Feasibility of Adapting Multisystemic Therapy to Improve Illness Management Behaviors and Reduce Asthma Morbidity in High Risk African American Youth: A Case Series

African-American adolescents have the highest rates of asthma morbidity and mortality, yet there are few successful behavioral interventions to improve illness management for this group. Mental health providers have an opportunity to expand their services and impact by targeting adolescents with poor asthma management. We describe the adaptation of Multisystemic Therapy (MST), an intensive, home and community-based treatment originally used with antisocial youth, for improving asthma management. We present a case study to illustrate the treatment model. Feasibility was demonstrated with eight African American adolescents with chronic, persistent asthma, suggesting that further evaluation of MST for youth with asthma and poor illness management is warranted.     

Les unités de soins intensifs psychiatriques (USIP) : expériences françaises et internationales

Psychiatric Intensive Care Units (PICU) propose a secure setting for patients with acute behavior disturbances who can not be managed in psychiatric general wards. Physical violence acts against patients or hospital staff, substance abuse, non-compliance for care and treatment, intensity of symptoms or absconding are frequent motives for admission. Patients are compulsorily detained in secure conditions. They are admitted from psychiatric facilities of a health area or by agreement between hospitals. Multidisciplinary working in psychiatric intensive care is essential, delivered by qualified staff. Care and treatment must be centered on the patient, multidisciplinary, intensive, comprehensive with an immediacy of response to critical situations. As length of stay should not exceed 2 months in duration, interface and liaison with original services of patients are important issues. In France, PICU exist notably at Cadillac, Lyon, Paris, Nice, Eygurande, Montpellier, Pau and Prémontré. These facilities appear as a missing level, an interesting alternative in mental health care system, between psychiatric general wards and maximum security hospitals. This paper reports the creation of a National Association of PICU in France, the existence of national minimum standards and international experiences.     

What is the best and easiest method of preventing counting in different temporal tasks?

The aim of the present study was to determine the best and easiest method of suppressing spontaneous counting in a temporal judgment task. Three classic methods used to avoid counting—instructions not to count, articulatory suppression, and administration of an interference task—were tested in temporal generalization, bisection, and reproduction tasks with two duration ranges (1–4 and 2–8 s). All the three no-counting conditions prevented participants from counting, counting leading to estimates that were more accurate and less variable and to violations of the fundamental scalar property of timing. With regard to the differences between the no-counting conditions, the interference task distorted time perception more strongly and increased variability in temporal estimates to a greater extent than did articulatory suppression, as well as the no-counting instructions condition. In addition, articulatory suppression produced more noise in behavioral outcome than did the no-counting instruction condition. In sum, although all methods have disadvantages, the instructions not to count actually constitute the simplest and more efficient method of preventing counting in timing tasks. However, further studies must now concentrate on the role of explicit instructions in our experience of perception.     

Evaluating the coordination dynamics of handwriting

This study aims to test the hypothesis that handwriting is governed by the dynamics of non-linear coupled oscillators. Accordingly, its first goal is to identify preferred, basic graphic shapes corresponding to spontaneously stable combinations of the two frequency-locked oscillatory x-y components of the trajectories. Six participants were required to produce 26 ellipsoids of varying eccentricities and orientations presented consecutively on a graphic tablet. These shapes corresponded to a systematic manipulation of the relative phase and the relative amplitude of the oscillators by a constant step. Results showed that among those, only eight ellipsoids were produced in a spontaneous and stable fashion. They were characterized by attraction of nearby shapes, and by a higher accuracy and velocity. Alike all periodic motion, graphic skills, hence handwriting, exhibit preferred coordination patterns, which can be ascribed to the non-linear coupling of two oscillators.     

Evening and morning EEG differences between young men and women adults

Evening and morning waking EEG (eyes closed) was recorded in 16 women and 13 men aged 18-26 years old. Participants were fitted with a 13-electrode montage (Fp1, Fp2, FZ, F7, F8, C3, C4, T3, T4, P3, P4, O1, and O2) referred to linked ears. For each recording electrode, EEG total spectral amplitude power (microV/Hz, 0.75-19.75 Hz) was compared using 2 (Gender) x 2 (Moments) analyses of variance for repeated measures and LSD post-hoc tests. We found significant simple Gender effects, with women displaying higher EEG values for Central, Frontal, Parietal, and left Temporal leads. Simple Moment effects were also found, with lower morning values in Temporal and left Frontal recording sites. A Gender x Moment interaction was found at the right Frontal recording site. No significant effects were found for Prefrontal and Occipital recording sites, whatsoever. These results bring new understandings of gender and time of day effects in waking EEG and point to different sensitivity in different cortical areas. The present results could explain some of the observations related to gender differences in cognitive performance.     

Short-term memory for time in children and adults: A behavioral study and a model

This experiment investigated the effect of the short-term retention of duration on temporal discrimination in 5- and 8-year-olds, as well as in adults, by using an episodic temporal generalization task. In each age group, the participants' task was to compare two successive durations (a standard and a comparison duration) separated by a retention interval of 500ms, 5s, or 10s, with the order of presentation of these two durations being counterbalanced. The results revealed a shortening effect for the first presented stimulus in all of the age groups, although this was greater in the younger children, thereby indicating the presence of a negative time-order error. Furthermore, introducing a retention delay between the two durations did not produce a shortening effect but instead flattened the generalization gradient, especially in the younger children. However, this flattening of the generalization gradient with the retention delay was more marked between 500ms and 5s than between 5s and 10s. Thus, retaining the first duration in short-term memory during a task requiring the comparison of two successive durations reduced temporal discrimination accuracy and did so to a greater extent in the younger children.     

The effects of interference and retention delay on temporal generalization performance

This study investigated the effect of forgetting of the standard duration on temporal discrimination in a generalization task. In two experiments, participants were given a temporal generalization task with or without a retention delay between the learning of the standard duration and the testing of the comparison durations. During this delay, they either performed or did not perform an interference task. Results failed to reveal any effect of 15-min and 24-h retention delays on time judgments (Experiment 1). However, when an interference task was performed during the 15-min delay (Experiment 2), there was a subjective shortening effect, indicating that the standard duration was judged shorter with than without an interference task. These findings suggest that when an interference task occurs immediately after initial temporal encoding, it affects the process of consolidation in reference memory.     

Facial Reactions to Emotional Facial Expressions: Affect or Cognition?

This study investigated whether observers' facial reactions to the emotional facial expressions of others represent an affective or a cognitive response to these emotional expressions. Three hypotheses were contrasted: (1) facial reactions to emotional facial expressions are due to mimicry as part of an affective empathic reaction; (2) facial reactions to emotional facial expressions are a reflection of shared affect due to emotion induction; and (3) facial reactions to emotional facial expressions are determined by cognitive load depending on task difficulty. Two experiments were conducted varying type of task, presentation of stimuli, and task difficulty. The results show that depending on the nature of the rating task, facial reactions to facial expressions may be either affective or cognitive. Specifically, evidence for facial mimicry was only found when individuals made judgements regarding the valence of an emotional facial expression. Other types of judgements regarding facial expressions did not seem to elicit mimicry but may lead to facial responses related to cognitive load.     

African American Adolescent-Caregiver Relationships in a Weight Loss Trial

Successful family-based weight loss interventions for African American adolescents are rare. Parent-adolescent interactions supporting adoption of healthier nutrition and physical activity practices are not well understood. African American caregivers' and adolescents' perspectives on how they worked together to achieve weight loss need further exploration. This study describes the relationships experienced by adolescents and caregivers during the 6-month, evidence-based FIT Families weight loss trial and explores differences between families whose adolescents were successful and unsuccessful with weight loss. Exit interviews conducted with 136 adolescents (age 12–16 years; BMI percentile ≥95) and their caregivers (primarily mothers) were taped and transcribed verbatim. Content and thematic analysis was conducted to explore differences between groups stratified by weight loss. Five adolescent-caregiver relationship patterns emerged which describe dyads working together, working alone, working against each other; caregiver support and caregiver working on self. When relationship patterns were compared between groups stratified by weight loss, three themes emerged: motivation, support, and persistence. Families that achieved the greatest weight loss referred more often to working together to reach weight loss goals, attributed their success to adolescent self-motivation, with engaged caregiver support which allowed families to persist in change efforts. Family relationships involving adolescent autonomy, engaged parental support, and persistence despite challenges, clustered differently among adolescents who were successful at weight loss compared to those who were not. Interventionists trained to reinforce effective adolescent-parent interactions will advance behavioral interventions for families who have typically benefited least in prior interventions.