatment showed the two active conditions statistically superior to symptom monitoring on change in Bowel Regularity, with CT superior to symptom monitoring on reduction in overall pain and in improvement in sense of well-being. Three-month follow-up data on 175 patients revealed maintenance of significant improvement or continued significant improvement on all IBS symptoms, including the McGill Pain Questionnaire. Group CT and psychoeducational support groups continued not to differ on any measure. We thus conclude that group CT is not superior to an attention placebo control condition.     

Speech production: Evidence for syntactically and phonologically determined units

The durational accuracy with which subjects can speak syntactically structured strings of words was compared with their accuracy in speaking word lists. These measurements underscored the great temporal precision of the human articulatory mechanism which appears to be the most precisely controlled movement system of the human body. Evidence is presented that when a syntactically structured message is being spoken, the centrally programmed innervational units involved in its articulatory implementation are greater in size and complexity than when a word list is being spoken.

     

Visual tracking of active and passive movements of the hand

Two experiments were performed to evaluate the influence of movement frequency and predictability on visual tracking of the actively and the passively moved hand. Four measures of tracking precision were employed: (a) saccades/cycle, (b) percent of pursuit movement, (c) eye amplitude/arm amplitude, (d) asynchrony of eye and hand at reversal. Active and passive limb movements were tracked with nearly identical accuracy and were always vastly superior to tracking an external visual target undergoing comparable motion. Proprioceptive information about target position appears to provide velocity and position information about target location. Its presence permits the development of central eye-movement programmes that move the eyes in patterns that approximate but do not exactly match, temporally or spatially, the motion of the hand.     

Prediction of treatment outcome among patients with irritable bowel syndrome treated with group cognitive therapy

Using a sample of over 125 patients with irritable bowel syndrome (IBS) who were treated with cognitive therapy administered in small groups, we sought to predict end of treatment and 3-month follow-up improvement in two changes indices of gastrointestinal (GI) symptoms (Pain/Discomfort Index which assessed change in abdominal pain, abdominal tenderness and bloating and Bowel Regularity Index which assessed change in diarrhea and constipation). We also sought to predict scores on IBS specific quality of life (QOL) and overall level of psychological distress using the Global Severity Index (GSI) of the Brief Symptom Inventory (BSI). Significant, but modest, levels of prediction were found for prediction of improvement in GI symptoms (4-15% of variance). Stronger significant prediction was obtained for the QOL and global psychological distress measure with R(2)'s ranging from 0.36 to 0.50. A wide variety of demographic, GI symptom, psychological status and psychiatric status variables entered the final prediction equations.     

Dopamine receptor D4 gene variation predicts preschoolers' developing theory of mind

Individual differences in preschoolers' understanding that human action is caused by internal mental states, or representational theory of mind (RTM), are heritable, as are developmental disorders such as autism in which RTM is particularly impaired. We investigated whether polymorphisms of genes affecting dopamine (DA) utilization and metabolism constitute part of the molecular basis of this heritability. Seventy-three 42- to 54-month-olds were given a battery of RTM tasks along with other task batteries that measured executive functioning and representational understanding more generally. Polymorphisms of the dopamine D4 receptor gene (DRD4) were associated with RTM performance such that preschoolers with shorter alleles outperformed those with one or more longer alleles. However, polymorphisms of the catechol-O-methyl transferase gene (COMT) and the dopamine transporter gene (DAT1) genes were not associated with children's RTM performance. Further tests showed that the association between DRD4 allele length and RTM performance was not attributable to a common association with executive functioning or representational understanding more generally. We conclude that DRD4 receptors, likely via their effects on frontal lobe development and functioning, may represent a neuromaturational constraint governing the stereotypical and universal trajectory of RTM development.     

State-dependent changes of prefrontal–posterior coupling in the context of affective processing: Susceptibility to humor

The aim of the present study was to examine whether interindividual differences in the coupling or decoupling of prefrontal and posterior cortices during the exposure to social–emotional information may predict an individual’s positive emotional responsiveness. Susceptibility to humor was assessed in a behavioral paradigm several weeks after the EEG recordings. State-dependent changes of prefrontal–posterior EEG beta coherence were recorded during stimulation with other people’s auditory expressions of cheerfulness and sadness. Greater decreases of coherence during the stimulation with positive affect expressions prospectively predicted greater positive emotional responsiveness, indicated by higher amusement ratings in response to cartoons and higher scores in a questionnaire measure of exhilarability. Greater increases of coherence during the stimulation with negative affect expressions did not predict perceived funniness but were related to shorter response latencies to the amusement ratings. The results further support the notion that a more loose prefrontal–posterior coupling may be related to loosening of control of the prefrontal cortex over incoming emotional information and, thus, to a propensity to deeper emotional involvement and a greater impact of perceptual input, whereas increased prefrontal–posterior coupling may be related to strong control and the propensity to protect oneself from becoming emotionally affected.     

Creative ways to well-being: Reappraisal inventiveness in the context of anger-evoking situations

Neuroscientific studies in the field of creativity mainly focused on tasks drawing on basic verbal divergent thinking demands. This study took a step further by investigating brain mechanisms in response to other types of creative behavior, involving more “real-life” creativity demands in the context of emotion regulation and well-being. Specifically, functional patterns of EEG alpha activity were investigated while participants were required to generate as many and as different ways as possible to reappraise presented anger-eliciting situations in a manner that reduces their anger. Cognitive reappraisal involves some of the same cognitive processes as in conventional verbal creativity tasks, inasmuch as it requires an individual to inhibit or disengage from an emotional event, to shift attention between different perspectives, and to flexibly adopt new solutions. To examine whether alpha oscillations during cognitive reappraisal are different from those during conventional creative ideation, the EEG was also assessed during performance of the Alternative Uses task, requiring individuals to generate as many and as original uses of an object as possible. While cognitive reappraisal was associated with a similar pattern of alpha power as observed in conventional verbal creative ideation, the former yielded significantly stronger alpha power increases at prefrontal sites, along with lower alpha increases at more posterior cortical sites, indicating higher cognitive control and less spontaneous imaginative thought processes in the generation of effective strategies to regulate an ongoing negative emotional state.     

Beyond abuse: the association among parenting style, abdominal pain, and somatization in IBS patients

This study assessed the relative strength of the association between abuse, negative parenting style, and somatization in irritable bowel syndrome (IBS) patients. Drawing from preclinical stress physiology and abuse research identifying the family social climate as a frequently stronger and independent determinant of long-term health effects than abuse-specific variables, we predicted that negative parenting behaviors would more strongly correlate with somatization than abuse. Subjects were 81 consecutively evaluated patients, who at baseline underwent psychological testing, measuring perceived parental style, abuse history, somatization, and pain. Although abuse correlated with maternal and paternal rejection, abuse was not associated with somatization. Higher levels of rejection and/or hostility among fathers (not mothers) were more strongly correlated with somatization than was abuse. Further, paternal parenting behaviors were more predictive of somatization than abuse, age, and gender. The lack of an association between abuse and somatization is discussed in light of limitations of biopsychosocial IBS models, whose strong focus on "pathological stressors" (e.g., abuse, trauma) as risk factors may overlook the importance of "less extreme" parenting variables in influencing somatic complaints. The relationship between parenting and somatization is discussed in the context of broader behavioral science research linking disruptions in the quality of parenting to dramatic and long-term changes in patterns of stress reactivity and brain abnormalities seen in IBS patients.     

Creative Thinking in an Emotional Context: Specific Relevance of Executive Control of Emotion-Laden Representations in the Inventiveness in Generating Alternative Appraisals of Negative Events

Although divergent thinking ability in different domains may largely rely on the same basic executive functions, domain-specific functions may also be important, in particular when it comes to more real-life creativity demands. This study investigated if functional executive control of emotion-laden representations may be specifically relevant in cognitive reappraisal, which implies being creative in an affective context. In a sample of 88 healthy individuals, the relation between the participants’ inventiveness in generating positive reappraisals of adverse events (Reappraisal Inventiveness Test) and in generating novel ideas without emotional component (conventional divergent thinking test) to their executive functioning in tasks without (Mittenecker Pointing Test) and with emotional contribution (humor processing task) was studied. In line with hybrid models of creative thinking, poorer basic inhibition skills were found to be associated with poorer fluency performance in both divergent thinking tasks. Relations applied more specifically to reappraisal inventiveness when it came to executive processes with a more prominent emotional component. Creative performance in both tasks may have been hampered by time limits. The results support the notion that, in addition to basic executive functioning, more specific cognitive control functions are implicated in more real-life creative performance, according to related domain-specific demands.     

Aspects of body self-calibration

The representation of body orientation and configuration is dependent on multiple sources of afferent and efferent information about ongoing and intended patterns of movement and posture. Under normal terrestrial conditions, we feel virtually weightless and we do not perceive the actual forces associated with movement and support of our body. It is during exposure to unusual forces and patterns of sensory feedback during locomotion that computations and mechanisms underlying the ongoing calibration of our body dimensions and movements are revealed. This review discusses the normal mechanisms of our position sense and calibration of our kinaesthetic, visual and auditory sensory systems, and then explores the adaptations that take place to transient Coriolis forces generated during passive body rotation. The latter are very rapid adaptations that allow body movements to become accurate again, even in the absence of visual feedback. Muscle spindle activity interpreted in relation to motor commands and internally modeled reafference is an important component in permitting this adaptation. During voluntary rotary movements of the body, the central nervous system automatically compensates for the Coriolis forces generated by limb movements. This allows accurate control to be maintained without our perceiving the forces generated.