Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms

The purpose of the present study was to examine the potential efficacy, patient acceptability, and feasibility of a novel, cognitive-behavioral therapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD) who have been stabilized on medications but still show clinically significant symptoms. Thirty-one adults with ADHD and stable psychopharmacology for ADHD were randomized to CBT plus continued psychopharmacology or continued psychopharmacology alone. Assessments included ADHD severity and associated anxiety and depression rated by an independent evaluator (IE) and by self-report. At the outcome assessment, those who were randomized to CBT had lower IE-rated ADHD symptoms (p < .01) and global severity (p < .002), as well as self-reported ADHD symptoms (p < .0001) than those randomized to continued psychopharmacology alone. Those in the CBT group also had lower IE-rated and self-report anxiety (p's < .04), lower IE-rated depression (p < .01), and a trend to have lower self-reported depression (p = .06). CBT continued to show superiority over continued psychopharmacology alone when statistically controlling levels of depression in analyses of core ADHD symptoms. There were significantly more treatment responders among patients who received CBT (56%) compared to those who did not (13%) (p < .02). These data support the hypothesis that CBT for adults with ADHD with residual symptoms is a feasible, acceptable, and potentially efficacious next-step treatment approach, worthy of further testing.     

Is inhibition of return a reflexive effect?

The inhibition of return (IOR) phenomenon is routinely considered an effect of reflexive attention because the paradigm used to generate IOR employs peripheral cues that are uninformative as to where a target will appear. Because the cues are spatially unreliable it is thought that there is no reason for attention to be committed volitionally to them, and hence, the IOR effect is considered reflexive. What has been generally overlooked, however, is that the cues provide reliable temporal information as to when a target will occur. This predictive information is used by participants to prepare volitionally for when a target is likely to appear. We investigated whether the IOR effect is a product of the volitional application of attention to peripheral cues for the use of their temporal information. To test this idea we rendered the temporal information provided by peripheral cues unreliable. While this eliminated participants using the cues volitionally, it did not abolish the IOR phenomenon. These data demonstrate two new findings. First, the IOR effect is fundamentally a reflexive phenomenon. Second, when peripheral cues are not used volitionally, the IOR effect is attenuated. Together, the present findings indicate that the IOR effect can be modulated by volitional (top-down) processes but it is not the product of them. We argue that an intimate link between fronto-parietal regions and the superior colliculus provide a functional neural mechanism for this volitional effect to impact IOR.     

Selection and inhibition in infancy: evidence from the spatial negative priming paradigm

We used a spatial negative priming (SNP) paradigm to examine visual selective attention in infants and adults using eye movements as the motor selection measure. In SNP, when a previously ignored location becomes the target to be selected, responses to it are impaired, providing a measure of inhibitory selection. Each trial consisted of a prime and a probe, separated by 67, 200, or 550 ms interstimulus intervals (ISIs). In the prime, a target was accompanied by a distractor. In the probe, the target appeared either in the location formerly occupied by the distractor (ignored repetition) or in another location (control). Adults exhibited the SNP effect in all three ISI conditions, producing slower saccade latencies on ignored repetition versus control trials. The SNP effect obtained for infants only under 550 and 200 ms ISI conditions. These results suggest that important developments in visual selection are rooted in emerging inhibitory mechanisms.     

Audio-visual speech perception is special

In face-to-face conversation speech is perceived by ear and eye. We studied the prerequisites of audio-visual speech perception by using perceptually ambiguous sine wave replicas of natural speech as auditory stimuli. When the subjects were not aware that the auditory stimuli were speech, they showed only negligible integration of auditory and visual stimuli. When the same subjects learned to perceive the same auditory stimuli as speech, they integrated the auditory and visual stimuli in a similar manner as natural speech. These results demonstrate the existence of a multisensory speech-specific mode of perception.     

On the effects of signaling reinforcer probability and magnitude in delayed matching to sample

Two experiments examined whether postsample signals of reinforcer probability or magnitude affected the accuracy of delayed matching to sample in pigeons. On each trial, red or green choice responses that matched red or green stimuli seen shortly before a variable retention interval were reinforced with wheat access. In Experiment 1, the reinforcer probability was either 0.2 or 1.0 for both red and green responses. Reinforcer probability was signaled by line or cross symbols that appeared after the sample had been presented. In Experiment 2, all correct responses were reinforced, and the signaled reinforcer durations were 1.0 s and 4.5 s. Matching was more accurate when larger or more probable reinforcers were signaled, independently of retention interval duration. Because signals were presented postsample, the effects were not the result of differential attention to the sample.     

Getting the Big Picture in Community Science: Methods That Capture Context

Community science has a rich tradition of using theories and research designs that are consistent with its core value of contextualism. However, a survey of empirical articles published in the American Journal of Community Psychology shows that community scientists utilize a narrow range of statistical tools that are not well suited to assess contextual data. Multilevel modeling, geographic information systems (GIS), social network analysis, and cluster analysis are recommended as useful tools to address contextual questions in community science. An argument for increased methodological consilience is presented, where community scientists are encouraged to adopt statistical methodology that is capable of modeling a greater proportion of the data than is typical with traditional methods.     

Dorsal stream deficits suggest hidden dyslexia among deaf poor readers: correlated evidence from reduced perceptual speed and elevated coherent motion detection thresholds

Prelingual deafness and developmental dyslexia have confounding developmental effects on reading acquisition. Therefore, standard reading assessment methods for diagnosing dyslexia in hearing people are ineffective for use with deaf people. Recently, Samar, Parasnis, and Berent (2002) reported visual evoked potential evidence that deaf poor readers, compared to deaf good readers, have dorsal stream visual system deficits like those previously found for hearing dyslexics. Here, we report new psychometric and psychophysical evidence that deficits in dorsal stream function, likely involving extrastriate area MT, are associated with relatively poor reading comprehension in deaf adults. Poorer reading comprehension within a group of 23 prelingually deaf adults was associated with lower scores on the Symbol Digit Modality Test, a perceptual speed test commonly used to help identify dyslexia in hearing people. Furthermore, coherent dot motion detection thresholds, which reflect the functional status of area MT, correlated negatively with reading scores in each visual quadrant. Elevated motion thresholds for deaf poor readers were not due to general cognitive differences in IQ but were specifically correlated with poor perceptual speed. With IQ controlled, a highly reliable right visual field advantage for coherent motion detection was found. Additional analyses suggested that the functional status of dorsal stream motion detection mechanisms in deaf people is related to reading comprehension, but the direction and strength of lateralization of those mechanisms is independent of reading comprehension. Our results generally imply that dyslexia is a hidden contributor to relatively poor reading skill within the deaf population and that assessment of dorsal stream function may provide a diagnostic biological marker for dyslexia in deaf people.     

When to Self-Correct Spelling Words: A Systematic Replication

Previous studies have consistently demonstrated self-correction to be more effective than traditional approaches to spelling instruction. This investigation examined the comparative effects of self-correction after attempting each word and self-correction after attempting a list of 10 words by six fifth-graders with learning disabilities or attention deficit-hyperactivity disorder. An alternating treatments design showed self-correction after each word to be more effective for (a) acquisition of new spelling words as measured by weekly spelling tests for five of the six students, and (b) maintenance of spelling words as measured by 1-week maintenance tests for all six students.     

Enhancing the effects of extinction on attention-maintained behavior through noncontingent delivery of attention or stimuli identified via a competing stimulus assessment

Recent research has shown that the noncontingent delivery of competing stimuli can effectively reduce rates of destructive behavior maintained by social-positive reinforcement, even when the contingency for destructive behavior remains intact. It may be useful, therefore, to have a systematic means for predicting which reinforcers do and do not compete successfully with the reinforcer that is maintaining destructive behavior. In the present study, we conducted a brief competing stimulus assessment in which noncontingent access to a variety of tangible stimuli (one toy per trial) was superimposed on a fixed-ratio 1 schedule of attention for destructive behavior for individuals whose behavior was found to be reinforced by attention during a functional analysis. Tangible stimuli that resulted in the lowest rates of destructive behavior and highest percentages of engagement during the competing stimulus assessment were subsequently used in a noncontingent tangible items plus extinction treatment package and were compared to noncontingent attention plus extinction and extinction alone. Results indicated that both treatments resulted in greater reductions in the target behavior than did extinction alone and suggested that the competing stimulus assessment may be helpful in predicting stimuli that can enhance the effects of extinction when noncontingent attention is unavailable. DESCRIPTORS: Attention-maintained problem behavior, competing stimuli, extinction, functional analysis, noncontingent reinforcement