Rumination-focused cognitive behaviour therapy for residual depression: a case series

The treatment of chronic and recurrent depression is a priority for the development of new interventions. The maintenance of residual symptoms following acute treatment for depression is a risk factor for both chronic depression and further relapse/recurrence. This open case series provides the first data on a cognitive-behavioural treatment for residual depression that explicitly targets depressive rumination. Rumination has been identified as a key factor in the onset and maintenance of depression, which is found to remain elevated following remission from depression. Fourteen consecutively recruited participants meeting criteria for medication--refractory residual depression [Paykel, E.S., Scott, J., Teasdale, J.D., Johnson, A.L., Garland, A., Moore, R. et al., 1999. Prevention of relapse in residual depression by cognitive therapy--a controlled trial. Archives of General Psychiatry 56, 829-835] were treated individually for up to 12 weekly 60-min sessions. Treatment specifically focused on switching patients from less helpful to more helpful styles of thinking through the use of functional analysis, experiential/imagery exercises and behavioural experiments. Treatment produced significant improvements in depressive symptoms, rumination and co-morbid disorders: 71% responded (50% reduction on Hamilton Depression Rating Scale) and 50% achieved full remission. Treating depressive rumination appears to yield generalised improvement in depression and co-morbidity. This study provides preliminary evidence that rumination-focused CBT may be an efficacious treatment for medication--refractory residual depression.     

Lexical restructuring in the absence of literacy

Vocabulary growth was suggested to prompt the implementation of increasingly finer-grained lexical representations of spoken words in children (e.g., [Metsala, J. L., & Walley, A. C. (1998). Spoken vocabulary growth and the segmental restructuring of lexical representations: precursors to phonemic awareness and early reading ability. In J. L. Metsala & L. C. Ehri (Eds.), Word recognition in beginning literacy (pp. 89-120). Hillsdale, NJ: Erlbaum.]). Although literacy was not explicitly mentioned in this lexical restructuring hypothesis, the process of learning to read and spell might also have a significant impact on the specification of lexical representations (e.g., [Carroll, J. M., & Snowling, M. J. (2001). The effects of global similarity between stimuli on children’s judgments of rime and alliteration. Applied Psycholinguistics, 22, 327-342.]; [Goswami, U. (2000). Phonological representations, reading development and dyslexia: Towards a cross-linguistic theoretical framework. Dyslexia, 6, 133-151.]). This is what we checked in the present study. We manipulated word frequency and neighborhood density in a gating task (Experiment 1) and a word-identification-in-noise task (Experiment 2) presented to Portuguese literate and illiterate adults. Ex-illiterates were also tested in Experiment 2 in order to disentangle the effects of vocabulary size and literacy. There was an interaction between word frequency and neighborhood density, which was similar in the three groups. These did not differ even for the words that are supposed to undergo lexical restructuring the latest (low frequency words from sparse neighborhoods). Thus, segmental lexical representations seem to develop independently of literacy. While segmental restructuring is not affected by literacy, it constrains the development of phoneme awareness as shown by the fact that, in Experiment 3, neighborhood density modulated the phoneme deletion performance of both illiterates and ex-illiterates.     

Words (but not tones) facilitate object categorization: evidence from 6- and 12-month-olds

Recent studies reveal that naming has powerful conceptual consequences within the first year of life. Naming distinct objects with the same word highlights commonalities among the objects and promotes object categorization. In the present experiment, we pursued the origin of this link by examining the influence of words and tones on object categorization in infants at 6 and 12 months. At both ages, infants hearing a novel word for a set of distinct objects successfully formed object categories; those hearing a sequence of tones for the same objects did not. These results support the view that infants are sensitive to powerful and increasingly nuanced links between linguistic and conceptual units very early in the process of lexical acquisition.     

Long-term consequences of early experience on adult avoidance learning in female rats: role of the dopaminergic system

Following our hypothesis that juvenile emotional and/or cognitive experience should affect learning performance at preweaning age as well as adulthood, the present study in female Wistar rats aimed to examine the impact of (i) avoidance training at preweaning age, (ii) exposure to repeated maternal separation, (iii) the combination of both, and (iv) the blockade of dopaminergic neurotransmission on adult two-way active avoidance learning in rats. We found that preweaning, i.e. three week old, rats were less capable of avoidance learning compared to adults. Our main findings revealed that preweaning avoidance training alone improved avoidance learning in adulthood. Furthermore, maternal separation alone also improved avoidance learning in preweaning and in adult rats, but this effect of maternal separation did not add up to the beneficial effect of preweaning avoidance training on adult learning. In addition, the pharmacological blockade of dopamine receptors during preweaning avoidance training via systemic application of haloperidol impaired preweaning avoidance performance in a dose-dependent manner. Testing the haloperidol-treated preweaning presumed "non-learners" as adults revealed that they still showed improved learning as adults. Taken together, our results strongly support the hypothesis that emotional as well as cognitive experience at preweaning age leaves an enduring "memory trace," which can facilitate learning in adulthood. Our pharmaco-behavioral studies suggest that unlike the adult brain, preweaning learning and memory formation is less dependent on dopaminergic mechanisms, which raises the intriguing question of possible alternative pathways.     

Religiosity and Spirituality: Influence on Quality of Life and Perceived Patient Self-Efficacy among Cardiac Patients and Their Spouses

The purpose of this study was to determine the influence of spirituality, religiosity, and religious coping on quality of life and self-efficacy among couples following a first time cardiac event. There was no significant association between measures for spirituality and religiosity and couples’ ratings for quality of life and self-efficacy. Negative forms of religious coping were associated with lower levels of quality of life and decreased confidence in the patient’s ability to perform physical tasks. Spouses’ measures for quality of life, self-efficacy, spirituality, religiosity, and religious coping were associated with patients’ measures for the same study variables. Joan F. Miller, RN, Ph.D., is Assistant Professor of Nursing, Bloomsburg University, Bloomsburg, Pennsylvania 17815 and Director of the Bloomsburg University Nursing Wellness Center. The author gives special thanks to Timothy R. McConnell, Ph.D., and Troy A. Klinger, M.S., for their research support and helpful feedback.     

Becoming irreplaceable: How comparisons to the partner’s alternatives differentially affect low and high self-esteem people

It is proposed that people are motivated to feel hard to replace in romantic relationships because feeling irreplaceable fosters trust in a partner’s continued responsiveness. By contrast, feeling replaceable motivates compensatory behavior aimed at strengthening the partner’s commitment to the relationship. A correlational study of dating couples and two experiments examined how satiating/thwarting the goal of feeling irreplaceable differentially affects relationship perception and behavior for low and high self-esteem people. The results revealed that satiating the goal of feeling irreplaceable increases trust for people low in self-esteem. In contrast, thwarting the goal of feeling irreplaceable increases compensatory behaviors meant to prove one’s indispensability for people high in self-esteem.     

Men’s Empathic Bias, Empathic Inaccuracy, and Sexual Harassment

This study investigated the relationship between men’s sexual harassment of women and men accuracy and bias when inferring women’s critical or rejecting thoughts and feelings. Eighty married men from the Arlington, Texas, USA community participated. Results indicated that men’s sexual harassment behavior is negatively related to men’s accuracy in determining when women have critical or rejecting thoughts or feelings. Further, men’s sexual harassment behavior is positively related to men’s bias to overattribute criticism and rejection. This pattern of findings suggests that male sexual harassers tend to over-infer women’s criticism and rejection and make these inferences at the wrong times. These findings also support recent speculation that men’s sexual harassment of women is related to aggression rather than seduction.     

A Model-Based Approach to Understanding Apraxia in Corticobasal Syndrome

Limb apraxia is a neurological disorder of higher cognitive function characterized by an inability to perform purposeful skilled movements and not attributable to an elementary sensorimotor dysfunction or comprehension difficulty. Corticobasal Syndrome (CBS) is an akinetic rigid syndrome with asymmetric onset and progression with at least one basal ganglia feature (rigidity, limb dystonia or myoclonus) and one cortical feature (limb apraxia, alien hand syndrome or cortical sensory loss). Even though limb apraxia is highly prevalent in CBS (70–80%), very few studies have examined the performance of CBS patients on praxis measures in detail. This review aims to (1) briefly summarize the clinical, neuroanatomical and pathological findings in CBS, (2) briefly outline what limb apraxia is and how it is assessed, (3) to comprehensively review the literature on limb apraxia in CBS to date and (4) to briefly summarize the literature on other forms of apraxia, such as limb-kinetic apraxia and buccofacial apraxia. Overall, the goal of the review is to bring a model-based perspective to the findings available in the literature to date on limb apraxia in CBS.