Using a System of Least Prompts Procedure to Teach Telephone Skills to Elementary Students with Cognitive Disabilities

Using the telephone to contact others can be an important skill in maintaining friendships with peers. This investigation used a system of least prompts (SLP) procedures to teach two telephone skills to 3 elementary students with cognitive disabilities: (a) placing phone calls and (b) leaving recorded voicemail messages. The SLP procedure was effective in teaching both skills to all 3 students. Results for maintenance and generalization, however, were mixed. This investigation was completed to partially satisfy the thesis requirement for a Master’s degree at the University of Kentucky.     

Coping with Crisis Across the Lifespan: The Role of a Telephone Hotline

We describe over 300,000 crisis calls made to a large national hotline over a 5-year period. Callers consisted of males and females between the ages of 10 and 89. Overall, a slight majority of callers were first time callers (52%) and most (73%) sought assistance with issues related to parenting, youth concerns, and mental health. Across the lifespan, issues dealing with loneliness increased with age whereas depression-related calls decreased. Additionally, females were more likely than their male counterparts to call the hotline by over a 2- to 1-margin. Findings lend preliminary support to the efficacy of crisis call centers to utilize a flexible, yet well-defined problem-solving approach to assist those of all ages calling with the wide range of problems.     

Children with ADHD in Residential Care

Little is known about the characteristics or functioning of children with ADHD in residential care as compared to their non-ADHD peers. This study evaluated data on 538 children with (n = 125) and without (n = 413) ADHD in residential care to determine demographic, mental health, behavioral, and treatment (i.e., medication use) characteristics. Results revealed that both groups presented elevated risks, however, scores for children with ADHD indicated even greater levels of need. Specifically, differences were found between the two groups on demographics (e.g., family reunification status, restrictiveness of prior out-of-home placements), behavior (e.g., attention problems, rule-breaking and aggressive behaviors) and medication status. Findings suggest there is a need for aftercare services to help support families as children transition from care, interventions to address behavior, and medication management through assessment and monitoring.     

Relationship between Mental Health and Burden among Primary Caregivers of Outpatients with Schizophrenia

There is growing recognition that caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health for caregivers. A quantitative cross‐sectional design and standardized instruments were used to collect data from 355 primary caregivers of adults in outpatient care with schizophrenia in China. Structural equation modeling was used to examine the association between caregiver burden and mental health among primary caregivers and whether this association is influenced by personality, coping style, and family functioning, based on a diathesis–stress perspective. Goodness‐of‐fit indices (χ²/df = 1.406, GFI = 0.919, CFI = 0.957, etc.) confirmed that the modified model fit the data well. In line with the diathesis–stress model, and with this study's hypotheses, we found that caregiver burden was significantly related to mental health outcomes directly. The final model showed that personality traits, coping style, and family function influenced the relationship between caregiver burden and mental health. The neuroticism personality traits have a direct effect on caregiver burden and family functioning in this sample. Coping style had a direct effect on the caregiver burden, and family functioning had a direct effect on the caregiver burden. Our final model about primary caregivers can be applied clinically to predict mental health outcomes from caregiver burden.     

Gait,balance, mobility and muscle strength in people with anxiety compared to healthy individuals

BackgroundAnxiety disorders are the most common mental disorders. Changes in psychomotor behavior can be observed in gross motor skills, with gait disturbances thought to reflect defective brain functions in psychiatric conditions. While balance deficits are well documented in anxiety, only little is known about gait characteristics of people with anxiety.ObjectiveThis study wishes to examine the existence of differences in gait, balance, mobility and muscle strength between people with anxiety and healthy individuals, and to investigate the relationship between level of anxiety and motor characteristics.MethodsAn observational study was conducted in a psychiatric out-patient unit at a large Israeli general hospital. The sample consisted of 93 participants, ages 18–65: 48 of them (27 female, 21 male) categorized as having anxiety, and 45 (25 female, 20 male) without anxiety. Participants were divided into two groups of various ages and both genders, and completed two questionnaires and four physical tests: objective anxiety assessment (Hamilton Anxiety Rating Scale); spatiotemporal gait parameters (10-meter walking test); balance function (Unipedal Stance Test); muscle strength evaluation, and mobility (Time Up and Go Test). No attempt was made to correlate between the anxiety and control groups based on age and/or gender.ResultsParticipants with anxiety (both genders) were characterized by slower walking speed, shorter step length, and fewer steps per minute (p < 0.001), as well as balance deficiency and mobility dysfunction (p < 0.001), compared to the control group. Muscle strength in women with anxiety was found to be significantly lower than in healthy women.ConclusionsTo the best of our knowledge, this study is the first of its kind to examine spatiotemporal gait components in patients with anxiety. Based on the findings, there is room to consider implementing gait analysis into the physical examination of patients with anxiety, as well as muscle strength, balance, and mobility function. Correct assessment and proper treatment of these aspects might contribute to the well-being of patients with anxiety.     

Embedded Cognition and Mental Causation: Setting Empirical Bounds on Metaphysics

In this paper, we challenge Jaegwon Kim’s version of neural reductionism according to which the causal powers of mental properties are pre-empted by those of neural properties. Using empirical and theoretical developments from the field of embedded cognition, we articulate and defend a notion of process externalism that extends Clark and Chalmers’ notion of an extended mind. We argue that process externalism undermines one of Kim’s key premises leading to the alternative conclusion that mental causation cannot be reduced to neural causation. Instead, mental properties have their own new causal powers just like other scientifically established macroproperties.     

Mental time travel,somatic markers and “myopia for the future”

Patients with damage to the ventromedial prefrontal cortex (VMPFC) are often described as having impaired ability for planning and decision making despite retaining intact capacities for explicit reasoning. The somatic marker hypothesis is that the VMPFC associates implicitly represented affective information with explicit representations of actions or outcomes. Consequently, when the VMPFC is damaged explicit reasoning is no longer scaffolded by affective information, leading to characteristic deficits. These deficits are exemplified in performance on the Iowa Gambling Task (IGT) in which subjects with VMPFC perform significantly worse than neurotypicals in a task which requires them learn from rewarding and punishing experience to make decisions. The somatic marker theory adopts a canonical theory of emotion, in which emotions function as part of a valencing system, to explain the role of affective processes. The first part of the paper argues against this canonical account. The second part provides a different account of the role of the role of the VMPFC in decision-making which does not depend on the canonical account of emotion. Together the first and second parts of the paper provide the basis for a different interpretation of results on the Iowa Gambling Task (IGT). In fact the IGT may be probing a deficit in what has been called mental time travel: the ability to access and use information from previous experience and imaginatively rehearse future experiences as part of the process of deliberation.     

Treatment Participation among Children with Conduct Problems and the Role of Telephone Reminders

Children with antisocial, aggressive and disruptive behaviour problems are among the most frequent referrals to mental health services. These young people and their families present with a range of adverse contextual factors and can prove challenging to engage. We examined the characteristics of children with conduct problems, treatment participation, and the impact of telephone reminder calls. Consecutive referrals (N=262) to two child and youth mental health services were randomly assigned to either a reminder call condition or service as usual. In comparison to referrals without conduct problems, conduct problem children presented with greater sources of psychosocial adversity, attended fewer initial appointments and were at greater risk of treatment refusal. Importantly, telephone reminder calls significantly increased treatment attendance, though only for participants with elevated conduct problems. Telephone reminder calls, however, had no impact on treatment refusal, regardless of conduct problem status. The findings highlight a straightforward approach for enhancing treatment participation among a group that has been challenging for mental health services.     

Effects of imagery training on cognitive performance and use of physiological measures as an assessment tool of mental effort

The effectiveness of motor imagery training on cognitive performance was examined and the physiological mechanisms involved in the contribution of mental practice to motor learning were considered. The subject's mental effort during motor imagery was assessed by using psychophysiological measures and particularly eye blink activity as an 'indirect' measurement of subjects' attention. An electronic flight simulation program (Multiple Attribute Task Battery--MATB) was used to assess performance. Twenty healthy volunteers participated in the study divided in two groups: the control group and the imagery-training group. The subjects of the imagery group were asked for additional imagery training. The subjects of the actual performing group were asked additionally to passively observe the task in order to have equal time of exposure to the task. Performance scores and physiological parameters such as heart rate, respiratory rate, eye blinking activity and muscular activity were recorded during all sessions. The results revealed significantly higher performance level of the imagery-training group than the control group. Heart rate and respiratory rate significantly increased during imagery sessions compared to rest. A slight electromyographic activity was observed during the imagination of movement. Our findings support the notion that mental practice improves motor performance in a task where spatiotemporal or dynamic control of the action is highly required. The effects of mental practice on motor performance could be explained by the existence of a top-down mechanism based on the activation of a central representation of the movements, since the vegetative activation during motor imagery seems to be centrally controlled.