Faulty Judgment,Expert Opinion,and Decision-Making Capacity

An assessment of decision-making capacity is the accepted procedure for determining when a person is not competent. An inferential gap exists between the criteria for capacity specific abilities and the legal requirements to understand relevant information and appreciate the consequences of a decision. This gap extends to causal influences on a person'scapacity to decide. Using a published case of depression, we illustrate that assessors' uses of diagnostic information is frequently not up to the task of bridging this inferential gap in a justifiable way. We then describe cases of faulty judgement which challenge the understanding of diagnostic causal influences. These cases help to clarify the nature of the expertise required for capacity assessments. In practice, the requirements of decision-making capacity are often abandoned to other considerations due to a lack of requisite expertise. The legal policy supporting decision-making capacity as a means to protective intervention is justified only if the requisite expertise is developed. We propose the requisite expertise to be developed in the long term as a distinct multidisciplinary endeavour.     

Downward causation without foundations

Emergence is interpreted in a non-dualist framework of thought. No metaphysical distinction between the higher and basic levels of organization is supposed, but only a duality of modes of access. Moreover, these modes of access are not construed as mere ways of revealing intrinsic patterns of organization: They are supposed to be constitutive of them, in Kant’s sense. The emergent levels of organization, and the inter-level causations as well, are therefore neither illusory nor ontologically real: They are objective in the sense of transcendental epistemology. This neo-Kantian approach defuses several paradoxes associated with the concept of downward causation, and enables one to make good sense of it independently of any prejudice about the existence (or inexistence) of a hierarchy of levels of being.     

Therapist effects and the dissemination of cognitive behavior therapy for chronic fatigue syndrome in community-based mental health care

ObjectiveThe purpose of the present study was to explore the role of the therapist in the dissemination of manualized cognitive behavior therapy (CBT) for chronic fatigue syndrome (CFS) outside specialized treatment settings.MethodWe used the routinely collected outcome data of three community-based mental health care centers (MHCs) which implemented and sustained CBT for CFS during the course of the study. Ten therapists, who all received the same training in CBT for CFS, and 103 patients with CFS were included.ResultsRandom effects modeling revealed a significant difference in mean post-treatment fatigue between therapists. The effect of the therapist accounted for 21% of the total variance in post-treatment fatigue in our sample. This effect could be explained by the therapists’ attitude toward working with evidence-based treatment manuals as well as by the MHC where CBT for CFS was delivered.ConclusionThe context in which CBT for CFS is delivered may play an important role in the accomplishment of established therapy effects outside specialized treatment settings. Due to the small sample size of MHCs and the different implementation scenarios in which they were engaged, our findings should be interpreted as preliminary results which are in need for replication.     

French Children’s Awareness of Gender Stereotypes About Mathematics and Reading: When Girls Improve Their Reputation in Math

Since 2000, surveys on academic achievement show gender inequalities in favor of girls in the school setting. The aim of the present study was to examine if gender stereotypes about academic abilities that are usually considered as fully demonstrated in the literature have to be updated. Three hundred ninety-eight French fifth graders from a medium-sized provincial town answered a questionnaire designed to examine, both with direct and indirect measures, if they hold different gender stereotypes concerning mathematics and reading depending on target’s age (children vs. adults). As expected, results showed that participants, regardless of their gender, were aware of a math-ability stereotype favorable to men when the stereotyped targets were adults. When the stereotyped targets were children and young adolescents, the math-ability stereotype was less clear. Participants believed that people think that girls succeed as well as boys in math. Concerning reading-ability, participants reported the “usual” stereotype favorable to females, regardless of the stereotyped target’s age (child or adult). Together these results suggest that academic gender stereotypes have to be reconsidered. The math-ability stereotype targeting children and favorable to both genders seems to show an improvement of the French girls’ reputation in mathematics. Moreover, the reputation of French boys in this domain seems to be poorer than reported in previous research.     

Associations of social relationships with consultation for symptoms of depression: a community study of depression in older men and women in Québec

To assess associations between social relationships and consultation for symptoms of depression, data from a representative sample of 2,811 French-speaking community-dwelling older adults in Québec were used. Less than half of the older adults meeting DSM criteria for depression (N = 379; 47.1%) had sought consultation about their depression-relevant symptoms in the preceding 12 months. Having a cohabitant partner or having children were not associated with frequency of consultation for women. Men without a partner tended to consult more frequently than men with a cohabiting partner (OR = 2.5; 95% CI = 0.81, 7.88). None of the men without a confidant had consulted. Among the 67 men with a confidant, consultation was more frequent among those not cohabiting with a partner (70%) than among those with a cohabiting partner (46%). The influence of social relationships on consultation for depression differed in men and women in this population of depressed elderly people in Québec.     

Language and syntactic impairment following stroke in late bilingual aphasics

Purpose

Bilingual aphasia generally affects both languages. However, the age of acquisition of the second language (L2) seems to play a role in the anatomo-functional correlation of the syntactical/grammatical processes, thus potentially influencing the L2 syntactic impairment following a stroke. The present study aims to analyze the influence of late age of acquisition of the L2 on syntactic impairment in bilingual aphasic patients.

Methods

Twelve late bilingual participants (speaking French as L2 and either English, German, Italian or Spanish as L1) with stroke-induced aphasia participated in the study. The MAST or BAT aphasia batteries were used to evaluate overall aphasia score. An auditory syntactic judgement task was developed and used to test participants syntactic performance.

Results

The overall aphasia scores did not differ between L1 and L2. In a multiple case analysis, only one patient had lower scores in L2. However, four patients presented significantly lower performances in syntactic processing in the late L2 than in their native language (L1). In these four patients the infarct was localized, either exclusively or at least partially, in the pre-rolandic region.

Conclusion

This pilot study suggests that, in late bilingual aphasics, syntactic judgment abilities may be more severely impaired in L2, and that this syntactic deficit is most likely to occur following anterior lesions.     

Effect on Comprehension of Preposed versus Postposed Adverbial Phrases

A challenge for psycholinguistics is to describe how linguistic cues influence the construction of the mental representation resulting from the comprehension of a text. In this paper, we will focus on one of these linguistic devices: the sentence-initial positioning of spatial adverbials such as In the park.... Three self-paced reading experiments were conducted to test the ‘Discourse Framing Hypothesis’ according to which preposed adverbials can be seen as frame builders announcing that incoming contents satisfy the same informational criterion specified by the adverbial. Our results indicate that spatial adverbials do not play the same role when they are in sentence-initial and in sentence-final position. These results are discussed in the framework of Zwaan’s Event Indexing Model.     

Spatial numerical associations in preschoolers

ABSTRACT

Three-to-five-year-old French children were asked to add or remove objects to or from linear displays. The hypothesis of a universal tendency to represent increasing number magnitudes from left to right led to predict a majority of manipulations at the right end of the rows, whatever children's hand laterality. Conversely, if numbers are not inherently associated with space, children were expected to favour laterality-consistent manipulations. The results showed a strong tendency to operate on the right end of the rows in right-handers, but no preference in left-handers. These findings suggest that the task elicited a left-to-right oriented representation of magnitudes that counteracted laterality-related responses in left-handed children. The young age of children and the lack of a developmental trend towards right preference weaken the hypothesis of a cultural origin of this oriented representation. The possibility that our results are due to weaker brain lateralisation in left-handers compared to right-handers is addressed in Discussion section.     

Normative accuracy and response time data for the computerized Benton Facial Recognition Test (BFRT-<Emphasis Type="Italic">c</Emphasis>)

We report normative data from a large (N = 307) sample of young adult participants tested with a computerized version of the long form of the classical Benton Facial Recognition Test (BFRT; Benton & Van Allen, 1968). The BFRT-c requires participants to match a target face photograph to either one or three of six face photographs presented simultaneously. We found that the percent accuracy on the BFRT-c (81%–83%) was below ceiling yet well above chance level, with little interindividual variance in this typical population sample, two important aspects of a sensitive clinical test. Although the split-half reliability on response accuracy was relatively low, due to the large variability in difficulty across items, the correct response times measured in this version—completed in 3 min, on average—provide a reliable and critical complementary measure of performance at individual unfamiliar-face matching. In line with previous observations from other measures, females outperformed male participants at the BFRT-c, especially for female faces. In general, performance was also lower following lighting changes than following head rotations, in line with previous studies that have emphasized participants’ limited ability to match pictures of unfamiliar faces with important variations in illumination. Overall, this normative data set supports the validity of the BFRT-c as a key component of a battery of tests to identify clinical impairments in individual face recognition, such as observed in acquired prosopagnosia. However, this analysis strongly recommends that researchers consider the full test results: Beyond global indexes of performance based on accuracy rates only, they should consider the time taken to match individual faces as well as the variability in performance across items.