Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Infant distractibility from social events mediates the relation between maternal responsiveness and infant language outcomes

Research demonstrates that contingent and appropriate maternal responsiveness to infant requests and bids for attention leads to better language outcomes. Research also indicates that infants who are less distracted by irrelevant competing stimulation and attend efficiently to audiovisual social events (e.g., faces and voices) show better language outcomes. However, few studies have assessed relations between maternal responsiveness, infant attention to faces and voices, and distractibility, and how together these factors lead to early language outcomes. A newly developed audiovisual protocol, the Multisensory Attention Assessment Protocol (MAAP; Bahrick et al., 2018), allows researchers to examine individual differences in attention to faces and voices and distractibility, and to assess relations with other variables. At 12 months, infants (n = 79) in an ongoing longitudinal study participated in the MAAP to assess intersensory matching of synchronous faces and voices and attention to an irrelevant competing visual distractor event. They also were observed in a brief play interaction to assess infant bids for attention and maternal responsiveness (accept, redirect, or ignore). At 18 months, receptive and expressive language were assessed using the Mullen Scales of Early Learning. Several noteworthy findings emerged: 1) mothers were generally responsive, accepting 74% and redirecting 14% of infant bids, 2) infants who had a greater number of their bids redirected by mothers, and who had better intersensory matching of synchronous faces and voices, showed less attention to the distractor, and 3) infants who showed less attention to the distractor had better receptive language. Findings demonstrate that maternal redirecting of infant attention by mothers who are generally responsive may promote better infant attentional control (lower distractibility) which in turn predicts better receptive language in toddlers.     

作业中断对任务绩效的影响及心理疲劳的调节作用

作业中断会对中断后行为绩效产生影响,探讨不同疲劳状态下中断对作业绩效影响的认知机制将有助于完善和发展中断的认知理论。本研究采用事件相关电位(ERP),通过在不同心理疲劳状态下执行数学题任务中断、暂停中断和不中断的空间2-back任务,结合行为数据和ERPs结果,分析作业中断对任务绩效的影响以及心理疲劳在其中的调节作用。实验结果发现,中断后诱发的P200和P300振幅显著提高,作业中断使得主任务的注意力资源下降,任务中断的无关信息干扰了主任务工作记忆,而疲劳状态则进一步加剧了中断对注意资源、工作记忆及行为绩效的负面效应。本研究在揭示作业中断认知过程及疲劳对其影响机理的同时,也支持了中断的目标记忆模型。     

内侧前额皮层-伏隔核环路在决策冲动中的作用：基于动物模型的研究

注意缺陷多动障碍(attentiondeficit/hyperactivitydisorder,ADHD)行为控制不足与决策冲动密切相关,后者受内侧前额皮层(medial prefrontal cortex, mPFC)与伏隔核(nucleus accumbens, NAc)调节。为调查ADHD决策冲动与m PFC-NAc间功能耦合的关系,研究采用ADHD模型SHR (spontaneously hypertensive rat, SHR)大鼠,结合延迟折扣任务和在体电生理,研究发现,与对照Wistar (WIS)大鼠相比, SHR大鼠对延迟大奖赏的选择百分比降低; WIS大鼠m PFC-NAc的Theta频段相干值表现为延迟选择时显著大于立即选择时、首次选择时大于连续选择时、转换试次时大于连续试次时,而SHR大鼠在上述条件均低于WIS大鼠。回归分析发现m PFC-NAc的相干差值与延迟大奖赏选择率显著正相关。结果表明m PFC-NAc间功能联系减弱是ADHD决策冲动缺陷的重要环路基础,该缺陷与其深度信息加工以及策略转换能力受损有关,扩展了ADHD决策冲动的认知和神经机制的认识。     

Year of Zoom in a Year of Doom: Lessons Learned Delivering ERP Remotely During the COVID-19 Pandemic

In response to the COVID-19 pandemic and consequential shutdown measures, many mental health professionals started providing therapy to patients exclusively via telehealth. Our research center, which specializes in studying and treating obsessive-compulsive disorder (OCD), historically has provided in-person exposure and response prevention (ERP) to adults with OCD, but shifted to telehealth during the pandemic. Unlike in other modes of talk therapy, ERP’s emphasis on therapist-supervised exposures presented unique opportunities and challenges to delivering treatment entirely via a virtual platform. This paper provides case examples to illustrate lessons we learned delivering ERP exclusively via telehealth in New York from March 2020 through June 2021 and offers recommendations for future study and practice. Though we observed a number of drawbacks to fully remote ERP, we also discovered advantages to delivering ERP this way, meriting additional research attention.     

Comparison of two video prompting interventions to teach daily living skills to adolescents with autism

The present study used an adapted alternating treatment design to evaluate and compare the effects of video prompting (VP) and video prompting plus frequency building (VP + FB) to teach daily living skills to three adolescents with autism spectrum disorder. Results demonstrated all three students made substantial improvements over their baseline performance using VP and VP + FB. Furthermore, a strong intervention effect emerged for VP and VP + FB conditions when compared to the control task. However, in terms of one intervention proving superior to the other (e.g., VP to VP + FB), the data offer a mixed interpretation with VP + FB affecting changes better for two of the three students. The FB component in the VP + FB produced strong, consistent gains for all students in terms of retention.     

Telehealth parent training for a young child at risk for autism spectrum disorder

The global pandemic has highlighted the importance of telehealth to access behavioral interventions. Face-to-face parent training improves the development and behaviors of young children at risk for autism spectrum disorder (ASD). We evaluated a telehealth parent training intervention for a child at risk for ASD. Two parents identified possible early ASD symptoms in their 30-month-old son (lack of imitation, pointing, and vocal manding). Both parents simultaneously received telehealth behavioral skills training on the Parent Intervention for Children at Risk for Autism program for 1 hour per week over 29 weeks. Multiple baseline designs across parent and child behaviors showed that both parents improved their parent teaching fidelity above 80% and the child improved on all trained behaviors. This study expands the utility of telehealth behavioral parent training to young children at risk for ASD to mitigate early symptoms of ASD.     

How infant-directed actions enhance infants’ attention,learning, and exploration: Evidence from EEG and computational modeling

When teaching infants new actions, parents tend to modify their movements. Infants prefer these infant-directed actions (IDAs) over adult-directed actions and learn well from them. Yet, it remains unclear how parents’ action modulations capture infants’ attention. Typically, making movements larger than usual is thought to draw attention. Recent findings, however, suggest that parents might exploit movement variability to highlight actions. We hypothesized that variability in movement amplitude rather than higher amplitude is capturing infants’ attention during IDAs. Using EEG, we measured 15-month-olds’ brain activity while they were observing action demonstrations with normal, high, or variable amplitude movements. Infants’ theta power (4–5 Hz) in fronto-central channels was compared between conditions. Frontal theta was significantly higher, indicating stronger attentional engagement, in the variable compared to the other conditions. Computational modelling showed that infants’ frontal theta power was predicted best by how surprising each movement was. Thus, surprise induced by variability in movements rather than large movements alone engages infants’ attention during IDAs. Infants with higher theta power for variable movements were more likely to perform actions successfully and to explore objects novel in the context of the given goal. This highlights the brain mechanisms by which IDAs enhance infants’ attention, learning, and exploration.     

“It's wrong to relax,you have to be on the go,go, go,all the time”: Emotional transformation in a case of emotion-focused therapy for generalised anxiety disorder

Generalised anxiety disorder (GAD) is a highly prevalent, chronic and impairing disorder. The aim of this study was to qualitatively describe the transformation in emotional processing across 16 sessions of a successful emotion-focused therapy (EFT) treatment for GAD. A theoretical framework derived from the EFT model of in-session emotional transformation proposed by Pascual-Leone and Greenberg was used as the basis for qualitative analysis. Additionally, the Classification of Affective Meaning States, the Client-Expressed Arousal Scale-III and the Client Emotional Productivity Scale-Revised were utilised by observer–raters to classify moment-by-moment shifts in client affective-meaning states, emotional arousal and emotional productivity. Results supported the emotion transformation model. The client presented in a state of poorly differentiated but highly aroused distress provoked by identifiable interpersonal and intrapersonal triggers. Emotional and behavioural avoidance provoked by fear of pain was evident. Accessing core pain and responding to attendant needs with compassion and protective anger was shown to facilitate the higher order emotional processing states of grief, relief and agency. Implications are proposed, including that addressing core emotional vulnerability may be a critical intervention in the successful treatment of GAD.     

自闭症谱系障碍社交动机理论：机制及干预探索

自闭症谱系障碍(Autism Spectrum Disorder, ASD)表现为社会交往困难以及重复刻板兴趣或行为。社交动机理论提出ASD个体是由于社交动机缺乏导致的社交障碍。目前该理论缺乏理论元素及结构关系的系统论证, 及基于此理论的低龄ASD儿童群体的研究证据。本研究拟采用心理实验法、眼动及近红外脑成像技术, 探索低龄ASD儿童早期社交奖赏、社交定向异常眼动标记及眶额叶脑区活动的神经机制。此外, 通过音乐奖赏强化学习的干预方式改善该理论的核心元素(社交奖赏), 观测能否改善ASD儿童的社交动机。本研究的开展有望对该理论进行系统验证, 并形成改善社交行为的潜在干预方案。