The memory deficits in alzheimer-type dementia: A review

This review is an account of recent experimental studies of memory deficits at the early stages of Alzheimer-type dementia, evaluating these studies in relation to current theories of memory functioning in humans. Whilst memory deficits are found to be widespread, some aspects are more resilient to impairment than others. For example, the processes associated with articulatory rehearsal in working memory are unimpaired despite a reduction in performance on most tests of primary memory. The “implicit” aspects of secondary memory appear to remain unimpaired, in contrast to a marked decline in “explicit” or “episodic” memory. In addition, there is evidence that the rate of forgetting from secondary memory is normal. Some aspects of episodic and semantic memory are found to be impaired as a consequence of a decline in the efficient organisation and processing of verbal material at encoding or retrieval. It is concluded that the deficits share particular features found in organic amnesia, but with additional deficits which relate to impairments in other domains of functioning.     

The Use of the Social Cognition and Object Relations Scale in a Primary Care Setting

Research has indicated that as many as 10% to 15% of primary care patients have symptoms that are not well explained medically. These patients could be labeled as “somatizers.” This study assessed the extent to which underlying psychological characteristics contribute to a person's level of somatization and service utilization. The Social Cognition and Object Relations Scale–Global Rating Method (SCORS–G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011; Westen, 1995) was used to rate early memory narratives of 100 patients in a suburban primary care setting. Using principal axis factoring, the SCORS–G was divided into 2 components and these components (cognitive and affective) were used in subsequent analyses. The affective component was significantly negatively correlated with 2 measures of somatization and positively related to physician ratings of global health. The affective component also showed a trend toward significance on overnight hospital stays and patient-rated health. The cognitive component showed a trend toward significance with both measures of somatization, but it was not correlated with other measures of health. This study demonstrates the value of assessing underlying processes (via SCORS–G ratings of early memory narratives) that contribute to increased rates of somatization and health care utilization. Clinical implications for the relationship between affect and physical health are explored.     

Use of Out-of-Home Care Among a Statewide Population of Children and Youth Enrolled in Medicaid

System-wide research on the use of out-of-home care among children and youth is needed to inform the development of policies and services. We used Medicaid claims from North Carolina to examine patterns of out-of-home care, identify demographic and diagnostic differences between those who received care in residential treatment, psychiatric hospitals, or general hospitals, and determine whether demographic or diagnostic characteristics were associated with having more than one out-of-home stay during the year. Among those who received out-of-home care during a 1 year period, 36% received care in residential treatment only, 32.4% in general hospitals only, and 17.6% in psychiatric hospitals only, while 14.0% used more than one sector of out-of-home care. Boys, teenagers, and youth in foster care or diagnosed with emotional disturbance or hyperkinetic syndrome had higher odds of receiving care in residential treatment only whereas girls, youth age 19–21, and those with depressive and stress and adjustment disorders had higher odds of receiving care from hospitals only. Teenagers and youth in foster care had higher odds of having more than one stay. Among those with more than one stay, there were 300 patterns of care and nearly half received care from more than one service sector. The implications for services and policy are discussed. Further research is needed to understand patterns of out-of-home care and the factors that influence placement decisions.     

Personality,interests, and career indecision: a multidimensional perspective

Researchers have consistently linked neuroticism to career indecision; however, other personality traits have been inconsistent predictors despite sound theoretical arguments. Similarly, little research has examined a trait‐based analysis of the relationship between vocational interests and career indecision. The purpose of the current study was to evaluate the structure of career indecision and to examine the prediction of this construct as both a unidimensional and multidimensional construct. Results suggest that career indecision is multifaceted and that both personality and vocational interests are more strongly related to career indecision than has been suggested by past research. Furthermore, consideration of this multidimensional nature can explain past inconsistencies in the relationships between indecision and personality.     

Exploring the visuo-spatial scratch pad

A series of four studies examines the relationship between the visuo-spatial scratch pad, the central executive and the articulatory loop. For this purpose a visuo-spatial memory task that does not have a large verbal component was developed. In Experiment 1 this task was used to demonstrate that the scratch pad, although functionally independent of the articulatory loop, is subject to interference from a tracking task. Experiment 2 examined the locus of interference of the tracking task with spatial memory. It was shown that interference is confined to the encoding phase; post presentation tracking does not disrupt visuo-spatial representation. Experiment 3 demonstrated that the tracking task employed requires some central executive resources. The final experiment examined the effect of a near-span consonant memory load on the spatial memory task. Disruption only occurred when the verbal load preceded, or was concurrent with, the spatial task. The results suggest that central executive resources are probably required to operate the scratch pad in most circumstances. However, minimal central capacity is required for maintenance rehersal.     

Meaning(fullness) Without Metaphysics: Another Look at Hume’s “Meaning Empiricism”

Although Hume has no developed semantic theory, in the heyday of analytic philosophy he was criticized for his “meaning empiricism,” which supposedly committed him to a private world of ideas, led him to champion a genetic account of meaning instead of an analytic one, and confused “impressions” with “perceptions of an objective realm.” But another look at Hume’s “meaning empiricism” reveals that his criterion for cognitive content, the cornerstone both of his resolutely anti-metaphysical stance and his naturalistic “science of human nature,” provides the basis for a successful response to his critics. Central to his program for reforming philosophy, Hume’s use of the criterion has two distinct aspects: a critical or negative aspect, which assesses the content of the central notions of metaphysical theories to demonstrate their unintelligibility; and a constructive or positive aspect, which accurately determines the cognitive content of terms and ideas.     

Performance of Ethical Military Research is Possible: On and Off the Battlefield

Many of the same fundamental principles and regulations that govern civilian biomedical research also apply to research conducted by the US Military. Despite these similarities, the conduct of research by the US Military has additional requirements designed to preserve service members' informed consent rights, ethical standards and information that may be deemed classified. Furthermore, there are also additional rules and regulations associated with potential research to be done in a combat setting. Before conducting battlefield research, many unique circumstances must be considered to include: (1) the current legal and regulatory requirements for advanced informed consent (2) the tactical situations, and the ability to adequately document in the "austere" environment (3) the need to provide improved drugs and devices for combat casualty care and (4) the special nature of the superior-subordinate relationship. This paper discusses historical background, regulatory oversight, ethical implications and release of information as it pertains to research conducted by the US Military.     

The impact of disclosure of HIV on the index patient's self-defined family

For most people facing a serious illness, the family is regarded as the primary source of support. Research suggests that patterns of support may differ for people infected with HIV. Access to support normally requires disclosure of one's health problem to others. This study examined the impact of disclosure of HIV on the index patient's self-defined family. Most participants were gay men attending a London HIV clinic. Both they and the care-givers whom they identified to the researchers were interviewed. The results of this qualitative study highlight the fact that many gay men with HIV do not regard their biological family as their primary social support system. Friends and partners were commonly cited as primary care-givers. Most of those interviewed who provided support to the infected individual clearly remembered the disclosure event. They also had a number of emotional reactions, over time, to disclosure. We argue that adjustment to illness among care-givers is a complex two-way, reciprocal process whereby the infected individual and care-giver take subtle cues from one another in terms of how they appear to one another to cope. Some emotionally painful feelings may be experienced but not openly expressed. Therapists who work with families affected by illness should first learn from the patient who he or she defines as 'family'. They should also enquire about the impact of disclosure of illness on all care-givers as well as subsequent reactions and unexpressed feelings associated with this.