Implicit trust in clinical decision-making by multidisciplinary teams

Synthese - In clinical practice, decision-making is not performed by individual knowers but by an assemblage of people and instruments in which no one member has full access to every piece of...     

Positive aspects of voice-hearing: a qualitative metasynthesis

Voice-hearing occurs in clinical and non-clinical samples, and the role of spiritual and cultural frameworks of understanding for percipients has received increased attention. This review aimed to identify and synthesise the existing qualitative literature relating to positive aspects of voice-hearing experiences, and to make recommendations based on these findings for clinical practice and future research. Qualitative papers that included positive aspects of voice-hearing were identified by undertaking a systematic search of six electronic databases, resulting in 22 papers. The quality of each paper was assessed and the meta-ethnographic approach was used to extract and synthesise the data. Six themes were identified relating to voices providing safety and protection, guidance, creating psychological and emotional well-being, providing companionship, facilitating personal growth and development, and connecting hearers to religious or spiritual belief systems. The findings suggest positive aspects of voice-hearing that may have clinical and research implications.     

Effects of therapy balls on children diagnosed with attention deficit hyperactivity disorder

Therapy balls are air‐filled rubber balls ranging from 20 to 30 in. in diameter that are sometimes used in place of traditional 4‐legged chairs in classrooms. Unfortunately, research on the effects of therapy balls as chairs is limited. Therefore, this study evaluated the effects of therapy balls on the on‐task behavior and academic performance of elementary students diagnosed with Attention Deficit Hyperactivity Disorder. An alternating treatments design was implemented with 4 students from the 3rd and 4th grades comparing therapy ball seating to traditional classroom chairs. No effect of the therapy balls was found, although students preferred sitting on the therapy balls. Teachers reported that the therapy balls were difficult to use and did not find them particularly effective.     

The Influence of Major Life Events and Personality Traits on the Stability of Affective Well-Being

The current study examines the influence of major life events compared to personality traits on the stability of affective well-being (AWB). It is shown how the decomposition of autocovariances can be used to estimate the degree of stability that is due to life events and personality traits. The approach is illustrated by an analysis of data from a nationally representative Australian sample with four consecutive waves of measurement. The autocovariances of positive and negative mood served as indicators of the stability of AWB. Big five personality traits as well as 21 major life events were used as predictor variables in a path analysis. In comparison to previous studies, this allowed to directly compare the effects of multiple events to the influence of personality traits in a longitudinal design. Results indicated medium stability coefficients for AWB. Ca. 10 % of the autocovariances could be accounted for by life events and about 20 % by personality traits. Both types of predictors together accounted for about 30 %. Among personality traits, emotional stability followed by extraversion had the highest effects. Among life events “financial worsening” and “serious personal injury/illness” had the highest effects. Additionally, life events were significantly correlated with personality traits as well as with other life events. In a next step, it might be interesting to compare the influence of Big Five personality traits and stable life circumstances on the stability of the cognitive well-being component, using a similar statistical procedure. Also, as the number of variables in large panel studies is limited, results should be complemented by more in-depth studies, favourably using multi-method approaches.     

Integrated cross-network connectivity of amygdala,insula, and subgenual cingulate associated with facial emotion perception in healthy controls and remitted major depressive disorder

Emotion perception deficits could be due to disrupted connectivity of key nodes in the salience and emotion network (SEN), including the amygdala, subgenual anterior cingulate cortex (sgACC), and insula. We examined SEN resting-state (rs-)fMRI connectivity in rMDD in relation to Facial Emotion Perception Test (FEPT) performance. Fifty-two medication-free people ages 18 to 23 years participated. Twenty-seven had major depressive disorder (MDD) in remission (rMDD, 10 males), as MDD is associated with emotion perception deficits and alterations in rsfMRI. Twenty-five healthy controls (10 males) also participated. Participants completed the FEPT during fMRI, in addition to an 8-minute eyes-open resting-state scan. Seed regions of interest were defined in the amygdala, anterior insula and sgACC. Multiple regression analyses co-varied diagnostic group, sex and movement parameters. Emotion perception accuracy was positively associated with connectivity between amygdala seeds and regions primarily in the SEN and cognitive control network (CCN), and also the default mode network (DMN). Accuracy was also positively associated with connectivity between the sgACC seeds and other SEN regions, and the DMN, particularly for the right sgACC. Connectivity negatively associated with emotion perception was mostly with regions outside of these three networks, other than the left insula and part of the DMN. This study is the first to our knowledge to demonstrate relationships between facial emotion processing and resting-state connectivity with SEN nodes and between SEN nodes and regions located within other neural networks.     

Competition between rhythmic and linguistic meaning revisited: the effect of task demands

This paper revisits the conclusion of our previous work regarding the dominance of meaning in the competition between rhythmic parsing and linguistic parsing. We played five-note rhythm patterns in which each sound is a spoken word of a five-word sentence. We asked listeners to indicate the starting point of the rhythm while disregarding which word would normally be heard as the first word of the sentence. In four studies, we varied task demands by introducing differences in rhythm complexity, rhythm ambiguity, rhythm pairing, and semantic coherence. We found that task complexity affects the dominance of meaning. We therefore amend our previous conclusion: when processing resources are taxed, listeners do not always primarily attend to meaning; instead, they primarily attend to the aspect of the pattern (rhythm or meaning) that is more salient.     

Understanding the ‘blind spot’ when children move from foster care into adoption‡

Current social work practice in the UK dictates that when children move from foster care into adoption, the transition takes place within 7 and 14 days, and usually there is no contact between the child and their former carer for several months after the move, if at all. Very little attention or research has been aimed at understanding the rationale for these procedures, or their impact on the children. Joining forces with social work colleagues in a Looked After Children’s team, two child psychotherapists carried out a piece of qualitative research to look at these moves in more detail, and try to tease out how and why these key decisions are made. Analysing data from interviews with foster carers, adopters and social workers, the researchers found that the emotional experience of the child, particularly their experience of losing their foster carer, loses centre stage in people’s minds during this transition, leading to what is described as a ‘blind spot’ across the network. A significant reason for this emerged, in that the children tended to be very compliant both during and after the move and lacking in any obvious distress at losing their former carers, despite having previously been described as passionately attached to them. The research showed that adults across the network, all struggling with intense anxieties of their own, tended to interpret this as evidence that the children were ‘fine’ rather than questioning what might be going on at a deeper level. These research findings are explored in the light of a knowledge base accumulated from a working understanding of attachment and loss in early childhood, and of the psychoanalytical phenomena of individual and organisational defences against loss. Implications for future practice are suggested.     

Profiling Perceptual Learning Styles of Chinese as a Second Language Learners in University Settings

This study revisited Reid’s (1987) perceptual learning style preference questionnaire (PLSPQ) in an attempt to answer whether the PLSPQ fits in the Chinese-as-a-second-language (CSL) context. If not, what are CSL learners’ learning styles drawing on the PLSPQ? The PLSPQ was first re-examined through reliability analysis and confirmatory factor analysis (CFA) with 224 CSL learners. The results showed that Reid’s six-factor PLSPQ could not satisfactorily explain the CSL learners’ learning styles. Exploratory factor analyses were, therefore, performed to explore the dimensionality of the PLSPQ in the CSL context. A four-factor PLSPQ was successfully constructed including auditory/visual, kinaesthetic/tactile, group, and individual styles. Such a measurement model was cross-validated through CFAs with 118 CSL learners. The study not only lends evidence to the literature that Reid’s PLSPQ lacks construct validity, but also provides CSL teachers and learners with insightful and practical guidance concerning learning styles. Implications and limitations of the present study are discussed.     

Subjective age and sleep in middle-aged and older adults

Objective: Chronological age is commonly used to explain change in sleep. The present study examines whether subjective age is associated with change in sleep difficulties across middle adulthood and old age.

Design: Participants were drawn from the second (2004–2005) and third (2013–2014) waves of the Midlife in the United States Survey (MIDUS, N = 2350; Mean Age: 55.54 years), the 2008 and 2014 waves of the Health and Retirement Study (HRS, N = 4066; Mean Age: 67.59 years) and the first (2011) and fourth (2014) waves of the National Health and Aging Trends Survey (NHATS, N = 3541; Mean Age: 76.46). In each sample, subjective age, sleep difficulties, depressive symptoms, anxiety and chronic conditions were assessed at baseline. Sleep difficulties was assessed again at follow-up.

Main outcome measures: Sleep difficulties.

Results: An older subjective age at baseline was related to an increase in sleep difficulties over time in the three samples, and was mediated, in part, through more depressive symptoms, anxiety and chronic conditions. Feeling older was associated with an increased likelihood of major sleeping difficulties at follow-up in the three samples.

Conclusion: Subjective age is a salient marker of individuals’ at risk for poor sleep quality, beyond chronological age.