To Use or Not to Use: The Prenatal Genetic Technology/Worry Conundrum

We conducted an exploratory, qualitative study investigating the factors influencing the use of genetic counseling and prenatal genetic testing for two groups: pregnant women 35 years of age and over (AMA) at the time of delivery and pregnant women with an abnormal maternal serum triple screen (MSAFP3). The convenience sample consisted of 25 semistructured interviews of women/couples and 50 observations of genetic counseling sessions. Worry turned out to be the most important variable influencing decision making about prenatal genetic testing and was greater in the MSAFP3 group than in the AMA group. The women in the AMA group appeared to assign the risk of having a child with Down syndrome to their age category rather than to themselves individually, whereas, the risk perception for women with an abnormal MSAFP3 appeared to have shifted from a general population risk for pregnant women to an individual, personal risk. There was a general lack of understanding and also more misinformation about the MSAFP3 screen compared to amniocentesis. Women in both groups were torn between fear of an invasive test and worry about the health of their fetus for the rest of their pregnancy if they did not undergo amniocentesis.     

A computational model of frontal lobe dysfunction: working memory and the Tower of Hanoi task

A symbolic computer model, employing the perceptual strategy, is presented for solving Tower of Hanoi problems. The model is calibrated—in terms of the number of problems solved, time taken, and number of moves made—to the performance of 20 normal subjects. It is then "lesioned" by increasing the decay rate of elements in working memory to model the performance of 20 patients with lesions to the prefrontal cortex. The model captures both the main effects of subject groups (patients and normal controls) performance, and the subject groups (patients and normal controls) by problem difficulty interactions. This leads us to support the working memory hypothesis of frontal lobe functions, but for a narrow range of problems.     

The pop out of scene-relative object movement against retinal motion due to self-movement

An object that moves is spotted almost effortlessly; it "pops out". When the observer is stationary, a moving object is uniquely identified by retinal motion. This is not so when the observer is also moving; as the eye travels through space all scene objects change position relative to the eye producing a complicated field of retinal motion. Without the unique identifier of retinal motion an object moving relative to the scene should be difficult to locate. Using a search task, we investigated this proposition. Computer-rendered objects were moved and transformed in a manner consistent with movement of the observer. Despite the complex pattern of retinal motion, objects moving relative to the scene were found to pop out. We suggest the brain uses its sensitivity to optic flow to "stabilise" the scene, allowing the scene-relative movement of an object to be identified.     

Neural correlates of visuospatial consciousness in 3D default space: Insights from contralateral neglect syndrome

One of the most compelling questions still unanswered in neuroscience is how consciousness arises. In this article, we examine visual processing, the parietal lobe, and contralateral neglect syndrome as a window into consciousness and how the brain functions as the mind and we introduce a mechanism for the processing of visual information and its role in consciousness. We propose that consciousness arises from integration of information from throughout the body and brain by the thalamus and that the thalamus reimages visual and other sensory information from throughout the cortex in a default three-dimensional space in the mind. We further suggest that the thalamus generates a dynamic default three-dimensional space by integrating processed information from corticothalamic feedback loops, creating an infrastructure that may form the basis of our consciousness. Further experimental evidence is needed to examine and support this hypothesis, the role of the thalamus, and to further elucidate the mechanism of consciousness.     

Evaluating Outcome Domains Assessing Caregivers of Individuals with Mental Illness: A Review

In this article, we describe the properties and consider the outcome dimensions of a collection of self‐administered questionnaires that assess caregivers of offspring with mental illness. To this end, we searched the MEDLINE, Web of Science, and PsycINFO databases, as well as reference lists of studies published between 1980 and 2012. We reviewed 43 instruments, and found multiple outcome domains, associated with either objective burden or subjective burden, or both. A number of tools captured additional negative aspects of caregiving (e.g., strain, stress, and worrying) as well as positive aspects (e.g., personal growth, strength, support, rewards, and satisfaction), supplemented by measures assessing caregivers' perceptions and attitudes toward their offspring with SMI (e.g., insight, stigma, and efficacy). This current review of existing measures and their specific domains contributes to a more comprehensive understanding of the caregiving experience and allows both clinicians and researchers to select the most appropriate measurement tools for their purposes.     

The Effect of Communication Change on Long‐term Reductions in Child Exposure to Conflict: Impact of the Promoting Strong African American Families (ProSAAF) Program

African American couples (n = 331) with children, 89% of whom were married, were assigned to either (a) a culturally sensitive couple‐ and parenting‐enhancement program (ProSAAF) or (b) an information‐only control condition in which couples received self‐help materials. Husbands averaged 41 years of age and wives averaged 39 years. We found significant effects of program participation in the short term on couple communication, which was targeted by the intervention, as well as over the long term, on self‐reported arguing in front of children. Long‐term parenting outcomes were fully mediated by changes in communication for wives, but not for husbands. For husbands, positive change depended on amount of wife reported change. We conclude that wives' changes in communication from baseline to posttest may be more pivotal for the couples' long‐term experience of decreased arguing in front of children than are husbands' changes, with wives' changes leading to changes in both partners' reports of arguments in front of children.     

Thinking and Working Relationally: Interviewing and Constructing Hypotheses to Create Compassionate Understanding

In the initial interviews of family therapy sessions, the therapist faces the challenge of obtaining and organizing the information that is most relevant toward understanding the essential concerns that families and couples bring to therapy. This article describes the process of clinical interviewing and case conceptualization used in training family therapists at the Ackerman Institute for the Family. This approach helps the therapist bring forward, and organize, specific information into relational hypotheses, or systemic‐relational conceptualizations, that allow both family members and the therapist to understand presenting problems within their relational contexts. While always provisional, relational hypotheses help anchor the therapist in a systemic‐relational frame and provide a conceptual through‐line to guide the ongoing work of the therapy. The process of interviewing and the construction of clear and complex conceptualizations of presenting problems are illustrated through case examples.     

Intersubjectivity and the creation of meaning in the analytic process

By means of a clinical illustration, the author describes how the intersubjective exchanges involved in an analytic process facilitate the representation of affects and memories which have been buried in the unconscious or indeed have never been available to consciousness. As a result of projective identificatory processes in the analytic relationship, in this example the analyst falls into a situation of helplessness which connects with his own traumatic experiences. Then he gets into a formal regression of the ego and responds with a so‐to‐speak hallucinatory reaction—an internal image which enables him to keep the analytic process on track and, later on, to construct an early traumatic experience of the analysand.