Escape as reinforcement and escape extinction in the treatment of feeding problems

Given the effectiveness of putative escape extinction as treatment for feeding problems, it is surprising that little is known about the effects of escape as reinforcement for appropriate eating during treatment. In the current investigation, we examined the effectiveness of escape as reinforcement for mouth clean (a product measure of swallowing), escape as reinforcement for mouth clean plus escape extinction (EE), and EE alone as treatment for the food refusal of 5 children. Results were similar to those of previous studies, in that reinforcement alone did not result in increases in mouth clean or decreases in inappropriate behavior (e.g., Piazza, Patel, Gulotta, Sevin, & Layer, 2003). Increases in mouth clean and decreases in inappropriate behavior occurred when the therapist implemented EE independent of the presence or absence of reinforcement. Results are discussed in terms of the role of negative reinforcement in the etiology and treatment of feeding problems.     

Effects of attention on dichotic listening in elderly and patients with dementia of the Alzheimer type

This article presents an overview of our studies in elderly and Alzheimer patients employing Kimura's dichotic digits paradigm as a measure for left hemispheric predominance for processing language stimuli. In addition to structural brain mechanisms, we demonstrated that attention modulates the direction and degree of ear asymmetry in dichotic listening. Elderly showed increasingly more difficulties focusing attention on the left ear (LE) with advancing age. Alzheimer patients showed severe deficits to allocate attention to the LE, which could result in a right ear advantage. These results may be attributed to a breakdown of the cortical attentional network which is mediated by frontal (inhibitory control of attention) and parietal regions (spatial attention and 'disengagement processes'). Both interhemispheric disconnectivity (callosal atrophy) and intrahemispheric disconnectivity (subcortical white matter lesions) appear to be important factors contributing to these findings.     

ASSESSMENT OF PREFERENCE FOR EDIBLE AND LEISURE ITEMS IN INDIVIDUALS WITH DEMENTIA

We conducted 2 studies on reinforcer preference in patients with dementia. Results of preference assessments yielded differential selections by 14 participants. Unlike prior studies with individuals with intellectual disabilities, all participants showed a noticeable preference for leisure items over edible items. Results of a subsequent analysis with 3 participants showed reinforcement effects when highly preferred items were delivered as consequences.     

Impairments of speech fluency in Lewy body spectrum disorder

Few studies have examined connected speech in demented and non-demented patients with Parkinson’s disease (PD). We assessed the speech production of 35 patients with Lewy body spectrum disorder (LBSD), including non-demented PD patients, patients with PD dementia (PDD), and patients with dementia with Lewy bodies (DLB), in a semi-structured narrative speech sample in order to characterize impairments of speech fluency and to determine the factors contributing to reduced speech fluency in these patients. Both demented and non-demented PD patients exhibited reduced speech fluency, characterized by reduced overall speech rate and long pauses between sentences. Reduced speech rate in LBSD correlated with measures of between-utterance pauses, executive functioning, and grammatical comprehension. Regression analyses related non-fluent speech, grammatical difficulty, and executive difficulty to atrophy in frontal brain regions. These findings indicate that multiple factors contribute to slowed speech in LBSD, and this is mediated in part by disease in frontal brain regions.     

Language deficits in pre-symptomatic Huntington's disease: evidence from Hungarian

A limited number of studies have investigated language in Huntington’s disease (HD). These have generally reported abnormalities in rule-governed (grammatical) aspects of language, in both syntax and morphology. Several studies of verbal inflectional morphology in English and French have reported evidence of over-active rule processing, such as over-suffixation errors (e.g., walkeded) and over-regularizations (e.g., digged). Here we extend the investigation to noun inflection in Hungarian, a Finno-Ugric agglutinative language with complex morphology, and to genetically proven pre-symptomatic Huntington’s disease (pre-HD). Although individuals with pre-HD have no clinical, motor or cognitive symptoms, the underlying pathology may already have begun, and thus sensitive behavioral measures might reveal already-present impairments. Indeed, in a Hungarian morphology production task, pre-HD patients made both over-suffixation and over-regularization errors. The findings suggest the generality of over-active rule processing in both HD and pre-HD, across languages from different families with different morphological systems, and for both verbal and noun inflection. Because the neuropathology in pre-HD appears to be largely restricted to the caudate nucleus and related structures, the findings further implicate these structures in language, and in rule-processing in particular. Finally, the need for effective treatments in HD, which will likely depend in part on the ability to sensitively measure early changes in the disease, suggests the possibility that inflectional morphology, and perhaps other language measures, may provide useful diagnostic, tracking, and therapeutic tools for assessing and treating early degeneration in pre-HD and HD.     

Recollection training and transfer effects in Alzheimer's disease: effectiveness of the repetition-lag procedure

Objective

This study was designed to extend the use of a memory training technique, known as the repetition-lag procedure, to Alzheimer patients. The specificity of this procedure is to target the process of recollection for improvement.

Method

A group of 12 patients were trained individually for 6 h. The training procedure consisted of a series of yes/no recognition tasks in which some words were repeated throughout the test list across gradually increasing delays. Their performance was evaluated on pre-and-post tests and compared with a recognition practice group and a no contact control group.

Results

Initially, recollection training patients only performed accurately when the delay between repetitions consisted of one intervening word, but by the end of training their performance increased up to four-word intervals. Interestingly, these benefits generalized to other measures of memory, such as working memory, visual memory and source recognition.

Conclusions

Effectiveness of the repetition-lag procedure in Alzheimer’s disease is discussed.     

移植物抗宿主病与移植物抗肿瘤的处置

移植物抗宿主病与移植物抗肿瘤是当前异基因造血干细胞移植中一对不可调和的矛盾。在解决这一矛盾方面,科学家们已取得了很大的进展。随着移植学、免疫学的发展和认识的深入,最终能够最大限度的削弱移植物抗宿主病,增强移植物抗肿瘤效应,提高移植后患者的生存质量。     

骨科疾病诊治中的辩证观

骨科医生在复杂的临床工作中,需要掌握科学的方法论。特别是掌握科学的辩证思维方法,建立局部与整体的观念,善于抓住主要矛盾。培养起辩证逻辑思维的能力。有助于正确分析和理解骨科疾病的诊断和治疗中的各种复杂问题,提高认识水平和实践能力。     

个体心理模式对慢性疾病预后的探讨

21世纪,慢性疾病逐渐成为威胁人类健康的重要原因。然而其预后一直不理想,对慢性疾病患者的心理模式进行了分析,结合工作实际,提出慢性疾病患者如何看待疾病和自身———有意识的或无意识的———在很大程度上决定了疾病的预后。     

宗教心理-鬼神心理疾病—濒死体验的诊断与预后

濒死体验是科学现象而不是灵学现象,有初步问卷和最终量表可供筛查和诊断;是心理疾病而不是精神病。美国精神病学学会《精神疾病诊断与统计手册》标定为“宗教—鬼神问题”。除非获得适当的心理治疗与社会心理康复,患者预后不良。