More than meets the eye: a consideration of the influence of a counsellor's visual impairment upon his therapeutic relationships

Other than through personal reflection and anecdotal evidence, I have had little opportunity to explore the influence of my visual impairment upon my therapeutic relationships. In order to address this, I conducted three research conversations with former clients (participants), each of whom had expressed an interest in participating in the research. Potential participants also had to meet the inclusion criteria for the research and provide informed consent prior to their participation. Research conversations were conducted between March and July 2009 and were analysed qualitatively, using a method informed by Moustakas's heuristic inquiry. Participants demonstrated idiosyncratic responses to my visual impairment; their perception of their responses to my visual impairment sometimes differed from mine. Feelings identified included uncertainty, disappointment and relief. My visual impairment appeared to influence the therapeutic relationship in a variety of ways, including resonance with the inner world significance of disability to the participant and interaction with my personal process. While not the therapeutic agent, my visual impairment had the potential to act as a catalyst in therapeutic change. The potential for me to either under-estimate or over-estimate the significance of my visual impairment highlights the need for continued self-awareness and the maintenance of an open and non-defensive attitude.     

常态脑老化认知功能障碍及相关代谢机制研究进展

常态脑老化（NBA ）是老年期痴呆的首要危险因素,与病态性脑老化有相似的病理基础,但并不完全相同。虽然单一的“脑老化”因素并不足以成为导致老年期痴呆的独立原因,但脑老化状态确实使得大脑对外界负性刺激的敏感性增加,进而使老年人更容易发生认知障碍。阿尔茨海默病等老年痴呆症状的治疗方面尚无逆转的方法,而是重在预防。因此,我们将重点放在痴呆发生之前更早的阶段---常态脑老化阶段,就常态脑老化状态下与认知功能障碍的表现、发生机理及代谢相关机制进行综述,旨在为早期寻找措施防止老年期痴呆性认知功能下降提供理论基础。     

The influence of social anxiety on the body checking behaviors of female college students

Social anxiety and eating pathology frequently co-occur. However, there is limited research examining the relationship between anxiety and body checking, aside from one study in which social physique anxiety partially mediated the relationship between body checking cognitions and body checking behavior (Haase, Mountford, & Waller, 2007). In an independent sample of 567 college women, we tested the fit of Haase and colleagues’ foundational model but did not find evidence of mediation. Thus we tested the fit of an expanded path model that included eating pathology and clinical impairment. In the best-fitting path model (CFI = .991; RMSEA = .083) eating pathology and social physique anxiety positively predicted body checking, and body checking positively predicted clinical impairment. Therefore, women who endorse social physique anxiety may be more likely to engage in body checking behaviors and experience impaired psychosocial functioning.     

Is working memory necessary for implementation intentions to enhance prospective memory in older adults with cognitive problems?

Implementation intentions are an effective strategy for improving prospective memory in older adults. However, their efficacy has never been assessed in older individuals with cognitive problems (i.e., individuals with subjective memory complaints or objective memory impairments). Furthermore, although most authors consider implementation intentions to depend on automatic processes, some studies have shown the necessity of residual preserved controlled processes for implementation intentions to be efficient. We examined the efficacy of implementation intentions in prospective memory in 45 older participants consulting a memory clinic. Half of the participants were instructed to form an implementation intention, the other half receiving standard instructions. Analyses showed that working memory moderated the efficacy of implementation intentions, which were efficient only in individuals with better working memory. These results corroborate the claim that a minimal level of cognitive resources is required for the technique, although implementation intentions might depend principally on automatic processes.     

Age- and education-adjusted normative data for the Montreal Cognitive Assessment (MoCA) in older adults age 70–99

The original validation study for the Montreal Cognitive Assessment (MoCA) suggests a cutoff score of 26; however, this may be too stringent for older adults, particularly for those with less education. Given the rapidly increasing number of older adults and associated risk of dementia, this study aims to provide appropriate age- and education-adjusted norms for the MoCA. Data from 205 participants in an ongoing longevity study were used to derive normative data. Individuals were grouped based on age (70–79, 80–89, 90–99) and education level (≤12 Years, 13–15, ≥16 Years). There were significant differences between age and education groups with younger and more educated participants outperforming their counterparts. Forty-six percent of our sample scored below the suggested cutoff of 26. These normative data may provide a more accurate representation of MoCA performance in older adults for specific age and education stratifications.     

Relationship of cognitive strategy use to prospective memory performance in a diverse sample of nondemented older adults with varying degrees of cognitive complaints and impairment

Although older adults typically have better performance on prospective memory (PM) tasks carried out in naturalistic settings, a paucity of research directly assesses older adults’ use of compensatory strategies on such tasks. The current study investigates external memory strategy use during performance of a clinical PM test that features both short-term (in laboratory) and long-term (out of laboratory) subtasks (i.e., the Royal Prince Alfred Prospective Memory Test – RPA-ProMem. Nondemented, community-dwelling older adults (n = 214; mean age = 80.5; 68.2% female; 39.7% non-white) with mild cognitive impairment, subjective cognitive decline, and healthy controls completed the RPA-ProMem while external strategy use was permitted and recorded. Overall, participants utilized external strategies 41% of the time on the RPA-ProMem. Increased utilization of external memory strategies was significantly associated with better PM performance. Additionally, better performance on executive functioning tasks was associated with increased use of external memory strategies. Results are discussed in relation to how memory strategy use can be enhanced to improve everyday memory ability in older adults at risk for dementia.     

Dual-task effects of simulated lane navigation and story recall in older adults with and without memory impairment

ABSTRACT

While driving is a complex task, it becomes relatively automatic over time although unfamiliar situations require increased cognitive effort. Much research has examined driving risk in cognitively impaired elders and found little effect. This study assessed whether mildly memory impaired elders made disproportionate errors in driving or story recall, under simultaneous simulated driving and story recall. Forty-six healthy (61% women; mean age = 76.4) and 15 memory impaired (66% women, mean age = 79.4) elders participated. Cognitive status was determined by neuropsychological performance. Results showed that during dual-task conditions, participants stayed in lane more, and recalled stories more poorly, than when they did the tasks separately. Follow-up analysis revealed that verbatim recall, in particular, was reduced while driving for healthy participants. While memory impaired participants performed more poorly than healthy controls on both tasks, cognitive status was not associated with greater dual-task costs when driving and story recall were combined.     

Influence of memory strategies on memory test performance: A study in healthy and pathological aging

ABSTRACT

The ability to generate memory strategies is a key factor in the performance of episodic memory tasks. Whether the ability to generate memory strategies exerts an influence in the performance of memory tests in the elderly population is still a matter of debate. Here we present results from an experimental memory task (Test of Memory Strategies, TMS), comprised of five lists of words starting from an incidental learning task, and four more lists which progressively gain in their external organization of the material, reducing the necessity of mobilizing complex memory strategies. TMS has been applied to four groups of elderly patients (amnestic Mild Cognitive Impairment – aMCI, multidomain (mMCI), and Vascular Cognitive Impairment – VCI and Depression) and a healthy aging group. In conditions with low organization of the material, the mMCI and VCI groups (both showing a greater executive function impairment) have shown lower performance. However, as the material was progressively organized, they improved their performance. The aMCI group showed similar performance to the control group at the lower level of external organization but did not improve performance in conditions with a high level of external organization. The mMCI and VCI groups showed lower performance on all TMS conditions compared with controls. Discriminant analysis revealed 90% sensitivity and specificity to differentiate between groups based on TMS conditions. These results indicate how executive functions influence performance on memory tasks in elderly subjects with different neuropsychological profiles.     

The role of item similarity in part-list cueing impairment

The presentation of a subset of studied items as retrieval cues can have detrimental effects on recall of the remaining (target) items. In three experiments we examined whether such part-list cueing impairment depends on the similarity between cue and target items. Item similarity was manipulated by making use of pre-experimental semantic similarities between cue and target items (Experiments 1 and 2), or was episodically induced through a similarity-encoding task, in which participants were asked to interrelate cue and target items in a meaningful way (Experiment 3). In all three experiments reliable part-list cueing impairment arose when the similarity between cues and targets was low, but no impairment was found when the similarity between cues and targets was high. Inhibitory as well as non-inhibitory explanations of the findings are discussed.     

Knowledge of Memory Aging Across the Lifespan

ABSTRACT. The authors examined knowledge of normal and pathological memory aging in a lifespan sample of 198 individuals who ranged in age from 13 to 88 years. Participants completed the Knowledge of Memory Aging Questionnaire (Cherry, Brigman, Hawley, & Reese, 2003). The authors hypothesized that high school students would be less knowledgeable about memory aging issues than college students, middle-aged, and community-dwelling older adults. Consistent with this hypothesis, response accuracy was lower for high school students compared to their older counterparts. Follow-up analyses revealed that high school students’ responses to a subset of questions that tap ageist views of adult cognition were less accurate than the other age groups, implying a response bias toward stereotypical images of memory aging. Implications for research and the design of instructional materials to increase people's knowledge about normative changes in adult cognition are discussed.