Longer term effects of stimulant treatments for Attention-Deficit/Hyperactivity Disorder

Of pharmacological options available for Attention-Deficit/Hyperactivity Disorder (ADHD), stimulant medications are the most studied, the most commonly used, the most effective, and the first-line choice for treatment. Evidence of the short-term efficacy of methylphenidate (MPH) and other stimulants as well as behavioral treatments in the management of symptoms of ADHD is abundant This paper reviews therapeutic trials with a duration or follow-up period of 12 months or more and evaluates the longer term outcomes of available treatments for ADHD. The trials were reported by Ialongo et al. (1993), Horn et al. (1991), Schachar, Tannock, Cunningham, and Corkum (1997), Gillberg et al. (1997), Hechtman and Abikoff (1995), and the National Institute of Mental Health (MTA Cooperative Group, 1999a, 1999b).     

Who is exaggerating cognitive impairment and who is not?

This chart review examined the effects of effort on neuropsychological assessment and test performance patterns among genuine and exaggerating patients, with and without neurological findings, as aids to diagnosing symptom exaggeration. The sample consisted of 561 consecutive patients involved in compensation claims. With a flexible neuropsychological test (NPT) battery, the claims were assessed over 2 days. The sample included 303 patients evaluated for traumatic brain injury, 55 patients with neurological disease, and 203 patients assessed for other conditions (eg, depression or chronic pain). An average of 38 ability measures per patient were used to generate an overall NPT domain score. Composite scores were also computed for symptom validity tests, self-report measures of psychiatric symptoms, and memory complaint inventory. Seven NPT cognitive subdomain scores were multiply regressed onto the symptom validity test composite, accounting for 45% of its total variance. Patients were also assigned to Genuine or Exaggerator groups based on symptom validity test performance. The NPT for Exaggerating patients averaged 1.43 standard deviations below that of Genuine patients, suggesting that NPT scores for most Exaggerating patients are underestimates of their true ability. Factor analysis results differed between these groups. As a result, clinicians might avoid falsely identifying genuine patients as exaggerating by incorporating their self-reports of psychiatric symptoms and memory complaints into the diagnostic process.     

The generalization of deferred imitation in enculturated chimpanzees (Pan troglodytes)

Deferred imitation of object-related actions and generalization of imitation to similar but not identical tasks was assessed in three human-reared (enculturated) chimpanzees, ranging in age from 5 to 9 years. Each ape displayed high levels of deferred imitation and only slightly lower levels of generalization of imitation. The youngest two chimpanzees were more apt to generalize the model's actions when they had displayed portions of the target behaviors at baseline, consistent with the idea that learning is more likely to occur when working within the "zone of proximal development." We argue that generalization of imitation is the best evidence to date of imitative learning in chimpanzees. Electronic Publication     

Shepherd Ivory Franz: His contributions to neuropsychology and rehabilitation

Shepherd I. Franz was an important figure in psychology of the last century, and historians of psychology have given recognition to much of his work. However, his experimental work with animals and his pioneer investigations in experimental and clinical neuropsychology have been largely ignored. This article reviews his conceptual, assessment, and treatment contributions, including (1) his pioneering work on the use of learned behavior as a baseline for the study of cerebral ablations, (2) his interest in brain plasticity, (3) his development of comprehensive psychological assessment methods, and (4) his work on the rehabilitation of neurological patients with techniques derived from his animal experiments. His work predated much of what is now part of the conceptual substance of the experimental and clinical neurosciences.     

Review of quantity and types of spirituality research in three health care databases (1962-1999): implications for the health care ministry

Using computer technology to identify the term "spiritual," these researchers present results of the 2306 citations and compare five criteria discovered with research reported in four pastoral counseling journals. The authors note the limitations of such a search and the possible implications of the findings for health care ministry.     

Color discrimination under chronic hypoxic conditions (simulated climb "Everest-Comex 97")

Hypoxia is known to alter visual functions. In the present study, the effects of chronic hypobaric hypoxia upon visual color discrimination were studied in 8 subjects participating in a simulated climb from sea level (PO2 = 210 hPa) to 8,848 m (PO2 = 70 hPa) over a 31-day period of confinement in a decompression chamber ('Everst-Comex 97'). During these investigations, the subjects were required to discriminate between colors of different hue in the red, blue, and green ranges. Alterations in color discrimination increased slightly but significantly as altitude increased. Impairments occurred mainly in the red and blue ranges. In addition, our results further indicate that color discrimination would be affected only when a minimum threshold of difference between color stimuli is not present. Methodological and physiological implications are discussed.     

Perceptual anticipation in handwriting: the role of implicit motor competence

In two experiments, perceptual anticipation--that is, the observer's ability to predict the course of dynamic visual events--in the case of handwriting traces was investigated. Observers were shown the dynamic display of the middle letter l excerpted from two cursive trigrams (lll or lln) handwritten by one individual. The experimental factor was the distribution of the velocity along the trace, which was controlled by a single parameter, beta. Only for one value of this parameter (beta = 2/3) did the display comply with the two-thirds power law, which describes how tangential velocity depends on curvature in writing movements. The task was to indicate the trigram from which the trace was excerpted--that is, to guess the letter that followed the specific instance of the l that had been displayed. In Experiment 1, the no answer option was available. Experiment 2 adopted a forced-choice response rule. Responses were never reinforced. When beta = 2/3, the rate of correct guesses was high (Experiment 1, P?correct? = .69; Experiment 2, P?correct? = .78). The probability of a correct answer decreased significantly for both smaller and larger values of beta, with wrong answers becoming predominant at the extremes of the range of variation of this parameter. The results are consistent with the hypothesis that perceptual anticipation of human movements involves comparing the perceptual stimulus with an internal dynamic representation of the ongoing event.     

Perceptual magnet and phoneme boundary effects in speech perception: do they arise from a common mechanism?

The question of whether sensitivity peaks at vowel boundaries (i.e., phoneme boundary effects) and sensitivity minima near excellent category exemplars (i.e., perceptual magnet effects) stem from the same stage of perceptual processing was examined in two experiments. In Experiment 1, participants gave phoneme identification and goodness ratings for 13 synthesized English /i/ and /e/ vowels. In Experiment 2, participants discriminated pairs of these vowels. Either the listeners discriminated the entire range of stimuli within each block of trials, or the range within each block was restricted to a single stimulus pair. In addition, listeners discriminated either one-step or two-step intervals along the stimulus series. The results demonstrated that sensitivity peaks at vowel boundaries were more influenced by stimulus range than were perceptual magnet effects; peaks in sensitivity near the /i/-/e/ boundary were reduced with restricted stimulus ranges and one-step intervals, but minima in discrimination near the best exemplars of /i/ were present in all conditions.