Cognitive deficits in major depression

Major depression is a mood disorder that is often accompanied by the impairment of cognitive functions. Although suggestive, the large range of existing neuropsychological, neuropsychiatric, and, lately, neuroimaging investigations have not yet given a consistent picture of the psychological and biological disturbances involved in this psychiatric disorder. The present study of the cognitive functions in depression was part of an extensive investigation, including neuropsychological testing, psychiatric examination, and neuroimaging. A representative sample of 40 severely depressed hospitalized patients and a group of 49 closely matched control subjects were tested with an extensive neuropsychological test battery. Results, corrected for various confounding factors, confirmed the current notion that depressed patients suffer from wide-spread cognitive impairments. The group analysis did not allow any hypothesis on a possible pattern to the dysfunctions, but heterogeneity in the test performances calls for further analysis of the data in patient subgroups in relation to neuroimaging results.     

On the speed of intuition: Intuitive judgments of semantic coherence under different response deadlines

Intuition is the ability to judge stimulus properties on the basis of information that is activated in memory but not consciously retrieved. We investigated one central feature of intuitive judgments--namely, their speed. Participants judged whether or not three clue words were coherent in the sense that they were weakly associated with a common fourth concept. To restrict the time available for conscious deliberation of possible solution words, participants had to synchronize their judgments with a response signal appearing at different lags after the clue words. In two experiments, participants discriminated coherent and incoherent triads reliably better than chance, even when they did not consciously retrieve the solution word and the lag between clue words and response signal was as short as 1.5 sec. Results indicate that intuitive judgments can indeed be made very fast and without extended conscious deliberation. Possible mechanisms underlying intuitive judgments are discussed.     

Evaluating the efficiency and community safety goals of the Broward County Mental Health Court

Mental health courts have developed as one response to persons with mental illness who are involved with the criminal justice system. This study investigated the efficiency and safety goals of one such court in Broward County, FL. Mental health court (MHC) clients spent significantly fewer days in jail for the index arrest associated with study enrollment than a comparison group. MHC clients had similar survival time to re-arrest up to one year after study enrollment. MHC clients did not significantly differ from the comparison group in self-reported aggressive acts over an 8 month follow-up period, while they did self-report significantly fewer acts of violence than the comparison group at the 8 month follow-up. These findings suggest that some of the benefits associated with the MHC reported in prior studies were not achieved at the expense of efficiency and safety.     

Training-based interventions in motor rehabilitation after stroke: theoretical and clinical considerations

Basic neuroscience research on brain plasticity, motor learning and recovery has stimulated new concepts in neurological rehabilitation. Combined with the development of set methodological standards in clinical outcome research, these findings have led to a double-paradigm shift in motor rehabilitation: (a) the move towards evidence-based procedures for the assessment of clinical outcome & the employment of disablement models to anchor outcome parameters, and (b) the introduction of practice-based concepts that are derived from testable models that specify treatment mechanisms. In this context, constraint-induced movement therapy (CIT) has played a catalytic role in taking motor rehabilitation forward into the scientific arena. As a theoretically founded and hypothesis-driven intervention, CIT research focuses on two main issues. The first issue is the assessment of long-term clinical benefits in an increasing range of patient groups, and the second issue is the investigation of neuronal and behavioural treatment mechanisms and their interactive contribution to treatment success. These studies are mainly conducted in the research environment and will eventually lead to increased treatment benefits for patients in standard health care. However, gradual but presumably more immediate benefits for patients may be achieved by introducing and testing derivates of the CIT concept that are more compatible with current clinical practice. Here, we summarize the theoretical and empirical issues related to the translation of research-based CIT work into the clinical context of standard health care.     

Coping through emotional approach: a new look at emotion, coping, and health-related outcomes

Researchers studying stress and coping processes have attempted to identify which coping strategies are most adaptive in stressful encounters. A generally accepted conclusion has been that emotion-focused coping processes are associated with dysfunctional outcomes. Studies from our and other research teams challenge the "bad reputation" of emotion-focused coping by demonstrating that items measuring emotion-focused strategies in published coping questionnaires are confounded with distress and self-deprecation. We have developed and validated new instruments to assess coping though acknowledging, understanding, and expressing emotion, that is, coping through emotional approach. Longitudinal and experimental studies using these new scales have documented the adaptive potential of emotional-approach coping in the context of several types of stressors, including infertility, breast cancer, and chronic pain. However, characteristics of the environmental context, stressful experience, and individual are important moderators of the relations of emotional-approach coping and health-related outcomes. Potential mediators and moderators of coping through emotional approach, clinical relevance of the construct, and directions for research are discussed.     

Modeling language acquisition in atypical phenotypes

An increasing number of connectionist models have been proposed to explain behavioral deficits in developmental disorders. These simulations motivate serious consideration of the theoretical implications of the claim that a developmental disorder fits within the parameter space of a particular computational model of normal development. The authors examine these issues in depth with respect to a series of new simulations investigating past-tense formation in Williams syndrome. This syndrome and the past-tense domain are highly relevant because both have been used to make strong theoretical claims about the processes underlying normal language acquisition. The authors conclude that computational models have great potential to advance psychologists' understanding of developmental deficits because they focus on the developmental process itself as a pivotal causal factor in producing atypical phenotypic outcomes.     

Word associations in deep dyslexia

Deep dyslexia is an acquired reading disorder resulting in the production of semantic errors during oral reading and an inability to read aloud nonwords. Several researchers have postulated that patients with deep dyslexia have both phonological and semantic access impairments but the data supporting these claims are not convincing. In fact, the hallmark feature of deep dyslexia--the semantic errors--strongly implies that these patients can access semantic information from printed words. We test the integrity of the semantic system in two such patients through auditory and visual word association tasks. The data support the notion that semantics remains intact and that the disorder and associated errors arise through a selection impairment related to failure of inhibitory connections in the phonological lexicon.     

Unique transitions between stimuli and responses in SRT tasks: Evidence for the primacy of response predictions

The present experiments aimed at separating the impact stimulus and response predictions have on serial learning and performance in SRT tasks. In Experiment 1, a unique transition between two of four responses in an otherwise random response sequence was triggered by ambiguous stimulus transitions, allowing local response predictions but no stimulus predictions. The data indicated explicit transition knowledge and strong performance benefits. In Experiments 2 and 3, unique transitions between two of four stimuli in otherwise random stimulus sequences allowed local stimulus predictions under conditions of ambiguous response transitions. The data indicated fragmentary explicit transition knowledge but no performance effects. Experiments 4a and 4b reveal that the inefficacy of the unique stimulus transitions in Experiments 2 and 3 was presumably due to the fact that the stimuli differed with respect to conjunctions of response relevant and response irrelevant features which participants did not have to attend. However, although in Experiments 4a and 4b unique transitions between response relevant stimuli were applied, substantial explicit transition knowledge but only marginal performance effects resulted. It is argued i) that in SRT tasks learning mechanisms are addressed that primarily strive for reliable predictions of forthcoming responses and ii) that for these mechanisms to work the predictors have to be attended. Response transitions are easily learned and used because both criteria are fulfilled. In contrast, pure stimulus transitions are learned only if the predictive stimuli are attended, and learned stimulus transitions become effective only to the extent that the predicted stimuli specify the required responses.