Analyzing aphasia data in a multidimensional symptom space

The utility of single-case vs. group studies has been debated in neuropsychology for many years. The purpose of the present study is to illustrate an alternative approach to group studies of aphasia, in which the same symptom dimensions that are commonly used to assign patients to classical taxonomies (fluency, naming, repetition, and comprehension) are used as independent and continuous predictors in a multivariate design, without assigning patients to syndromes. One hundred twenty-six Italian-speaking patients with aphasia were first classified into seven classic aphasia categories, based on fluency, naming, auditory comprehension, and repetition scales. There were two goals: (1) compare group analyses based on aphasia types with multivariate analyses that sidestep classification and treat aphasic symptoms as continuous variables; (2) present correlation-based outlier analyses that can be used to identify individuals who occupy unusual positions in the multivariate "symptom space." In the service of the first goal, group performance on an external validation measure (the Token Test) was assessed in three steps: analyses of variance based on aphasia type, regressions using the same cut-offs for fluency, naming, comprehension and repetition as independent but dichotomous predictors, and regressions using the same subscales as continuous predictors (with no cut-offs). More variance in Token Test performance was accounted for when symptoms were treated as continuous predictors than with the other two methods, though use of independent but dichotomous predictors accounted for more variance than aphasia taxonomies. Thus, if we by-pass classical taxonomies and treat patients as points in a multidimensional symptom space, better predictions are obtained. Outlier analyses show that group results depend on heterogeneity among patients, which can be used as a search tool to identify potentially interesting dissociations. Hence this multivariate group approach is complementary to and compatible with single-case methods.     

The effects of prenatal maternal stress on children's cognitive development: Project Ice Storm

There exists considerable research on the effects of prenatal maternal stress on offspring. Animal studies, using random assignment to experimental and control groups, demonstrate the noxious effects of prenatal maternal stress on physical, behavioural and cognitive development. The generalizability of these results to humans is problematic given that cognitive attributions moderate reactions to stressors. In humans, researchers have relied upon maternal anxiety or exposure to life events as proxies for the stressors used with animals. Yet, the associations between maternal anxiety or potentially non-independent life events and problems in infants are confounded by genetic transmission of temperament from mother to child. We summarize the literature on prenatal maternal stress and infant cognitive development, leading to the conclusion that the human literature lacks the ability to separate the effects of the objective exposure to a stressor and the mother's subjective reaction. We then describe our prospective Project Ice Storm in which we are following 150 children who were exposed in utero to a natural disaster. We demonstrate significant effects of the objective severity of exposure on cognitive and language development at age two years with important moderating effects of the timing during pregnancy. The implications of our findings are discussed.     

Nursing and psychological treatments

Presents a comment on "Psychological Treatments" by D. H. Barlow. In his article, Barlow pointed to the need "to solidify the identification of psychology as a health care profession" by changing the terminology of practice in the health care context from psychotherapy to psychological treatments and suggested that the only persons qualified to carry out such interventions are doctoral-level psychologists. Unfortunately, there was no discussion of the health care professionals who already provide psychological treatments in health care settings and their contribution to the evidence base supporting such treatment. The authors find several aspects of the article to be problematic. Overall, the authors feel that suggesting that psychology should claim treatment of psychological disorders and psychological components of physical disorders in health care settings as exclusively its own domain ignores the research and clinical contributions of others.     

The role of the bereavement group in the face of 9/11: a self-psychology perspective

The sudden traumatic loss of a spouse equates to an assault on self and the loss of both an internal and external self-object. Mourning requires compensatory self-objects to help in the restoration of self and in the creation of new self-structure. The catastrophe of 9/11 not only assaulted thousands with unanticipated traumatic loss, but also devastated the usual networks of support. In this light, the bereavement group became a valuable venue for self-restoration and recovery. In her group work with 9/11 corporate and uniformed service widows, the author applies a self-psychology perspective that considers that empathic immersion not only affords safety and stabilization, but the opportunity to have self-object needs met in a process that restores and develops self-structure. She proposes the bereavement group as a cohesive self-object milieu serving mirroring, twinship, and idealizing needs. Drawing upon clinical examples, she illuminates the capacity of the group to establish safety, regulate affect, reduce isolation and shame, rekindle memory, and foster coping skills. As such, the group affords a restoration of the assaulted self, an integration of the loss, and an emerging redefinition of self.     

Do behavioral disturbances in persons with Alzheimer's disease predict caregiver depression over time?

Random effects models were used to examine the association between behavioral disturbances in persons with Alzheimer's disease (N = 90) and caregiver depressive symptoms at 2-month intervals over an 18-month period. There was substantial variability in trajectories of change in caregiver depressive symptoms over time but no systematic increase in distress despite increased severity of dementia symptoms. Total behavioral disturbances were associated with higher levels of caregiver depressive symptoms: this effect was primarily attributable to aggressive behaviors. No consistent departure from linearity was evident in the relationship between behavior and depression over time.     

Preserved spatial memory over brief intervals in older adults

Two studies compared young and older adults' memory for location information after brief intervals. Experiment 1 found that accuracy of intentional spatial memory for individual locations was similar in young and older participants for set sizes of 3 and 6. Both groups also encoded individual locations in relation to the larger configuration of locations. Experiment 2 showed that like young adults, older adults' latency to respond to a test probe in a letter working memory task was negatively influenced by spatial information that was irrelevant to the task. This interference effect indicated preserved incidental memory for spatial information in older adults. Together, these data suggest that initial encoding of spatial information for relatively small numbers of items is largely preserved in healthy older adults and that representations of spatial information persist over short intervals.     

Levels of abstraction in orangutan (Pongo abelii) categorization

Levels of abstraction have rarely been manipulated in studies of natural concept formation in nonhumans. Isolated examples have indicated that animals, relative to humans, may learn concepts at varying levels of abstraction with differential ease. The ability of 6 orangutans (Pongo abelii) of various ages to make natural concept discriminations at 3 levels of abstraction was therefore investigated. The orangutans were rewarded for selecting photos of orangutans instead of humans and other primates (concrete level), primates instead of other animals (intermediate level), and animals instead of nonanimals (abstract level) in a 2-choice touch screen procedure. The results suggest that, like a gorilla (Gorilla gorilla gorilla) tested previously (Vonk & MacDonald, 2002), orangutans can learn concepts at each level of abstraction, and unlike other nonhumans, most of these subjects rapidly learned the intermediate level discrimination.     

Effectiveness of training in organizations: a meta-analysis of design and evaluation features

The authors used meta-analytic procedures to examine the relationship between specified training design and evaluation features and the effectiveness of training in organizations. Results of the meta-analysis revealed training effectiveness sample-weighted mean ds of 0.60 (k = 15, N = 936) for reaction criteria, 0.63 (k = 234, N = 15,014) for learning criteria, 0.62 (k = 122, N = 15,627) for behavioral criteria, and 0.62 (k = 26, N = 1,748) for results criteria. These results suggest a medium to large effect size for organizational training. In addition, the training method used, the skill or task characteristic trained, and the choice of evaluation criteria were related to the effectiveness of training programs. Limitations of the study along with suggestions for future research are discussed.     

Memory enhancement for emotional words: Are emotional words more vividly remembered than neutral words?

Individuals are more likely to remember negative information than neutral information. In the experiments reported here, we examined whether individuals were also more likely to remember details of the presentation of negative words, as compared with neutral words. In Experiment 1, the remember-know procedure was used to examine the effect of emotion on the vividness of an individual's memory, showing that remember responses were more frequently assigned to negative words than neutral words. In Experiment 2, a source memory paradigm was used, and again, evidence that individuals' memories were more detailed for negative than for neutral words was found. In Experiments 3-6, we examined the relative contribution of valence and arousal, finding that both dimensions increased the vividness of remembered information (i.e., items with valence only and those that elicited arousal were better remembered than neutral information) but that the effect was greater for words that evoked arousal than for those with valence only. The results support a qualitative, as well as a quantitative, memory benefit for emotional, as compared with neutral, words.     

Psychoeducation and managed care: Clinical issues for the 1990s

Managed care has challenged mental health professionals to develop more efficient ways of addressing patient care needs. Psychoeducational programs, for patients and their families, have emerged as a medium by which relevant education and mutual support can be provided to participants. A review of the literature, a comprehensive model of psychoeducation, and the advantages of such models within the managed care program are offered. Also addressed are issues and import, treatment and research considerations.