Statewide Implementation of Cognitive Behavioral Therapy for Psychosis Through a Learning Collaborative Model

Cognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based psychotherapeutic intervention (EBPI) for adults with schizophrenia spectrum disorders that remains under-implemented in the United States (U.S.). There has been little empirical attention on implementation and dissemination strategies for this EBPI. The Learning Collaborative (LC) model is a method of implementing evidence-based practices across agencies and geographic regions that may facilitate CBTp implementation and dissemination in the US.We applied the LC model in an attempt to enhance the accessibility of CBTp in community mental health settings statewide. Providers (N = 56) from 12 agencies voluntarily participated in an in-person, CBTp workshop followed by 6 months of biweekly phone-based consultation sessions (Phase 1). Twenty-one providers opted to participate in an additional 6-month CBTp LC immediately following completion of the initial CBTp LC (Phase 2). Adoption, penetration, provider-perceived skill development, fidelity, as well as provider-perceived implementation barriers were re-assessed during and 6 months after completion of Phase 2.One year after the completion of the Phase 2 LC, 21% of the original trainee group across 3 of the 12 participating agencies continued to offer CBTp to clients. CBTp trainees were treating between one and two clients each. Self-assessed CBTp skills improved modestly over the Phase 2 consultation period. On average, both clinicians and supervisors reached an acceptable fidelity score on the sessions reviewed. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the LC model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Identified challenges and recommendations should be considered in future implementation efforts.     

Bioinspired decision-making for a socially interactive robot

Nowadays, robots and humans coexist in real settings where robots need to interact autonomously making their own decisions. Many applications require that robots adapt their behavior to different users and remember each user’s preferences to engage them in the interaction. To this end, we propose a decision making system for social robots that drives their actions taking into account the user and the robot’s state. This system is based on bio-inspired concepts, such as motivations, drives and wellbeing, that facilitate the rise of natural behaviors to ease the acceptance of the robot by the users. The system has been designed to promote the human-robot interaction by using drives and motivations related with social aspects, such as the users’ satisfaction or the need of social interaction. Furthermore, the changes of state produced by the users’ exogenous actions have been modeled as transitional states that are considered when the next robot’s action has to be selected. Our system has been evaluated considering two different user profiles. In the proposed system, user’s preferences are considered and alter the homeostatic process that controls the decision making system. As a result, using reinforcement learning algorithms and considering the robot’s wellbeing as the reward function, the social robot Mini has learned from scratch two different policies of action, one for each user, that fit the users’ preferences. The robot learned behaviors that maximize its wellbeing as well as keep the users engaged in the interactions.     

On the blessing of abstraction

The “blessing of abstraction” refers to the observation that acquiring abstract knowledge sometimes proceeds more quickly than acquiring more speci?c knowledge. This observation can be formalized and reproduced by hierarchical Bayesian models. The key notion is that more abstract layers of the hierarchy have a larger “effective” sample size, because they combine information across multiple speci?c instances lower in the hierarchy. This notion relies on speci?c variables being relatively concentrated around the abstract “overhypothesis”. If the variables are highly dispersed, then the effective sample size for the abstract layers will not be appreciably larger than for the speci?c layers. Moreover, the blessing of abstraction is counterbalanced by the fact that data are more informative about lower levels of the hierarchy, because there is necessarily less stochasticity intervening between speci?c variables and the data. Thus, in certain cases abstract knowledge will be acquired more slowly than speci?c knowledge. This paper reports an experiment that shows how manipulating dispersion can produce both fast and slow acquisition of abstract knowledge in the same paradigm.     

Adapting the Unique Minds Program: Exploring the Feasibility of a Multiple Family Intervention for Children with Learning Disabilities in the Context of Spain

The Unique Minds Program (Stern, Unique Minds Program, 1999) addresses the socio‐emotional needs of children with learning disabilities (LD) and their families. Children and their parents work together in a multiple family group to learn more about LD and themselves as people with the capacity to solve problems in a collaborative way, including problems in family school relationships. This article reports the cultural adaptation of the program for use in Spain and findings from a feasibility study involving three multiple family groups and a total of 15 children and 15 mothers, using a pre‐post design. This Spanish adaptation of the program is called “Mentes Únicas”. Standardized outcome measures indicated an overall statistically significant decrease in children's self‐rated maladjustment and relationship difficulties by the end of the program. Improvements were endorsed by most mothers, although they were not always recognized by the children's teachers. The program had a high level of acceptability: Mothers and children felt safe, understood, and helped throughout the sessions. The efficacy of the adapted intervention for the context of Spain remains to be tested in a more rigorous study.     

Learning in the brain–computer interface: insights about degrees of freedom and degeneracy from a landscape model of motor learning

In this paper, we examine the role of degrees of freedom and their degeneracy in learning in the brain–computer interface paradigm. Though the traditional notion of degrees of freedom in motor learning gave emphasis to muscle and joint activity, the broader concept of dimensions of behavior is relevant to brain–computer interface learning where there is no muscle activity. The role of degeneracy in the dimensions of brain activity is proposed to enhance learning through robustness to stability loss and adaptability in the search for new stable states. Principles for the application of augmented information for learning to coordinate and control the degenerate degrees of freedom in the brain–computer interface are outlined.     

Testing the Adult Development Tower of Babel Hypothesis: Homogeneous by Perry Position Collaborative Learning Groups and Graduate Student Satisfaction

The purpose of this quasi-experimental study was to investigate what appears to be a grounding assumption in some adult developmental and educational research: persons of differing epistemologies who are grouped together will understand one another less well than persons who are grouped homogeneously. A robust effect is discussed within the context of adult development theory, research on collaborative learning groups, and Bruffee's social constructionist challenge (K. A. Bruffee, 1993) to Perry and to cognitive development theory. Collateral research questions relating to covariates of developmental position (according to the Perry scheme) are entertained; confirmatory qualitative data are presented.     

The effects of process and outcome accountability on judgment process and performance

This article challenges the view that it is always better to hold decision makers accountable for their decision process rather than their decision outcomes. In three multiple-cue judgment studies, the authors show that process accountability, relative to outcome accountability, consistently improves judgment quality in relatively simple elemental tasks. However, this performance advantage of process accountability does not generalize to more complex configural tasks. This is because process accountability improves an analytical process based on cue abstraction, while it does not change a holistic process based on exemplar memory. Cue abstraction is only effective in elemental tasks (in which outcomes are a linear additive combination of cues) but not in configural tasks (in which outcomes depend on interactions between the cues). In addition, Studies 2 and 3 show that the extent to which process and outcome accountability affect judgment quality depends on individual differences in analytical intelligence and rational thinking style.     

Low environmental calcium blocks long-term memory formation in a freshwater pulmonate snail

The freshwater snail Lymnaea stagnalis (L.) is considered a calciphile and exhibits reduced growth and survival in environments containing less than 20 mg/l environmental calcium. Although it has no apparent effect on survival at 20 mg/l, reducing environmental calcium increases metabolic demand, and as such we consider that this level of calcium acts as a stressor on the snail. We exposed snails to acute periods of low environmental calcium and tested their ability to form intermediate-term memory (ITM) and long-term memory (LTM) following one trial operant conditioning (1TT) to reduce aerial respiratory activity in hypoxic conditions. We also assessed whether there were changes in the electrophysiological properties of a single neuron, right pedal dorsal 1 (RPeD1), which has been demonstrated to be necessary for LTM formation. Following training in high (80 mg/l) environmental calcium, L. stagnalis formed ITM and LTM lasting 24 h and demonstrated a significant reduction in all activity measured from RPeD1; however when snails were exposed to low (20 mg/l) environmental calcium they were able to form ITM but not LTM. Although no behavioral LTM was formed, a partial reduction in RPeD1 activtiy measured 24 h after training was observed, indicating a residual effect of training. The strong effect that environmental calcium concentration had on physiology and behavior in response to training to reduce aerial respiration in L. stagnalis suggests that it is an element of gastropod husbandry that needs to be carefully considered when studying other traits. This study also indicates that L. stagnalis found naturally in low calcium environments may be less able to adapt to novel stressors than populations found in harder waters.     

Interference with reelin signaling in the lateral entorhinal cortex impairs spatial memory

Entorhinal neurons receive extensive intracortical projections, and form the primary input to the hippocampus via the perforant pathway. The glutamatergic cells of origin for the perforant pathway are distinguished by their expression of reelin, a glycoprotein involved in learning and synaptic plasticity. The functional significance of reelin signaling within the entorhinal cortex, however, remains unexplored. To determine whether interrupting entorhinal reelin signaling might have consequences for learning and memory, we administered recombinant receptor-associated protein (RAP) into the lateral entorhinal cortex (LEC) of young Long-Evans rats. RAP prevents reelin from binding to its receptors, and we verified the knockdown of reelin signaling by quantifying the phosphorylation state of reelin’s intracellular signaling target, disabled-1 (DAB1). Effective knockdown of reelin signaling was associated with impaired performance in the hippocampus-dependent version of the water maze. Moreover, inhibition of reelin signaling induced a localized loss of synaptic marker expression in the LEC. These observations support a role for entorhinal reelin signaling in spatial learning, and suggest that an intact reelin signaling pathway is essential for synaptic integrity in the adult entorhinal cortex.     

学业优秀者和学业不良者的倒摄抑制比较 ——从结构化和非结构化角度

以汉字为实验材料,以学业优秀者和学业不良者为被试,探讨学习材料的结构化和非结构化性质对倒摄抑制产生的影响,以及两类学生学习两类材料时的倒摄抑制差异。并通过指导语,逐步揭示结构化材料中的规则,迫使被试采用有效的学习策略,来观察倒摄抑制的变化情况。结果表明:一、与非结构化材料相比,学习结构化材料表现出更好的记忆绩效,但未发现两者对倒摄抑制的不同影响;二、和学优者相比,学业不良者的记忆绩效较差,倒摄抑制值也较大;三、对材料规则的提示会促进学业不良学生的记忆绩效,降低倒摄抑制,但对学习优秀者的影响不大;四、一些汉字识别特征影响倒摄抑制,如当干扰项和目标项构形相同时,会降低倒摄抑制。