A functional neuroimaging analysis of the Trail Making Test-B: implications for clinical application

Recent progress has been made using fMRI as a clinical assessment tool, often employing analogues of traditional "paper and pencil" tests. The Trail Making Test (TMT), popular for years as a neuropsychological exam, has been largely ignored in the realm of neuroimaging, most likely because its physical format and administration does not lend itself to straightforward adaptation as an fMRI paradigm. Likewise, there is relatively more ambiguity about the neural systems associated with this test than many other tests of comparable clinical use. In this study, we describe an fMRI version of Trail Making Test-B (TMTB) that maintains the core functionality of the TMT while optimizing its use for both research and clinical settings. Subjects (N=32) were administered the Functional Trail Making Test-B (f-TMTB). Brain region activations elicited by the f-TMTB were consistent with expectations given by prior TMT neurophysiological studies, including significant activations in the ventral and dorsal visual pathways and the medial pre-supplementary motor area. The f-TMTB was further evaluated for concurrent validity with the traditional TMTB using an additional sample of control subjects (N=100). Together, these results support the f-TMTB as a viable neuroimaging adaptation of the TMT that is optimized to evoke maximally robust fMRI activation with minimal time and equipment requirements.     

Creation and End-Directedness

Does the act of creation show itself anywhere within the creation? A common contemporary ontology tends to see two possibilities for those who want to defend a notion of creation. The first is to argue that an original set of materials was brought into existence out of nothing by divine action a long time ago. The second, in the tradition of Paley, posits a specific divine action that oversees the development of some of the materials into entities with an end-directedness. Much contemporary energy focuses on the second possibility. The argument of the paper is that the ontology behind both of these possibilities, which limits itself to the notions of a creation of materials and the building of some of the materials into end-directed entities, conceals rather than reveals the idea of creation. The paper tries to show how an Aristotelian sense of nature, with its recognition of internal teleology and original spontaneity, offers a better starting point for coming up against the mystery of divine creative activity.     

Experiencing the Other as the Self: Cultural Diversity Courses as Liberating Praxis

Abstract. In response to our increasingly global and multicultural world, undergraduate degree plans have come to include courses, which meet the Diversity requirement. While diversity may have a variety of definitions, clearly the educational institution believes that all students earning a degree should complete course work that exposes them to cultures not their own. Courses that fulfill Diversity requirements often include “Introduction to World Religions,” among others. Even a traditional‐style teaching of such a course will accomplish a certain degree of broadening of students’ perspectives. The risk, however, is that at the end of the course the students are simply better informed about sets of people whom they would still objectify as the other. This article describes an experiential method of teaching which enables students to begin to change their consciousness, as well as their body of information, by learning to experience the other as self. The author calls this the identification/participation method.     

The Positive Illusory Bias: Do Inflated Self-Perceptions in Children with ADHD Generalize to Perceptions of Others?

This study examined whether children with symptoms of attention-deficit/hyperactivity disorder (ADHD) demonstrate positive illusory perceptions of their own competence and others' competence. Participants (67 children with ADHD symptoms; 40 non-ADHD children) completed the Self-Perception Profile for Children and rated actors' competence in videos clips where inconsistent cues of performance had to be integrated in order to determine the actor's competence. Teachers completed the Teacher Rating Scale of Child's Actual Behavior. Children with ADHD symptoms overestimated their own competence relative to teachers' estimates in all domains significantly more than non-ADHD children. There were no significant group differences in perceptions of others' competence. Findings suggest that positive illusions are exclusive to perceptions of self and do not extend to perceptions of others.     

Response to commentary on the multimodal treatment study of ADHD (MTA): mining the meaning of the MTA

In the December 2000 issue of the Journal of Abnormal Child Psychology, we published a set of papers presenting secondary analyses of the Multimodal Treatment Study of ADHD (MTA), and R. A. Barkley (2000) provided a commentary. A critique of the design of the study (MTA Cooperative Group, 1999) was presented based on a theoretical perspective of a behavioral inhibition deficit that has been hypothesized as the core deficit of ADHD (R. A. Barkley, 1997). The commentary questioned the design and analysis of the MTA in terms of (1) the empirical criteria for selection of components of behavioral (Beh) intervention, (2) the effectiveness of the Beh intervention, (3) the methods for analyses at the group and individual level, (4) implications of the MTA findings for clinical practice, (5) the role of genetics in response to treatment, and (6) the lack of a nontreatment control group. In this response, we relate the content of the papers to the commentary, (1) by reviewing the selection criteria for the Beh treatment, as outlined by K. C. Wells, W. E. Pelham, et al. (2000), (2) by addressing the myth that the MTA Beh treatment was ineffective (Pelham, 1999), (3) by describing the use of analyses at the level of the individual participant, as presented by J. S. March et al. (2000) and W. E. Pelham et al. (2000) as well as elsewhere by J. M. Swanson et al. (2001) and C. K. Conners et al. (2001), (4) by relating some of the suggestions from the secondary analyses about clinically relevant factors such as comorbidity (as presented by J. S. March et al., 2000) and family and parental characteristics (as presented by B. Hoza et al., 2000, S. P. Hinshaw et al., 2000, and K. C. Wells, J. N. Epstein, et al., 2000), (5) by discussing the statistical concept of heritability and the lack of a significant difference in the presence of ADHD symptoms in parents of the MTA families compared to parents in the classmate-control families (as presented by J. N. Epstein, et al., 2000), and (6) by acknowledging that an ethically necessary weakness of the MTA design is that it did not include a no-treatment control group. We discuss the use of secondary analyses to suggest how, when, and for what subgroups effectiveness of the Beh treatment may have been manifested. Finally, we invite others to use the large and rich data set that will soon be available in the public domain, to perform secondary analyses to mine the meaning of the MTA and to evaluate theories of ADHD and response to treatments.     

A Longitudinal Study of Interparental Conflict, Emotional and Behavioral Reactivity, and Preschoolers' Adjustment Problems among Low-Income Families

Researchers have begun to develop models that explain the processes by which interparental conflict impacts children's adjustment. The present study tested a model based on emotional security theory. The longitudinal relations among interparental conflict, boys' reactions to conflict, and internalizing and externalizing problems were examined in a sample of 129 mother–son dyads from low-income, 2-parent families from the time sons were age 2 to 5. Results indicated that children exposed to interparental conflict were more likely to have concurrent and later behavior problems and that patterns of interparental conflict across time made unique contributions in predicting later problems. Children's emotional reactivity in response to conflict had no direct relation to interparental conflict and only modest relations to behavior problems. However, interparental conflict and reactivity factors interacted to predict behavior problems at ages 3 1/2 and 5. Thus, some support was demonstrated for emotional reactivity as a moderator in the development of young children's behavior problems.     

Relations between infant irritability and maternal responsiveness in low-income families

Relations between infant irritability and maternal responsiveness at 12 and18 months were investigated in low-income mother-infant dyads. Emphasis was placed on whether results varied according to measurement strategies, infant gender, or level of maternal social support and satisfaction with that support. Irritability was measured separately through observation and maternal report, responsiveness was measured observationally, and maternal social support and satisfaction were self-reported via questionnaire. Concurrent relations between irritability and responsiveness were, in general, negative and were larger when irritability was measured observationally rather than by maternal report. Correlations were similar across gender. No longitudinal relations were found between irritability and responsiveness. Amount of maternal social support was weakly related to responsiveness and to responses to infant irritability, and the nature of these relations was unexpected. Irritability-responsiveness relations varied as a function of measurement strategies, which may in part explain mixed findings in the empirical literature.     

The Development of Early Externalizing Problems Among Children from Low-Income Families: A Transformational Perspective

The present study examined pathways leading to early externalizing problems from age 1 to 31/2 in a design that took advantage of our knowledge of normative progression and normative socialization as well as findings from research on risk. A sample of 130 low-income participants was followed longitudinally from 12 to 42 months using observational measures of developmentally salient parenting and child disruptive behavior to predict early externalizing problems. Results are best accommodated by concepts such as transformation and transaction from developmental psychology. For boys, both child and parent variables predicted later externalizing. For girls and boys, the interaction between child noncompliance and maternal rejection was significant.