Visual associations to retrieve episodic memory across healthy elderly,mild cognitive impairment,and patients with Alzheimer’s disease

Episodic memory tests need to determine the degree to which patients with moderate to severe memory deficits can still benefit from retrieval support. Especially in the case of Alzheimer’s disease (AD), this may support health care to be more closely aligned with patients’ memory capacities. We investigated whether the different measures of episodic memory of the Visual Association Test-Extended (VAT-E) can provide a more detailed and informative assessment on memory disturbances across a broad range of cognitive decline, from normal to severe impairment as seen in AD, by examining differences in floor effects. The VAT-E consists of 24 pairs of black-and-white line drawings. In a within-group design, we compared score distributions of VAT-E subtests in healthy elderly controls, mild cognitive impairment (MCI), and AD (n = 144), as well as in relation to global cognitive impairment. Paired associate recall showed a floor effect in 41% of MCI patients and 62% of AD patients. Free recall showed a floor effect in 73% of MCI patients and 84% of AD patients. Multiple-choice cued recognition did not show a floor effect in either of the patient groups. We conclude that the VAT-E covers a broad range of episodic memory decline in patients. As expected, paired associate recall was of intermediate difficulty, free recall was most difficult, and multiple-choice cued recognition was least difficult for patients. These varying levels of difficulty enable a more accurate determination of the level of retrieval support that can still benefit patients across a broad range of cognitive decline.     

PARENTS AND THEIR CHILD AND THE ANALYST IN THE MIDDLE

The first part of this paper explains how the transgenerational mandate influences the mental activity of the child. When a child acts the denied suffering of the parental couple, the analyst risks being imprisoned by the transgenerational mandate. Frequently the analyst is unconsciously asked by the parents to cure without curing because the child's psychological birth, still in the making, threatens the defensive equilibrium of the parents. The analyst is thus caught between the parents and the child and must find his/her own way forward in order to free the child from the burden of the mandate. In the second part of the paper, an analysis of a 5-year-old child is presented. The author shows how a transgenerational mandate may hold a traumatic potential because it can impair heavily the child's capacity to think. The author also describes the way in which she works with the parents and how she manages the setting and the style of the interpretation. She insists in particular on the need to sustain the child's perceptions in order to gradually allow the child to take roots in his/her experiences and therefore develop his/her own identity.     

Parental Responsibility and the Morality of Selective Abortion

It is now a common opinion in Western countries that a child's impairment would probably place an unexpected burden on her parents, a burden that the parents have not committed themselves to dealing with. Therefore, selective abortion is in general a morally justified option for the parents. I argue that this view is based on biased information about the quality of life of individuals with impairments and their families. Also, a conscious decision to procreate should bring about conscious assent to assuming obligations as a parent. This implies a duty of caring for any kind of child. Consequently, if the child's condition is not such that it would make its life not worth living, and if the parents live in an environment where they are able to provide their child and themselves an adequate well-being, they do not have a morally sufficient reason to terminate the pregnancy on the grounds of fetal abnormality.     

Neuropsychological Functioning Associated with High-Altitude Exposure

This article focuses on neuropsychological functioning at moderate, high, and extreme altitude. This article summarizes the available literature on respiratory, circulatory, and brain determinants on adaptation to hypoxia that are hypothesized to be responsible for neuropsychological impairment due to altitude. Effects on sleep are also described. At central level, periventricular focal damages (leuko-araiosis) and cortical atrophy have been observed. Frontal lobe and middle temporal lobe alterations are also presumed. A review is provided regarding the effects on psychomotor performance, perception, learning, memory, language, cognitive flexibility, and metamemory. Increase of reaction time and latency of P300 are observed. Reduced thresholds of tact, smell, pain, and taste, together with somesthetic illusions and visual hallucinations have been reported. Impairment in codification and short-term memory are especially noticeable above 6,000 m. Alterations in accuracy and motor speed are identified at lower altitudes. Deficits in verbal fluency, language production, cognitive fluency, and metamemory are also detected. The moderating effects of personality variables over the above-mentioned processes are discussed. Finally, methodological flaws found in the literature are detailed and some applied proposals are suggested.     

Effect of lexical cues on the production of active and passive sentences in Broca's and Wernicke's aphasia

This study compared the sentence production abilities of individuals with Broca's and Wernicke's aphasia in an attempt to explore the extent to which impaired lexical retrieval impedes sentence production. The ability to produce active and passive reversible and non-reversible sentences was examined when varying amounts of lexical information was provided. The results showed that both Wernicke's and Broca's aphasic individuals were impaired in passive sentence production and that these difficulties were not overcome when lexical cues (the relevant nouns and uninflected verb) were provided. However when auxiliary and past tense morphemes were provided along with the verb stem, production of passive sentences improved drastically for both groups. Analysis of error patterns, however, revealed differences between the two groups, suggesting that Broca's aphasic subjects may find passive sentences difficult due to problems with retrieving the relevant grammatical morphemes. Subjects with Wernicke's aphasia may have been unable to automatically access the passive sentence structure.     

Selective inhibition in children with attention-deficit hyperactivity disorder off and on stimulant medication

Selective inhibition requires discrimination between auditory signals and is assessed using a modification of the stop-signal task. Selective inhibition was assessed in a group of 59 clinic-referred, DSM-IV-diagnosed children with attention-deficit hyperactivity disorder (ADHD) and compared to that of a community sample of 59 children. Methylphenidate (MPH) effects on selective inhibition were assessed in a subset of the ADHD sample that participated in an acute, randomized, placebo-controlled, crossover trial with 3 fixed doses of MPH. Children with ADHD performed more poorly than controls on the majority of selective stop-signal task parameters: they exhibited more anticipatory (invalid) responses, with less accurate and more variable responses on the response execution task, as well as a slower selective inhibition process. MPH improved speed of both inhibition and response execution processes; it also reduced variability of response execution and decreased nonselective inhibition. On the one hand, findings are consistent with purported inhibition deficit in ADHD, but on the other hand, suggest that neither the impairment itself, nor MPH effects, were restricted to inhibition.     

Posttraumatic stress disorder and psychosocial functioning within two samples of MVA survivors

To examine criterion F variables of PTSD, the psychosocial functioning of two samples of motor vehicle accident (MVA) survivors was investigated. Within each sample, comparisons between MVA survivors with and without PTSD were conducted on four psychosocial functioning indices at three time points. In addition, the relationships between specific PTSD symptom clusters and psychosocial functioning indices were examined. The study revealed that, in general, MVA survivors with PTSD evidenced poorer psychosocial functioning than did survivors without PTSD. The emotional numbing symptoms of PTSD emerged as the most consistent predictors of the psychosocial functioning indices. The implications of these findings to the comprehensive treatment of PTSD are discussed.     

Cognitive impairment and the 10-year survival probability of a normal 62-year-old population

The predictive value of cognitive impairment together with demographic and health factors on long-term survival was evaluated. The population sample comprised 389 subjects, all 62 years old. Cognitive performances were measured using verbal, visuomotor and memory tests. Cognitive impairment was determined by comparing performances with norms derived from healthy controls. Ten years after testing, the probability of survival was 89% for the cognitively preserved subjects, 80% for those with mild impairment, and 71% for those with moderate impairment (p = 0.009). Relative risk (RR) for shortened survival was 1.7 (95% CI 0.9-3.2) for the mildly, and 2.6 (95% CI 1.4-4.8) for the moderately impaired. Perceived health problems were, as expected, related to reduced survival (p < 0.001, RR 3.6, 95% CI 2.1-6.0), and there was an association between cognitive impairment and impaired perceived health (p = 0.040). Multivariate analyses with Cox's regression models showed that cognitive impairment, in particular, impaired episodic memory had an association with survival, in addition to the expected effects. Thus, memory impairment may reflect very early signs of underlying disease, and so the findings provide predictive validity for the cognitive methods used.     

Getting a grip on the resilience to blur: The impact of simulated vision loss on a visually guided combat sports interaction

Research has shown that performance in highly visually demanding sports can be resilient to substantial levels of blur. This raises the question whether the need for high visual clarity might be reduced even more in less visually demanding sports such as combat sports, where athletes compete at relatively close distances. The aim of this study was to examine the resilience to blur in the grip fighting phase of judo as an exemplar of a visually guided combat sports task. The results were particularly relevant for the purposes of Paralympic judo for athletes with vision impairment (VI judo), because athletes are currently allowed to compete with a visual acuity (VA) of 1.0 logMAR or worse (i.e., 6/60 or 20/200 vision), suggesting this is the presumed level of impairment that decreases performance in able-sighted judo. We let 28 able-sighted judo athletes compete in pairs in a series of grip fighting tasks under increasing levels of simulated vision impairment. Visual function was tested in each condition by measuring VA and contrast sensitivity (CS). We found that VA was a better predictor than CS of grip fighting performance. VA needed to be reduced to at least 1.3 logMAR before a decrease in performance was found, with approximately twice as much blur needed to be applied when compared to visually demanding tasks such as cricket batting, but less than what has been found in static tasks such as basketball free-throw shooting and golf putting. These findings hold implications for VI judo regulations, suggesting that a more severe degree of impairment should be required to participate than is currently the case.     

听障学生汉语唇读面部加工方式的差异：来自眼动的证据

为探讨高低唇读理解能力听障学生唇读面部加工方式的差异,研究采用视频—图片匹配范式并结合眼动技术,考察高低唇读能力组语前-语中-语后和整体面部加工方式。结果发现,虽然两组都表现出社会协调模式,但高唇读能力组社会协调分数更高,且眼部维持时间更长。表明高唇读能力者整体加工和眼部、口形并行加工能力强,支持凝视假说和社会协调模式;低唇读能力者整体加工效率低,更依赖口形,未能通过补偿策略获得良好的补偿效果。