Dynamic testing of learning potential in adults with cognitive impairments: A systematic review of methodology and predictive value

Dynamic testing includes procedures that examine the effects of brief training on test performance where pre‐ to post‐training change reflects patients’ learning potential. The objective of this systematic review was to provide clinicians and researchers insight into the concept and methodology of dynamic testing and to explore its predictive validity in adult patients with cognitive impairments. The following electronic databases were searched: PubMed, PsychINFO, and Embase/Medline. Of 1141 potentially relevant articles, 24 studies met the inclusion criteria. The mean methodological quality score was 4.6 of 8. Eleven different dynamic tests were used. The majority of studies used dynamic versions of the Wisconsin Card Sorting Test. The training mostly consisted of a combination of performance feedback, reinforcement, expanded instruction, or strategy training. Learning potential was quantified using numerical (post‐test score, difference score, gain score, regression residuals) and categorical (groups) indices. In five of six longitudinal studies, learning potential significantly predicted rehabilitation outcome. Three of four studies supported the added value of dynamic testing over conventional testing in predicting rehabilitation outcome. This review provides preliminary support that dynamic tests can provide a valuable addition to conventional tests to assess patients’ abilities. Although promising, there was a large variability in methods used for dynamic testing and, therefore, it remains unclear which dynamic testing methods are most appropriate for patients with cognitive impairments. More research is warranted to further evaluate and refine dynamic testing methodology and to further elucidate its predictive validity concerning rehabilitation outcomes relative to other cognitive and functional status indices.     

Manipulating perception versus action in recalibration tasks

We conducted six experiments to examine how manipulating perception versus action affects perception–action recalibration in real and imagined blindfolded walking tasks. Participants first performed a distance estimation task (pretest) and then walked through an immersive virtual environment on a treadmill for 10 min. Participants then repeated the distance estimation task (posttest), the results of which were compared with their pretest performance. In Experiments 1a, 2a, and 3a, participants walked at a normal speed during recalibration, but the rate of visual motion was either twice as fast or half as fast as the participants' walking speed. In Experiments 1b, 2b, and 3b, the rate of visual motion was kept constant, but participants walked at either a faster or a slower speed. During pre- and posttest, we used either a blindfolded walking distance estimation task or an imagined walking distance estimation task. Additionally, participants performed the pretest and posttest distance estimation tasks in either the real environment or the virtual environment. With blindfolded walking as the distance estimation task for pre- and posttest, we found a recalibration effect when either the rate of visual motion or the walking speed was manipulated during the recalibration phase. With imagined walking as the distance estimation task, we found a recalibration effect when the rate of visual motion was manipulated, but not when the walking speed was manipulated in both the real environment and the virtual environment. Discussion focuses on how spatial-updating processes operate on perception and action and on representation and action.     

There is nothing paranormal about near-death experiences: how neuroscience can explain seeing bright lights, meeting the dead, or being convinced you are one of them

Approximately 3% of Americans declare to have had a near-death experience. These experiences classically involve the feeling that one's soul has left the body, approaches a bright light and goes to another reality, where love and bliss are all encompassing. Contrary to popular belief, research suggests that there is nothing paranormal about these experiences. Instead, near-death experiences are the manifestation of normal brain function gone awry, during a traumatic, and sometimes harmless, event.     

Learning and Living Systemic: Exploring the Personal Effects of Family Therapy Training

Despite growing recognition that systemic family therapists need to be adept at personal reflection and managing the therapeutic relationship, little research has explored the effects of training beyond the development of skills. This article provides a report on a qualitative study focussed on the personal effects of family therapy training, with particular reference to the aspects of training that foster personal reflection and growth. Twenty three trainees from three training institutions were interviewed, utilizing the practices of grounded theory. Trainees reported a deepening relational awareness, which applied to both personal and professional domains and included shifts in perspectives on relationships with loved ones. Five aspects of training were identified as responsible: (1) personally challenging experiences with clients; (2) supervisors who live the paradigm; (3) the demystification of theory; (4) a safe supervisory space; and (5) the development of trusting peer relationships. Interns also described, in turn, how their personal development affected their clinical work, particularly in the development of compassion and empathy. This study serves to highlight training practices that support reflective practice in systemic family therapy.     

The influence of prior knowledge and repeated questioning on children's long-term retention of the details of a pediatric examination

Children's recall of the details of pediatric examinations was examined over the course of a 6-month interval. Although the 83 4- to 7-year-old participants reported a substantial amount of information at each assessment, performance declined over time, dropping sharply over the course of 3 months but then remaining constant out to the final interview at 6 months. As expected, older children provided more total information than younger children did and reported a greater proportion of the event components in response to general rather than specific questions. However, comparable patterns of remembering and forgetting over time were observed at each age level. In addition, no effects of repeated questioning--in the form of an interview at 3 months for half of the children--were observed on performance at the 6-month assessment. Moreover, children's prior knowledge about routine doctor visits was assessed before the checkup for half of the participants at each age and was associated with initial but not delayed recall. Although knowledge increased with age as expected, it nonetheless affected recall over and above the influence of age.     

Children in family therapy

The distinctive skills of child psychotherapy can be utilized in the development of a form of conjoint family therapy especially applicable to the field of child psychiatry. It is suggested that the engagement of children in the process particularly enhances the specific characteristics and potentialities of this form of treatment.     

Counselor Education Students’ Perceptions of Wellness and Mental Health in African American Men: The Effects of Colorism

Colorism is discrimination based on skin tone. Skin color influences clinicians’ diagnostic impressions. The degree to which colorism influences counseling students’ clinical decision making is unknown. This study examined colorism's effect on counselor education master's students’ (N = 154) clinical decisions. Analysis of covariance failed to produce statistically significant results when comparing students’ evaluations of a male African American's mental health and wellness, when controlling for presentation management, across 4 skin tones. Counselors should include colorism in diversity training. El colorismo es la discriminación basada en el tono de la piel. El tono de la piel influye en las impresiones diagnósticas de los profesionales clínicos. Se desconoce hasta qué punto el colorismo influye en las decisiones clínicas de los estudiantes de consejería. Este estudio examinó el efecto del colorismo en las decisiones clínicas de estudiantes de maestría en educación de consejeros (N = 154). El análisis de la covarianza no produjo resultados estadísticamente significativos al comparar las evaluaciones de los estudiantes sobre la salud mental y el bienestar de un cliente afroamericano varón, controlando la gestión de la presentación de 4 tonos de piel diferentes. Los consejeros deberían incluir el colorismo en la capacitación de diversidad.     

Prenatal Maternal Distress: A Risk Factor for Child Anxiety?

The deleterious association between various types of prenatal maternal psychological distress (PNMS, anxiety, depression, psychological distress, stress) and childhood anxiety symptomatology (internalizing behaviors, anxiety symptoms) has been established using both retrospective and prospective longitudinal studies across varied demographic cohorts and throughout development. Yet, the existing literature cannot claim maternal distress during pregnancy to be a specific risk factor for anxiety symptomatology, as studies utilizing such observational designs are unable to adequately account for confounding of potential genetic factors and the postnatal environment. In this review, we examine studies that attempt to minimize such confounding and thus disentangle the unique intrauterine exposure effect of varying types of PNMS on childhood anxiety symptomatology. Such methodologies include paternal versus maternal comparison studies, sibling comparisons, prenatal cross-fostering designs and timing of exposure studies (including disaster studies). Of the identified studies, findings indicate that prenatal maternal distress is likely to constitute a risk factor for anxiety symptomatology, although more studies are needed to replicate current findings in order to determine whether there are clear differences in effects across specific types of PNMS and for specific subpopulations. We review the methodological limitations and strengths of the literature prior to exploring avenues of future research and implications for theory and clinical practice.