Positive aspects of caregiving as a moderator of treatment outcome over 12 months

The authors examined the influence of positive aspects of caregiving (PAC) as a moderator of treatment outcome across 12 months in 1 of the original sites of the Resources for Enhancing Alzheimer's Caregiver Health I project. They used multilevel random coefficients regression analysis to predict time-varying PAC, depression, behavioral bother, and daily care burden in Alzheimer's caregivers (N = 243; mean age = 60.89, SD = 14.19). They found that time-varying PAC was predicted by time-varying daily care burden. They also found significant effects of time-varying PAC for depression, behavioral bother, and daily care burden. Notably, a PAC x Phase x Treatment effect was found for daily care burden, such that individuals who endorsed less PAC benefited most from the intervention across 12 months. The tendency to positively appraise the caregiving experience (i.e., PAC) in response to chronic stressors such as Alzheimer's caregiving may affect individuals' responsiveness to, and benefit from, interventions, whereas only daily care burden affected the tendency to find enjoyment in caregiving across 12 months. Future intervention research should assess individual PAC in order to better tailor interventions to caregiving needs.     

Training and transfer effects of executive functions in preschool children

Executive functions, including working memory and inhibition, are of central importance to much of human behavior. Interventions intended to improve executive functions might therefore serve an important purpose. Previous studies show that working memory can be improved by training, but it is unknown if this also holds for inhibition, and whether it is possible to train executive functions in preschoolers. In the present study, preschool children received computerized training of either visuo‐spatial working memory or inhibition for 5 weeks. An active control group played commercially available computer games, and a passive control group took part in only pre‐ and posttesting. Children trained on working memory improved significantly on trained tasks; they showed training effects on non‐trained tests of spatial and verbal working memory, as well as transfer effects to attention. Children trained on inhibition showed a significant improvement over time on two out of three trained task paradigms, but no significant improvements relative to the control groups on tasks measuring working memory or attention. In neither of the two interventions were there effects on non‐trained inhibitory tasks. The results suggest that working memory training can have significant effects also among preschool children. The finding that inhibition could not be improved by either one of the two training programs might be due to the particular training program used in the present study or possibly indicate that executive functions differ in how easily they can be improved by training, which in turn might relate to differences in their underlying psychological and neural processes.     

Effects of performance expectancy and self-focused attention on social interaction

We investigated the impact of performance expectancies and self-focused attention on social performance in a mixed-sex dyad. A group of 48 undergraduate men with self-reported moderate social anxiety were divided into two groups on the basis of their high or low performance expectancies. Subjects were asked to respond to several self-report questionnaires before and after making a 4-5-min phone call to a female confederate for the purpose of getting acquainted. Half of the subjects in each expectancy group performed in the presence of a self-focusing stimulus (video camera). When anxiety level was controlled for, focus of attention alone had a very limited effect on performance. Expectancy had a significant influence on social performance, but only if subjects were self-focused. Thus confident subjects were rated by judges as more socially skilled than were doubtful subjects, but only when the camera was present. The interaction between these variables parallels previous research and supports the self-regulation model of Carver and Scheier.     

Reducing cigarette smoking in a retarded adult: An application of self-management procedures

An attempt was made to reduce the overall number of cigarettes smoked per day with a mildly retarded adult. Self-monitoring was compared to self-monitoring plus self-graphing and goal setting procedures in reducing the number of cigarettes smoked. Self-monitoring plus self-graphing and goal setting was superior to self-monitoring alone when the goal was set at 15 cigarettes per day, but the actual number of cigarettes smoked increased when the goal was set at 12. The number of cigarettes smoked during all treatment conditions was lower than either baseline conditions. The therapist also reduced the patient's caffeine intake and switched the client's brand of cigarettes to a low “tar”/nicotine brand. The reduction in caffeine and “tar”/nicotine was related to a small and transient increase in somatic complaints and verbal abuse, as well as the complete elimination of nocturnal enuresis. Brand switching to low “tar”/nicotine cigarettes did not result in an increase in the number of cigarettes smoked per day.     

A SELF-INSTRUCTIONAL PACKAGE FOR INCREASING ATTENDING BEHAVIOR IN EDUCABLE MENTALLY RETARDED CHILDREN

The purpose of this study was to develop a self-instructional package that would aid highly distractible retarded children in increasing their attending behavior in a training and two generalization (a one-to-one and a classroom) situations. Three untrained subjects were monitored for general comparison and social validation purposes. One of these control subjects was distractible and the other two (criterion comparison) were evaluated as not having attentional problems. A multiple baseline design was employed in which training was sequentially introduced across subjects. During training, the experimental subjects were taught through self-instruction to focus their attention and to cope with two tasks, math and printing. After learning the self-instructions the subjects were systematically and sequentially exposed to photo-slides of distracting situations, to audio-distractors composed of noisy lunchroom verbal peer interactions, and to in vivo distractors provided by kindergarten children playing with wooden blocks in the training setting. The entire training procedure was handled in a game-like context to maintain subject interest and to facilitate generalization. The results suggested that the training package produced direct and generalized changes in self-instructional behavior. In addition, a decrease in off-task behavior occurred during math, printing, and also during a phonics program in the one-to-one and classroom situations. However, reliable changes in academic task performance were not observed. Finally, no systematic changes on any of the dependent measures occurred for the three untrained subjects.     

A computerized test for the assessment of mild cognitive impairment subtypes in sentence processing

This study examines thesentence processing ability of mild cognitive impairment (MCI) subtypes. In addition to standard MCI neuropsychological tests, an experimental approach was applied to assess language. 133 people (93 MCI/40 controls) participated in novel computerized sentence processing tasks. Results presented statistically significant differences between MCI/controls andMCI subtypes (ANOVA):(a) duration F(2,92) = 19.259,p < .001) in sentence construction; (b) correct answers (F(2, 89) = 8.560,p < .001) and duration (F2,89) = 15.525,p < .001)in text comprehension; (c) correct answers (F(2, 92) = 8.975,p < .001) andduration (F(2, 92) = 4.360,p = .016) in metaphoric sentences comprehension; (d) correct answers (F(2, 92) = 12.836,p < .001) andduration (F(2, 92) = 10.974,p < .001) in verb form generation. Subtle changes in MCIsubtypes could affect sentence processing and provide useful information for cognitive decline risk estimation and screening purposes.     

Irrational Option Exclusion

In this paper, I describe a hitherto overlooked kind of practical irrationality, which I call irrational option exclusion. An agent who suffers from this problem does not merely fail to act on her best judgement – she fails to realize that the superior action is even an option for her. I furthermore argue that this kind of irrationality is serious enough to undermine moral responsibility. I show that an agent suffering from this problem has compromised reasons-responsiveness, does not really express her will through action, and has a hard time doing otherwise; thus, from the standpoint of several popular moral responsibility theories, we ought to conclude that her responsibility is at the very least diminished.     

Theory of mind and joint action in Parkinson’s disease

It has been suggested that the Theory of Mind (ToM) may rely on more basic processes of social cognition, such as action control (e.g., joint action), even if little is known about this relationship. The relationship between ToM and joint action can be studied in patients with Parkinson’s disease (PD), because they are characterized not only by a deficit in ToM (and in its cognitive and affective subcomponents) but also by a deficit in the inhibition of competing responses. Sixty PD patients and 60 matched healthy controls (HCs) performed a go/no-go Flanker task in both joint and individual conditions. Cognitive (Advanced Test or AT) and affective (Emotion Attribution Task or EAT) ToM also were measured. Thirty-five PD patients and matched HCs also performed the standard Flanker task, as a control measure. In patients, only individuals with high AT scores exhibited a joint Flanker effect, whereas in HCs the joint effect was found irrespectively of AT score. Patients with low EAT scores showed a greater interference effect than patients with high scores, whereas the opposite pattern was found for HCs. In regression analysis AT and EAT scores predicted the Flanker effect in the joint condition only. In the standard task, both groups showed a Flanker effect. The role of different fronto-striatal circuits, especially in PD patients, could explain the different involvement of cognitive and affective ToM in joint tasks. The Flanker effect is discussed considering the referential coding account and the attention-focus account as possible candidates to explain joint action effects.     

Genetic Counseling for Early-onset Familial Alzheimer Disease in Large Aboriginal Kindred from a Remote Community in British Columbia: Unique Challenges and Possible Solutions

A novel, pathogenic presenilin 1 (PS1) mutation has recently been identified in a large Aboriginal kindred living in dispersed communities throughout British Columbia, Canada. Disseminating genetic information and ensuring that appropriate genetic counseling services are provided to all concerned relatives have posed several unique challenges. These challenges include knowledge exchange and continuity of care in a geographically remote and culturally distinct community. To our knowledge, this is the first time a specific genetic counseling approach has been needed for early-onset familial Alzheimer disease (EOFAD) in a North American Aboriginal community.     

The Resources for Enhancing Alzheimer's Caregiver Health (REACH): project design and baseline characteristics

The Resources for Enhancing Alzheimer's Cargiver Health (REACH) project was designed to test promising interventions for enhancing family caregiving for persons with dementia. The purpose of this article is to describe the research design, interventions, and outcome measures used in REACH and to characterize the sample recruited for the study. Nine interventions and 2 control conditions were implemented at 6 sites; 1,222 dyads were randomly assigned to an intervention or a control condition. The caregiver sample was 18.6% male with an average age of 62.3 years (56% Caucasian, 24% Black, and 19% Hispanic). Caregivers reported high levels of depressive symptoms and moderate burden. Care recipients were older, with a mean age of 79, and were moderately to severely impaired with mean Mini-Mental State Exam scores of 13/30.