Weighing the Evidence: A Systematic Review on Long-Term Neurocognitive Effects of Cannabis Use in Abstinent Adolescents and Adults

Findings on neurocognitive effects of sustained cannabis use are heterogeneous. Previous work has rarely taken time of abstinence into account. In this review, we focus on understanding sustained effects of cannabis, which begin when clinical symptoms of the drug have worn off after at least 14 days. We conducted a search between 2004 and 2015 and found 38 studies with such a prolonged abstinence phase. Study-design quality in terms of evidence-based medicine is similar among studies. Studies found some attention or concentration deficits in cannabis users (CU). There is evidence that chronic CU might experience sustained deficits in memory function. Findings are mixed regarding impairments in inhibition, impulsivity and decision making for CU, but there is a trend towards worse performance. Three out of four studies found evidence that motor function remains impaired even after a time of abstinence, while no impairments in visual spatial functioning can be concluded. Functional imaging demonstrates clear differences in activation patterns between CU and controls especially in hippocampal, prefrontal and cerebellar areas. Structural differences are found in cortical areas, especially the orbitofrontal region and the hippocampus. Twenty studies (57 %) reported data on outcome effects, leading to an overall effect size of r _mean?=?.378 (CI 95 %?=?[.342; .453]). Heavy use is found to be more consistently associated with effects in diverse domains than early age of onset. Questions of causality―in view of scarce longitudinal studies, especially those targeting co-occurring psychiatric disorders―are discussed.     

TEAM SPORTS FOR THE SEVERELY RETARDED: TRAINING A SIDE-OF-THE-FOOT SOCCER PASS USING A MAXIMUM-TO-MINIMUM PROMPT REDUCTION STRATEGY

A program to teach three severely retarded adults to use a side-of-the-foot soccer pass was evaluated. A 9-step stimulus-response chain was taught using forward chaining. In contrast to usual practice, intensive physical prompts were provided initially to teach each response component, then systematically faded. Approximately 20 lessons (trials) were presented in 20-min sessions. A multiple baseline across subjects design showed that the three trainees achieved the no-prompt criterion after 24, 29, and 22 sessions, respectively. Subanalyses indicated that successive response components were learned only after training was implemented. Follow-up data were obtained 57 and 276 days later in the training room and in a gymnasium; in both settings, criterion was achieved with fewer than three reinstructions.     

Revisiting an era in Germany from the perspective of adolescents in mother‐headed single‐parent families

Much of the documented work on families headed by single mothers is based on empirical evidence from North America and a few Anglo‐Saxon countries. Many researchers consider single‐mother families to be at a disadvantage because of nonsupportive family policies. This paper uses data from a social context that differed hugely in this respect—the German Democratic Republic (GDR). The GDR provided extensive state support to single‐mother families and, thus, was vastly different from other countries. Based on a literature review and using Hill's family stress theory, this paper is based on the hypothesis that adolescents living in mother‐headed single‐parent families and those living with their biological parents would have near‐similar social outcomes (display of psychosomatic symptoms, perception of stress, display of delinquent behaviour, life satisfaction, academic self‐efficacy, and academic grades) and family‐related outcomes (relationship with parents and perception of family environment). Further, it was hypothesized that adolescents from stepfather families would display more negative social and family‐related outcomes when compared with respondents from the other two family types. The sample comprised 1302 adolescents (M  =  13.82 years, SD  =  1.88) who were recruited from the city of Leipzig in the year immediately following German unification, 1991. Respondents reported on measures of psychosomatic symptoms, stress, delinquency, life satisfaction, academic achievement, and family‐related variables. ANCOVAs, with a control for income adjusted for household size, indicated adolescents from single‐mother families to have very similar experiences to respondents living with their biological parents on all measures except for their assessment of family environment. Adolescents living in stepfather families reported the least favourable experiences. Results are indicative of a social context in Germany that, despite unification and the early hardships for single‐mother families, still provided these families with more opportunities than constraints.     

Emotions as metarepresentational states of mind: Naturalizing the belief–desire theory of emotion

Describes the outlines of a computational explication of the belief–desire theory of emotion, a variant of cognitive emotion theory. According to the proposed explication, a core subset of emotions including surprise are nonconceptual products of hardwired mechanisms whose primary function is to subserve the monitoring and updating of the central representational system of humans, the belief–desire system. The posited emotion-producing mechanisms are analogous to sensory transducers; however, instead of sensing the world, they sense the state of the belief–desire system and signal important changes in this system, in particular the fulfillment and frustration of desires and the confirmation and disconfirmation of beliefs. Because emotions represent this information about the state of the representational system in a nonconceptual format, emotions are nonconceptual metarepresentations. It is argued that this theory of emotions provides for a deepened understanding of the role of emotions in cognitive systems and solves several problems of psychological emotion theory.     

Stationäre Kinder- und Jugendpsychiatrie sowie Psychotherapie bei substanzabhängigen Jungen und Mädchen

This study examines post-treatment outcomes (6 and 12 months post-release) of a multimodal child and adolescent psychiatric and psychotherapeutic inpatient treatment program for boys and girls diagnosed with substance use disorders (n=71) in 2 centres. Up to now there has been a lack of outcome research in this field in Germany. Outcome measures included drug use patterns and psychopathology. The greatest reductions in prevalence at 1 year follow-up occurred for cannabis, methamphetamine, cocaine and heroin use. Additionally the patients and their parents also reported significant improvements in adolescent’s psychopathology at the 1 year follow-up. The results underline the importance of disorder-specific, multimodal inpatient programs for the treatment of children and adolescents with substance use disorders.