Psychological treatment of eating disorders

Significant progress has been achieved in the development and evaluation of evidence-based psychological treatments for eating disorders over the past 25 years. Cognitive behavioral therapy is currently the treatment of choice for bulimia nervosa and binge-eating disorder, and existing evidence supports the use of a specific form of family therapy for adolescents with anorexia nervosa. Important challenges remain. Even the most effective interventions for bulimia nervosa and binge-eating disorder fail to help a substantial number of patients. A priority must be the extension and adaptation of these treatments to a broader range of eating disorders (eating disorder not otherwise specified), to adolescents, who have been largely overlooked in clinical research, and to chronic, treatment-resistant cases of anorexia nervosa. The article highlights current conceptual and clinical innovations designed to improve on existing therapeutic efficacy. The problems of increasing the dissemination of evidence-based treatments that are unavailable in most clinical service settings are discussed.     

EEG mu rhythm and imitation impairments in individuals with autism spectrum disorder

Imitation ability has consistently been shown to be impaired in individuals with autism. A dysfunctional execution/observation matching system has been proposed to account for this impairment. The EEG mu rhythm is believed to reflect an underlying execution/observation matching system. This study investigated evidence of differential mu rhythm attenuation during the observation, execution, and imitation of movements and examined its relation to behaviorally assessed imitation abilities. Fourteen high-functioning adults with autism spectrum disorder (ASD) and 15 IQ- and age-matched typical adults participated. On the behavioral imitation task, adults with ASD demonstrated significantly poorer performance compared to typical adults in all domains of imitation ability. On the EEG task, both groups demonstrated significant attenuation of the mu rhythm when executing an action. However, when observing movement, the individuals with ASD showed significantly reduced attenuation of the mu wave. Behaviorally assessed imitation skills were correlated with degree of mu wave attenuation during observation of movement. These findings suggest that there is execution/observation matching system dysfunction in individuals with autism and that this matching system is related to degree of impairment in imitation abilities.     

Early social attention impairments in autism: social orienting, joint attention, and attention to distress

This study investigated social attention impairments in autism (social orienting, joint attention, and attention to another's distress) and their relations to language ability. Three- to four-year-old children with autism spectrum disorder (ASD; n = 72), 3- to 4-year-old developmentally delayed children (n = 34), and 12- to 46-month-old typically developing children (n = 39), matched on mental age, were compared on measures of social orienting, joint attention, and attention to another's distress. Children with autism performed significantly worse than the comparison groups in all of these domains. Combined impairments in joint attention and social orienting were found to best distinguish young children with ASD from those without ASD. Structural equation modeling indicated that joint attention was the best predictor of concurrent language ability. Social orienting and attention to distress were indirectly related to language through their relations with joint attention. These results help to clarify the nature of social attention impairments in autism, offer clues to developmental mechanisms, and suggest targets for early intervention.     

Using taxometric analysis to distinguish a small latent taxon from a latent dimension with positively skewed indicators: the case of involuntary defeat syndrome

Joining the debate on the structure of depression, S. R. H. Bearh and N. Amir (2003) analyzed college students' responses to 6 Beck Depression Inventory (BDI) items with predominantly somatic content and concluded that they identified a small latent taxon corresponding to involuntary defeat syndrome. An exact replication of these analyses yielded virtually identical taxometric results, but parallel analyses of simulated taxonic and dimensional comparison data matching the intercorrelations and skewed distributions of the BDI items showed the results to be more consistent with dimensional than with taxonic latent structure. Analyses in a clinical sample with nonskewed indicators further supported a dimensional interpretation. The authors discuss methodological strategies for conducting and interpreting taxometric analyses under the adverse conditions commonly encountered in psychopathology research, including skewed indicators and small putative taxa.     

Use of the high-probability instructional sequence and escape extinction in a child with food refusal

We used the high-probability (high-p) instructional sequence with and without escape extinction in the treatment of food refusal. Acceptance increased and refusal decreased only with the introduction of escape extinction. These results raise important questions about the high-p sequence in the treatment of food refusal.     

A stage is a stage is a stage: a direct comparison of two scoring systems

L. Kohlberg (1969) argued that his moral stages captured a developmental sequence specific to the moral domain. To explore that contention, the author compared stage assignments obtained with the Standard Issue Scoring System (A. Colby & L. Kohlberg, 1987a, 1987b) and those obtained with a generalized content-independent stage-scoring system called the Hierarchical Complexity Scoring System (T. L. Dawson, 2002a), on 637 moral judgment interviews (participants' ages ranged from 5 to 86 years). The correlation between stage scores produced with the 2 systems was .88. Although standard issue scoring and hierarchical complexity scoring often awarded different scores up to Kohlberg's Moral Stage 2/3, from his Moral Stage 3 onward, scores awarded with the two systems predominantly agreed. The author explores the implications for developmental research.     

Neuropsychological Performance in Gulf War Era Veterans: Motivational Factors and Effort

Assuming that the underlying etiology of unexplained health-related symptoms in returning Gulf War (GW) veterans is multifactorial, the possible role of feigning or exaggeration of symptoms is worth consideration as a contributing factor. The present study assessed the relationship between motivation to perform well during neuropsychological assessment and objective neuropsychological test performance. Motivation was measured as the score on a visual memory task (Test of Memory Malingering, TOMM) of low difficulty. Participants included 77 veterans from the cohorts of GW- (n = 58) and Germany-deployed (n = 19) GW-era veterans described in two other papers in this issue who were administered the TOMM. Most veterans earned perfect or near-perfect scores on the TOMM (48–50/50). Scores 47 were associated with lower scores on neuropsychological tasks assessing attention, executive functions, and memory. Variability in test performance within and between tasks measuring similar functions was also found in participants with lower TOMM scores.     

Haptic tracking permits bimanual independence

This study shows that in a novel task-bimanual haptic tracking-neurologically normal human adults can move their 2 hands independently for extended periods of time with little or no training. Participants lightly touched buttons whose positions were moved either quasi-randomly in the horizontal plane by 1 or 2 human drivers (Experiment 1), in circle and square patterns in the vertical plane by 2 human drivers (Experiment 2), or at different frequencies in the horizontal plane by 2 human drivers (Experiment 3). Bimanual contact was maintained equally well in all conditions even though in Experiment 1 the left- and right-hand motions were uncorrelated (in the 2-driver condition), in Experiment 2 the left- and right-hand motions were spatially incongruous when circles and squares were tracked at the same time, and in Experiment 3 the left- and right-hand motions maintained different frequency ratios. Because haptic tracking has revealed that humans can in fact move their 2 hands independently, it may have potential as a new behavioral tool for revealing other perceptual-motor capabilities.     

Older spouses' perceptions of partners' chronic arthritis pain: implications for spousal responses, support provision, and caregiving experiences

This study of older patients with osteoarthritis and their spouses examined concordance between patients' and spouses' reports of patients' pain severity and the association of concordance with support and caregiving outcomes. Patients and spouses independently viewed videotapes of the patient performing simulated household tasks and provided ratings of patients' pain. Spousal overestimation of patients' pain was the most common type of nonconcordance. Spouses who were accurate in their perceptions of their partner's level of pain during a log-carrying task responded less negatively and provided emotional support that was more satisfying to patients. In addition, spouses who were accurate in their perceptions of their partner's pain during the log-carrying task reported less stress from providing support and assistance. Future research that uses such observational methods may be highly useful for understanding the effects of chronic illness on older couples.     

Functional localization and double dissociations: the relationship between internal structure and behavior

Lesioning studies are often used in cognitive neuroscience to make inferences about the architecture of cognition. Recently, computational models have been used to address some of the underlying assumptions-such as modularity and locality-often implicitly used when interpreting lesion data. In this article, we explore the "functional localization" assumption and its role in interpreting lesioning data, especially from double dissociations. The functional localization assumption states that units or subunits within an information processing system become functionally specialized for dealing with specific aspects of the input environment. Networks were trained on one of two problems-an abstract "rules and sub-rules" problem, and a more concrete "logic classification" problem-and then systematically lesioned. Networks were analyzed in terms of their overt behavior, and more importantly, in terms of their internal structure. Performance deficits in both form and magnitude could be directly related to the ablated internal structure of the networks. That is, if an ablated area had little or no functional localization, then little or no behavioral dissociations were observed. If, however, the ablated area had very specific internal structure, then very specific behavioral dissociations were observed. It is important to note, however, that there was not a one-to-one correspondence between internal structure and behavioral dissociations, implying that cognitive neuroscientists must be careful when using lesioning data to theorize about the functional architecture of cognition.