Treatment of panic disorder with agoraphobia: randomized placebo-controlled trial of four psychosocial treatments combined with imipramine or placebo

Few randomized controlled trials have included panic disorder patients with moderate to severe agoraphobia. Therefore, this population was studied using pharmacotherapy as well as psychotherapy. At the time of the study, imipramine was widely used as a pharmacological treatment. Also, current practice guidelines for patients with panic disorder find selective serotonin reuptake inhibitors and tricyclic antidepressants roughly comparable in terms of efficacy. Therefore, the main objective of this study is to compare four psychosocial treatments-cognitive and graded in vivo exposure treatments, graded in vivo exposure, cognitive treatment, and supportive therapy-to evaluate the benefits of combining cognitive therapy with exposure in vivo. These treatments were combined with imipramine or placebo for a total of eight experimental conditions. Participants presented moderate to severe agoraphobia. The method involved a randomized, double-blind, placebo-controlled trial with 137 participants who completed a 14-session protocol involving the treatments just mentioned. Measures were taken at baseline and posttreatment and at 3-, 6-, and 12-month follow-up. All treatment conditions were statistically and clinically effective in reducing self-reported panic-agoraphobia symptoms over the 1-year follow-up. No statistical differences were observed between imipramine and placebo conditions. This study found that all treatment modalities helped reduce panic and agoraphobic symptomatology over a 1-year follow-up period. These surprising results support the need to document the relations among the various components of an intervention. This would make it possible to assess the relative efficacy of the treatment components rather than of the intervention as a whole.     

Effect of arousal on internal clock speed in real action and mental imagery.

The possible implication of an internal clock as a mechanism accounting for the temporal homology between actual and mental walking is studied. To observe this phenomenon, stressful sound stimuli were used to increase arousal, which is known to activate the internal clock. Seventeen participants performed three tasks: (1) a time production task, used as a reference task reflecting the internal clock speed; (2) an actual walking task; and (3) a mental walking task, all three in two sound conditions (no noise and noise). The results showed a significant effect of arousal on time in each task. The effect of noise, increasing the arousal level, was greater in time production and mental imagery tasks than in real action. In addition, the percentages of change between the two sound conditions for actual and mental walking time were not statistically different. These findings are further evidence of the existence of a timing process common to actual and mental walking. The data are consistent with the implication of an internal clock in both actual and mental walking.     

‘Undecidability’ or ‘anticipatory resoluteness’ Caputo in conversation with Heidegger

In this article I will consider John D. Caputo’s hermeneutics of deconstruction or what he calls ‘radical hermeneutics’, with ‘undecidability’ as its major theme, in conversation with Martin Heidegger’s notion of ‘resolute existence’. Through an examination of the different positions of Caputo, Heidegger, and also Kierkegaard, Derrida and Meister Eckhart on the possibility of repetition, the hermeneutical circle and the mystical way of prayer and faith, I am arguing that deconstruction is not the end of hermeneutics, it is not the final destination of an interpretative task, and thus deconstructive hermeneutics has to concede a reconstructive process. Further, I am arguing that Caputo’s ‘radical hermeneutics’ is too reductionist to keep any meaning for the hermeneutic enterprise to aspire to. I am contending, rather, that it is resolute existence that theology aspires to as it is a move beyond ‘undecidability’.     

Neuropsychological Measures that Predict Progression from Mild Cognitive Impairment to Alzheimer's type dementia in Older Adults: a Systematic Review and Meta-Analysis

This study aimed to determine the extent to which cognitive measures can predict progression from mild cognitive impairment (MCI) to Alzheimer’s type dementia (AD), assess the predictive accuracy of different cognitive domain categories, and determine whether accuracy varies as a function of age and length of follow-up. We systematically reviewed and meta-analyzed data from longitudinal studies reporting sensitivity and specificity values for neuropsychological tests to identify individuals with MCI who will develop AD. We searched articles in Medline, Cochrane, EMBASE, PsycINFO, and the Web of Science. Methodological quality was assessed using the STARDem and QUADAS standards. Twenty-eight studies met the eligibility criteria (2365 participants) and reported predictive values from 61 neuropsychological tests with a 31-month mean follow-up. Values were pooled to provide combined accuracy for 14 cognitive domains. Many domains showed very good predictive accuracy with high sensitivity and specificity values (≥ 0.7). Verbal memory measures and many language tests yielded very high predictive accuracy. Other domains (e.g., executive functions, visual memory) showed better specificity than sensitivity. Predictive accuracy was highest when combining memory measures with a small set of other domains or when relying on broad cognitive batteries. Cognitive tests are excellent at predicting MCI individuals who will progress to dementia and should be a critical component of any toolkit intended to identify AD at the pre-dementia stage. Some tasks are remarkable as early indicators, whereas others might be used to suggest imminent progression.     

Professional Journeys of International Medical Graduates in Quebec: Recognition,Uphill Battles,or Career Change

In Quebec and Canada, immigration policies are designed to attract “the best and the brightest.” Once migration occurs, however, the “brain waste” is challenging. This research focuses on the professional trajectories of international medical graduates (IMG) who migrate to Quebec. The main goal is to understand why certain individuals of a similar occupational group can easily access the doctoral profession while others cannot. Following a qualitative approach, and stemming from IMGs’ perspectives, this article explores the interplay of economic, social, and symbolic resources in a context of highly fragmented institutional resources and protectionism. We are critical of the individual-centered approaches that ignore social norms and constraints. If migrants are free to choose their paths and manner of integration, the “human capital” approach is limited in explaining the heterogeneous pathways within the same professional group. The current structure for professional recognition places unusual constraints on IMGs, whereby some encounter more obstacles than others. The “battle” for professional recognition takes shape in a highly competitive context, one which—although presented as a neutral process—is underlain with ideological, relational, and subjective currents.     

Parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China

The objective of this study was to examine the relationship between parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China. In this study, cross-sectional data were collected from 755 AIDS orphans (296 double orphans and 459 single orphans), 466 vulnerable children living with HIV-infected parents, and 404 comparison children in China. The trusting relationship with current caregivers was measured with a 15-item scale (Cronbach's α?=?0.84) modified from the Trusting Relationship Questionnaire developed by Mustillo et al. in 2005 (Quality of relationships between youth and community service providers: Reliability and validity of the trusting relationship questionnaire. Journal of Child and Family Studies, 14, 577-590). The psychosocial measures include rule compliance/acting out, anxiety/withdrawal, peer social skills, school interest, depressive symptoms, loneliness, self-esteem, future expectation, hopefulness about future, and perceived control over the future. Group mean comparisons using analysis of variance suggested a significant association (p?相似文献   

Brand names on packaging and their impact on purchase preference

This study examines whether appearance of corporate, product and dual brand names (or a combination of brand names used together) on packaging influence consumer purchase preference. The face‐to‐face survey consists of consumers rating their purchase preference on a 7‐point scale sixteen random brand names, and combinations of brand names on packaging along with three different prices, each for two product categories: chocolate and cereals – a total of 4032 observations are examined. Hypotheses are tested using multiple linear regression models. The findings show corporate, product and dual brand names have little impact on purchase preference per se, instead brand category dominance influence consumer choice, and corporate names do not add value as previously thought. The study suggests trends and contexts in which, a corporate name and a product brand name may be extended to optimise consumer brand associations and influence purchase, as well as strategies for extending in remote product categories. Future research needs focusing on international consumers' response on brand linkages in the international arena, and the issues of brand building and brand equity maintenance in international markets. The study makes contribution to brand extension, brand portfolio management and strategic brand management research. Copyright © 2011 John Wiley & Sons, Ltd.     

Colour, face, and visuospatial imagery abilities in low-vision individuals with visual field deficits

This study investigates to what extent visual perception integrity is necessary for visual mental imagery. Sixteen low-vision participants with severe peripheral visual field loss, 16 with severe central field loss, 6 left brain-damaged patients with right homonymous hemianopia, 6 right brain-damaged patients with left homonymous hemianopia, and 16 normally sighted controls performed perceptual and imagery tasks using colours, faces, and spatial relationships. Results showed that (a) the perceptual and mental image>ry disorders vary according to the type of visual field loss, (b) hemianopics had no more difficulties imagining spatial stimuli in their contralesional hemispace than in their ipsilesional one, and (c) the only hemianopic participant to have perceptual and mental imagery impairments suffered from attentional deficits. Results suggest that (a) visual memory is not definitively established, but rather needs perceptual practice to be maintained, and (b) that visual mental imagery may involve some of the attentional-exploratory mechanisms that are employed in visual behaviour.     

Coordination dynamics of elliptic shape drawing: effects of orientation and eccentricity

The aim of the present study was to show the effect of orientation on producing ellipses of various eccentricities. Ten right-handed adults were required to reproduce eight series of 84 ellipses on a graphic tablet at spontaneous speed. The ellipses displayed seven eccentricities, corresponding to the Lissajous plot produced by two orthogonal harmonic oscillators whose relative phase (RP) varied from 0° (a line) to 90° (a circle), and twelve orientations, the long axis of the ellipses aligned in a direction ranging from three to nine o’clock with respect to the body transverse plane. Results confirmed the participant’s preference for two eccentricities, 0° and 45°, that is, a line and an ellipse of intermediate eccentricity, respectively. Except for the circle, insensitive to orientation by definition, orientation became a cogent constraint: In the 10:30 o’clock direction, line drawing (0° RP) increased in variability and the intermediate ellipse (45° RP) was attracted towards a circle (90° RP). These findings suggest an interaction between orientation effects, putatively due to differences in the motion of the wrist and fingers, and eccentricity effects, which may pertain to preferences arising from the non-linear coupling between the effectors.     

The beneficial effect of synchronized action on motor and perceptual timing in children

We examined the role of action in motor and perceptual timing across development. Adults and children aged 5 or 8 years old learned the duration of a rhythmic interval with or without concurrent action. We compared the effects of sensorimotor versus visual learning on subsequent timing behaviour in three different tasks: rhythm reproduction (Experiment 1), rhythm discrimination (Experiment 2) and interval discrimination (Experiment 3). Sensorimotor learning consisted of sensorimotor synchronization (tapping) to an isochronous visual rhythmic stimulus (ISI = 800 ms), whereas visual learning consisted of simply observing this rhythmic stimulus. Results confirmed our hypothesis that synchronized action during learning systematically benefitted subsequent timing performance, particularly for younger children. Action‐related improvements in accuracy were observed for both motor and perceptual timing in 5 years olds and for perceptual timing in the two older age groups. Benefits on perceptual timing tasks indicate that action shapes the cognitive representation of interval duration. Moreover, correlations with neuropsychological scores indicated that while timing performance in the visual learning condition depended on motor and memory capacity, sensorimotor learning facilitated an accurate representation of time independently of individual differences in motor and memory skill. Overall, our findings support the idea that action helps children to construct an independent and flexible representation of time, which leads to coupled sensorimotor coding for action and time.