Neurocognitive Function and Suicide in U.S. Army Soldiers

This prospective cohort study used administrative data from the Army Study to Assess Risk and Resilience in Servicemembers to examine associations between neurocognitive functioning and subsequent suicidal events among Regular Army enlisted soldiers during the years 2004–2009. Cases were all soldiers who completed the Army's Automated Neuropsychological Assessment Metrics (ANAM) computerized testing battery prior to documented suicide attempt (n = 607), ideation (n = 955), or death (n = 57). Controls were an equal‐probability sample of 9,893 person‐months from other soldiers. Exploratory factor analysis of five ANAM tests identified a general neurocognitive factor that excluded the mathematic processing test (MTH). When examined separately in logistic regression analyses that controlled for sociodemographics and prior mental health diagnosis, both the general neurocognitive factor (logit [β] = ?.197 to ?.521; p < .01) and MTH (β = ?.024 to ?.064; p < .05) were associated with all outcomes. When both predictors were examined simultaneously, the general neurocognitive factor continued to be associated with all outcomes (β = ?.164 to ?.417; p < .05) and MTH continued to be associated with suicide attempt (β = ?.015; p = .046) and ideation (β = ?.014; p = .018). These small but robust associations suggest that future research must continue to examine the extent to which objective neurocognitive tests may enhance understanding and prediction of suicide risk.     

Positive Mental Health as a Predictor of Problematic Internet and Facebook Use in Adolescents and Young Adults

Recent research on Problematic Internet Use and Problematic Facebook Use (PIU and PFU) has focused on the idea that people who engage in PIU or PFU are more likely to present with mental health problems. The goal of the present study was to examine the contribution of positive mental health (PMH) to PIU and PFU among adolescents and young adults. A total of 1927 Italian adolescents and young adults participated in the study. Structural equation modeling showed that PMH is negatively linked to both PIU and PFU, indicating that PMH may be an important antecedent for both PIU and PFU among adolescents and young adults. In conclusion, dimensions of PMH may be taken into account by researchers and educational practitioners in preventing both PIU and PFU.     

Suicidal–Homicidal Ideation in Mass Killers and Transcendence

This article examines the role that suicidal–homicidal ideation plays in influencing mass killers and draws on the author’s concept of transcendent fantasy theory. Although numerous researchers touch on the fact that 50% of mass killers commit suicide, few have traced and compared the suicidal person’s fantasy process with that of the suicidal–homicidal killer’s fantasy process. Suicidal individuals tend to be intropunitive. They internalize the blame for real or imagined failures, and they seek to escape from such failures, or to inflict punishment on him- or herself for the same reasons. Mass killers externalize the blame for their real or imagined losses. Due to their mordant bitterness toward self and others, these suicidal–homicidal individuals often fantasize not only about escaping, but transcending their feelings of inadequacy, self-doubt, and worthlessness by having society see them as powerful, clever, and superior for pulling off a massacre and making (in their view) oppressive people pay.     

Quantifier comprehension in corticobasal degeneration

In this study, we investigated patients with focal neurodegenerative diseases to examine a formal linguistic distinction between classes of generalized quantifiers, like "some X" and "less than half of X." Our model of quantifier comprehension proposes that number knowledge is required to understand both first-order and higher-order quantifiers. The present results demonstrate that corticobasal degeneration (CBD) patients, who have number knowledge impairments but little evidence for a deficit understanding other aspects of language, are impaired in their comprehension of quantifiers relative to healthy seniors, Alzheimer's disease (AD) and frontotemporal dementia (FTD) patients [F(3,77)=4.98; p<.005]. Moreover, our model attempts to honor a distinction in complexity between classes of quantifiers such that working memory is required to comprehend higher-order quantifiers. Our results support this distinction by demonstrating that FTD and AD patients, who have working memory limitations, have greater difficulty understanding higher-order quantifiers relative to first-order quantifiers [F(1,77)=124.29; p<.001]. An important implication of these findings is that the meaning of generalized quantifiers appears to involve two dissociable components, number knowledge and working memory, which are supported by distinct brain regions.     

CBT intensity and outcome for panic disorder in a primary care setting

A hybrid efficacy-effectiveness design in which participants (n = 91/93) were retained in the study regardless of whether or not they received treatment enabled evaluation of CBT intensity in relation to panic disorder in the primary care setting. CBT intensity was operationalized as number of cognitive-behavioral therapy sessions, number of follow-up booster phone calls, and secondarily, as number of cognitive behavioral coping and exposure strategies. Baseline psychosocial and demographic predictors of CBT intensity were analyzed first. Severity of anxiety sensitivity predicted number of cognitive behavioral sessions, but no baseline variables predicted number of follow-up booster phone calls or number of coping and exposure strategies. Multivariate logistic and linear regressions were used to evaluate the degree to which treatment intensity predicted 3-month and 12-month outcomes (anxiety sensitivity, phobic avoidance, depressive symptoms, disability, and medical and mental health functioning) after controlling for potential confounding baseline variables. Number of cognitive behavioral therapy sessions predicted lower anxiety sensitivity at 3 and 12 months, and number of follow-up booster phone calls predicted lower anxiety sensitivity, less phobic avoidance, and less depression at 12 months. These findings indicate that "dose" of psychotherapy was an important predictor of outcome. The significance of follow-up booster phone contact is discussed as an index of continued self-management of panic and anxiety following acute treatment.     

Large-scale neural network for sentence processing

Our model of sentence comprehension includes at least grammatical processes important for structure-building, and executive resources such as working memory that support these grammatical processes. We hypothesized that a core network of brain regions supports grammatical processes, and that additional brain regions are activated depending on the working memory demands associated with processing a particular grammatical feature. We used functional magnetic resonance imaging (fMRI) to test this hypothesis by comparing cortical activation patterns during coherence judgments of sentences with three different syntactic features. We found activation of the ventral portion of left inferior frontal cortex during judgments of violations of each grammatical feature. Increased recruitment of the dorsal portion of left inferior frontal cortex was seen during judgments of violations of specific grammatical features that appear to involve a more prominent working memory component. Left posterolateral temporal cortex and anterior cingulate were also implicated in judging some of the grammatical features. Our observations are consistent with a large-scale neural network for sentence processing that includes a core set of regions for detecting and repairing several different kinds of grammatical features, and additional regions that appear to participate depending on the working memory demands associated with processing a particular grammatical feature.