Conceptualization and measurement of family outcomes associated with families of individuals with intellectual disabilities

The purpose of this review is to (a) document the current status of conceptualizing and measuring family outcomes related to having a member with an intellectual disability and (b) determine the extent to which family research focuses on internal family characteristics as contrasted to external family support. The reviewers collected 28 articles using the terms well-being, adaptation, family functioning, or family quality of life in the title. Results of our analyses are presented as a comparison between well-being, adaptation, and family functioning articles in one group and family quality of life articles in a second group. Both groups lacked explicit conceptual definitions, theory, and random/representative samples. The articles placed an undue emphasis on maternal participation, and tended to report a single family member score as representative of the whole family. Two major differences between the groups was a tendency for family quality of life studies to be grounded in conceptual frameworks and focus on new instrument development. Recommendations for future research directions are included.     

Perfectionism and multiphasic personality inventory (MMPI) indices of personality disorder

The present research tested the hypothesis that personal and social aspects of the perfectionism construct are related differentially to indices of personality disorders. A sample of 90 psychiatric patients was examined with respect to their scores on the Multidimensional Perfectionism Scale (MPS) and the personality disorder subscales (PDS) of the Minnesota Multiphasic Personality Inventory. The MPS provides measures of self-oriented, other-oriented, and socially prescribed perfectionism, whereas the PDS assess levels of various personality disorder symptoms. Zero-order and partial correlations indicated that the perfectionism dimensions of the MPS were related to various subscales of the PDS and, perhaps more importantly, that the findings vary as a function of the perfectionism dimension in question. The results are discussed in terms of the importance of perfectionism in personality disorder symptom patterns.     

A positive emotional bias in confabulatory false beliefs about place

Some neurological patients with medial frontal lesions exhibit striking confabulations. Most accounts of the cause of confabulations are cognitive, though the literature has produced anecdotal suggestions that confabulations may not be emotionally neutral, having a ('wish-fulfilment') bias that shapes the patient's perception of reality in a more affectively positive direction. The present study reviewed every case (N = 16) of false beliefs about place reported in the neuroscientific literature from 1980 to 2000, with blind raters evaluating the 'pleasantness' of the patient's actual and confabulated locations. In each case the confabulated location was evaluated as more pleasant. This striking finding supports the claim that there may be a systematic affective bias in the false beliefs held by neurological patients with confabulation.     

Central executive secondary tasks in object recognition: an analogue of the unusual views deficit in the neurologically normal?

The particular problem of recognition from unusual viewpoints, may well involve a substantial problem-solving component and employ frontal/central executive resources. The present study investigates this question using a dual-task technique. In Experiment 1, the reliability of an unusual views effect was demonstrated. Experiment 2 showed that a central executive secondary task selectively disrupts unusual views recognition. These results are discussed in the context of existing lesion and functional imaging findings.     

Direct versus indirect emotional consequences on the Iowa Gambling Task

The Iowa Gambling Task has been widely used in the assessment of neurological patients with ventro-mesial frontal lesions. The Iowa Group has claimed that the Gambling Task is too complex for participants to follow using cognition alone, so that participants must rely on emotion-based learning systems (somatic markers). The present study investigates whether similar tasks can be performed without direct somatic markers. In a 'Firefighter' task closely matched to the classic Gambling Task, participants evaluate the performance of others--so that they experience reward and punishment indirectly. In contrast to the gradual improvement in performance seen on the classic Iowa Gambling Task, participants on the Firefighter Task showed no learning effect, mirroring the performance of patients with ventro-mesial frontal lesions, and suggesting that the task is very difficult to perform without direct somatic marker information. The use of this task as empirical measure of 'empathy' are discussed.     

The analysis of drawing from memory performance in brain-damaged patients

The drawing from memory task is frequently used in cognitive neuropsychology to investigate visual processing impairments. However, in surprising contrast to most other neuropsychological tests, the analyses of results on this task are most often based solely on qualitative judgements about the normality of a patient's performance. In most case reports, these judgements are not made with reference to normative data and are not made by individuals who are impartial with respect to the study (that is, using a blind rating procedure). There are several grounds for arguing that such analyses are inadequate. First, seemingly abnormal drawings made by a patient may well be within the range of performance shown by control subjects. Second, judgments that are not based on a blind rating procedure are likely to be influenced by knowledge about the patient's performance on other tasks. We describe an alternative assessment procedure that addresses both of these concerns.     

Emotion-based learning on a simplified card game: the Iowa and Bangor Gambling Tasks

The Iowa Gambling Task (IGT) has been widely used in the assessment of neurological patients with frontal lesions. Emphasis has been placed on the complexity of the task (i.e., four decks of varying contingency pattern) with the suggestion that the participant must use emotion-based learning to deal with a complex decision-making process. The present study used a single deck card game (the Bangor Gambling Task, BGT), matched in many respects with the Iowa Gambling Task, in which the contingencies varied over time (gradually becoming worse for the participant) rather than across deck (as in the IGT). Forty participants performed both tasks. Performance on the tasks showed many similarities, with participants showing a comparable pattern of incremental learning on both tasks, reaching an analogous final level of performance. More importantly, there was a high correlation (r(2) = .93) in performance between the two tasks, the most salient feature of which was that virtually every participant who fell below categorisation of impaired IGT performance, also did very poorly on the BGT. These findings bear on the question of whether arguments about the 'complexity' of the Iowa Gambling Task necessarily explain why it appears to require emotion-based learning. The Bangor Gambling Task might also be a useful tool for clinical neuropsychologists, in the assessment of patients with executive dysfunction-given that the task is easier and quicker to administer than the Iowa Gambling Task, but appears to share the same performance features.     

Paradoxical effects of education on the Iowa Gambling Task

Suitable normative information on the Iowa Gambling Task (IGT) is not currently available, though it is clear that there is great individual variability in performance on this assessment tool. Given that the task is presumed to measure the emotion-based learning systems that are thought to form the biological basis of 'intuition,' there is some reason to think that education (especially tertiary education) might explicitly de-emphasise the role of emotion-based learning in decision-making. This suggests the paradoxical finding that better-educated participants should show poorer performance on the IGT. We recruited 30 participants (all female, all aged 18-25) to participate in a 'real money' version of the IGT. There was no significant difference in performance in blocks 1-3 of the task (trials 1-60). However, there was a substantial effect of education on the final two blocks (trials 61-100), such that the less-well-educated participants produced twice as much of an improvement over baseline as did their university-educated colleagues. A range of possible explanations for this remarkable finding are discussed. The most likely appears to be that tertiary education specifically discourages the use of emotion-based learning systems in decision-making. These findings bear on the extent to which education has a role to play in our reliance on cognition and emotion in decision-making, including the likely role of education in the generation and maintenance of false beliefs.