Combining Pharmacotherapy with cognitive-behavioral interventions for obsessive-compulsive disorder

This paper reviews the evidence-based literature concerning the efficacy and effectiveness of cognitive behavior therapy (CBT), drug treatment and their combination for obsessive compulsive disorder (OCD). After a brief outline of the seminal studies, the state of the art is presented with reference to the consensual recommendations proposed in the last 10 years. Management of OCD rests on potent selective serotonin reuptake inhibitors and CBT, used separately, sequentially, or concurrently. A hierarchical model for clinical decision-making is reported. With greater severity of OCD, it is recommended to add medications. However, the response rate is still too low in many patients, and some patients remain refractory to any kind of treatment. This stresses the importance of joint efforts of psychological and biological teams to develop new treatments.     

Modulation of brain activity during phonological familiarization

We measured brain activity in 12 adults for the repetition of auditorily presented words and nonwords, before and after repeated exposure to their phonological form. The nonword phoneme combinations were either of high (HF) or low (LF) phonotactic frequency. After familiarization, we observed, for both word and nonword conditions, decreased activation in the left posterior superior temporal gyrus, in the bilateral temporal pole and middle temporal gyri. At the same time, interaction analysis showed that the magnitude of decrease of activity in bilateral posterior temporal lobe was significantly smaller for LF nonwords, relative to words and HF nonwords. Decrease of activity in this area also correlated with the size of behavioral familiarization effects for LF nonwords. The results show that the posterior superior temporal gyrus plays a fundamental role during phonological learning. Its relationship to sublexical and lexical phonological processing as well as to phonological short-term memory is discussed.     

Rhythmic masking release: effects of asynchrony, temporal overlap, harmonic relations, and source separation on cross-spectral grouping

The rhythm created by spacing a series of brief tones in a regular pattern can be disguised by interleaving identical distractors at irregular intervals. The disguised rhythm can be unmasked if the distractors are allocated to a separate stream from the rhythm by integration with temporally overlapping captors. Listeners identified which of 2 rhythms was presented, and the accuracy and rated clarity of their judgment was used to estimate the fusion of the distractors and captors. The extent of fusion depended primarily on onset asynchrony and degree of temporal overlap. Harmonic relations had some influence, but only an extreme difference in spatial location was effective (dichotic presentation). Both preattentive and attentionally driven processes governed performance.     

A cross-linguistic data bank for oral picture naming in Dutch, English, German, French, Italian, Russian, Spanish, and Swedish (PEDOI)

The well established effect of word frequency on adult's picture naming performance is now called into question. This is particularly true for variables which are correlated with frequency, as is the case of age of word acquisition. Since the work of [Carrol and White, 1973] there is growing agreement among researchers to confer an important role in lexical access to this variable. Indeed, it has been shown ( [Hodgson and Ellis, 1998]) that for normal English-speaking adults only the variables 'age-of-acquisition' and 'name agreement' are independent predictors of naming success among the various variables considered. However, when brain-damaged subjects with and without degenerative pathologies are studied, word frequency and word length as well as concept familiarity all give significant effects ( [Hirsh and Funnell, 1995]; [Lambon Ralph et al., 1998]; [Nickels and Howard, 1995]). Finally, it has been suggested that the production of specific error types may be related to such variables. According to [Nickels and Howard, 1994] the production of semantic errors is specifically affected by 'imageability' and in the recent study by [Kremin et al., 2001] 'age of acquisition' predicts (frank) word finding difficulties.     

Surface dyslexia: A case report and some theoretical implications to reading models

This paper reports on the psycholinguistic investigation of a surface dyslexic aphasic patient's abilities to handle written material. The analysis of paralexic errors produced in reading aloud single words and nonwords classically suggested that the patient was using an analytical strategy parsing the letter string stimulus, from left to right, into graphemes, and assigning phonemic values to graphemes. The patient's results were found to be sensitive to irregularities in correspondence between graphemes and phonemes not only in reading aloud but in lexical decisions, writing on dictation, rhyming, and written-word comprehension. Moreover, the patient's linguistic behavior brought out the reverse pattern observed in deep-dyslexic performances within word/nonword and content/function word dimensions. It was found that some semantic information about written words could be retrieved from both phonological and nonphonological processes presumably operating concurrently and both providing converging or conflicting pieces of meaning to the understanding of written words. Some considerations derived from the observation of this pathological reading behavior are discussed, contributing to a psycholinguistic model of normal reading.     

Evidence of metacognitive awareness in young children who have experienced a repeated event

Two studies examined children's confidence judgments in the accuracy of their memories after repeated experience of an event. Children aged 5 to 6 years took part in an event once or four times, were provided with misinformation either shortly after (Study 1) or a while after (Study 2), and interviewed with yes/no recognition questions 3 months later. Children in the repeated‐experience conditions were highly confident of their accurate responses to questions about items that were identical rather than variable across occurrences, and this discrimination was best at the shorter delay. The results show that children were able to metacognitively monitor the accuracy of their responses to qualitatively different kinds of details, and indicate that age is not the only determinant of metacognitive awareness after being misled. Rather, the nature of event representations must also be considered. Copyright © 2005 John Wiley & Sons, Ltd.     

Secrecy and suggestibility: are children's memories for secrets less suggestible than other memories?

Adult secrecy research has found a memory‐enhancing effect for information kept secret as the secret is mentally rehearsed each time the adult is required to prevent it being reported (e.g. Lane & Wegner, 1994). The present study examined possible memory‐enhancing effects of children keeping information secret. Two hundred and thirty two five to eight year olds took part in a puppet‐making task. During the task the puppet‐maker sprayed glitter onto the puppets. Half the children were told to keep a secret (that the spray had been taken from Disneyland) and the other half (the control group) were merely told the spray was from Disneyland. One week later the children were interviewed either by the puppet‐maker (the secret‐giver) or by the puppet‐maker's friend (the secret‐novice). The five to six year olds showed no effect of the secret condition, whereas the seven to eight year olds made significantly less errors in their free recall in the secret condition compared to the control condition. There was no effect of the secret condition on children's suggestibility to leading questions. However, both age groups were significantly more suggestible when interviewed by the secret‐giver. Finally, both age groups showed a recall deficit in the secret condition. Copyright © 2004 John Wiley & Sons, Ltd.