Sensitivity to lexical denotation and connotation in brain-damaged patients: A double dissociation?

Sets of words can be grouped in terms of their denotation (cold and warm both refer literally to temperature) or in terms of their connotation (cold and warm connote remoteness and intimacy, respectively). To assess whether these two facets of meaning are dissociable, unilaterally left- and right-hemisphere-damaged patients were presented with word triads and asked to group together the two words that were closest in meaning. Right-hemisphere-damaged patients showed a preserved sensitivity to denotation, and a selective insensitivity to connotative facets of meanings. In contrast, left-hemisphere-damaged patients exhibited a preserved sensitivity to connotation as well as a selective insensitivity to denotative aspects of meanings. Inasmuch as normal control subjects displayed a flexible sensitivity to both denotative and connotative aspects of meaning, the results suggest that unilateral brain damage selectively curtails use of one or the other major aspect of word meaning.     

The nature of the phonological disorder in conduction aphasia

Sequences of attempts to name pictured objects were used to examine phonological dysfunction in three diagnostic subgroups of aphasia. A prevalence of "phonologically-oriented sequences" (i.e., those sequences that contained only attempts with a phonological resemblance to the target word) was found to be a diagnostic criterion for conduction aphasia. When compared to a group of Broca's (n = 7) and Wernicke's (n = 5) aphasics, all the conduction aphasics (n = 6) produced proportionately more of such phonologically-oriented sequences on a picture naming test. An examination of the phonologically-oriented sequences produced by the conduction aphasics indicates that speech production in conduction aphasia involves dysfunction at an early stage of sound-encoding. The theoretical implications of this view are discussed.     

Conceptual,methodological, and clinical issues in the assessment of anxiety disorders

Many conceptual, methodological, and clinical issues remain unresolved in the assessment of anxiety disorders. Despite the prevalence, incidence, chronicity, and severity of anxiety disorders, research efforts and funding have fallen behind with regard both to other disorders and to addressing critical issues in the field. The primary objective of this paper is to provide a scientific critique regarding a number of often ignored yet salient considerations in anxiety-disorders assessment. Critical analyses of and recommendations regarding the multidimensional nature of anxiety, comorbidity, uniformity myths, synchrony, normative comparisons, psychometric properties of measures, and treatment integrity are offered. Finally, promising areas of clinical research are presented to enhance further the current understanding of the complexities inherent in assessing anxiety disorders.Preparation of this paper was supported in part by NIMH Grant MH36299.     

The importance of assessing treatment integrity: An example in the anxiety disorders

One purpose of this investigation was to examine the importance of assessing treatment integrity in a study evaluating a treatment for specific anxiety disorders. Three subjects, two social phobics and one simple phobic, received self-instruction training (Phase I) followed by exposure and self-instruction training (Phase II) in a multiple baseline across subjects design. All subjects were assessed during a pretreatment baseline and throughout treatment using measures of treatment integrity and measures of change in phobic severity. Improvement took place at different times for different subjects. Measures of treatment integrity, which consisted of monitoring of self-statements as well as practice outside the session, indicated that treatment was not always received as intended and that improvement was correlated with practice. The usefulness of measures of treatment integrity in both clinical and research settings is highlighted.     

Exogenous verbal response inhibition in adults who do and do not stutter

IntroductionBehavioral and questionnaire-based studies suggest that children who stutter (CWS) exhibit poorer response inhibition than children who do not stutter (CWNS). However, the behavioral findings in adults who stutter (AWS) are less unequivocal and mainly based on manual response inhibition. Further study is therefore needed, especially given the lack of studies on verbal response inhibition among these groups.MethodsThirteen AWS and 14 adults who do not stutter (AWNS) participated in a verbal stop signal task (SST) in which they were asked to read aloud six Chinese characters as fast as possible during the go-signal and ignore-signal trials and refrain from naming them during the stop-signal trials.ResultsThe two groups showed a comparable response reaction time in the go-signal and ignore-signal trial conditions. Furthermore, there were no significant differences in terms of the stop-signal reaction time (SSRT) and accuracy. However, a significant positive correlation was found between SSRT and the frequency of stuttering in conversation but not in reading.ConclusionCurrent findings seem to provide additional support that exogenously triggered response inhibition among AWS does not differ from AWNS. The association between stuttering frequency and SSRT seems to suggest that individuals with more severe stuttering in conversational speech have reduced exogenous response inhibition. However, this finding needs to be further explored in future studies using different measures of stuttering severity.     

Year of Zoom in a Year of Doom: Lessons Learned Delivering ERP Remotely During the COVID-19 Pandemic

In response to the COVID-19 pandemic and consequential shutdown measures, many mental health professionals started providing therapy to patients exclusively via telehealth. Our research center, which specializes in studying and treating obsessive-compulsive disorder (OCD), historically has provided in-person exposure and response prevention (ERP) to adults with OCD, but shifted to telehealth during the pandemic. Unlike in other modes of talk therapy, ERP’s emphasis on therapist-supervised exposures presented unique opportunities and challenges to delivering treatment entirely via a virtual platform. This paper provides case examples to illustrate lessons we learned delivering ERP exclusively via telehealth in New York from March 2020 through June 2021 and offers recommendations for future study and practice. Though we observed a number of drawbacks to fully remote ERP, we also discovered advantages to delivering ERP this way, meriting additional research attention.     

Correspondence between resident- and staff-report on the QABF: Do justice-involved youth agree with residential staff?

Residents in juvenile residential treatment facilities (JRTFs) often display various emotional, behavioral, and educational needs. Researchers have recently developed behavioral interventions to increase residents' appropriate behavior such as cooperation with facility staff instructions, accepting feedback from facility staff, and tolerating unpleasant events. However, there is not a generally accepted tool for assessing the operant function of residents' problem behavior in JRTFs. For various logistical reasons, indirect functional assessments may be more appropriate in a JRTF than manipulating either antecedent or consequent events. This study obtained scores on the Questions About Behavior Function (QABF) assessment for 17 residents from two dormitory staff members for each resident. To increase the number of respondents, each resident completed a QABF for their own behavior. Results revealed moderate to high correspondence (i.e., agreement) for highest and lowest potential operant function of problem behavior between combinations of JRTF staff and residents. These preliminary findings suggest additional research with the QABF in JRTFs is warranted.     

Le médecin expert confronté aux confidences de la personne expertisée

During an expertise, if the expert “discovers” or is entrusted with information concerning an offence, should he report it to the authorities? Could the expert be sanctioned in the absence of denunciation of a tort or criminal act? The answer will be nuanced on a case-by-case basis. The expert confronted with the revelation of a crime or misdemeanor must decide in good conscience what he reveals in his report, or even report it to the prosecution.     

People who help people: A needs assessment of those who provide interpersonal support to individuals with chronic illnesses

Social support during an ongoing illness has been shown to be beneficial for both the provider and the receiver, but people often struggle with offering effective, appropriate support. There is a lack of communication-focused training not specifically tied to caregiving or training that is designed for all social network members of a person experiencing a chronic illness, which we call interpersonal support providers (ISPs). We conducted a concurrent mixed-methods needs assessment, surveying both ISPs and support receivers, to understand communicative challenges and inform an evidence-based intervention. Analysis of results from an online survey (N_providers = 91, N_receivers = 97), consisting of five open-ended and 15 quantitative items, suggests that ISPs have difficulty managing their worries and emotions while providing comfort to others, which may impact support quality. In addition, ISPs and receivers both identify “listening” as a key skill for ISPs to hone, though ISPs feel they are more skilled at listening than receivers say they are. Lastly, ISPs feel they are good at sharing information and advice, but receivers often perceive it as patronizing or unhelpful. These results will inform the creation of an intervention for everyone offering emotional, esteem, and informational support to individuals with chronic illnesses.