Adapting Cognitive Processing Therapy for PTSD for People With Disabilities: A Case Study With a U.S. Veteran

Many veterans receiving treatment for PTSD in the VA health care system are also living with a disability and utilize assistive technologies for communication and/or mobility. While evidence-based treatments for PTSD have been disseminated in VA hospitals nationwide, clinicians may have concerns about implementing these treatments with people with disabilities or question how to adapt evidence-based protocols to facilitate successful outcomes. This clinical case study details the treatment of a 48-year-old male U.S. veteran with a diagnosis of military-related PTSD and significant functional and communicative complexities characteristic of locked-in syndrome. The study implemented an adapted protocol of Cognitive Processing Therapy (CPT), a first-line evidence-based psychotherapy for PTSD with unknown application to people with disabilities. CPT protocol structure, length, and delivery was adapted to accommodate the veteran’s assistive devices and functional abilities. The veteran experienced a clinically significant reduction in PTSD symptoms over the course of treatment, suggesting successful application of the adapted protocol. In addition to symptom reduction, the veteran reported advances in his ability to tolerate emotional distress while engaged in goal-directed behavior and improved interpersonal functioning. Results suggest that CPT can be adapted and effective in instances where the presence of disability and multiple assistive technologies impact standard treatment implementation. This information is valuable in its potential ability to make evidence-based psychotherapies more accessible and disability-sensitive. Clinical recommendations for using and adapting CPT for people with disabilities are provided.     

Consumer Motivations for Pursuing Genetic Testing and their Preferences for the Provision of Genetic Services for Hearing Loss

Genetic services for deafness are being increasingly sought due to the introduction of early hearing detection and intervention programs, as well as the rapid progress in the identification of deafness genes. This study aimed to assess the motivations of consumers for pursuing genetic testing as well as their preferences for provision of these services. We conducted 5 focus groups consisting of hearing parents of deaf children, deaf parents, and unmarried deaf adults. Motivations for pursuing genetic testing included determining the etiology, helping to alleviate the guilt associated with the diagnosis of hearing loss in a child, and acquiring information to help them and other family members prepare for the future. Most participants thought that a genetic counselor/geneticist would be the most appropriate professional to provide genetics services. For culturally Deaf individuals, the communication method was seen as more important than the type of professional. Parents preferred that genetic evaluation, including testing, occur either immediately at or a few months after the audiologic diagnosis of hearing loss.     

The role of color in human face detection

Significant advances have been made in understanding human face recognition . However, a fundamental aspect of this process, how faces are located in our visual environment, is poorly understood and little studied. Here we examine the role of color in human face detection. We demonstrate that detection performance declines when color information is removed from faces, regardless of whether the surrounding scene context is rendered in color. Furthermore, faces rendered in unnatural colors are hard to detect, suggesting a role beyond simple segmentation. When faces are presented such that half the surface is colored appropriately, and half unnaturally, performance declines. This suggests that observers are not simply using the presence of skin color "patches" to detect faces. Rather, our data suggest that detection operates via a face template combining diagnostic color and face-shape information. These findings are consistent with color-template approaches used in some computer-based face detection systems.     

Separation-Individuation Issues and Castration Anxiety: Their Curious Influence on the Epigenesis of Myopia

This author suggests that myopia is related to psychogenic factors involving an unconscious representation of, and defense against tension. Further, the argument is made that such tension directly causes the extra-ocular muscles of the eyeball to tighten, ultimately creating the errors of refraction, which define the condition known as myopia. The author makes the case that the specific nature of the tension has to do with an interruption in the separation–individuation process that has occurred, in which the myopic individual experiences separation anxiety, and is now “required” to stay close to the mother for fear of abandonment. Apparently, the only way myopes are then able to achieve some sort of psychological distance is through the development of high-level abstract conceptualization abilities. In addition to separation fears, this author notes that myopes exhibit significantly higher levels of castration anxiety as compared with normal-sighted individuals, matched in IQ. Tables showing empirical findings supporting the above psychoanalytic interpretations are provided for the readers review.     

From parent education to collective action: ‘Childrearing with love’ in post‐war Guatemala

The paper discusses the implementation and effect of group‐based parenting workshops oriented by the principles of liberation psychology in a low‐income, hispanicized community in Guatemala City. The objective of this initiative was not only to improve outcomes in the parent–child relationship, but to galvanize the formation of community‐based support groups that could have multiple ends. The theoretical foundations of the project are introduced, before illustrating their practical application. Sixteen months post‐intervention, largely positive effects were being sustained in parent child relations. The project was also successful in generating social action through the formation of grass‐roots women's organizations. Copyright © 2008 John Wiley & Sons, Ltd.     

Long-Term Neuropsychological Outcomes of Childhood Onset Acute Disseminated Encephalomyelitis (ADEM): a Meta-Analysis

The long-term neurocognitive prognosis of childhood onset acute disseminated encephalomyelitis (ADEM) is unclear. This review and quantitative synthesis of the available literature examined whether there are long-term impacts of childhood ADEM on neurocognitive functioning. A search of online databases (MEDLINE, EMBASE, EBSCO CINAHL, PsycINFO and the Cochrane Database of Systematic Reviews) from their inception to October 2015 and reference lists identified 13 papers eligible for inclusion in the systematic review; seven of these were eligible for inclusion in meta-analyses. The systematic review indicated that, at a group level there is a positive long-term neuropsychological outcome from childhood onset ADEM. However, despite the apparent absence of long-term negative impacts of ADEM at a group level, at an individual level impairments in the areas of IQ, attention, executive functioning, processing speed, learning and memory, visuospatial skills and internalising symptoms were found in up to 43% of patients when aggregated across the studies. No significant negative effect of ADEM for any of the neuropsychological domains examined was found in meta-analyses. However, the effects for Processing Speed (r _mean = ?0.296 (CI 95% = ?0.605-0.013)) and Internalising symptoms (r _mean = 0.242 (CI 95% = ?0.014-0.564)) approached significance (p = 0.06), suggesting a trend towards ADEM leading to long-term reduced processing speed and elevated internalising symptoms. Together, our findings suggest that despite a generally positive neurocognitive outcome post childhood ADEM there are a subset of individuals who can suffer from ongoing specific cognitive impairments. Clinical implications and research priorities are discussed.     

Does a rat release a soaked conspecific due to empathy?

In Experiment 1, rats choosing in an E maze preferred to release a rat standing in a pool of water to dry ground over a rat already standing on dry ground. Five additional experiments showed that the choosing rat’s preference for releasing the wet rat was maintained by two separable outcomes: (1) the social contact offered by the released rat and (2) the reinforcing value of proximity to a pool of water. These results call into question Sato et al.’s (Anim Cogn 18:1039–1047, 2015) claim to have demonstrated that a rat’s releasing of a wet rat to dry ground is empathically motivated.     

The shared and unique genetic relationship between mental well-being,depression and anxiety symptoms and cognitive function in healthy twins

Alterations to cognitive function are often reported with depression and anxiety symptoms, yet few studies have examined the same associations with mental well-being. This study examined the association between mental well-being, depression and anxiety symptoms and cognitive function in 1502 healthy adult monozygotic (MZ) and dizygotic (DZ) twins, and the shared/unique contribution of genetic (G) and environmental (E) variance. Using linear mixed models, mental well-being was positively associated (p?β?=?0.127), inhibition (β?=?0.096), cognitive flexibility (β?=?0.149), motor coordination (β?=?0.114) and working memory (β?=?0.156), whereas depression and anxiety symptoms were associated (p?β?=??0.134), inhibition (β?=??0.139), cognitive flexibility (β?=??0.116) and executive function (β?=??0.139). Bivariate twin modelling showed well-being shared a small environmental correlation with motor coordination and a small genetic correlation with working memory. Trivariate twin modelling showed well-being shared a small genetic correlation with inhibition, whereas depression and anxiety symptoms shared a small environmental correlation with inhibition. The remaining variance was mostly driven by unique G and/or E variance. Overall, well-being and depression and anxiety symptoms show both independent and shared relationships with cognitive functions but this is largely attributable to unique G or E variance and small shared G/E variance between pairs of variables.     

Associative independence revisited: competition between conflicting associations can be resolved or even reversed in one trial

In one type of association-memory paradigm, after studying pairs of the form AB, AC, participants must recall both B and C in response to A. Counterintuitively, yet often replicated, recall probabilities of B and C are typically uncorrelated (“associative independence”). This face-value independence is now understood to reflect a negative correlation due to AB and AC competing, approximately offset by a positive correlation produced by subject- and item-variability. The outcome might vary with stimulus material; for noun-pairs, and with a single study trial per pair, AB and AC have been found to be positively correlated. We replicated the positive correlation between AB and AC for noun-pairs, but this did not differ from the correlation expected for independent memory tests, suggesting that for noun pairs, AB and AC are independent on average. In Experiment 2, participants instructed to form separate images for AB and AC again produced an independence pattern, but participants instructed to combine AB and AC into an integrative image produced a facilitation pattern. Thus, the relationship between AB and AC varies, and can be influenced by study strategy. Association-memory models may need to accommodate a diverse range of AB–AC relationships, and studies that build on AB/AC learning may need to consider whether AB/AC start out with a competitive, facilitatory or independent relationship.     

Hits and false positives in face matching: a familiarity-based dissociation

In recognition memory for unfamiliar faces, performance for target-present items (hits) does not correlate with performance for target-absent items (false positives), a result which runs counter to the more usual mirror effect. In this paper we examinesubjects' performance on fac e matching, a nd demonstrate no relationship-between performance on matching items and performance on nonmatching items. This absence of a mirror effect occurs for multidistractor, 1-in-10 matching tasks (Experiment 1) and for simple paired-item tasks (Experiment 2). In Experiment 3 we demonstrate that matching familiar faces produces a strong mirror effect. However, inverting the familiar faces causes the association to disappear once more (Experiment 4). We argue thatfamiliar and unfamiliar faces are represented in qualitatively different ways.