Decision Making with Uncertain Reinforcement in Children with Attention Deficit/Hyperactivity Disorder (ADHD)

Reward-related processes are impaired in children with ADHD. Whether these deficits can be ascribed to an aversion to delay or to an altered responsiveness to magnitude, frequency, valence, or the probability of rewards still needs to be explored. In the present study, children with ADHD and normal controls aged 7 to 10 years performed a simple probabilistic discounting task. They had to choose between alternatives where the magnitude of rewards was inversely related to the probability of outcomes. As a result, children with ADHD opted more frequently for less likely but larger rewards than normal controls. Shifts of the response category after positive or negative feedback, however, occurred as often in children with ADHD as in control children. In children with ADHD, the frequency of risky choices was correlated with neuropsychological measures of response time variability but unrelated to measures of inhibitory control. It is concluded that the tendency to select less likely but larger rewards possibly represents a separate facet of dysfunctional reward processing, independent of delay aversion or altered responsiveness to feedback.     

Developmental changes of win-stay and loss-shift strategies in decision making

This study aims to clarify the developmental changes in real-life decision making when strategy is adjusted using both positive and negative feedback, that is, whether strategic adjustment evolves with age. A total of 84 participants divided into three age groups (children, adolescents, and adults) performed the standard version of the Iowa Gambling Task (IGT). Children and adolescents showed a strong bias in favor of disadvantageous choices whereas adults learned to decide advantageously during the course of the task. Interestingly, the results clearly demonstrate that children did not switch differently following gains and losses whereas adolescents and adults switched more often after a loss than after a gain, corresponding to the “loss-shift” and the “win-stay” strategies, respectively. The results also revealed that adults switched less often after losses compared to children and adolescents and, thus, used the loss-stay strategy more often than the 2 youngest groups. These new findings suggest that successful completion of the IGT by adults requires fine feedback monitoring and more frequent use of the win-stay and loss-stay strategic adjustments.     

Characterization of Children's Decision Making: Sensitivity to Punishment Frequency,Not Task Complexity

On a gambling task that models real-life decision making, children between ages 7 and 12 perform like patients with bilateral lesions of the ventromedial prefrontal cortex (VMPFC), opting for choices that yield high immediate gains in spite of higher future losses (Crone &; Van der Molen, 2004 Crone, E. A. and Van der Molen, M. W. 2004. Developmental changes in decision-making: Performance on a gambling task previously shown to rely on ventromedial prefrontal cortex. Developmental Neuropsychology, 25(3): 251–279. [PUBMED][INFOTRIEVE][CROSSREF][Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]). The current study set out to characterize developmental changes in decision making by varying task complexity and punishment frequency. Three age groups (7–9 years, 10–12 years, 13–15 years) performed two versions of a computerized variant of the original Iowa gambling task. Task complexity was manipulated by varying the number of choices participants could make. Punishment frequency was manipulated by varying the frequency of delayed punishment. Results showed a developmental increase in the sensitivity to future consequences, which was present only when the punishment was presented infrequently. These results could not be explained by differential sensitivity to task complexity, hypersensitivity to reward, or failure to switch response set after receiving punishment. There was a general pattern of boys outperforming girls by making more advantageous choices over the course of the task. In conclusion, 7–12-year-old children—like VMPFC patients—appear myopic about the future except when the potential for future punishment is high.     

Social aspects of career choice from the perspective of habitus theory

The concept of habitus designates a cognitive structure that is socially embedded and can give valuable insight into the social influences on career choice. A study investigating the relationship of habitus to career choice is presented in a sample of Icelandic youth aged 19–22 (N = 476). Measures of habitus were developed on the basis of reported cultural and leisure activities. The analysis of leisure and cultural items progressed in two steps: factor analysis and cluster analysis. The clusters constitute the four different habitus groups: Pop and fashion, Sports and rock, Music, and Literature. Correspondence factor analysis showed that the habitus groups (clusters) were related to other social variables, such as gender and class; validating habitus theory. Additionally, habitus measures were strongly linked to career variables, such as occupational perception and preferred future occupation. The results support previous research in showing that habitus theory is relevant to career counseling theory and can be a basis of understanding the relationship between social structure and career choice.     

Social comparison influences on disciplinary panels: a brief qualitative study in Kenyan secondary schools

This study investigated the influences of social comparisons on group polarization in decision making among members of selected Kenyan secondary school disciplinary panels. Ten participants from 10 selected secondary school disciplinary panels were involved. Semi-structured interviews were used to collect qualitative data on the experiences of the participants regarding the influences of social comparisons on their decision-making behaviours during participation in their schools’ disciplinary hearing meetings. The results revealed that in the dynamic interactions among disciplinary panel members during disciplinary hearing meetings, the panel members engaged in social comparisons among themselves, leading to their shifts in decision-making behaviours in favour of consensus in group decisions or group polarization in decision making.     

Using Stories in Dynamically Oriented Clinical Social Work

Abstract

This paper uses concepts from discourse analysis to understand the meaning making functions of narrative in clinical treatment and to describe the interactive processes through which these functions are achieved. “Negotiative” and “heuristic” narrative processes are described as they occur in ordinary conversation. The relevance of these concepts to clinical practice is then explored using case material.     

Failure to Mentalize: Defect or Defense?

ABSTRACT

The author reviews current thinking on the phenomena of failure to mentalize and provides an alternative to the structural defect point of view. Also included are some clinical implications of this alternative viewpoint.     

The Effect of Demographic Variables on Client Attachment Patterns to Clinical Social Workers

Abstract

Client attachment to therapist is a new topic in the field of clinical social work. Using attachment theory, this study examined the relationship between three types of client attachment to therapist (secure, avoidant-fearful, and preoccupied) and the following variables: marital status, age of participant, and gender of the social worker, among a sample of 174 mental health clients. The results showed that there is a significant relationship between a secure pattern and gender of the social worker. In addition, they showed a significant relationship between avoidant-fearful and preoccupied patterns and the marital status of the participants. Furthermore, the results indicated a significant relationship between a preoccupied pattern and the age of the participants. The findings of the current study have implications for the field of clinical social work in Kuwait.     

Thirty Years Later: An Oncologist Reflects on Kubler-Ross's Work

As compared with conventional vaccine production systems, plant-made vaccines (PMVs) are said to enjoy a range of advantages including cost of production and ease of storage for distribution in developing countries. In this article, we introduce the science of PMV production, and address ethical issues associated with development and clinical testing of PMVs within three interrelated domains: PMVs as transgenic plants; PMVs as clinical research materials; and PMVs as agents of global health. We present three conclusions: first, while many of the ethical issues raised by PMVs are familiar, PMVs add a new dimension to old issues, and raise some novel issues for ethicists and policy-makers; secondly, it is premature to promise broad applicability of PMVs across the developing world without having demonstrated their feasibility; thirdly, in particular, proponents of PMVs as a solution to global health problems must, as a condition of the ethical conduct of their research, define the commercial feasibility of PMVs for distribution in the developing world.