Contextual influences in aphasia: effects of predictive versus nonpredictive narratives

The influence of prior linguistic predictive and nonpredictive context on the comprehension of reversible passive sentences was investigated in 16 adults with aphasia. Eight subjects were classified as fluent and 8 as nonfluent. Subjects were presented with the sentences in isolation and preceded by nonpredictive and predictive contextual paragraphs. The overall results indicated that the subjects benefited significantly from the prior contextual narratives regardless of whether the paragraphs were predictive or nonpredictive. There were no significant differences between the two subject groups. The significant facilitation generated by the nonpredictive context suggests that redundancy of information may play a role in comprehension.     

Age differences in memory performance and memory ratings as measured in a sample survey

Age differences in memory performance were studied in a probability sample of a cross-section of 1,491 adults living in the Detroit metropolitan area, with an oversample of those age 60 and older. Both a recall and a recognition measure were adapted to the survey context by querying respondents about the nature of the questions asked in an immediately preceding interview. Subjective memory assessment was also measured, using global memory ratings performed by the respondent, his or her spouse, and the interviewer. A clear, age-related decline in memory performance was found in this population sample. Subjective memory assessment also declined across age groups, but the relation was weaker. On the basis of multiple regression analyses of the recognition measure and the respondent's self-rated memory, which were judged to have the best measurement qualities, a substantial part of these age differences can be accounted for by differences in sociodemographic composition between age groups, by cognitive functioning and physical health.     

Mental health expert witnesses: Of science and crystal balls

This article reviews the history of and basis for mental health testimony. It surveys the roles of such experts in the legal system and the concomitant problems with current approaches. Finally, it suggests specific reforms that may improve the use of mental health experts in legal proceedings.     

Errors in the quantification of uncertainty: A product of heuristics or minimal probability knowledge base?

The use of intuitive heuristics (e. g. representativeness and availability) has been put forward as an explanation for peoples' assignment of probabilities (Tversky and Kahneman, 1971). This phenomenon is seen as robust since experts as defined by education (professional psychologisis), despite advanced training in statistics and methodology, rely on the same heuristics as novices (lay people). Both experts and novices, as defined by education, were studied in a series of experiments and further classified as experts and novices according to their probability knowledge base, prior to receiving (or not) a brief (15-minute) training session. Immediately following training, subjects completed a probability test which consisted of ten Tversky and Kahneman (e. g. 1974) problems. The training significantly increased the number of problems correctly solved on the probability test and eliminated the expert/novice education classification. The results of a follow-up test 5 weeks after the experiment indicated that the training group maintained its superior performance. It is proposed that failure to use proper methods of probability assignment may not be due to intrinsic human inference biases or heuristics, but is a result of a minimal probability knowledge base.     

A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia

A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.     

Followup in psychoanalysis: clinical and research values

Psychoanalysis has never developed a tradition of systematic followup study to evaluate outcome and to improve technique and theory for a variety of reasons, partly theoretical, stemming from the conception of the unfolding transference neurosis and its analytic resolution as the precondition for cure, and partly historical, having to do with the happenstance of its development as a private practice-based discipline and training outside of the academic setting. Freud, however, was never bound by such strictures and published whatever post-treatment data he acquired on all his best-known case histories. But following Freud most analysts, with some notable exceptions, eschewed followup activity as unanalytic. It is this tradition that more recent studies like those of Pfeffer in New York and the Psychotherapy Research Project of The Menninger Foundation in Topeka have squarely challenged. Data are presented from the Menninger project dealing specifically with the impact of routine planned followup on issues of treatment termination and resolution and on the nature of the post-treatment period. The degree and kind of patient cooperation with the followup inquiry, the impact of followup on treatment termination and resolution (both impeding and facilitating), and the role of followup intervention in relation to return to formal post-treatment therapy (or consolidating against it), are all discussed.     

Private-sector care for chronically mentally ill individuals. The more things change, the more they stay the same

Two profit-making industries, nursing homes and board-and-care homes, care for about one million chronic mental patients. This care is primarily custodial and probably not very different from the care patients received in the public sector prior to deinstitutionalization. Moreover, certain characteristics of privately owned facilities encourage poor patient care so as to maximize profit. The problem could be ameliorated if chronic mental patients were strong and informed consumers or if the public sector strongly regulated proprietary care. However, neither of these two conditions now hold. Perhaps the apparent difficulties in significantly improving care for chronically mentally ill individuals despite seemingly major changes in policy reflect a fundamental problem in overall social policy--a reluctance to care for chronically indigent individuals of all kinds.     

Emotional disturbance and the development of self-consciousness in adolescence

The development of self-consciousness and its relationship to emotional disturbance was examined in early and late adolescence. The Imaginary Audience Scale was administered to emotionally disturbed and nondisturbed adolescents. As predicted, results indicated that self-consciousness decreased with age in nondisturbed adolescents. For the emotionally disturbed adolescents, the development of self-consciousness in temporary situations did not follow consistent patterns, as indicated by interaction effects. A significant negative relationship was found between intelligence test scores and self-consciousness in the disturbed group. The findings support the premise that social-cognitive shifts found in early to late adolescence are disrupted in disturbed populations. The mediating role of social experience as a factor in cognitive and emotional development is discussed.