When Anxiety Symptoms Masquerade as Medical Symptoms: What Medical Specialists Know about Panic Disorder and Available Psychological Treatments

Under-recognition of somatic symptoms associated with panic in primary care settings results in unnecessary and costly diagnostic procedures and inappropriate referrals to cardiologists, gastroenterologists, and neurologists. In the current study specialists’ knowledge regarding the nature and treatment of panic were examined. One-hundred and fourteen specialists completed a questionnaire assessing their knowledge about panic attacks, including their perceptions of psychologists’ role in treating panic. Respondents answered 51% of knowledge items correctly. Although most knew the definition of a panic attack, they knew less about clinical features of panic and its treatment. Specifically, whereas 97.4% believed medication effectively relieves panic symptoms, only 32.5% knew that cognitive-behavioral therapy (CBT) is a first-line treatment. Only 6% reported knowing how to implement CBT, and only 56.1% recognized that psychologists could effectively treat panic. These findings demonstrate significant gaps in specialists’ knowledge about panic and the need to enhance physician knowledge about panic attacks and their treatment.     

Quantitative competencies in infancy

We review recently published papers that have contributed to our understanding of how the preverbal infant represents number, area and time. We review evidence that infants rely on two distinct systems to represent number nonverbally and highlight the similarities in the ratio‐dependent discrimination of number, time and area. Contrary to earlier assertions that continuous dimensions are more salient (and thus more discriminable) to the infant than numerosity, we argue that the opposite conclusion is better supported by the data. The preverbal infant may be better able to extract numerosity than continuous variables from arrays of discrete items.     

When to offer cognitive behavioural or psychoanalytic psychotherapy in an integrated psychotherapy service: Are everyday allocation decisions theoretically congruent?

Different modes of psychotherapy can be an effective form of treatment for a range of mental health problems. Psychotherapy provision in the NHS is organised in a variety of ways, with patient entry to various modes of therapy determined by a range of factors including evidence‐based guidelines and patient or referrer preference. The methods by which patients arrive at a particular mode of psychotherapy are largely unreported. This paper aims to describe this process in one UK NHS psychotherapy service offering cognitive behavioural and psychoanalytic psychotherapy, and provides data to inform a discussion on the theoretical congruence of these allocation decisions.     

College Goals: Do Self-Determined and Carefully Considered Goals Predict Intrinsic Motivation,Academic Performance,and Adjustment During the First Semester?

The present study investigated whether choosing autonomous goals for pursuing a college education and reflecting on those goals promotes intrinsic motivation toward coursework, higher grades and improved adjustment to college over time. Incoming first-year college students responded to the College Goals Questionnaire before starting classes, and to the Student Adaptation to College Questionnaire and the Work Preference Inventory during their first semester. Results indicated that the degree to which students who reflected on their goals had high levels of both intrinsic and extrinsic motivation. The autonomy of students' goals predicted grade point average, high intrinsic motivation, low extrinsic motivation, and improvement in social and emotional adjustment over time. These findings contribute to the literature on personal goals by establishing the importance of having well-thought- through and autonomous goals during the transition to college.     

Alexithymia, Cumulative Feedback, and Differential Response Patterns on the Iowa Gambling Task

ABSTRACT Although the role of emotional processing is central to contemporary models of risky decision making, to date the role of trait emotional understanding has not been explored experimentally in this context. The current experiment ( N =326) explores the role of alexithymia with respect to performance on the standard Iowa Gambling Task (IGT) and a version where cumulative financial feedback is obscured. Standard learning on the IGT was observed for those low in alexithymia. Those high in alexithymia learned to avoid disadvantageous decks over the first half of the task. However, over the later trials they showed a change in performance, shifting from advantageous to disadvantageous and back to advantageous decks again (termed an "explore-learn-change-return" strategy). It is argued that this is due to an inability to fully consolidate earlier learning and reduced sensitivity to losses. The absence of cumulative feedback independently resulted in reduced performance.     

Impact of simulated visual impairment on the cognitive test performance of young adults

Aims. This study investigated the effect of simulated visual impairment on the speed and accuracy of performance on a series of commonly used cognitive tests. Methods. Cognitive performance was assessed for 30 young, visually normal subjects (M=22.0±3.1 years) using the Digit Symbol Substitution Test (DSST), Trail Making Test (TMT) A and B and the Stroop Colour Word Test under three visual conditions: normal vision and two levels of visually degrading filters (Vistech^TM) administered in a random order. Distance visual acuity and contrast sensitivity were also assessed for each filter condition. Results. The visual filters, which degraded contrast sensitivity to a greater extent than visual acuity, significantly increased the time to complete (p<.05), but not the number of errors made, on the DSST and the TMT A and B and affected only some components of the Stroop test. Conclusions. Reduced contrast sensitivity had a marked effect on the speed but not the accuracy of performance on commonly used cognitive tests, even in young individuals; the implications of these findings are discussed.     

Age effects on attentional blink performance in meditation

Here we explore whether mental training in the form of meditation can help to overcome age-related attentional decline. We compared performance on the attentional blink task between three populations: A group of long-term meditation practitioners within an older population, a control group of age-matched participants and a control group of young participants. Members of both control groups had never practiced meditation. Our results show that long-term meditation practice leads to a reduction of the attentional blink. Meditation practitioners taken from an older population showed a reduction in blink as compared to a control group taken from a younger population, whereas, the control group age-matched to the meditators’ group revealed a blink that was comparatively larger and broader. Our results support the hypothesis that meditation practice can: (i) alter the efficiency with which attentional resources are distributed and (ii) help to overcome age-related attentional deficits in the temporal domain.     

The Utility of Genetic Counseling Prior to Offering First Trimester Screening Options

In order to evaluate the utility of genetic counseling at the time of first trimester screening in patients with no previously identified genetic concerns, we reviewed family history data for 700 women seen for genetic counseling in Utah during 2005-2006. The mean maternal age was 35 years (Range: 16–47 years). The majority of patients seen were non-Jewish Caucasians (90.8%, 634/700). A three-generation pedigree was obtained from each woman by one of two certified genetic counselors and subsequently classified as “negative” (no birth defects/genetic disorders); “positive” (birth defect or genetic condition with a minimal/low risk of recurrence; additional evaluation/genetic testing during pregnancy not indicated); or “significant” (birth defect or genetic condition with an increased risk of recurrence; additional evaluation/genetic testing during the pregnancy indicated). About 72% (501/700) of the histories were negative, 19% (134/700) were positive, and about 9% (65/700) were significant. Among patients with significant family histories, 66% (n = 43) were women less than 35 years of age. We conclude that assessing a patient’s family history at the time of first trimester serum screening is a valuable resource for pregnancy management.