Visual attention capacity: a review of TVA-based patient studies

Psychophysical studies have identified two distinct limitations of visual attention capacity: processing speed and apprehension span. Using a simple test, these cognitive factors can be analyzed by Bundesen's Theory of Visual Attention (TVA). The method has strong specificity and sensitivity, and measurements are highly reliable. As the method is theoretically founded, it also has high validity. TVA-based assessment has recently been used to investigate a broad range of neuropsychological and neurological conditions. We present the method, including the experimental paradigm and practical guidelines to patient testing, and review existing TVA-based patient studies organized by lesion anatomy. Lesions in three anatomical regions affect visual capacity: The parietal lobes, frontal cortex and basal ganglia, and extrastriate cortex. Visual capacity thus depends on large, bilaterally distributed anatomical networks that include several regions outside the visual system. The two visual capacity parameters are functionally separable, but seem to rely on largely overlapping brain areas.     

The Representation of Sublexical Orthographic-Phonologic Correspondences: Evidence from Phonological Dyslexia

Although there is considerable evidence that grapheme and body units are involved in assembling phonology from print, there is little evidence supporting the involvement of syllabic representations. We provide evidence on this point from a phonological dyslexic patient (ML) who, as a result of brain damage, is relatively unable to read nonwords. ML was found to be able to perform tasks assumed to reflect processes involved in assembled phonology (i.e. segmentation, orthographic-phonologic conversion, and blending) when the units involved were syllables, but demonstrated considerable difficulty when they were onset, body, or phoneme units. Additionally, both ML and matched controls were much better able to find words in an anagrams task (Treiman & Chafetz, 1987) when they resulted from the combination of segments corresponding to syllables than when they did not. It is suggested that the relationship between print and sound is represented at multiple levels (including the syllable) (Shallice, Warrington, & McCarthy, 1983) and that ML's nonword reading impairment is the result of disruption of representations below the level of the syllable.     

Heterogeneity of deficits in developmental dyslexia and implications for methodology

Most of the studies overviewed by Farmer and Klein (1995) in their review of temporal processing disorders in developmental dyslexia have taken a group study approach in which a group of dyslexic readers is compared with a group of normal readers on some task thought to be relevant to the reading disorder. Because of the acknowledged heterogeneity of deficits among developmental dyslexics, this group study methodology is inappropriate and is likely to lead to findings in one lab that cannot be replicated in another. The single case study methodology, which has been used successfully in the study of adult neuropsychological impairments, should be adopted in the study of developmental impairments as well. In the case study approach, each individual is studied thoroughly with tasks designed to tap the various components of the cognitive domain under study in order to determine which components are spared and which impaired. Data are not averaged, but reported separately for each case. Some recent findings from case studies on developmental dyslexia are reviewed and suggestions are made as to how the case study approach could be used in analyzing whether a temporal processing disorder, or any other hypothesized factor, is causal to the reading disorder.     

Selection demands versus association strength in the verb generation task

Neuroimaging and neuropsychological data from Thompson-Schill and colleagues (Thompson-Schill, D’Esposito, Aguirre, & Farah, 1997; Thompson-Schill et al., 1998) showed that in the verb generation task, the left inferior frontal gyrus (left IFG) was more involved in a high-selection condition, in which the noun had two verb responses of equal association strength, than in a low-selection condition, in which the noun had only one strongly associated verb. They proposed that the left IFG was involved in selecting semantic information from competing alternatives. The present study compared verb generation in two high-selection conditions that varied in the association strength of the most frequently produced verbs. The results from neurally intact participants and a patient with a lesion that included the left IFG indicated that association strength between nouns and the most frequently produced verb, rather than competition during verb selection, affected verb generation. The degree of involvement of the left IFG may depend on the difficulty of verb retrieval as reflected in association strength.     

Semantic short-term memory and its role in sentence processing: a replication

Previous studies have shown that an aphasic patient (AB) with a semantic short-term memory deficit (STM) had difficulties comprehending and producing sentences with structures that demanded the simultaneous retention of several individual word meanings (Martin & Freedman, 2001a, 2001b; Martin & Romani, 1994; Martin, Shelton, & Yaffee, 1994). The present study provides a replication of these findings with an additional case (ML) who shows a striking dissociation between preserved semantic knowledge and disrupted semantic STM. ML performed poorly on comprehension tasks for sentences that required the retention of single word meanings across several intervening words. In contrast, he did not show an effect of intervening words on processing grammatical relations. ML had difficulty producing adjective-noun phrases, though able to produce the individual nouns and adjectives. These findings support the contention that there is a semantic retention capacity, involved in both comprehension and production, that is separate from semantic knowledge representations.     

Short-term memory and sentence processing: Evidence from neuropsychology

Traditional models of memory assume that short-term memory, as measured by memory span, plays an important role in linguistic processing and the learning ofverbal information. Contradicting this view are findings from a brain-damaged patient, E.A., who, despite a verbal memory span of about two items, demonstrated normal sentence comprehension in a variety oftasks. She was, however, impaired whenever verbatim phonological information had to be maintained or learned. These results and those from other patients with reduced span suggest that the phonological storage capacity that is critical to memory span plays only a limited role in language processing, specifically in the maintenance and learning of phonological forms. Implications for models of short-term memory are discussed. It is argued that short-termmemory should be seen as deriving from the processing and retentive capacities of language processing modules, with span tasks drawing on only a subset of these modules.     

A qualitative study of the therapists' experiences of working with community reinforcement and family training

Community reinforcement and family training (CRAFT) was developed to help and support concerned significant others (CSO) of people with, for example, alcohol use disorder. The aim of this study was to investigate therapists' experiences of working with CRAFT and their experiences of the CSOs receiving CRAFT. The study has a qualitative design and is based on three focus group interviews with 17 therapists. Interviews were analysed using thematic analysis. The analysis revealed six themes and four subthemes: Concerned significant others—A special group; Help prior to CRAFT—Offering information and a shoulder; CRAFT as a new and specific method (The toolbox of CRAFT, Formats for delivering CRAFT, Introducing a diary as homework and Implementing self-help material—Alone or in combination with sessions); Moving from a lack of structure to structure; Change in CSOs from the therapists' point of view; and Change in the therapist's role (Dilemmas—Personalising the intervention). The therapists were generally satisfied with the method and found it easy to adapt to. Moreover, working using a manual was more structured than they were used to and increased feelings of working professionally with the CSOs. Specifically, most therapists found the self-help book useful and indispensable in their work with CRAFT, but also agreed that it could not be used as a stand-alone intervention for most CSOs. The therapists' experiences are relevant for implementation of manualised, structured approaches and group-based interventions more broadly.     

Cognitive Behavior Therapy for Women With Generalized Anxiety Disorder in the Perinatal Period: Impact on Problematic Behaviors

Generalized anxiety disorder (GAD) is the most frequently diagnosed anxiety disorder among women in the perinatal period (pregnancy to one year postpartum). Recent studies have examined the relationship between problematic behaviors and GAD symptoms. Studies in nonperinatal samples indicate that adults with GAD engage in avoidance and safety behaviors and these behaviors are associated with greater symptom severity. Little research has examined the use of problematic behaviors among pregnant or postpartum women. However, preliminary research suggests that these behaviors may have a negative impact on both anxious women and their children. Our aim was to examine the extent to which women with GAD in pregnancy or the postpartum engage in problematic behaviors and whether cognitive behavioral therapy is effective in reducing these behaviors. Fifty-eight women with GAD in pregnancy or postpartum were recruited from a larger clinical trial (Clinicaltrials.gov ID NCT02850523) evaluating the effectiveness of group-based cognitive behavioral therapy (CBGT) for perinatal anxiety disorders. The results indicated that women with perinatal GAD reported high levels of avoidance and safety behaviors and greater engagement in these behaviors was associated with higher levels of worry and related symptoms. CBGT was effective in reducing GAD symptoms and problematic behaviors and a bidirectional relationship was found between changes in worry and problematic behaviors during treatment. Limitations and future directions are discussed.