The Burden of Dementia: A Medical and Research Perspective

Alzheimer's disease remains the most common form of dementia. Dementia symptoms vary depending on individual personality, life experience, and social and cultural influences. As dementia progresses, involvement of multi-disciplinary health care professionals is needed to manage the disease. Alzheimer research is progressing rapidly. While 5% of all Alzheimer's disease may be genetically determined, the majority is not. Susceptibility genes can reveal the risk of contracting Alzheimer's disease. Early life risk factors such as education, nutrition, and vascular disease may increase the likelihood of dementia in later life. In the United States, two acetylcholinesterase inhibitors have been approved as cognitive enhancers. Possible prevention and symptomatic treatment interventions have focused on estrogen replacement therapy, antioxidants, and anti-inflammatory medications. Research advances have improved the clinical management of dementia. Ethical implications to the patient, family, and society are multiple and remain challenging.     

认知方式与幼儿部分遮挡绘画关系的研究

本研究考察了５—６岁儿童不同认知方式对部分遮挡绘画任务的影响。实验设定不同形式的误导情境,共有两部分组成。研究结果表明：１．儿童绘画表征水平的发展存在个别差异。２．在误导情境下,场独立儿童比场依存儿童能保持较稳定的策略选择倾向。３．画两个相同物体的遮挡要难于画两个不同物体的遮挡。４．在符号概念编码和空间编码中间存在着一些过渡形态。     

Mother Knows Best? Mother and Child Report of Behavioral Difficulties of Children of HIV-Infected Mothers

Children of HIV-infected mothers have more psychosocial adjustment difficulties than do those of noninfected mothers. In this study, child psychosocial adjustment in children of HIV-infected women is examined across the three stages of HIV-infected: asymptomatic, symptomatic and AIDS. Participants were 99 HIV-infected women and 148 noninfected women. Children were not identified as being HIV infected. Mother and child reports of behavioral difficulties are compared, and competing hypotheses about mother report of child behavior difficulties are tested. Results indicate an ascending linear trend for child report of internalizing and externalizing difficulties from the noninfected stage through increasingly severe stages of HIV-infection. According to mother report, child externalizing and internalizing difficulties are nonlinear, as mothers report an increase through the infected symptomatic stage, then a decrease in the AIDS stage. Implications for assessment, prevention and intervention in families with maternal HIV infection are discussed.     

The Associations between Mothers’ and Grandmothers’ Depressive Symptoms,Parenting Stress,and Relationship with Children: An Actor–Partner Interdependence Mediation Model

Three-generation households that include parents and grandparents raising children together have become increasingly common in China. This study examined the relations among depressive symptoms, parenting stress, and caregiver–child relationships in the mother–grandmother dyadic context. Participants were mothers and grandmothers from 136 three-generation households. Results from Actor–Partner Interdependence Mediation Modeling indicated that mothers’ depressive symptoms were indirectly related to mother–child conflict/closeness through own parenting stress; grandmothers’ depressive symptoms were indirectly related to grandmother–child conflict through own parenting stress. Mothers’ depressive symptoms were indirectly related to grandmothers’ conflict with children through grandmothers’ parenting stress, and grandmothers’ depressive symptoms were indirectly related to mothers’ conflict/closeness with children through mothers’ parenting stress. The relation between mothers’ parenting stress and mother–child closeness was stronger than the relation between grandmothers’ parenting stress and grandmother–child closeness. Findings highlight the implications of using a family system perspective and the dyadic approach in understanding and improving family functioning in Chinese three-generation households.     

Maintenance of Relationship and Individual Functioning Gains Following Online Relationship Programs for Low‐Income Couples

Initial evidence suggests that gains in relationship functioning from brief, web‐based programs are maintained through one year following the intervention; however, whether these results generalize to a low‐income sample is unclear. Furthermore, previous research from in‐person couple therapy suggests there may be different shapes of maintenance slopes for behavioral versus acceptance‐based techniques. This study contacted 668 individuals who enrolled in online behavioral (ePREP) or acceptance‐based (OurRelationship) programs one year following completion of the program. Multilevel modeling was used to examine linear and quadratic rates of change in the year following the online intervention as well as total amount of change from pretreatment to 12‐month follow‐up for both relationship and individual functioning. The majority of couples who responded continued to be in a relationship with the same partner (68.3%). Examinations of relationship functioning indicated couples in both programs maintained their gains over follow‐up (i.e., no significant linear or quadratic changes), with medium‐to‐large within‐group effect sizes from pre‐ to one‐year follow‐up. There were no significant differences in relationship outcomes between OurRelationship and ePREP. Similarly, examinations of individual functioning outcomes indicated couples maintained their gains over follow‐up or continued to improve. In total, couples experienced small‐to‐medium within‐group effect sizes from pretreatment to one‐year follow‐up, with larger effects for individuals who were initially distressed. These results suggest that online programs create lasting change for low‐income couples in relationship and individual functioning, with minimal differences between behavioral and acceptance‐based orientations.     

The effects of co‐occurring ADHD symptoms on electrophysiological correlates of cognitive control in young people with Tourette syndrome

Efficient cognitive control is implicated in tic control in young people with Tourette syndrome (TS). Attention‐deficit/hyperactivity disorder (ADHD) frequently co‐occurs with TS and is associated with impaired cognitive control. Young people with TS and ADHD (TS+ADHD) show poorer cognitive control performance than those with TS, but how co‐occurring ADHD affects underlying neural activity is unknown. We investigated this issue by examining behavioural and event‐related potential (ERP) correlates of cognitive control in young people with these conditions. Participants aged 9–17 with TS (n = 17), TS+ADHD (n = 17), ADHD (n = 11), and unaffected controls (n = 20) performed a visual Go/Nogo task during electroencephalography (EEG) recording. Behavioural performance measures (D‐prime, RT, reaction time variability, post‐error slowing) and ERP measures (N2, P3, error‐related negativity (ERN), error positivity (Pe)) were analysed in a 2 (TS‐yes, TS‐no) × 2 (ADHD‐yes, ADHD‐no) factorial analysis to investigate the effects of TS, ADHD, and their interaction. The results of these analyses showed that ADHD was associated with poorer performance and reduced amplitude of all ERPs, reflecting widespread cognitive control impairments. Tourette syndrome was associated with slowed RTs, which might reflect a compensatory slowing of motor output to facilitate tic control. There was no interaction between the TS and ADHD factors for any behavioural or ERP measure, indicating the impairing effects of ADHD on behaviour and electrophysiological markers of cognitive control were present in TS+ADHD and that RT slowing associated with TS was unaffected by co‐occurring ADHD symptoms.     

The application of the satir model of family therapy to the families in Hong Kong: A personal reflection

Practitioners in Hong Kong have shown an increasing interest in various family therapy approaches since the 1980s. This paper offers a critique of the major concepts and techniques of the Satir model applied to families in Hong Kong. Cultural considerations are examined in relation to the family structure and hierarchy, the Chinese self and self-esteem, communication patterns, and family rules. Implications for the application of the Satir model of family therapy in Hong Kong are discussed.     

WALKER PERCY,LANGUAGE, AND HOMO SINGULARIS

The novelist Walker Percy argued that modern science has a tremendous blind spot in its view of human nature. Unlike purely physical phenomena, which can be explained by the interaction of dyadic relationships, human beings must also be understood in terms of triadic relationships brought into being by symbolic language. The self brought into being by symbolic language is nonmaterial but real, and operates by different “laws” than those that govern dyadic relations. In making this case, Percy drew a sharp line between human and nonhuman language, a line that more recent developments in science has challenged. However, Percy's central point, that the agent of symbolic language cannot be understood within a materialist framework, remains valid.     

Quitting smoking: The importance of non-smoker identity in predicting smoking behaviour and responses to a smoking ban

Objective: We examined how ‘smoker’ and ‘non-smoker’ self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e. the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban.

Design: Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers.

Main outcome measures: Intention to quit, quit attempts and ‘rejecting’, ‘victimizing’, ‘socially conscious smoking’ and ‘active quitting’ responses to the smoking ban.

Results: Non-smoker identities are more important than smoker identities in predicting intention to quit, quit attempts and responses to the smoking ban, even when controlling for other important predictors such as nicotine dependence. Smokers with stronger non-smoker identities had stronger intentions to quit, were more likely to attempt to quit between measurements, and showed less negative and more positive responses to the smoking ban. The association between non-smoker self-identity and intention to quit was stronger among smokers with lower than higher SES.

Conclusion: Antismoking measures might be more effective if they would focus also on the identity of smokers, and help smokers to increase identification with non-smoking and non-smokers.