Gait and risk of falls associated with frontal cognitive functions at different stages of Alzheimer's disease

ABSTRACT

The decline in frontal cognitive functions contributes to alterations of gait and increases the risk of falls in patients with dementia, a category which included Alzheimer's disease (AD). The objective of the present study was to compare the gait parameters and the risk of falls among patients at different stages of AD, and to relate these variables with cognitive functions. This is a cross-sectional study with 23 patients with mild and moderate AD. The Clinical Dementia Rating was used to classify the dementia severity. The kinematic parameters of gait (cadence, stride length, and stride speed) were analyzed under two conditions: (a) single task (free gait) and (b) dual task (walking and counting down). The risk of falls was evaluated using the Timed Up-and-Go test. The frontal cognitive functions were evaluated using the Frontal Assessment Battery (FAB), the Clock Drawing Test (CDT) and the Symbol Search Subtest. The patients who were at the moderate stage suffered reduced performance in their stride length and stride speed in the single task and had made more counting errors in the dual task and still had a higher fall risk. Both the mild and the moderate patients exhibited significant decreases in stride length, stride speed and cadence in the dual task. Was detected a significant correlation between CDT, FAB, and stride speed in the dual task condition. We also found a significant correlation between subtest Similarities, FAB and cadence in the dual task condition. The dual task produced changes in the kinematic parameters of gait for the mild and moderate AD patients and the gait alterations are related to frontal cognitive functions, particularly executive functions.     

On psychic reality and neutrality: Empathy and the work of construction in countertransference

Abstract

The clinical challenges faced in encountering patients who do not fit the standard treatment of Oedipus conflicts clearly show the limitations of the interpretative method, thus making indispensable the study of clinical concepts and techniques as a way to broaden the psychoanalytic horizons. In order to analyse the different psychopathological problems resistant to traditional clinical approaches, it is necessary to reorganise the technique on the basis of a better understanding of the ways in which subjectivity is rooted in early psychic constitution. In this way, empathy becomes important as a clinical tool. The use of empathy must be understood as a decisive factor in handling clinical cases and situations in which the treatment encounters obstacles that restrict the power of the analyst's verbal interventions.In this case, can we say that the use of empathy interferes directly with and changes the position of the concept of psychic reality? Moreover, as we use empathy, can we also say that the concept of neutrality is transformed, without being abandoned? The intention of this paper is to discuss these questions using clinical material taken from the analysis of borderline clinical cases and situations.     

The Enhanced Cognitive Interview: Testing Appropriateness Perception,Memory Capacity and Error Estimate Relation with Report Quality

The Enhanced Cognitive Interview (ECI) has been widely studied. However, research has overlooked witnesses' attitudes toward the interview and how error estimate and memory capacity relate to report quality. Participants watched a mock robbery video and were interviewed 48 hours later with either the Portuguese version of the ECI or a Structured Interview (SI). Participants interviewed with the ECI provided more information without compromising accuracy, particularly in free recall. Report accuracy was stable across interview phases and information categories. A higher perception of interview appropriateness (how witnesses evaluate the appropriateness of the interview procedure used) was linked with more detailed reports and more interest in being an interviewee. Participants over‐estimated their error rate, and their memory capacity was not related to witnesses' recall. It is essential to take into account their perception of interview appropriateness and use alternative methods to evaluate report quality. Major implications for real‐life investigations are discussed. Copyright © 2015 John Wiley & Sons, Ltd.     

认知冲突协调问题与心智的架构

心智架构或认知架构是指一个功能相对完整的认知系统的基本组织结构。经典认知科学的理论或模型大多采纳了某种类似于冯·诺依曼式计算机体系结构的心智架构,即认知系统由一些各司其职的心理模块与一个负责整合与协调的中枢部门所构成。进化心理学的众量模块性论题对经典认知科学的心智架构观提出了严厉挑战,并引发了许多争议。本文提出认知冲突协调问题是任何一个足够复杂的认知系统均需要处理的基本问题,并以此来审视关于心智架构的论战,指出此问题对众量模块性论题构成了严重的困难。     

Adult age differences in frontostriatal representation of prediction error but not reward outcome

Emerging evidence from decision neuroscience suggests that although younger and older adults show similar frontostriatal representations of reward magnitude, older adults often show deficits in feedback-driven reinforcement learning. In the present study, healthy adults completed reward-based tasks that did or did not depend on probabilistic learning, while undergoing functional neuroimaging. We observed reductions in the frontostriatal representation of prediction errors during probabilistic learning in older adults. In contrast, we found evidence for stability across adulthood in the representation of reward outcome in a task that did not require learning. Together, the results identify changes across adulthood in the dynamic coding of relational representations of feedback, in spite of preserved reward sensitivity in old age. Overall, the results suggest that the neural representation of prediction error, but not reward outcome, is reduced in old age. These findings reveal a potential dissociation between cognition and motivation with age and identify a potential mechanism for explaining changes in learning-dependent decision making in old adulthood.     

The dark side of “doing the right thing”: regulatory mode predicts the inaction inertia effect

The inaction inertia effect refers to the idea that when people miss out on an initial opportunity, they are prone to stay inactive afterward. However, little is known about how personality relates to inaction inertia. The purpose of this research is to investigate the role of regulatory mode in the inaction inertia effect. Study 1 found that an assessment mode positively predicts inaction inertia while a locomotion mode is not related to inaction inertia. Study 2 replicated this finding in a different scenario. Study 3 found that priming assessment mode (compared with locomotion mode) predicts inaction inertia. Implications of how regulatory mode influences inaction inertia are discussed.     

权重望寡：如何化解低地位领导的补偿性辱虐管理行为?

权力与地位来源不同且体验有别, 二者分离是常态。如果领导者手握权柄却缺乏相应的地位威望, 将限制其控制力, 产生潜在不良后果。基于低地位补偿理论, 构建一个两阶段调节的中介模型, 设计两项研究, 旨在探索领导者“权重望寡” (即权力高, 地位低)所诱发的负面领导行为及其干预机制。研究1揭示: 相对于权力与地位匹配, 领导者权重望寡诱发辱虐管理。研究2探索其成因, 显示: (1)自我损耗中介权重望寡与辱虐管理的关系; (2)领导者正念以及更高层领导信任联合调节自我损耗的中介效应。研究表明, 低地位领导在维护地位过程中产生的自我损耗是引发辱虐管理的主因, 同时辱虐管理强度因人而异, 适可而止, 自身正念和高层信任有助于限制其作为不良补偿手段的蔓延。研究拓展了低地位补偿理论的应用领域, 也为化解权力与地位分离带来的组织冲突提供管理启示。     

In what conditions are intercultural practices implemented in disadvantaged and diverse settings in Portugal? Associations with professional and organization-related variables

Social Psychology of Education - Although intercultural practices are believed to be extremely relevant to combat educational disadvantages, evidence on the factors that are related to their...     

执行功能对个体情绪调节策略使用倾向和调节效果的影响

为了探讨执行功能对情绪调节的作用,通过两个研究分析执行功能对情绪调节策略使用倾向和情绪调节效果的影响。研究1以100名大学生为被试,采用执行功能任务和情绪调节策略问卷考察执行功能与情绪调节策略使用倾向之间的关系;研究2招募了40名大学生被试,采用执行功能任务和情绪调节任务考察执行功能对情绪调节效果的影响,依据执行功能总分对被试进行分组,分析前33%高执行功能被试和后33%低执行功能被试在情绪调节效果上是否存在差异。结果发现,执行功能越低的个体越倾向于选择使用表达抑制策略,执行功能越高的个体使用认知重评策略进行情绪调节的效果更好。     

Cognitive distortions and eating pathology: specificity of thought-shape fusion

Thought–shape fusion (TSF) is a cognitive distortion that has been linked with eating pathology; however, the specificity of this distortion to eating disorders has not yet been examined. The current study set out to investigate the effects of a TSF induction on susceptibility to TSF in three groups of women: individuals with an eating disorder (n = 33), individuals with obsessive-compulsive disorder (OCD; n = 24), and control women with no history of either an eating disorder or obsessive-compulsive disorder (n = 26). Participants were assigned to receive either a TSF induction or a neutral induction, and their cognitive, emotional, and behavioral responses were assessed. As expected, the results demonstrated that individuals with eating disorders were more susceptible to TSF than were women with OCD and control participants, reporting higher state TSF, more negative affect, and more neutralization behavior. The results also supported the specificity of this distortion by demonstrating that individuals with OCD were not particularly susceptible to TSF. In fact, control participants demonstrated an increased susceptibility to TSF relative to women with OCD, as evidenced by their higher levels of trait TSF, and increased self-reported distress/difficulty in imagining a food-related situation.