Nonlinear blood pressure effects on cognition in old age: separating between-person and within-person associations

Midlife hypertension is associated with increased risk of cognitive impairment in later life. The association between blood pressure (BP) in older ages and cognition is less clear. In this study we provide estimates of between-person and within-person associations of BP and cognition in a population-based sample (N = 382) followed from age 70 across 12 occasions over 30 years. Between-person associations refer to how individual differences in BP relates to individual differences in cognition. Within-person associations refer to how individual and time specific changes in BP relate to variation in cognition. Hierarchical linear models were fitted to data from three cognitive measurements (verbal ability, spatial ability, and perceptual speed) while accounting for demographic and health-related covariates. We found consistent nonlinear between-person associations between diastolic BP (DBP) and cognition, such that both low (<75 mmHg) and high (>95 mmHg) pressure were associated with poorer cognition. Within-person decreases in systolic BP (SBP) and DBP were associated with decreases in perceptual speed. Notably, between-person and within-person estimates did not reveal similar associations, suggesting the need to separate the two effects in the analysis of associations between BP and cognition in old age.     

History’s Ethical Demand: Memory,Denial, and Responsibility in the Wake of the Holocaust

What does it mean to discover an unspoken Nazi past in one’s own family? In a moment defined by chance and circumstance, I discovered that my German grandfather had joined the Nazi Party. Using my family’s struggle with memory as a site of inquiry, I examine the process of remembering, its transmission, and dissociation, particularly as it relates to past and present perpetrator groups. What lurks in the silences that are passed down between generations? How does our collective response to history’s atrocities shape what we what we know and remember as individuals? How do we define the moral obligations of memory, or understand the power of dissociation more than seven decades after the Holocaust? When does complacency in the face of past or present injustice make us complicit? Any answer to these questions points to the complexity of memory and the ethical demands of history. Connections between collective crimes of the past and social injustices in the present are considered and different forms of historical awareness and personal responsibility are discussed. In the face of overt prejudice and racism, “history’s call” and the work of psychoanalysis are inherently related.     

Use of the MMPI-2 in American Indians: II. Empirical correlates

R. W. Robin, R. L. Greene, B. Albaugh, A. Caldwell, and D. Goldman (2003) reported that members of 2 American Indian tribal groups had statistically significant higher T scores on several MMPI-2 clinical, content, and supplementary scales than did the MMPI-2 normative group. The present study investigated the empirical correlates of the MMPI-2 scales in these American Indian tribal members. There were a large number of significant correlates reflecting antisocial symptoms with Scales 4 (Psychopathic Deviate), 9 (Hypomania), Anger, and Antisocial Practices. There were even a larger number of significant correlates reflecting generalized distress and negative affect with Scales 7 (Psychosthenia), 8 (Schizophrenia), Anxiety, Obsessions, Depression, and Welsh Anxiety. The rationally derived MMPI-2 content scales generally had larger correlations with these constructs than the clinical scales. Thus, the differences reported by R. W. Robin et al. (2003), appear to reflect behaviors and symptoms that American Indians participants were experiencing rather than test bias.     

On the limits of advance preparation for a task switch: do people prepare all the task some of the time or some of the task all the time?

This study investigated the nature of advance preparation for a task switch, testing 2 key assumptions of R. De Jong's (2000) failure-to-engage theory: (a) Task-switch preparation is all-or-none, and (b) preparation failures stem from nonutilization of available control capabilities. In 3 experiments, switch costs varied dramatically across individual stimulus-response (S-R) pairs of the tasks-virtually absent for 1 pair but large for others. These findings indicate that, across trials, task preparation was not all-or-none but, rather, consistently partial (full preparation for some S-R pairs but not others). In other words, people do not prepare all of the task some of the time, they prepare some of the task all of the time. Experiments 2 and 3 produced substantial switch costs even though time deadlines provided strong incentives for optimal advance preparation. Thus, there was no evidence that people have a latent capability to fully prepare for a task switch.     

Cultural differences in affective forecasting: the role of focalism

The impact bias in affective forecasting-a tendency to overestimate the emotional consequences of future events-may not be a universal phenomenon. This prediction bias stems from a cognitive process known as focalism, whereby predictors focus attention narrowly on the upcoming target event. Three studies supported the hypothesis that East Asians, who tend to think more holistically than Westerners, would be less susceptible to focalism and, consequently, to the impact bias. In Studies 1 and 2, Euro-Canadians exhibited the impact bias for positive future events, whereas East Asians did not. A thought focus measure indicated that the cultural difference in prediction was mediated by the extent to which participants focused on the target event (i.e., focalism). In Study 3, a thought focus manipulation revealed that defocused Euro-Canadians and East Asians made equally moderate affective forecasts.     

Conceptually driven pharmacologic approaches to acute trauma

Secondary prevention of posttraumatic stress disorder (PTSD) entails intervening in the aftermath of a traumatic event to forestall the development of PTSD. There has been little psychopharmacologic research in this area. This is surprising, given that PTSD is the mental disorder with the most clearly identified cause and onset. In a translational model of PTSD's pathogenesis presented herein: A traumatic event (unconditioned stimulus) overstimulates endogenous stress hormones (unconditioned response); these mediate an overconsolidation of the event's memory trace; recall of the event in response to reminders (conditioned stimulus); releases further stress hormones (conditioned response); these cause further overconsolidation; and the overconsolidated memory generates PTSD symptoms. Noradrenergic hyperactivity in the basolateral amygdala is hypothesized to mediate this cycle. Preventing pre-synaptic norepinephrine release with alpha2-adrenergic agonists or opioids, or blocking post-synaptic norepinephrine receptors with beta-adrenergic antagonists such as propranolol, reduces hormonally enhanced memories and fear conditioning. Two controlled studies of trauma victims presenting to emergency rooms suggest that posttrauma propranolol reduces subsequent PTSD, as does one naturalistic clinical study of morphine treatment of burned children. Cortisol both enhances memory consolidation and reduces memory retrieval, leading to mixed predictions. Two controlled studies of intensive care unit patients found that cortisol reduced PTSD. One study did not find benzodiazepines effective in preventing PTSD. Selective serotonin reuptake inhibitors, antiepileptics, and alpha2-adrenergic agonists have yet to be tried.     

Episodic memory change in late adulthood: Generalizability across samples and performance indices

Younger adults recall more information from episodic memory tasks than do older adults. Because longitudinal studies are rare and often incompatible, the extent of actual late-life memory change is not well established. We assemble two different longitudinal samples of normal older adults, each of which is tested twice at a 3-year interval, using a large battery of episodic memory indicators. Together, two-wave data from both the Victoria Longitudinal Study in Canada (n = 400) and the Kungsholmen Project in Sweden (n = 168) cover a 40-year span of adulthood, ranging from 54 to 94 years of age. Principal memory tasks include categorizable word lists, story recall, and random word lists, as well as indicators of cognitive support. Overall, an examination of performance on sets of common and complementary episodic tasks reveals that, for both samples, actual 3-year changes are modest and that, when decline occurs, it is gradual. The exception-greater decline for more supported tasks-suggests that these may be especially sensitive to late-life changes.