Les modifications du fonctionnement exécutif dans le vieillissement normal

We provide here an overview of the current state of research in the domain of executive functioning in normal aging. Normal aging has generally been associated with executive control deficits. Although impaired performance is effectively observed for the executive functions of updating, shifting, inhibition and dual-task coordination, preserved performance is also sometimes observed. We interpreted the presence of preserved performance as reflecting the integrity of some executive sub-processes or the existence of distinct functions within an executive function previously considered as unitary. Moreover, these difficulties appear also influenced by the efficiency of attentional processes (i.e., processing speed), working memory capacity and some individual genetic characteristics. Changes in the neural networks associated to executive processes were also reported. These changes consist in increased or decreased activity in task-related networks, or the recruitment of supplementary brain areas. They are considered to reflect compensatory processes or inefficient use of brain networks, when they are respectively associated to preserved or impaired task-performance.     

The inaccuracy of nurses' perception of elderly patients' well-being

Abstract

Thirty elderly day hospital patients rated two aspects of their well-being: life-satisfaction and depression. The key-nurse estimated these values for each patient, using the same, validated scales. Patients' ratings of life-satisfaction and depression intercorrelated. as did the nurses' estimates, but the nurses' scores were unrelated to those of the patients. Patients' well-being correlated with their estimates of the time they spent in solitary activity, whereas nurses' estimates correlated with overt engagement and behavioural dependency. It is likely that general nurses' lack of perception of their elderly patients' well-being arises, in part, because their assessments are based on aspects of their patients' overt behaviour which are unrelated to actual well-being.     

Medical Settings as a Context for Research on Cognitive Development

Medical contexts provide a rich opportunity to study important theoretical questions in cognitive development and to investigate the influence of a range of interacting factors relating to the child, the experience, and the broader social context on children's cognition. In the context of examples of research investigating these issues, we consider several specific advantages of conducting research in medical settings: the diverse range of participants, experiences, and potential research paradigms and the opportunities for student training. We discuss the benefits and challenges of conducting research within medical contexts and consider ways of attempting to maximize the former and of addressing the latter.     

Asking Parents to Prepare Children for an Event: Altering Parental Instructions Influences Children's Recall

The authors investigated whether manipulating parents' goals regarding their discussion of an upcoming staged event with their 6-year-old children differentially influenced the children's recall. Parents (n = 62) were asked to prepare their child for a staged novel event—“visiting the pretend zoo”—to take place 1 day later. One group (inform) was asked to simply tell their child about the event, whereas a second group (discuss) was asked to engage their child in conversation and seek their child's perspective. A third group of parents (control) read an unrelated story to their child. Relative to parents in the control and inform conditions, parents in the discuss condition engaged their children in richer, more diverse, and complex conversation and their children made more contributions to the conversation. When their recall was tested 1 week later, however, children in the inform condition, relative to the discuss and control conditions, recalled more correct information overall. The reports of children in the inform and discuss conditions were highly accurate, and more so than those of children in the control condition. The findings and their possible underlying mechanisms are discussed.     

Talking about parts of a past experience: The impact of discussion style and event structure on memory for discussed and nondiscussed information

This experiment examined the impact of selective postevent discussion of high- and low-elaborative styles on 5- and 6-year-olds' (N = 47) memory for discussed and nondiscussed aspects of a staged event ("Visiting the Pirate"). The event contained both logically and arbitrarily connected scenes. Discussion was spaced over 3 days, and memory was assessed 1 day later. Compared with a no-discussion condition, memory for discussed information was enhanced after high- but not low-elaborative discussion for both logically and arbitrarily connected scenes. For arbitrarily connected scenes, memory for nondiscussed aspects was impaired relative to the no-discussion condition, with the degree of impairment being equal after high- and low-elaborative discussion. In contrast, for logically connected scenes, memory for nondiscussed information was not impaired after discussion of either style.     

The potentially somatizing effect of clinical consultation

Many patients who present physical symptoms that their doctors cannot explain by physical disease have persisting symptoms and impairment. An influential view has been that such symptoms are the somatization of emotional distress, but there has also been concern that medical practice contributes to shaping these presentations. Analysis of patients' accounts indicate that they approach these consultations with a sense of being the expert on the nature and reality of their symptoms and, in primary care at least, they seek convincing explanations, engagement, and support. They often describe doctors as doubting that their symptoms are real and as not taking their symptoms seriously. Observational research has demonstrated that patients presenting idiopathic symptoms in primary care generally provide cues to their need for explanation or to psychosocial difficulties. Their doctors tend to provide simple reassurance rather than detailed explanations, and often disregard psychosocial cues. Patients seem to intensify their presentation in consequence, elaborating and extending their accounts of their symptoms, perhaps in the effort to engage their doctors and demonstrate the reality of their symptoms. When doctors propose physical investigation and treatment in response to such escalating presentation, they thereby inadvertently somatize patients' psychological presentation. Consultations, therefore, have elements of contest, whereby patients seek engagement from doctors who seek to disengage. Although provision of a medical label, such as a functional diagnosis, can legitimize patients' complaints and avoid contest, this is at the risk of indicating that medicine can take responsibility for managing the symptoms. More collaborative relationships rely on doctors recognizing patients' authority in knowing about their symptoms, and providing tangible explanations that make sense to the patient and allow them to tolerate or manage the symptoms. Researchers need to study how doctors can best achieve these aims within routine consultations.     

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.     

Selective postevent review and children's memory for nonreviewed materials

Two experiments investigated the impact of selective postevent questioning on children's memory for nonreviewed materials. In both experiments, children participated in a series of novel activities. Children in the selective-review condition were subsequently questioned about half of these and comparisons were made to memory in a no-review condition. In Experiment 1, participants were 60 5- and 9-year-olds. For children in both age groups, memory for nonreviewed activities was impaired 20 min later in free recall. In Experiment 2, participants were 60 5-year-olds. Memory impairment was found following a 1-day delay after spaced review (three sessions over 3 days) but not after massed review (three sessions on 1 day). In both experiments, memory impairment was absent when specific retrieval cues were provided. The possible mechanisms underlying these findings and their potential practical implications are discussed.     

Pre-event discussion and recall of a novel event: how are children best prepared?

We investigated the conditions under which information 1 day before a novel event influenced 6-year-olds' recall 2 weeks later. In Experiment 1A, four preparation conditions included either the event goals, goals with narration of the event actions and objects, photographs of the objects with goals and narration, or photographs with narration and child verbalization of the actions and objects. Compared with an irrelevant preparation control condition, goals with narration reduced errors, but correct recall was increased only when photographs were included. Child verbalization together with goals, narration, and photographs increased correct recall relative to goals with narration. In Experiment 1B, neither photographs nor preparation alone improved recall relative to the control condition. Experiment 2 found no further advantage of increasing children's participation in the preparation via questions. Overall, the impact of preevent information on memory is influenced by the nature of the information and the child's participation in the preparation.