Cognitive Functioning,Behavior, and Quality of Life After Stroke in Childhood

Rationale: To provide a better understanding of cognitive functioning, motor outcome, behavior and quality of life after childhood stroke and to study the relationship between variables expected to influence rehabilitation and outcome (age at stroke, time elapsed since stroke, lateralization, location and size of lesion).

Methods: Children who suffered from stroke between birth and their eighteenth year of life underwent an assessment consisting of cognitive tests (WISC-III, WAIS-R, K-ABC, TAP, Rey-Figure, German Version of the CVLT) and questionnaires (Conner's Scales, KIDSCREEN).

Results: Twenty-one patients after stroke in childhood (15 males, mean 11;11 years, SD 4;3, range 6;10–21;2) participated in the study. Mean Intelligence Quotients (IQ) were situated within the normal range (mean Full Scale IQ 96.5, range IQ 79–129). However, significantly more patients showed deficits in various cognitive domains than expected from a healthy population (Performance IQ p?=?.000; Digit Span p?=?.000, Arithmetic's p?=?.007, Divided Attention p?=?.028, Alertness p?=?.002). Verbal IQ was significantly better than Performance IQ in 13 of 17 patients, independent of the hemispheric side of lesion. Symptoms of ADHD occurred more often in the patients' sample than in a healthy population (learning difficulties/inattention p?=?.000; impulsivity/hyperactivity p?=?.006; psychosomatics p?=?.006). Certain aspects of quality of life were reduced (autonomy p?=?.003; parents' relation p?=?.003; social acceptance p?=?.037). Three patients had a right-sided hemiparesis, mean values of motor functions of the other patients were slightly impaired (sequential finger movements p?=?.000, hand alternation p?=?.001, foot tapping p?=?.043). In patients without hemiparesis, there was no relation between the lateralization of lesion and motor outcome. Lesion that occurred in the midst of childhood (5–10 years) led to better cognitive outcome than lesion in the very early (0–5 years) or late childhood (10–18 years). Other variables such as presence of seizure, elapsed time since stroke and size of lesion had a small to no impact on prognosis.

Conclusion: Moderate cognitive and motor deficits, behavioral problems, and impairment in some aspects of quality of life frequently remain after stroke in childhood. Visuospatial functions are more often reduced than verbal functions, independent of the hemispheric side of lesion. This indicates a functional superiority of verbal skills compared to visuospatial skills in the process of recovery after brain injury. Compared to the cognitive outcome following stroke in adults, cognitive sequelae after childhood stroke do indicate neither the lateralization nor the location of the lesion focus. Age at stroke seems to be the only determining factor influencing cognitive outcome.     

Faking on self-report emotional intelligence and personality tests: Effects of faking opportunity, cognitive ability, and job type

We assessed the combined effects of cognitive ability, opportunity to fake, and trait job-relevance on faking self-report emotional intelligence and personality tests by having 150 undergraduates complete such tests honestly and then so as to appear ideal for one of three jobs: nurse practitioner, marketing manager, and computer programmer. Faking, as expected, was greater (a) in higher-g participants, (b) in those scoring lower under honest conditions (with greater opportunity to fake), and (c) on job-relevant traits. Predicted interactions accounted for additional unique variance in faking. Combining all three factors yielded a “perfect storm” standardized difference of around 2, more than double the overall .83 estimate. Implications for the study of faking are discussed.     

Chaotic attractors in the therapeutic system 1

Because little research had been done on the presence and role of latent communication in the context of team‐conducted family therapy, the writers set out to monitor unconscious responses generated under these conditions. Specifically, they investigated an ongoing family treatment situation conducted according to the “reflecting team model.” One team of therapists handles the actual treatment session, while the other observes from behind a one‐way mirror. During the course of a session, the second team makes suggestions to the treatment team either by telephone or by calling the therapists out of the treatment room.

As the project developed, the writers found that the unconscious responses of both family and treatment teams indicated a process at work beyond the conscious intentions of the participants. That is, the therapeutic enterprise was functioning as a dynamical system, whose increasing complexity suggested a self organizing principle at work. This paper traces the development of the system's movement toward greater complexity, identifies the specific interventions that indicate this process, describes how all participants demonstrated a high degree of resonance and synchronization with this overarching‐self organizing pattern. This paper serves to alert therapists to the role of unconscious communication within the therapeutic system and postulates that the generation of form within psychotherapy follows many of the same self organizing processes found in other human and non human systems.     

Re‐framing systemic paradigms for the art of learning

Thoughtful people are increasingly concerned that the current paradigms for social, corporate, and educational activities are in disgraceful disarray. The “problem‐solving” or analytical model, the competitive or game model, the commercial or consumer model, the bureaucratic or institutional model, and the disease or illness model which prevail in public discourse are proving to be especially unwholesome. We cannot, however, educate ourselves without paradigms. A credible educational paradigm must be generally accessible without being simplistic, informative without being monothematic, and accommodating as well as discriminating. Given our disquiet with the current cognitive situation, a renewing paradigm must be somehow novel; given the character of human nature, a sustaining paradigm must be somehow familiar.

For a very long time now, professional Sciences have committed themselves to paradigms about “reality out there,” while professional Arts have devoted themselves to expressing “imagination from within here.” The more these two worldviews polarize in opposition to one another, the more room there is—and the more human heed there becomes—for mediation by an applied philosophy which accommodates the “real” as well as the “imaginary” in a complementary way. Such a philosophy would address not only “what do you know?” and “how do you do?” but also “how do you know?” and “why do you do?” In earlier times, people would have been considered neither educated nor wise unless they appreciated the Sciences and the Arts whole. In our time, we may not survive unless we can re‐integrate our fractured perceptions. How might we proceed to do so? There may be a systemological way.     

Justice to Nature and to the Disadvantaged

This article argues against using the practice of discounting and shows that both the time preference and the opportunity cost of capital arguments, put forward to justify discounting, are in conflict when we take the holistic approach to the environment. Both the time preference and the opportunity cost concepts are the tools to support the institution of interest. Using a hierarchical systems approach it is argued that in order to save the super hierarchical system (biosphere as a whole in our case) the contemporary economic system has to renew so that the humanity and global ecosystem may persist.     

Preliminary evidence for low openness to experience as a pre-clinical marker of incipient cognitive decline in older adults

The current study examined self-reported Openness to Experience as a marker of incipient cognitive decline among older adults. Seventy five cognitively-intact, community-dwelling adults ages 58–87 were assessed with the NEO Personality Inventory-Revised (NEO PI-R; (Costa & McCrae, 1992) and the Mattis Dementia Rating Scale 2nd edition (DRS-2; (Mattis, Jurica, & Leitten, 1988) to examine association with incipient decline over approximately 1 year. Low Openness to Experience was associated with decline, controlling for baseline screening scores, age, education, and the other four personality factors. Examination of facet-level associations indicated that lower scores on the Values and Aesthetics facets of Openness primarily explained the association. Current findings build on prior research suggesting that exaggerated reaction to novelty may signal pre-clinical cognitive decline.     

Self-control and frequency of model presentation: Effects on learning a ballet passé relevé

The purpose of this experiment was to examine the combined effects of self-control and frequency of model presentation on learning a complex motor skill, i.e., ballet passé relevé. Before practice started self-control participants were asked to choose two viewings or six viewings (before practice and then every five trials) and the externally controlled groups were yoked to their self-control counterparts. All participants completed 15 acquisition trials followed by 5 trials for the immediate and 5 trials for the delayed retention tests 48 hours later. Dependent variables included cognitive representation scores, physical reproduction rankings, and balance time. Statistical analyses indicated that under limited physical practice conditions self-control and higher frequency of model presentation facilitated the development of cognitive representation and did not produce further benefits in movement reproductions and balance time. The results were discussed with respect to the social cognitive theory.     

The relationship between n-back performance and matrix reasoning — implications for training and transfer

We have previously demonstrated that training on a dual n-back task results in improvements in fluid intelligence (Gf) as measured by matrix reasoning tasks. Here, we explored the underlying mechanisms of this transfer effect in two studies, and we evaluated the transfer potential of a single n-back task. In the first study, we demonstrated that dual and single n-back task performances are approximately equally correlated with performance on two different tasks measuring Gf, whereas the correlation with a task assessing working memory capacity was smaller. Based on these results, the second study was aimed on testing the hypothesis that training on a single n-back task yields the same improvement in Gf as training on a dual n-back task, but that there should be less transfer to working memory capacity. We trained two groups of students for four weeks with either a single or a dual n-back intervention. We investigated transfer effects on working memory capacity and Gf comparing the two training groups' performance to controls who received no training of any kind. Our results showed that both training groups improved more on Gf than controls, thereby replicating and extending our prior results.     

Event memory and suggestibility in abused and neglected children: trauma-related psychopathology and cognitive functioning

This study examined event memory and suggestibility in 3- to 16-year-olds involved in forensic investigations of child maltreatment. A total of 322 children were interviewed about a play activity with an unfamiliar adult. Comprehensive measures of individual differences in trauma-related psychopathology and cognitive functioning were administered. Sexually and/or physically abused children obtained higher dissociation scores than neglected children, and sexually abused children were more likely to obtain a diagnosis of posttraumatic stress disorder than physically abused children, neglected children, and children with no substantiated abuse histories. Overall, older children and children with better cognitive functioning produced more correct information and fewer memory errors. Abuse status per se did not significantly predict children’s memory or suggestibility whether considered alone or in interaction with age. However, among highly dissociative children, more trauma symptoms were associated with greater inaccuracy, whereas trauma symptoms were not associated with increased error for children who were lower in dissociative tendencies. Implications of the findings for understanding eyewitness memory in maltreated children are discussed.