Fehldiagnose Aufmerksamkeitsdefizit- und Hyperaktivit?tssyndrom?

Although it is assumed both by healthcare professionals as well as by public opinion that attention deficit hyperactivity disorder (ADHD) is widely overdiagnosed, so far there is little empirical evidence to support this presumption. However, the presented study shows clear evidence for an overdiagnosis of ADHD. Furthermore, the data demonstrate that based on identical symptoms, boys more often receive a diagnosis for ADHD than girls. A false ADHD diagnosis also correlates with a recommendation for medical and psychotherapeutic treatment. One explanation for misdiagnosis is the fact that therapists in the course of diagnosis, as with other everyday decision-making processes, are influenced by heuristics. The most common heuristics that can lead to misdiagnosis are the representativeness heuristic and the availability heuristic. Such mistakes could be avoided by clearly following diagnostic criteria and the use of structural interviews.     

Cognitive Load Disrupts Implicit Theory-of-Mind Processing

Eye movements in Sally-Anne false-belief tasks appear to reflect the ability to implicitly monitor the mental states of other individuals (theory of mind, or ToM). It has recently been proposed that an early-developing, efficient, and automatically operating ToM system subserves this ability. Surprisingly absent from the literature, however, is an empirical test of the influence of domain-general executive processing resources on this implicit ToM system. In the study reported here, a dual-task method was employed to investigate the impact of executive load on eye movements in an implicit Sally-Anne false-belief task. Under no-load conditions, adult participants displayed eye movement behavior consistent with implicit belief processing, whereas evidence for belief processing was absent for participants under cognitive load. These findings indicate that the cognitive system responsible for implicitly tracking beliefs draws at least minimally on executive processing resources. Thus, even the most low-level processing of beliefs appears to reflect a capacity-limited operation.     

Assessment of Attention in Preschoolers

In the past two decades, there has been an increased interest in the assessment and treatment of preschool children presenting with concerns about attention problems. This article reviews the research and clinical literature involving assessment of attention and related skills in the preschool years. While inattention among preschoolers is common, symptoms alone do not necessarily indicate a disorder, and most often represent a normal variation in typical preschool child development. Thus, accurate identification of ??disordered?? attention in preschoolers can be challenging, and development of appropriate, norm-referenced tests of attention for preschoolers is also difficult. The current review suggests that comprehensive assessment of attention and related functions in the preschool child should include thorough review of the child??s history, planned observations, and formal psychometric testing. The three primary methods of psychometric assessment that have been used to characterize attentional functioning in preschool children include performance-based tests, structured caregiver interviews, and rating scales (parent, teacher, and clinician). Among performance-based methods for measurement of attention in the preschool years, tests have been developed to assess sustained attention, selective (focused) attention, span of attention (encoding/manipulation), and (top-down) controlled attention??including freedom from distractibility and set shifting. Many of these tests remain experimental in nature, and review of published methods yields relatively few commercially available, nationally normed tests of attention for preschoolers, and an overall dearth of reliability and validity studies on the available measures.     

Eye movements reveal sustained implicit processing of others' mental states

The ability to attribute mental states to others is crucial for social competency. To assess mentalizing abilities, in false-belief tasks participants attempt to identify an actor's belief about an object's location as opposed to the object's actual location. Passing this test on explicit measures is typically achieved by 4 years of age, but recent eye movement studies reveal registration of others' beliefs by 7 to 15 months. Consequently, a 2-path mentalizing system has been proposed, consisting of a late developing, cognitively demanding component and an early developing, implicit/automatic component. To date, investigations on the implicit system have been based on single-trial experiments only or have not examined how it operates across time. In addition, no study has examined the extent to which participants are conscious of the belief states of others during these tasks. Thus, the existence of a distinct implicit mentalizing system is yet to be demonstrated definitively. Here we show that adults engaged in a primary unrelated task display eye movement patterns consistent with mental state attributions across a sustained temporal period. Debriefing supported the hypothesis that this mentalizing was implicit. It appears there indeed exists a distinct implicit mental state attribution system.     

Does the Vigilance-Avoidance Gazing Behavior of Children with Separation Anxiety Disorder Change after Cognitive-Behavioral Therapy?

Cognitive biases are of interest in understanding the development of anxiety disorders. They also play a significant role during psychotherapy, where cognitive biases are modified in order to break the vicious cycle responsible for maintaining anxiety disorders. In a previous study, the vigilance-avoidance pattern was shown in children with separation anxiety disorder (In-Albon et al. Journal of Abnormal Child Psychology 38:225-235, 2010). The exhibited avoidance pattern may be essential for the maintenance of the anxiety disorder. Therefore, in the present study we used eye tracking methodology presenting disorder specific pictures to examine possible changes in the vigilance-avoidance pattern in 18 children with separation anxiety disorder after cognitive-behavioral treatment (CBT) and 13 healthy controls. Results indicated that following treatment, the vigilance pattern of children with separation anxiety disorder reduced significantly. Thus, the vigilance-avoidance pattern can be modified by CBT.     

Minimal mimicry: Mere effector matching induces preference

Both mimicking and being mimicked induces preference for a target. The present experiments investigate the minimal sufficient conditions for this mimicry-preference link to occur. We argue that mere effector matching between one’s own and the other person’s movement is sufficient to induce preference, independent of which movement is actually performed. In Experiments 1 and 2, participants moved either their arms or legs, and watched avatars that moved either their arms or legs, respectively, without any instructions to mimic. The executed movements themselves and their pace were completely different between participants (fast circular movements) and targets (slow linear movements). Participants preferred avatars that moved the same body part as they did over avatars that moved a different body part. In Experiment 3, using human targets and differently paced movements, movement similarity was manipulated in addition to effector overlap (moving forward–backward or sideways with arms or legs, respectively). Only effector matching, but not movement matching, influenced preference ratings. These findings suggest that mere effector overlap is sufficient to trigger preference by mimicry.     

Evaluation of a Combined Cognitive Behavioural Therapy and Interpersonal Process Group in the Psychotherapy Training of Clinical Psychologists

It is now widely acknowledged that both content and process elements of psychotherapy play a part in client treatment outcomes. Despite this, there are pressures on Australian clinical psychology training programs to teach evidence‐based approaches in a relatively short time frame. Producing clinical psychology graduates who have an adequate level of competence in evidence‐based practice and meeting the demands of professional accreditation requirements can mean that less time is available to teach the process elements of psychotherapy. The aim of this study was to conduct a preliminary evaluation of a clinical psychology psychotherapy training program that combines an interpersonal process group with a cognitive behavioural therapy training model that incorporates self‐reflection and self‐practice. Eleven participants who participated in the training in 2008 completed the Counseling Self‐Estimate Inventory at pre‐ and post‐training. Significant improvements on the majority of the subscales of this inventory were found. A separate sample of nine trainees and clinical psychology registrars who also previously completed the program attended individual interviews in 2010 aimed at gaining their perspective regarding various aspects of the program. Self‐practice of cognitive behavioural therapy techniques was found to be important in the identification and management of trainees’ own core beliefs, and to their appreciation of how challenging this process may be for clients. The interpersonal process group was described by participants as enhancing their competency as psychotherapists. Common themes included the experience of anxiety and a high level of emotion, and understanding how this experience might be similar for clients; increased self‐awareness; and increased competence in process issues. Many participants believed the process and content components of training were equally important to their development as psychotherapists.     

Introspective disputes deflated: the case for phenomenal variation

Sceptics vis-à-vis introspection often base their scepticism on ‘phenomenological disputes’, ‘introspective disagreement’, or ‘introspective disputes’ (ID) (see Kriegel in Phenomenol CognSci 6(1):115–136, 2007; Bayne and Spener in Philos Issues 20(1):1–22, 2010; Schwitzgebel in Perplexities of consciousness, MIT Press, Cambridge, 2011): introspectors massively diverge in their opinions about experiences, and there seems to be no method to resolve these issues. Sceptics take this to show that introspection lacks any epistemic merit. Here, I provide a list of paradigmatic examples, distill necessary and sufficient conditions for IDs, present the sceptical argument encouraged by IDs, and review the two main strategies (resolution and containment) to reject such a scepticism. However, both types of strategies are unsatisfactory. In order to save introspection from the looming sceptical threat, I advocate a deflationary strategy, based on either an ‘Argument from Perceptual Kinship’ or an ‘Argument from Ownership’. In the end, there cannot be any genuine IDs, for nothing can fulfil the reasonable conditions for IDs. What looks like IDs may instead be indicators of phenomenal variation. Debates that look like IDs may then arise even if introspection were a perfect method to know one’s mind. Thus, scepticism vis-à-vis introspection based on IDs rests on shaky grounds.