Destructiveness, atrocities and healing: epistemological and clinical reflections

In this paper, destructiveness is approached as a multi-dimensional phenomenon where the mental health perspective addresses only one of these dimensions. An attempt is made to locate this phenomenon in the context of epistemological and societal considerations. Critical of mono-dimensional explanations based on causal-reductive epistemology, the paper instead proposes the idea of an 'ecology of destructiveness', according to which mental health professionals cannot possibly continue to assume the role of detached observers. The ordinariness and archetypal fascination of destructiveness are discussed as preventing the psychologizing and pathologizing of it. In addition, it is suggested that 'destructiveness may be a tragic facet of the human condition', without this implying any justification of it. Based on my work with a group of Bosnian ex-camp prisoners, some basic principles of how one can work with survivors of atrocities are derived and discussed. A central feature of this work is the attempt to create an appropriate therapeutic context within which a 'therapeutic presence' and 'therapeutic witnessing' can be developed. Finally, the relevance of Jungian insights to this kind of work is reviewed and the emergence of new types of defences of the self is identified.     

L’entraînement de la mémoire de travail par le programme Cogmed et le TDAH

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Inattention, hyperactivity, and impulsivity are key symptoms of ADHD. It is typically associated with working memory deficits at the cognitive level. For this reason, interventions have been designed to train working memory in ADHD. Currently, Cogmed Working Memory Training program is the most commonly used and studied program in clinical practice and research. This program is proposed as an intervention for ADHD that targets working memory deficits with specific exercises through intensive training sessions.ObjectivesThe goal of this literature review is to examine the effects of the Cogmed program in children and adolescents with ADHD on working memory, inhibition, non-verbal reasoning, attention functioning, ADHD symptoms and academic achievement. All existing studies on the subject that included a control group (n = 8) are reviewed.ResultsIt is clear from most studies that Cogmed training program increases and verbal and visuospatial working memory (or the phonological loop and visuospatial sketchpad in Baddeley's model (1986, 2007), among ADHD participants. However, transfer of learning is not demonstrated on other components of working memory that are not directly targeted by the program such as the central executive described in Baddeley's model or the secondary memory defined by Unsworth & Engle (2007). With regards to far transfer measures, results are controversial for inhibition, non-verbal reasoning, ADHD symptoms reported by parents, and reading abilities. No improvement is demonstrated for attentional capacities, ADHD symptoms reported by teachers and mathematic reasoning.ConclusionCogmed training improves verbal and visuospatial working memory, two cognitive functions that play an important role in ADHD. However, Cogmed's exercises need to be modified in order to train more complex working memory components such as the central executive (Baddeley, 1986, 2007) and the secondary memory (Unsworth & Engle, 2007), which are more impaired in ADHD than the phonological loop and visuospatial sketchpad. Another approach would be to design programs that can tackle a larger range of cognitive functions that are impaired in ADHD (e.g., inhibition). In future, studies evaluating such modified programs, direct observation instruments that are more sensitive to short-term changes need to be included. Follow-up measures should also be systematically included.     

Psychometric properties of the Problem Video Game Playing scale in adults

IntroductionInternet Gaming Disorder (IGD) was introduced for the first time within the “conditions for further study” in the fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association, and a systematic review has concluded that the only available instrument for its measurement is the Problem Video Game Playing scale (PVP). Nevertheless, this scale was presented as a diagnostic tool for adolescents, and to date no study has analyzed its properties amongst adults.ObjectiveThe aim of the study was to analyze and compare the diagnostic and psychometric properties of the PVP in adult and adolescent gamers.MethodTwo samples of adult (n = 525) and adolescent (n = 384) gamers completed a survey including patterns of play, PVP, Severity of Dependence Scale, and other measures of playing to excess.ResultsConfirmatory factor analyses revealed that the scale presents a one-factor structure that is similar to that of the original version, both in adults and adolescents. Construct validity was supported by highly significant associations between the PVP and all alternative measures of playing to excess. On the other hand, reliability values were lower than in previous studies.ConclusionsThe PVP scale's properties are appropriate for the measurement of problem video gaming in adults as well as in adolescents, but studies with clinical assessments are still needed before any cutoff value for diagnosis can be established.     

Exploring inter-task transfer following a CO-OP approach with four children with DCD: A single subject multiple baseline design

IntroductionCognitive Orientation to daily Occupational Performance (CO-OP) approach has been shown to be effective for improving the performance of tasks worked on in therapy and the use of cognitive strategies. No study to date seems to have explored its effectiveness for improving performance of untrained tasks (inter-task transfer) in children with Developmental Coordination Disorder (DCD).ObjectiveThis study aimed to determine whether CO-OP leads to improved performance in an untrained task.MethodsA single-subject design with multiple baselines across skills was adopted, with three replications. Four children with DCD (7–12 years) received 10 sessions of CO-OP intervention where each child worked on three tasks during therapy sessions and a fourth task was identified, but not worked on, to verify inter-task transfer. Task performance was rated over four phases (baseline, intervention, post-intervention, follow-up) using the Performance Quality Rating Scale (PQRS-OD). Graphed data was statistically analyzed using a two or three standard deviation band method.ResultsSignificant improvement was obtained for 11 of 12 tasks worked on during therapy and for two of the four untrained tasks.ConclusionThese results indicate that the effectiveness of CO-OP to improve untrained tasks in children merit further exploration.     

Emotion recognition in children with Fetal Alcohol Spectrum Disorders

There is a limited amount of research that examines social-emotional functioning in children with Fetal Alcohol Spectrum Disorder (FASD), and the majority of it relies on parent and teacher reports of social impairments. Because these provide broad measures of social function, they fail to elucidate the underlying specific skills with which this group of children has difficulty. The current study examines emotion-recognition abilities in children with FASD, as it plays a central role in social interaction. Participants were 22 children with diagnosed FASD (ages 8–14), and age- and gender-matched typically developing controls. Tasks included measures of emotion recognition from three nonlinguistic modalities: facial expressions, emotional tone of voice, and body positioning and movement. Participant’s parents completed measures of adaptive and behavioral function that were related to children’s performance on aspects of emotion recognition. Overall, the results show that children with FASD have more difficulties with emotion recognition than typically developing age-matched peers, but these difficulties may not be clinically significant (e.g., smaller effect size) or may be specific to the age of the individual exhibiting the emotion (i.e., child vs. adult). These results are discussed in the context of previous studies.     

Resurgence is greater following a return to the training context than remaining in the extinction context

The present study examined whether resurgence of a previously reinforced target response upon removing alternative reinforcement would be greater when (1) returning to the original training context (ABA context changes) versus (2) remaining in the analogue treatment context in which the alternative response was differentially reinforced (ABB context changes). Experiment 1 arranged reinforcement of button pressing with points exchangeable for money in university students. Experiment 2 arranged reinforcement of lever pressing with food for rats. Experiment 3 arranged reinforcement of responses to a touchscreen with small bites of food with children diagnosed with ASD. Overall, resurgence of target responding tended to be greater when returning to the original training context (A) than when remaining in the analogue treatment context (B). These findings suggest context changes with differential reinforcement treatments could exacerbate the recurrence of problem behavior resulting from reductions in treatment integrity through failure to reinforce appropriate behavior.     

The assessment of autistic traits with the Autism Spectrum Quotient: Contribution of the French version to its construct validity

IntroductionThe Autism Spectrum Questionnaire (AQ, Baron-Cohen et al., 2001) is a self-report assessment tool aiming at screening autistic traits in normal intelligence adults. While numerous versions in other languages than English now exist, few factorial evidence do sustain the valid use of this instrument as it was conceived, based upon five distinct dimensions (Social skills, Communication, Attention to detail, Attention switching, Imagination); no such study exists with a French version of the AQ. The aim of our study is therefore to present the French version of the scale and to explore its factorial validity with confirmatory factorial analyses and, possibly, its invariance across men and women.MethodSeveral confirmatory factorial analyses, with the robust WLSMV estimator for categorical response format, were run on the questionnaire data from 788 French-speaking students (17–25 years old) at university faculties or schools for higher education in Belgium. The original five-factor measurement model of the AQ was assessed as well as alternative models. An exploratory factorial analysis was also applied to get more insight as to possible sources of misfit.ResultsNo measurement model – neither the original five-factor one nor any of the six other models tested – did produce statistics or fit indices close to significant values: there was no fit to the data. The internal consistency of the subscales was weak; the exploratory factorial analysis further confirmed that as much as ten factors were needed to explain 45% of the data variance.ConclusionOur results, with a French version of the scale, add to many other ones which suggest that the AQ is a too heterogeneous questionnaire with somewhat ill-defined dimensions and non specific/ambiguous items. The questionnaire should probably be shortened and its content realigned to core features of the autism spectrum.