Intensive Cognitive Processing Therapy Associated With Reduced PTSD Treatment Dropout in a Case-Controlled Study of Treatment-Seeking Veterans

Cognitive Processing Therapy (CPT) is an empirically supported psychotherapy for posttraumatic stress disorder (PTSD). The complex issue of treatment attrition is a frequently cited concern regarding CPT and other evidence-based psychotherapies for PTSD. The current study investigated the feasibility and effectiveness of “intensive” CPT, a treatment-consistent modification of CPT in which sessions are conducted more frequently than standard protocol. Fifty-four military veterans (20% female; M_age = 46; 80% Caucasian) seeking outpatient treatment for PTSD were included in this study. Patients who elected to receive intensive CPT (n = 27) were matched with archival records of individuals who received standard CPT (n = 27). Patients across treatment conditions were matched based on baseline symptom severity as measured by the PTSD Checklist for DSM-5 (PCL-5; M_PCL-5 = 52.61). Treatment outcomes were compared and longitudinal multilevel modeling was used to compare rate of symptom change over time. Patients who elected to engage in intensive CPT were twice as likely to complete treatment (88.9%) as those who received standard CPT (44.4%), X²(1, N = 54) = 12.00, p = .001. On average, intensive CPT patients completed treatment in about 25% of the time as standard CPT patients (33.8 days vs. 125.7 days). Patients in intensive CPT also demonstrated greater benefit: 81.4% reported a clinically significant improvement in PCL-5 scores compared to 51.8% of those in standard CPT, X²(1, N = 54) = 5.33, p = .020, φ = −0.314. Intensive and standard CPT performed comparably in regard to final PCL-5 score, change over time, and screening cutoff. In addition, there were no differences in treatment outcomes based on licensure status of the provider nor whether treatment was delivered in person or virtually. Intensive CPT represents a novel, treatment-consistent adaptation that was utilized to treat a group of veterans with PTSD with minimal treatment dropout. Patients who elected to engage in more frequent treatment were more likely to complete treatment, did so in one quarter of the time, and reported similar to better treatment outcomes. Providers may consider encouraging their patients to participate in treatment as frequently as they are able. However, preliminary findings are based on a nonrandom sample and design limitations temper conclusions.     

Ask me why,don't tell me why: Asking children for explanations facilitates relational thinking

Identifying abstract relations is essential for commonsense reasoning. Research suggests that even young children can infer relations such as “same” and “different,” but often fail to apply these concepts. Might the process of explaining facilitate the recognition and application of relational concepts? Based on prior work suggesting that explanation can be a powerful tool to promote abstract reasoning, we predicted that children would be more likely to discover and use an abstract relational rule when they were prompted to explain observations instantiating that rule, compared to when they received demonstration alone. Five- and 6-year-olds were given a modified Relational Match to Sample (RMTS) task, with repeated demonstrations of relational (same) matches by an adult. Half of the children were prompted to explain these matches; the other half reported the match they observed. Children who were prompted to explain showed immediate, stable success, while those only asked to report the outcome of the pedagogical demonstration did not. Findings provide evidence that explanation facilitates early abstraction over and above demonstration alone.     

Associations between risk factors,developmental outcomes,and executive function in neonatal intensive care unit graduates at 2 years: A retrospective study

This study explores the extent to which medical and sociodemographic variables and cognitive and language skills are associated with executive function (EF) skills in neonatal intensive care unit (NICU) graduates at 24 months of adjusted age. We explored cognitive, language, and EF skills in 42 NICU graduates who participated in a NICU follow-up programme clinic. The association between risk factors and EF and the completion of the EF assessment were explored. Correlational analyses revealed that child gender was associated with EF scores. Analyses revealed cognitive skills, language skills, and multiple gestational births were associated with EF assessment completion. Our findings are among the first to examine EF skills in NICU graduates as young as 24 months of age using a multidimensional, child completed measure. Implications for NICU follow up programmes, the consideration of early interventions aimed to positively affect EF skills, and considerations for future studies are discussed.     

Who is a thinker? With age,higher SES American children increasingly associate social status with divisions in labour

This exploratory report investigates how children, aged 6- to 12-years, reason about divisions in labour. It focuses on understanding when in development children might associate higher status groups with intellectual as opposed to physical labour. It explores this question by introducing a sample of mostly mid/high-SES American children to a novel factory setting and then asking them who is likely to have one of two jobs: a ‘builder’ (physical labour), or ‘thinker’ (intellectual labour) job. Older children were more likely than younger children to associate an individual's higher social status with intellectual labour work as opposed to physical labour work. Children also explained their reasoning, and with age their explanations focused more on social factors like the role of access to ‘choices’ or opportunities in shaping the nature of others' work.     

注意缺陷多动障碍-发展性阅读障碍共患儿童的干预效果及其内在机理

注意缺陷多动障碍和发展性阅读障碍是两类常见的儿童神经发育障碍, 二者共患率高达25%~48%。共患问题不仅使儿童自身面临着严重的认知、行为和心理损害, 还给家庭、学校和社会带来了沉重的负担, 对共患儿童的干预是极为必要且重要的。以共患病理机制假说为基础, 可将既往共患儿童的干预研究划分为以下两大类：(1)基于表型假说的干预方案, 如药物干预、阅读干预以及二者联合干预, 相应方案干预效果的迁移性和稳定性均有待深入考究; (2)基于共同缺陷假说的干预方案, 如针对核心共同认知缺陷之一的加工速度问题的干预已初显成效, 但相关研究较少, 干预效果需更多研究进一步系统性地考察。最后就共患儿童的干预方案现状进行了反思和展望。     

Exploring mechanisms that affect retrograde memory for public events in amnestic mild cognitive impairment: A longitudinal update

Here, we examined mechanisms that affect retrograde memory in amnestic mild cognitive impairment (a-MCI) as a function of longitudinal clinical outcome. 8 a-MCI who converted to Alzheimer's dementia (AD) during the subsequent 3-year follow-up (converter a-MCI) and 10 a-MCI who remained clinically stable during the same period (stable a-MCI) were compared at the baseline evaluation (i.e., when they were diagnosed as a-MCI) using a remote memory questionnaire for public events that allows disentangling the differential contribution of storage and retrieval mechanisms to performance accuracy. Results suggest that deficits in remote memory are primarily explained by impaired retrieval abilities in stable a-MCI and by impaired storage in converter-to-AD a-MCI. This distinction between retrograde amnesia due to defective trace utilisation in stable a-MCI and trace storage in converter a-MCI is consistent with the temporal unfolding of declining anterograde memory over the course of disease progression to AD.     

One-year prediction of cognitive decline following cognitive-stimulation from real-world data

Clinical evidence based on real-world data (RWD) is accumulating exponentially providing larger sample sizes available, which demand novel methods to deal with the enhanced heterogeneity of the data. Here, we used RWD to assess the prediction of cognitive decline in a large heterogeneous sample of participants being enrolled with cognitive stimulation, a phenomenon that is of great interest to clinicians but that is riddled with difficulties and limitations. More precisely, from a multitude of neuropsychological Training Materials (TMs), we asked whether was possible to accurately predict an individual's cognitive decline one year after being tested. In particular, we performed longitudinal modelling of the scores obtained from 215 different tests, grouped into 29 cognitive domains, a total of 124,610 instances from 7902 participants (40% male, 46% female, 14% not indicated), each performing an average of 16 tests. Employing a machine learning approach based on ROC analysis and cross-validation techniques to overcome overfitting, we show that different TMs belonging to several cognitive domains can accurately predict cognitive decline, while other domains perform poorly, suggesting that the ability to predict decline one year later is not specific to any particular domain, but is rather widely distributed across domains. Moreover, when addressing the same problem between individuals with a common diagnosed label, we found that some domains had more accurate classification for conditions such as Parkinson's disease and Down syndrome, whereas they are less accurate for Alzheimer's disease or multiple sclerosis. Future research should combine similar approaches to ours with standard neuropsychological measurements to enhance interpretability and the possibility of generalizing across different cohorts.     

Smartphone use and daily cognitive failures: A critical examination using a daily diary approach with objective smartphone measures

While smartphones have brought many benefits and conveniences to users, there is continuing debate regarding their potential negative consequences on everyday cognition such as daily cognitive failures. A few cross-sectional studies have found positive associations between smartphone use and cognitive failures. However, several research gaps remain, such as the use of cross-sectional designs, confounds related to stable individual differences, the lack of validity in self-report measures of smartphone use, memory biases in retrospective self-reports, and the lack of differentiation between smartphone checking and smartphone screen time. To simultaneously address the aforementioned shortcomings, the current study examined the within-person associations between various objective indicators of smartphone use and daily cognitive failures using a 7-day daily diary study. Multilevel modelling revealed that smartphone checking, but not total smartphone screen time, predicted a greater occurrence of daily cognitive failures at the within-person level. Surprisingly, we also found negative within-person associations between smartphone screen time for social- and tools-related applications and daily cognitive failures, suggesting that some types of smartphone use may temporarily benefit one's cognitive functioning. This finding demonstrates the importance of studying the specific functions of smartphone use and their differential cognitive consequences, as well as highlights the complex relations between smartphone use and cognition.     

Construal level among poor children: Executive function implications

Poverty impedes children's executive function (EF). Therefore, it is necessary to mitigate the negative effect of poverty by developing efficient interventions to improve poor children's cognitive function. In three studies, we examined whether high-level construals can improve EF among poor children in China. In Study 1, we observed a positive relationship between family socioeconomic status and children's EF, which was moderated by construal level (n = 206; M_age = 9.71; 45.6% girls). In Study 2a, we experimentally induced high- versus low-level construals and found that poor children with high-level construals exhibited better EF than those with low-level construals (n = 65; M_age = 11.32; 47.7% girls). However, the same intervention did not affect the performance of affluent children in Study 2b (n = 63; M_age = 10.54; 54% girls). Moreover, we found that the interventional effects of high-level construals improved the ability of children living in poverty to make healthy decisions and delayed gratification in Study 3 (n = 74; M_age = 11.10; 45.9% girls). These findings may have implications for using high-level construals as an effective intervention to improve poor children's EF and cognitive capacity.     

Early cognitive development and parental education

Relations between cognitive development in infancy and early childhood, and parental education were examined. Previous research has found little association between measures of the parenting environment, including parental education and socio‐economic status (SES), and cognitive development in infants and children under 2 years of age. However, the earlier studies may not have reliably measured individual differences in cognitive abilities, thus, there is uncertainty as to what age elements in the parental environment affect cognitive development. Seventy‐six infants were tested on a range of cognitive tasks at 3‐month intervals between the ages of 9 and 18 months. Information on parental education (a component of SES) was collected. Seventy‐one of the children returned at 27 months and completed the Bayley Scales of Infant Development, Mental Scale, which was used as an outcome measure for the earlier tasks. The findings present a clear indication that cognitive development in early childhood is affected by the parenting environment, at least from as early as 12 months. Copyright © 1999 John Wiley & Sons, Ltd.