Neuropsychological screening for cognitive impairment using computer-assisted tasks

The aim of this study was to validate a computer-assisted screening battery for classifying patients into two groups, those with and without cognitive impairment. Participants were all patients referred to the neuropsychology clinics at four VA medical centers during a 1-year period. Patients meeting the study inclusionary criteria (N = 252) were administered the Neurobehavioral Evaluation System-3 (NES3) computer-assisted battery. A detailed neuropsychological examination was carried out by an experienced neuropsychologist, who diagnosed the patient as cognitively impaired or not impaired. The neuropsychologist's diagnosis was the gold standard. Recursive partitioning analyses yielded several classification procedures using the NES3 data to predict the gold standard These procedures produced a set of six NES3 tasks that provide good sensitivity and specificity in predicting di- agnosis. Sensitivity and specificity for the least random classification procedure were 0.87 and 0.67, respectively. The results suggest that computer-assisted screening methods are a promising means of triaging patients.     

Melatonin and sleep qualities in healthy adults: pharmacological and expectancy effects

The impact of expectancy on melatonin's effects on sleep qualities was investigated. Both the pharmacological dose of 6 mg of melatonin and the expectation of receiving melatonin were predicted to improve subjective ratings of sleep qualities. The balanced placebo design varied 2 factors within-subjects: actual treatment and expected treatment. Adults (N = 53; 21 men and 32 women) between the ages of 26 and 71 years were administered either 6 mg of melatonin or a placebo for 8 nights. An instructional manipulation directed participants' expectations. Participants rated their nightly sleep experiences. Results revealed that feelings upon awakening differed between genders and that expecting melatonin increased ratings of sleep continuity. Most important, high ratings of "grogginess/tiredness" were associated with receiving melatonin, regardless of expectancy, as well as with receiving placebo when melatonin was expected. Overall, the findings underscore the need to consider expectancy and gender differences in research on melatonin and sleep experiences.     

Therapist Self-Efficacy in Delivering Cognitive Processing Therapy in a Randomized Controlled Implementation Trial

Efforts to improve the implementation of evidence-based treatments (EBT) have recently made important strides. One such example is understanding the vital role that weekly consultation plays as therapists learn to deliver an EBT. Because mechanism-based research can further support EBT implementation, the present study sought to examine the potential relationship between therapist self-efficacy in relation to treatment fidelity and outcomes.We examined therapist self-efficacy ratings from 80 therapists working with 188 patients. These data were collected as part of a randomized controlled implementation trial testing cognitive processing therapy (CPT). Across post-workshop training conditions, we ran multilevel models to assess (1) changes in therapist self-efficacy, (2) therapist self-efficacy in relation to treatment fidelity, and (3) therapist-self-efficacy in relation to patient PTSD symptom outcomes.We found that therapist self-efficacy significantly improved over the course of 6 months of CPT training. Baseline therapist self-efficacy was differentially associated with client outcomes based on post-workshop training condition. Specifically, therapists with low self-efficacy that did not receive post-workshop consultation tended to have poorer outcomes than therapists with low self-efficacy that received consultation. In the present sample, therapist self-efficacy was not related to treatment fidelity.As this was the first study to examine therapist self-efficacy in the implementation of an evidence-based treatment, our findings suggest that self-efficacy may be an important implementation factor in treatment outcomes and worthy of ongoing research.     

Equivalence relations do exist before they are tested: Confirmatory evidence revealed by EEG measurements

We examined equivalence-based N400 effects by comparing EEG data from participants with different experiences with equivalence testing. Before a priming task used in EEG measurement, Group 1 was given only matching-to-sample training trials whereas Group 2 was exposed to matching-to-sample training and equivalence probe trials. We asked whether exposure to the reinforcement contingency was sufficient to bring about an N400 outcome that might indicate potentially emergent equivalence relations or if such a response depended on experience with equivalence tests. Results showed robust N400 in both groups. Experience with equivalence tests did not further increase the N400 effects. Our findings add confirmatory evidence that equivalence relations may originate via the reinforcement contingency alone. Furthermore, complementary EEG data collected from priming tasks involving words from natural language showed functional overlap between laboratory-defined equivalence and natural word-based N400 effects.     

Sex and age modulate the visual perception of distance

An experiment was conducted to evaluate the ability of 28 younger and older adults to visually bisect distances in depth both indoors and outdoors; half of the observers were male and half were female. Observers viewed 15-m and 30-m distance extents in four different environmental settings (two outdoor grassy fields and an indoor hallway and atrium) and were required to adjust the position of a marker to place it at the midpoint of each stimulus distance interval. Overall, the observers’ judgments were more accurate indoors than outdoors. In outdoor environments, many individual observers exhibited perceptual compression of farther distances (e.g., these observers placed the marker closer than the actual physical midpoints of the stimulus distance intervals). There were significant modulatory effects of both age and sex upon the accuracy and precision of the observers’ judgments. The judgments of the male observers were more accurate than those of the female observers and they were less influenced by environmental context. In addition, the accuracies of the younger observers’ judgments were less influenced by context than those of the older observers. With regard to the precision of the observers’ judgments, the older females exhibited much more variability across repeated judgments than the other groups of observers (younger males, younger females, and older males). The results of our study demonstrate that age and sex are important variables that significantly affect the visual perception of distance.     

Forgetting from lapses of sustained attention

When performing any task for an extended period of time, attention fluctuates between good and bad states. These fluctuations affect performance in the moment, but may also have lasting consequences for what gets encoded into memory. Experiment 1 establishes this relationship between attentional states and memory, by showing that subsequent memory for an item was predicted by a response time index of sustained attention (average response time during the three trials prior to stimulus onset). Experiment 2 strengthens the causal interpretation of this predictive relationship by treating the sustained attention index as an independent variable to trigger the appearance of an encoding trial. Subsequent memory was better when items were triggered from good versus bad attentional states. Together, these findings suggest that sustained attention can have downstream consequences for what we remember, and they highlight the inferential utility of adaptive experimental designs. By continuously monitoring attention, we can influence what will later be remembered.     

Reduction of anxiety sensitivity in relation to nicotine withdrawal symptoms during smoking cessation: an examination among successful quitters

Anxiety sensitivity has been implicated as a potential risk factor for post-quit withdrawal symptoms. The present study examined relations between the extent of change in anxiety sensitivity and the course of nicotine withdrawal symptoms experienced during the initial two weeks of a quit attempt among treatment-seeking smokers. The sample consisted of 29 adult daily smokers (34% female; M_age = 47.7, SD = 13.1) who successfully quit and maintained their abstinence. After adjusting for the effects of gender, treatment condition, use of nicotine replacement therapy, nicotine dependence, alcohol use problems, baseline levels of anxiety sensitivity, and reductions in negative affect, greater reductions in anxiety sensitivity were related to faster decreases in withdrawal symptoms. The current data suggest that there may be merit to employ anxiety sensitivity reduction methods for the management of emergent withdrawal symptoms in smoking cessation treatment.     

Behaviorally Based Interventions for Teaching Social Interaction Skills to Children with ASD in Inclusive Settings: A Meta-analysis

Behaviorally based interventions have been demonstrated to be effective to teach social interaction skills for children with autism spectrum disorders in general education. However, the overall and moderating effects of these interventions have not been previously investigated in inclusive settings. The goal of this study was to investigate the overall effectiveness and contextual factors that moderate intervention effectiveness in inclusive settings. Findings showed overall high effect size based on studies previously considered of methodological quality in single-case research. Interventions are demonstrated to be highly effective for children aged 2–10 years. While differences were found according to target social skills and behavioral components used, no differential effects were found regarding intervention implementer and peer training. The findings highlight the practical significance of behavioral interventions and guide educators toward more suitable evidence-based practices in inclusive settings.     

The enduring significance of Christos Yannaras: some further works in translation

The Greek philosopher and theologian Christos Yannaras is becoming better known in the English-speaking world with the publication of an increasing number of his works in English translation. With the help of Wittgenstein and Heidegger, Yannaras articulates an ontological (as opposed to an ontic) version of Being based on relation. Beings exist not as ontic entities but only with reference to the person. Relation actually constitutes existents. Our fulfilment as human beings lies in our ascending from the mode of nature, which is bound by necessity, to a mode of existence characterised by self-transcending referentiality or love. Two obstacles are considered: the problem of evil and the ‘religionisation’ of Christianity. The fundamental problem of evil is that it renders human life without meaning. There are, however, no rational explanations of evil. The only reply lies beyond language, in faith/trust, self-transcendence and self-offering. A religionised version of Christianity transforms faith into an ideology which holds out salvation as a reward for the individual. The Church – the ecclesial event – is not a collection of individuals seeking their own salvation but a community of people called to struggle together to attain true existence, to pass from the finite mode of nature to that mode which knows no limitations of decay and death. An intellectualist approach to philosophy does not help us to achieve this goal. For philosophy is not simply an exercise in thinking but the struggle to attain existential freedom. Such freedom is transformatory, referential and ek-static.