Use of Functional Magnetic Resonance Imaging in the Early Identification of Alzheimer's Disease

A growing body of evidence suggests that a preclinical phase of Alzheimer's disease (AD) exists several years or more prior to the overt manifestation of clinical symptoms and is characterized by subtle neuropsychological and brain changes. Identification of individuals prior to the development of significant clinical symptoms is imperative in order to have the greatest treatment impact by maintaining cognitive abilities and preserving quality of life. Functional magnetic resonance imaging (fMRI) offers considerable promise as a non-invasive tool for detecting early functional brain changes in asymptomatic adults. In fact, evidence to date indicates that functional brain decline precedes structural decline in preclinical samples. Therefore, fMRI may offer the unique ability to capture the dynamic state of change in the degenerating brain. This review examines the clinical utility of blood oxygen level dependent (BOLD) fMRI in those at risk for AD as well as in early AD. We provide an overview of fMRI findings in at-risk groups by virtue of genetic susceptibility or mild cognitive decline followed by an appraisal of the methodological issues concerning the diagnostic usefulness of fMRI in early AD. We conclude with a discussion of future directions and propose that BOLD-fMRI in combination with cerebral blood flow or diffusion techniques will provide a more complete accounting of the neurovascular changes that occur in preclinical AD and thus improve our ability to reliably detect early brain changes prior to disease onset.     

Honoring Protective Responses: Reframing Resistance in Therapy Using Polyvagal Theory

Therapists often conceptualize resistance as client behaviors that impede progress; this perspective threatens the therapeutic alliance, especially in couple and family therapy where increased resistance and multiple alliances are present. Polyvagal theory reframes and normalizes resistant behaviors as preconscious, protective responses emerging from our autonomic nervous system. The theory also explains how humans reciprocate safety cues to connect with each other; therapists can use concepts of polyvagal theory to manage their own emotional regulation and foster safety and connection in therapy. Polyvagal concepts deepen our understanding of protective behaviors presenting in couple and family therapy; therapists can help couple and family clients to recognize protective behaviors in their own relationships and facilitate safer connection and engagement. Clinical implications are presented: psychoeducation can help clients normalize and understand their protective processes; therapist presence and immediacy acknowledges and normalizes protective behaviors as they arise; therapist and client self-regulation skills support connection; therapist genuineness is a precondition to client safety; and understanding of polyvagal theory enhances assessment of conflict and enactments in couple and family therapy.

     

Making global news: “Freedom of speech” and “Muslim rage” in U.S. journalism

The American press began to take notice of the Danish cartoons after they began to circulate outside of Europe. The press primarily framed the events as a single problem of global interaction: an issue of ‘freedom of speech’ opposed to ‘religious sensitivity.’ Much of the coverage permitted, within limits, a plurality of voices. Drawing on a case study of stories about the ‘cartoon controversy’ in the Boston Globe, I argue that U.S. journalism is organized by a logic of objectivity that seeks to produce a ‘perspectiveless perspective on all perspectives’ (Bourdieu, On television. New York: The New Press, 1998), showing voices on ‘both sides,’ simultaneously masked and contributed to the press’s reifying a series of events into a single global ‘event,’ one that reflected a clash of Western and Islamic values.

Dimensional Personality Traits Broadly and Selectively Associated with Normative Externalizing Behavior

This study aimed to distinguish personality traits that are widely associated with several types of externalizing behaviors from personality traits that are more selectively associated with one or only a few specific types of externalizing behavior. A wide range of externalizing behaviors (e.g. alcohol and drug use, risky driving, aggressive acts, sexual promiscuity and relationship infidelity, academic misconduct) typical among an undergraduate population (N?=?257) were examined along with a range of personality traits measured using the Section III personality model for the DSM-5. We found that externalizing behavior was best associated with the domain level trait Antagonism and, to a lesser degree, Disinhibition. Antagonism’s association with problematic behavior was primarily accounted for by the facet trait Deceitfulness. Deceitfulness was found to be associated with a wide range of behaviors including relationship infidelity, theft, aggressive acts, and drug and alcohol use. Associations between Disinhibition and problem behavior, especially risky driving and poor work or school performance, were best accounted for by the Irresponsibility facet, as opposed to the Impulsivity or Distractibility facet traits. This comprehensive multivariate approach is important for a more complete understanding of the complex relationship that exists between personality traits and externalizing behavior. A better understanding of factors precipitating externalizing behavior could ultimately lead to an increased ability to target interventions to individuals most susceptible to engage in problematic behavior.     

Discovering Argumentative Patterns in Energy Polylogues: A Macroscope for Argument Mining

A macroscope is proposed and tested here for the discovery of the unique argumentative footprint that characterizes how a collective (e.g., group, online community) manages differences and pursues disagreement through argument in a polylogue. The macroscope addresses broader analytic problems posed by various conceptualizations of large-scale argument, such as fields, spheres, communities, and institutions. The design incorporates a two-tier methodology for detecting argument patterns of the arguments performed in arguing by an interactive collective that produces views, or topographies, of the ways that issues are generated in the making and defending of standpoints. The design premises for the macroscope build on insights about argument patterns from pragma-dialectical theory by incorporating research and theory on disagreement management and the Argumentum Model of Topics. The design reconceptualizes prototypical and stereotypical argument patterns for characterizing large-scale argumentation. A prototype of the macroscope is tested on data drawn from six threads about oil-drilling and fracking from the subreddit Changemyview. The implementation suggests the efficacy of the macroscope’s design and potential for identifying what communities make controversial and how the disagreement space in a polylogue is managed through stereotypical argument patterns in terms of claims/premises, inferential relations, and presentational devices.     

Predictors of depressive symptoms among breast cancer patients during the first year post diagnosis

It is important to identify predictors of psychological health among breast cancer patients that can be relatively easily identified by medical care providers. This article investigates the role of one class of such potential predictors: easily identified demographics that have potential social and/or practical implications. Specifically, we examined whether income, marital status, presence of children in the home, education, travel distance, age and rurality interact with time to predict psychological health over the first year post diagnosis. Two hundred and twenty five breast cancer patients receiving radiation treatment completed four surveys over the course of 13 months that included measures of both their physical health and depressive symptoms. The results revealed that women who were not married had children living in the home or had to travel long distances to receive radiation treatment reported higher levels of depressive symptoms across the entire study. Women with lower incomes reported increased depressive symptoms, but only after the completion of treatment. Younger women reported elevated depressive symptoms during initial treatment, but this effect dissipated after the completion of treatment. The current results suggest that demographic patient characteristics may indeed be useful in identifying both when and for whom depressive symptoms are particularly likely to be problematic.     

When is ignorance bliss? The effects of inaccurate self-assessments of knowledge on learning and attrition

Two studies were conducted to examine the implications of inaccurate self-appraisals in online training. Self-assessment of knowledge moderated the effects of trainees’ performance on subsequent performance and attrition. Performance was highest after uniformly positive ratings (i.e., high self-assessment and high performance), followed by underestimation, overestimation, and uniformly negative ratings, respectively. Attrition was lowest after uniformly positive ratings, followed by underestimation, uniformly negative ratings, and overestimation, respectively. Effort had a more positive effect on performance following low than high self-assessments and this interaction fully mediated the self-assessment/performance interaction on subsequent performance. Commitment had a more negative effect on subsequent attrition following low than high self-assessments and this interaction fully mediated the self-assessment/performance interaction on subsequent attrition. Finally, trainee conscientiousness affected their behavior when their performance and self-assessments were inconsistent—overestimating and underestimating performance increased attrition more for trainees low in conscientiousness and impaired performance more for trainees high in conscientiousness.     

Demographic Question Placement: Effect on Item Response Rates and Means of a Veterans Health Administration Survey

Purpose

This study examined whether demographic question placement affects demographic and non-demographic question completion rates, non-demographic item means, and blank questionnaire rates using a web-based survey of Veterans Health Administration employees.

Methodology

Data were taken from the 2010 Voice of the Veterans Administration Survey (VoVA), a voluntary, confidential, web-based survey offered to all VA employees. Participants were given two versions of the questionnaires. One version had demographic questions placed at the beginning and the other version had demographic questions placed at the end of the questionnaire.

Findings

Results indicated that placing demographic questions at the beginning of a questionnaire increased item response rate for demographic items without affecting the item response rate for non-demographic items or the average of item mean scores.

Implications

In addition to validity issues, a goal for surveyors is to maximize response rates and to minimize the number of missing responses. It is therefore important to determine which questionnaire characteristics affect these values. Results of this study suggest demographic placement is an important factor.

Originality/Value

There are various opinions about the most advantageous location of demographic questions in questionnaires; however, the issue has rarely been examined empirically. This study uses an experimental design and a large sample size to examine the effects of demographic placement on survey response characteristics.