Phenotypes of sleeplessness: stressing the need for psychodiagnostics in the assessment of insomnia

Insomnia is a too general term for various subtypes that might have different etiologies and therefore require different types of treatment. In this explorative study we used cluster analysis to distinguish different phenotypes in 218 patients with insomnia, taking into account several factors including sleep variables and characteristics related to personality and psychiatric comorbidity. Three clusters emerged from the analysis. The ‘moderate insomnia with low psychopathology’-cluster was characterized by relatively normal personality traits, as well as normal levels of anxiety and depressive symptoms in the presence of moderate insomnia severity. The ‘severe insomnia with moderate psychopathology’-cluster showed relatively high scores on the Insomnia Severity Index and scores on the sleep log that were indicative for severe insomnia. Anxiety and depressive symptoms were slightly above the cut-off and they were characterized by below average self-sufficiency and less goal-directed behavior. The ‘early onset insomnia with high psychopathology’-cluster showed a much younger age and earlier insomnia onset than the other two groups. Anxiety and depressive symptoms were well above the cut-off score and the group consisted of a higher percentage of subjects with comorbid psychiatric disorders. This cluster showed a ‘typical psychiatric’ personality profile. Our findings stress the need for psychodiagnostic procedures next to a sleep-related diagnostic approach, especially in the younger insomnia patients. Specific treatment suggestions are given based on the three phenotypes.     

Men’s experience of a guided self-help intervention for hot flushes associated with prostate cancer treatment

Up to 80% of men who receive androgen deprivation therapy report hot flushes and for many these are associated with reduced quality of life. However it is recognised that there are a number of barriers to men’s engagement with support to manage symptoms and improve quality of life. This qualitative study was embedded within a larger randomised controlled trial (MANCAN) of a guided self-help cognitive behavioural intervention to manage hot flushes resulting among men receiving androgen deprivation therapy. The study aimed to explore the engagement and experiences with the guided self-help intervention. Twenty men recruited from the treatment arm of the MANCAN trial participated in a semi-structured interview exploring acceptability of the intervention, factors affecting engagement and perceived usefulness of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed using a Framework approach. Over two thirds of respondents (69%) reported reading the intervention booklet in full and over 90% reporting practising the relaxation CD at least once a week. Analysis of the interviews identified three super-ordinate themes and these related to changes in hot flush symptomatology (learned to cope with hot flushes in new ways), the skills that participants had derived from the intervention (promoting relaxation and reducing stressors), and to a broader usefulness of the intervention (broader impact of the intervention and skills). The present study identified positive engagement with a guided self-help intervention and that men applied the skills developed through the intervention to help them undertake general lifestyle changes. Psycho-educational interventions (e.g. cognitive behaviour therapy, relaxation, and positive lifestyle elements) offer the potential to be both effective and well received by male cancer survivors.     

Self‐efficacy or perceived behavioural control: Which influences consumers' physical activity and healthful eating behaviour maintenance?

This research investigated the role of a commercial program, Michelle Bridges 12 Week Body Transformation (MB12WBT), that uses a variety of tools including social support to influence weight management behaviours such as exercising and eating healthfully. The need for research into weight management remains current given obesity rates have continued to increase in recent decades. Weight management is a complex behaviour that for many consumers involves barriers that influence their commitment to continue exercising and eating healthily. The Theory of Planned Behaviour is frequently used to explain, and to a lesser extent predict, behaviours such as physical activity and healthy eating; however, there is much debate as to whether a perceived behavioural control variable or self‐efficacy is the best predictor of behaviour. Structural equation modelling was used to analyse data from a sample of 724 respondents who answered a baseline and three month follow‐up survey. The analysis revealed self‐efficacy and perceived behavioural control were two distinct constructs. Self‐efficacy was a better predictor of behaviour than perceived behavioural control variables as suggested in the original Theory of Planned Behaviour. Furthermore, self‐efficacy had a significant impact on exercising and eating healthfully behaviour. The findings and implications for both behaviour change theory and practice are discussed.     

阅读障碍儿童的形音捆绑缺陷及其脑神经机制

形音捆绑缺陷研究是国内外阅读障碍研究领域的一个新方向。本文阐述了形音捆绑加工的理论与定义,综述了国内外研究者经常采用的三种形音捆绑的研究范式:配对联想学习、变化检测范式和线索回忆任务,介绍并分析了各研究范式的优缺点、适用范围及主要研究发现。同时,综述与评价了国内外有关阅读障碍形音捆绑缺陷的脑机制研究的主要结论及不足。最后,本文讨论了现有研究在实验设计和理论上的贡献与不足,提出了今后的研究方向和改进建议。     

青少年创造性发展及其脑机制研究进展

青少年时期是创造性发展的关键阶段,探明青少年创造性发展规律及其神经机制对于培养和激发个体的创新潜能具有重要意义。本文综述了青少年创造性发展及其脑机制的研究进展,分别对青少年创造性思维发展趋势、影响因素及其相应的脑机制展开综述,并在此基础上进行了展望。总体而言,青少年时期创造性思维发展呈现出两个波峰(11~13岁,15~16岁)的发展趋势;青少年创造性发展受外部原生家庭教养方式和学校教师激励以及内部情绪动机和自我管理能力的影响较大;前额叶对青少年创造性发展具有重要作用,这可能与该脑区涉及执行控制功能有关。针对青少年创造性发展的教育干预以及大脑可塑性可能成为该领域的研究热点;而大样本纵向跟踪多模态脑影像数据库的建立可为相关研究提供重要支持。     

Executive dysfunction affects word list recall performance: Evidence from amyotrophic lateral sclerosis and other neurodegenerative diseases

The Rey Auditory Verbal Learning Test (RAVLT) is widely used in clinical practice to evaluate verbal episodic memory. While there is evidence that RAVLT performance can be influenced by executive dysfunction, the way executive disorders affect the serial position curve (SPC) has not been yet explored. To this aim, we analysed immediate and delayed recall performances of 13 non‐demented amyotrophic lateral sclerosis (ALS) patients with a specific mild executive dysfunction (ALSci) and compared their performances to those of 48 healthy controls (HC) and 13 cognitively normal patients with ALS. Moreover, to control for the impact of a severe dysexecutive syndrome and a genuine episodic memory deficit on the SPC, we enrolled 15 patients with a diagnosis of behavioural variant of frontotemporal dementia (bvFTD) and 18 patients with probable Alzheimer's disease (AD). Results documented that, compared to cognitively normal subjects, ALSci patients had a selective mid‐list impairment for immediate recall scores. The bvFTD group obtained low performances with a selectively increased forgetting rate for terminal items, whereas the AD group showed a disproportionately large memory loss on the primary and middle part of the SPC for immediate recall scores and were severely impaired in the delayed recall trial. These results suggested that subtle executive dysfunctions might influence the recall of mid‐list items, possibly reflecting deficiency in control strategies at retrieval of word lists, whereas severer dysexecutive syndrome might also affect the recall of terminal items possibly due to attention deficit or retroactive interference.     

Study of behavioural and neural bases of visuo‐spatial working memory with an fMRI paradigm based on an n‐back task

The goal of this study was to propose a new functional magnetic resonance imaging (fMRI) paradigm using a language‐free adaptation of a 2‐back working memory task to avoid cultural and educational bias. We additionally provide an index of the validity of the proposed paradigm and test whether the experimental task discriminates the behavioural performances of healthy participants from those of individuals with working memory deficits. Ten healthy participants and nine patients presenting working memory (WM) deficits due to acquired brain injury (ABI) performed the developed task. To inspect whether the paradigm activates brain areas typically involved in visual working memory (VWM), brain activation of the healthy participants was assessed with fMRIs. To examine the task's capacity to discriminate behavioural data, performances of the healthy participants in the task were compared with those of ABI patients. Data were analysed with GLM‐based random effects procedures and t‐tests. We found an increase of the BOLD signal in the specialized areas of VWM. Concerning behavioural performances, healthy participants showed the predicted pattern of more hits, less omissions and a tendency for fewer false alarms, more self‐corrected responses, and faster reaction times, when compared with subjects presenting WM impairments. The results suggest that this task activates brain areas involved in VWM and discriminates behavioural performances of clinical and non‐clinical groups. It can thus be used as a research methodology for behavioural and neuroimaging studies of VWM in block‐design paradigms.     

Emotional self-efficacy,conduct problems,and academic attainment: Developmental cascade effects in early adolescence

The study is amongst the first of its kind to utilise developmental cascade modelling in order to examine the inter-relations between emotional self-efficacy, conduct problems, and attainment in a large, nationally representative sample of English adolescents (n = 2414, aged 11 years). Using a 3-wave, longitudinal, cross lagged-design, we tested three cascading hypotheses: adjustment erosion, adjustment fortification, and academic incompetence. A fourth hypothesis considered the role of shared risk. Results supported small effects consistent with the cascade hypotheses, and a small but significant effect was found for shared risk. Strengths and limits of the study are considered alongside a discussion of the implications for these findings.     

Neuroimaging and Occupational Therapy: Bridging the Gap to Advance Rehabilitation in Developmental Coordination Disorder

Developmental coordination disorder (DCD) is a neurodevelopmental disorder characterized by poor motor skills that interfere with a child's ability to perform everyday activities. Little is known about the neural mechanisms that implicate DCD, making it difficult to understand why children with DCD struggle to learn motor skills and selecting the best intervention to optimize function. Neuroimaging studies that utilize magnetic resonance imaging techniques have the capacity to play a critical role in helping to guide clinicians to optimize functional outcomes of children with DCD using evidence-based rehabilitation interventions. The authors' goal is to describe how neuroimaging research can be applied to occupational therapy and rehabilitation sciences by highlighting projects that are at the forefront of the field and elucidate future directions.     

母亲积极养育行为对儿童顺从行为的早期预测与双向作用:从婴儿到学步儿

顺从是儿童早期重要的社会化成就。传统理论关注父母控制策略对顺从的作用,但实证结果表明其解释率有限;当前理论更加关注积极养育行为在顺从发展中具有发展适宜性的作用机制。本研究采用追踪设计考察了84个家庭从儿童6个月到3岁时母亲的敏感性和鼓励自主两种积极养育行为与学步儿顺从发展的关系。结果表明:(1)1岁前母亲敏感性对学步儿2岁时的合作性顺从有正向预测作用,对2岁到3岁合作性顺从的变化没有预测作用;(2)1岁前母亲敏感性对学步儿2岁时的情境性顺从和2岁到3岁的情境性顺从的变化均有负向预测作用;(3)在2岁到3岁期间,母亲的鼓励自主与学步儿的合作性顺从水平有双向正向预测作用,但与情境性顺从不存在双向预测关系。