Reflections on the process of psychotherapeutic change as applied to medical situations

This article takes the basic ideas on the process of changing implicit knowledge put forward in this special issue, and extends them beyond psychotherapy to include other therapeutic relationships that occur in medicine. One vignette, from an encounter between a medical student and a dying patient, illustrates how a “moment of meeting” changes the student as well as the patient. The second shows how therapeutic interventions for new mothers with their newborn infants involve “moments of meeting” that alter the mother's implicit knowledge of her baby and of herself as a mother. © 1998 Michigan Association for Infant Mental Health     

Effects of perceived disability on persuasiveness of computer-synthesized speech

Are perceptions of computer-synthesized speech altered by the belief that the person using this technology is disabled? In a 2 x 2 factorial design, participants completed an attitude pretest and were randomly assigned to watch an actor deliver a persuasive appeal under 1 of the following 4 conditions: disabled or nondisabled using normal speech and disabled or nondisabled using computer-synthesized speech. Participants then completed a posttest survey and a series of questionnaires assessing perceptions of voice, speaker, and message. Natural speech was perceived more favorably and was more persuasive than computer-synthesized speech. When the speaker was perceived to be speech-disabled, however, this difference diminished. This finding suggests that negatively viewed assistive technologies will be perceived more favorably when used by people with disabilities.     

Acute hunger of rat pups elicits increased kyphotic nursing and shorter intervals between nursing bouts: implications for changes in nursing with time postpartum

Earlier findings, based on limited behavioral observations, indicate that nursing behavior in rats declines dramatically in duration over time postpartum-despite increasing ingestion of milk by rat pups to meet their growth and metabolic needs-although hungry pups elicit more nursing than do well-nourished pups. The authors compared the nursing pattern in detail for 6 hr on Days 7 and 14 and induced hunger in pups acutely with mammary-duct-ligated dams unable to provide milk. Compared with Day 7, on Day 14, supine nursing and the interval between nursing bouts increased, whereas hovering over pups and kyphotic nursing decreased. When pups were increasingly hungry, these age-related changes were counteracted. Thus, the ingestive motivation of pups largely regulates the nursing pattem over time.     

Distortions in the memory of the pitch of speech

Corneille, Huart, Becquart, & Brédart (2004) found that people remember ambiguous race faces as closer to a race prototype than they actually are. In three studies, we examined whether this memory bias generalizes to voice memory. In Studies 1 and 2, participants listened to synthesized male and female speech samples (high, moderate, or low pitch) and were asked to identify a voice target when paired against distracters higher or lower in pitch. The results showed that pitch distortions occurred, with the pattern consistent with assimilation toward low and high ends of the pitch continuum. Study 3 replicated this result with a wider voice pitch range. The results parallel those of Corneille et al. (2004). The implications of this work are discussed.     

Inferior Parietal Perfusion, Lateralization, and Neuropsychological Dysfunction in Alzheimer's Disease

The severity of inferior parietal perfusion deficits in Alzheimer's disease (AD) is strongly associated with global intellectual decline. The relationship to specific losses of neuropsychological functioning, however, is less clear, as is the relative importance of the side (left vs. right) of hemispheric deficit. In this study, 53 patients with probable AD and 35 elderly controls received both a resting¹³³Xe rCBF measurement and neuropsychological examination. AD patients demonstrated the expected bilateral deficits in inferior parietal perfusion, as well as impairment on measures of mental status, intelligence, verbal and visual memory, attention, language, and construction abilities. The severity of this bilateral parietal deficit, in turn, was associated with virtually all of these AD-related neuropsychological impairments, most strongly with declining Performance IQ. Left-sided deficits correlated better with overall declines in IQ, as well as with declining attention and language fluency. Right-sided deficits, on the other hand, correlated best with declines in mental status and—paradoxically—verbal memory and contributed independently to declines in Full Scale and Performance IQ. In terms of the number and strength of their association to neuropsychological measures, left-sided deficits appear much more predictive of cognitive decline in AD. Right-sided deficits, however, may be most important for predicting aspects of performance skill that are only indirectly assessed in standard paper-and-pencil format. Overall, it appears that both sides make significant, but independent contributions to general functional decline in AD, but that left-sided deficits are more closely associated with cognitive decline as measured by most standard neuropsychological measures.     

Systems without a graphical causal representation

There are simple mechanical systems that elude causal representation. We describe one that cannot be represented in a single directed acyclic graph. Our case suggests limitations on the use of causal graphs for causal inference and makes salient the point that causal relations among variables depend upon details of causal setups, including values of variables.