Neuropsychology of mildly disabled patients with relapsing-remitting multiple sclerosis

Previous papers have mainly demonstrated the presence of cognitive impairment in patients with multiple sclerosis (MS), these changes have been traditionally associated with the later stages of the disease. In the current study, a comprehensive neuropsychological battery was administered to 216 relapsing-remitting MS patients with mild clinical disability (EDSS相似文献   

The free and cued selective reminding test for predicting progression to Alzheimer's disease in patients with mild cognitive impairment: A prospective longitudinal study

Amnestic mild cognitive impairment (aMCI) patients carry a greater risk of conversion to Alzheimer's disease (AD). Therefore, the International Working Group (IWG) on AD aims to consider some cases of aMCI as symptomatic prodromal AD. The core diagnostic marker of AD is a significant and progressive memory deficit, and the Free and Cued Selective Reminding Test (FCSRT) was recommended by the IWG to test memory in cases of possible prodromal AD. This study aims to investigate whether the performance on the FCSRT would enhance the ability to predict conversion to AD in an aMCI group. A longitudinal study was conducted on 88 aMCI patients, and neuropsychological tests were analysed on the relative risk of conversion to AD. During follow‐up (23.82 months), 33% of the aMCI population converted to AD. An impaired FCSRT TR was significantly associated with the risk of conversion to dementia, with a mean time to conversion of 25 months. The FCSRT demonstrates utility for detecting AD at its prodromal stage, thus supporting its use as a valid clinical marker.     

Factor Structure,Internal Consistency and Criterion Validity of the Full‐form and Short‐form Versions of the Centrality of Events Scale in Young People

The perceived centrality of a traumatic event has been hypothesized to impact subsequent responses to that event and shown to be positively associated to a number of psychological problems. In order to understand the role of this construct in adjustment to stress and trauma, reliable and valid measures are needed. The objective of this study was to evaluate the factor structure, internal consistency and convergent validity of the full‐form and short‐forms of the Centrality of Event Scale when used with young people. A sample of 262 undergraduate students completed this study. Confirmatory factor analyses, Cronbach alpha coefficients and Pearson correlation coefficients were performed. The findings support a one‐factor structure of the full 20‐item and the short 7‐item versions. We also found that both versions provide reliable and valid scores when used with young people. We recommend the use of the 7‐item version to minimize assessment burden. Copyright © 2017 John Wiley & Sons, Ltd.     

In hindsight, life flows from left to right

Three experiments investigated the mental representation of meaningful event sequences. Experiment 1 used extended (5 min long) naturalistic scenes excerpted from commercial movies. Experiments 2 and 3 presented everyday activities by means of sequences of six photographs. All experiments found both left–right and distance effects in an order decision task, suggesting that when contemplated in hindsight, experienced events unfold along a left-to-right analogical mental line. Present results are discussed in the context of the mental representation of other kinds of ordinal sequences, and other left–right effects reported in non-ordinal domains.     

Age‐related changes in the dynamics of fear‐related regulation in early childhood

Self‐regulation is a dynamic process wherein executive processes (EP) delay, minimize or desist prepotent responses (PR) that arise in situations that threaten well‐being. It is generally assumed that, over the course of early childhood, children expand and more effectively deploy their repertoire of EP‐related strategies to regulate PR. However, longitudinal tests of these assumptions are scarce in part because self‐regulation has been mostly studied as a static construct. This study engages dynamic systems modeling to examine developmental changes in self‐regulation between ages 2 and 5 years. Second‐by‐second time‐series data derived from behavioral observations of 112 children (63 boys) faced with novel laboratory‐based situations designed to elicit wariness, hesitation, and fear were modeled using differential equation models designed to capture age‐related changes in the intrinsic dynamics and bidirectional coupling of PR (fear/wariness) and EP (strategy use). Results revealed that dynamic models allow for the conceptualization and measurement of fear regulation as intrinsic processes as well as direct and indirect coupling between PR and EP. Several patterns of age‐related changes were in line with developmental theory suggesting that PR weakened and was regulated more quickly and efficiently by EP at age 5 than at age 2. However, most findings were in the intrinsic dynamics and moderating influences between PR and EP rather than direct influences. The findings illustrate the precision with which specific aspects of self‐regulation can be articulated using dynamic systems models, and how such models can be used to describe the development of self‐regulation in nuanced and theoretically meaningful ways.     

Evaluation of Breast Cancer Patients with Genetic Risk in a University Hospital: Before and After the Implementation of a Heredofamilial Cancer Unit

The identification of patients at risk for breast cancer by genetic testing has proven to reduce breast cancer mortality. In 2010, due to a lack of systematization in hereditary cancer assistance in our center, we implemented a multidisciplinary Heredofamilial Cancer Unit (HFCU). We analyze if the HFCU improved the rates of referrals and preventive management of breast cancer patients with genetic risk. We retrospectively compared family history records, referrals of high-risk patients to genetic counseling, and detection and management of patients with BRCA1/2 mutations in two cohorts of breast cancer patients diagnosed before (first period: 2007–2010) and after the creation of the HFCU (second period: 2010–2013). In the first period, 893 patients were included, and 902 were included in the second. Due to the inability to establish their genetic risk, 142 patients (15.9%) vs. 70 (7.8%) were excluded from analysis (p?<?0.001). Among the evaluable patients, 194 (25.8%) vs. 223 (26.8%) fulfilled one or more risk criteria (p?=?0.65). Family history documentation in patient’s medical records (92.4 vs. 97.8%, p?<?0.001) and referral rate (26.3 vs. 52%, p?<?0.0001) significantly increased in the second period. Eight BRCA1/2 mutations were detected among patients referred in the first period and 17 among those referred to the HFCU. The rate of preventive surgeries in patients with BRCA mutations significantly increased in the second period (25 vs. 76.5%, p?=?0.03). In conclusion, there was a clear improvement in family history records, referrals, and preventive surgeries in breast cancer patients with genetic risk after the implementation of the HFCU.     

Acceptance and Commitment Therapy as a Spiritually Integrated Psychotherapy

This article presents acceptance and commitment therapy (ACT) as a spiritually integrated therapeutic modality. ACT is a value‐driven therapy that involves facilitating transcendence of physical, mental, and emotional experience to alleviate human suffering; as such, ACT shares common ground with the domain of spirituality. Approached as a spiritually integrated therapy, ACT can help clients to access spiritual resources and create life meaning as well as aid in the resolution or transformation of spiritual struggles. Given that spiritual struggles, in particular, can have a significant impact on mental health and well‐being, this article provides guidance in how ACT can address such struggles.