Improved Perceptions of Emotion Regulation and Reflective Functioning in Parents: Two Additional Positive Outcomes of Parent-Child Interaction Therapy

The purpose of this study was to test whether Parent-Child Interaction Therapy (PCIT), a widely used effective therapy for children’s externalizing behaviors and parenting problems, was associated with improvements in parents’ emotion regulation and reflective functioning. We also investigated whether these improvements had unique associations with children’s improvements in externalizing and internalizing symptoms. Participants were 139 Australian children aged 29 to 83 months and their caregivers; all were referred for child externalizing behavior problems coupled with parenting skill deficits or high parent stress. All data were gathered via a questionnaire completed prior to and after completion of PCIT. Significant improvements were found in parents’ self-reported emotion dysregulation and capacity to use cognitive reappraisal for emotion regulation. There was also improvement in parents’ self-report of children’s symptoms, parenting practices, and reflective functioning in the form of prementalizing, which measured a low capacity to understand the emotional world of the child. Multiple regression showed that improvements in cognitive reappraisal, prementalizing, and negative parenting practices were associated with improvement in children’s symptoms. The findings extend the existing evidence for PCIT as an effective parenting intervention, adding parents’ perceived emotion regulation and reflective functioning to the list of positive outcomes from PCIT. Improved emotion regulation and reflective functioning, unique from changes in parenting practices, could be mechanisms that help explain why PCIT has been associated with improvements in children’s externalizing behaviors.     

Age-related declines in general cognitive abilities of Balb/C mice are associated with disparities in working memory, body weight, and general activity

A defining characteristic of age-related cognitive decline is a deficit in general cognitive performance. Here we use a testing and analysis regimen that allows us to characterize the general learning abilities of young (3-5 mo old) and aged (19-21 mo old) male and female Balb/C mice. Animals' performance was assessed on a battery of seven diverse learning tasks. Aged animals exhibited deficits in five of the seven tasks and ranked significantly lower than their young counterparts in general learning abilities (aggregate performance across the battery of tasks). Aging added variability to common core performance (i.e., general learning ability), which translated into increased variability on the individual cognitive tasks. Relatedly, general learning abilities did not differ between the two ages among the best quartile of learners (i.e., cognitive abilities were spared in a subsample of the aged animals). Additionally, working memory capacity (resistance to interference) and duration (resistance to decay) accounted for significantly more of the variability in general learning abilities in aged relative to young animals. Tests of 15 noncognitive performance variables indicated that an increase in body weight (and an associated decrease in general activity) was characteristic of those aged animals which exhibited deficient general learning abilities. These results suggest the possibility that general cognitive deficits in aged animals reflect a failure of specific components of the working memory system, and may be related to variations in body weight and an associated decrease in activity.     

Rates and Correlates of DSM-IV Diagnoses in Women Newly Diagnosed with Breast Cancer

Although the presence of psychological distress has been documented in women with breast cancer, previous studies have not established rates of DSM-IV diagnoses in this population, nor have prior investigations compared the utility of diagnostic interviewing vs. symptom checklists to assess distress. DSM-IV diagnoses of anxiety disorders and major depression, symptoms of anxiety and depression, and quality of life were examined in 207 women with newly diagnosed breast cancer. Eighteen percent of breast cancer patients met criteria for a current DSM-IV anxiety or depressive disorder and 54% met criteria for a disorder at some point in their lifetime. These rates are comparable to those found in recent community epidemiological studies (e.g., R. C. Kessler, K. A. McGonagle, S. Zhao, C. B. Nelson, M. Hughes, S. Esheman, et al., 1994). Sensitivity, specificity, and positive predictive value for anxiety and depression symptoms as predictors of DSM disorders were relatively poor. However, after accounting for demographic, treatment, and cancer variables, self-reported anxiety symptoms were significantly related to the presence of an anxiety disorder and self-reported depressive symptoms were significantly related to a diagnosis of a depressive disorder. Symptoms of anxiety and depression contributed significantly and uniquely to physical, medical, and sexual quality of life; DSM-IV diagnoses were not significantly related to quality of life after controlling for symptoms of depression and anxiety. The importance of measuring both symptoms of distress and psychiatric diagnoses in cancer patients and the clinical practice implications of the results are discussed.     

Personality Changes Associated with Localized Brain Injury in Elderly Populations

Emotional disturbances following brain damage have been frequently reported in the literature. However, systematic investigation of these disorders and their specific causes were not common until the last 30 years. However, the number of research studies into this area remains slight compared to the voluminous literature on the cognitive effects of brain injury. The completed research has fallen into 3 major areas: (1) The study of clients with localized brain injuries to evaluate whether the site of the injury predicts the emotional reactions; (2) the effect of time poststroke on personality changes; and (3) the relation of neuropsychological deficits to emotional changes. This paper provides a comprehensive review of the research that has been completed in this area with elderly subjects along with an analysis of the current state of the knowledge in this area. Future directions for research to further our understanding are discussed.     

Effect of family environment and donor source on patient quality of life following renal transplantation.

The authors examined the degree to which the supportiveness of a patient's family environment predicts change in quality of life following renal transplantation. The sample consisted of 95 patients receiving renal grafts from either a living donor or a cadaveric donor. Patients were initially assessed prior to transplantation with follow-up assessment occurring an average of 5.5 months after transplantation. Among patients receiving a living-donor kidney, those reporting a more supportive family environment exhibited reduced depression, improved mobility, and improved social functioning. However, those living-donor recipients reporting less family support exhibited increased depression and diminished mobility and social functioning after transplantation. Patients receiving a kidney from a cadaveric donor showed modest improvements in quality of life regardless of the degree of family support.     

Lexical Acquisition in Probable Alzheimer''s Disease

Patients with probable Alzheimer's disease (pAD) were exposed to a new verb in a naturalistic fashion. We probed their knowledge of the word's semantic and grammatical characteristics for several minutes following this exposure, and compared this with their performance on parallel measures assessing known words. Significant differences were seen between pAD patients and controls in the acquisition of the new verb's semantic meaning and its argument structure, but pAD patients did not differ from controls in the acquisition of the new word's grammatical form class. Individual patient analyses demonstrated parallel deficits restricted to the semantic meaning and argument structure of the new word and known words in several pAD patients, suggesting that a selective language impairment contributed to their word learning deficit. This pattern is consistent with an intimate relationship between semantic meaning and argument structure in semantic memory. Other pAD patients had difficulty learning about all aspects of the new word, despite good performance with known words, suggesting that compromised memory may have limited their lexical acquisition.     

MUSICAL REINFORCEMENT OF PRACTICE BEHAVIORS AMONG COMPETITIVE SWIMMERS

This study determined whether music could be used as a reinforcer for increasing productive and decreasing nonproductive behavior of 6 competitive swimmers during the dry-land portion of a practice session. The swimmers were randomly assigned to either the contingent reinforcement group, who received music for productive behavior, or the noncontingent group, who received music regardless of their training productivity. An ABAB design showed that a large and immediate increase in productive practice behavior and decrease in nonproductive practice behavior occurred during the contingent phase compared to the baseline phase. Subjects rated the musical reinforcement favorably and elected to have the procedure continued.     

Reversal operations after brain damage

The ability to perform reversals—that is, the appreciation of the relationship between original and transformed states of knowledge—is critical to human thought processes. In order to assess whether a number of “special-purpose processors” are responsible for reversal operations, depending on the particular context in which the reversal is couched, or whether a single “core processing mechanism” subserves a critical aspect of reversal operations regardless of the specific context, patients with localized brain damage were asked to solve eight reversal problems. Visual and auditory reversals mediated by linguistic and non-linguistic symbol systems were presented. The findings demonstrate that patients with insult to the anterior portion of the right hemisphere encounter more difficulty performing reversals than patients with right posterior insult, Broca's aphasics, and fluent aphasics. This is regardless of the symbol system mediating the reversal, regardless of the modality of presentation, and regardless of the amount of available processing time. Subjects with insult to the posterior region of the left hemisphere or the right hemisphere also exhibit some difficulty solving reversal problems, although their difficulties appear modality specific. These data lend support to the claim that a core processing mechanism may play a critical role in the performance of reversal operations.