A pilot randomized trial of metacognitive therapy vs applied relaxation in the treatment of adults with generalized anxiety disorder

Metacognitive Therapy (MCT) and Applied Relaxation (AR) were compared in a pilot treatment trial of generalized anxiety disorder (GAD). Twenty outpatients meeting criteria for DSM-IV-TR GAD were assessed before treatment, after treatment and at 6 m and 12 m follow-up. The patients were randomized and treated individually for 8-12 weekly sessions. There was no drop-out from MCT and 10% at 6 m follow-up from AR. At post-treatment and at both follow-up points MCT was superior to AR. Standardized recovery rates for MCT at post-treatment were 80% on measures of worry and trait-anxiety compared with 10% following AR. At 6 m follow-up recovery rates for MCT were 70% on both measures compared with 10% and 20% for AR. At 12 m follow-up recovery rates for MCT were 80% (worry) and 60% (trait-anxiety) compared with 10% and 20% following AR. The recovery rates for MCT are similar to those obtained in an earlier uncontrolled trial (Wells & King, 2006). The effect sizes and standardized recovery rates for MCT suggest that it is a highly effective treatment.     

An evaluation of the value of choice-making opportunities in single-operant arrangements: simple fixed- and progressive-ratio schedules

The current study compared the effects of choice and no-choice reinforcement conditions on the task responding of 3 children with autism across 2 single-operant paradigm reinforcer assessments. The first assessment employed simple fixed-ratio (FR) schedules; the second used progressive-ratio (PR) schedules. The latter assessment identified the differential strength of choice-making conditions in promoting task responding relative to no-choice conditions for 2 participants; no differential findings were obtained during the FR assessment.     

箱庭疗法缓解初中生考试焦虑的有效性

以18名考试焦虑初中生为被试,采用等组前后测设计,以考察箱庭疗法缓解考试焦虑的效果,并与放松训练进行比较。结果表明:箱庭疗法与放松训练一样能够有效地缓解初中生的考试焦虑情绪,但其干预效果的保持性要优于放松训练。     

A comparison of prompting methods to teach sight words to students with autism spectrum disorder

Time delay procedures are one of the most commonly used and effective strategies for teaching sight words to learners with disabilities. However, less is known about whether they are differentially effective and efficient with learners. This study compared the effectiveness and efficiency of progressive time delay and simultaneous prompting on sight word acquisition among three learners with autism spectrum disorder using an adapted alternating treatments design across word sets. For two participants, both procedures led to skill acquisition with no clear differences in efficiency. For the remaining participant, neither procedure was effective; therefore, the reading task was changed to a receptive one, and a stimulus fading intervention package was implemented.     

Effects of scapular retraction/protraction position and scapular elevation on shoulder girdle muscle activity during glenohumeral abduction

According to scapulohumeral rhythm, shoulder abduction is followed through scapular upward rotation to ensure joint mobility and stability. Of interest, the shoulder abduction can be performed holding the scapula in different positions and in association with scapular elevation, with possible effects on shoulder muscle activity. Therefore, the aim of the study was to analyze the activity of relevant shoulder muscles and the activity ratios between the scapulothoracic muscles, during shoulder abduction performed in different combinations of scapular position (neutral, retracted, protracted) and scapular elevation.The electromyographic activity of middle deltoid, serratus anterior, upper, middle and lower fibers of trapezius was recorded during shoulder abduction movements executed holding the scapula in neutral, retracted and protracted position, and subsequently a shoulder elevation movement. The activation of each muscle and the scapulothoracic muscles activity ratios were determined every 15 degrees, from 15° to 120° of abduction.Scapular retraction led to higher activation of the entire trapezius muscle, whereas protraction induced higher upper trapezius, middle deltoid and serratus anterior activity, along with lower activity of middle and lower trapezius. Shoulder elevation led to higher activity of the upper trapezius and middle deltoid. Moreover, it induced lower activation of the serratus anterior and middle and lower trapezius, thus leading to high ratios between the upper trapezius and the other scapulothoracic muscles, especially between 15 and 75 degrees of abduction.This study highlights that shoulder abduction performed with scapular protraction and in combination with scapular elevation leads to increased activity of the middle deltoid and upper trapezius, resulting in imbalances between the scapulothoracic muscles that could hamper the optimal scapulohumeral rhythm. The abduction performed in the aforementioned scapular conditions also induce potential reciprocal inhibition effects between the movers and stabilizers muscles of scapula, suggesting different motor control strategies of integrating a common shoulder movement with various modification of the scapular position.     

Posture,muscular tone and visual attention in 5 month‐old infants

The present paper aims at studying the relationships between posture, muscle tone and visual attention in 5 month‐old infants. To this end, a specially designed seating arrangement made it possible to vary posture while keeping constant the spatial relationship between eyes and stimuli. Five month‐olds were placed in the reclining position (30°) or in a more erect position (60°). The more erect the posture, the more difficult it should be for the infant to maintain a straight body axis. Muscle tone was evaluated, and infants distinguished in terms of whether they were hypertonic or hypotonic. It was hypothesised that in a more erect position hypotonic children, who experience more difficulties in maintaining posture, should organise their visual exploration in ways different from those considered to be hypertonic. To test it, pairs of three‐dimensional stimuli were presented in the distal visual field for one group (N=48) and in the proximal visual field in another group (N=32) for 2 min in each posture. The dynamical organisation of attention was evaluated through the number and duration of fixations on each target, the number of shifts from one target to the other (alternations) and the number of repetitions (back to the previous target). Results showed that visual behaviour was significantly affected by the distance at which stimuli were presented. Infants spent more time in visual exploration when the object was within reach than when it was out of reach. Although posture was shown to play a role in the organisation of visual exploration, no link with muscle tone was found, a surprising result which is discussed. Copyright © 2002 John Wiley & Sons, Ltd.     

Neuropsychological differentiation of progressive aphasic disorders

The differentiation of subtypes of primary progressive aphasia (PPA) remains challenging. We aimed to identify optimum neuropsychological measures for characterizing PPA, to examine the relationship between behavioural change and subtypes of PPA and to determine whether characteristic profiles of language, working memory, and behavioural changes occur in PPA. Forty-seven patients with PPA and multi-domain Alzheimer's disease (AD) together with 19 age-matched controls underwent a large battery of working memory and language tests. We found that simple tasks of sentence ordering, narrative production, and buccofacial praxis were particularly useful in differentiating non-fluent/agrammatic variant PPA (nfvPPA) from other PPA subtypes, whereas a test of single word comprehension was useful in detecting semantic dementia (SD). No individual tests were discriminating for logopenic variant PPA (lvPPA) relative to nfvPPA. LvPPA and multidomain AD exhibited similar language profiles. A principal components analysis revealed that characteristic PPA profiles extended beyond the realms of language, in particular, the presence of apraxia in nfvPPA, behavioural changes in SD, and working memory deficits in lvPPA. These findings suggest that not all tests are equally discriminatory for PPA and highlight the importance of a test profile in differentiating PPA. These results also support the view that lvPPA is a focal form of AD and emphasize the difficulties classifying lvPPA.     

Psychosocial Issues That Face Patients With Charcot-Marie-Tooth Disease: The Role of Genetic Counseling

Charcot-Marie-Tooth (CMT) disease is a hereditary debilitating progressive muscular atrophy and sensory neuropathy of the distal extremities. CMT is usually nonlife threatening. Signs of the disease usually present in childhood or in young adulthood and the level of disability can be variable within and between families. Research addressing specific psychosocial and emotional issues faced by individuals with CMT is limited. Fourteen adults with a clinical and/or molecular diagnosis of CMT (ages 32–74 years) consented to an audio taped interview. The format of the interview was based around an informal questionnaire to prompt and guide the interviewee to describe their experiences of living with a disabling genetic disorder. The interviews focused on their experiences of first symptoms and diagnosis, their life experience with CMT, their limitations due to disability and the role of genetic counseling. This study identifies and explores life issues that individuals with CMT may face, specifically grief over the loss of independence, emotional pain and stress such as embarrassment and guilt of passing on a gene mutation, impact on quality of life, the impact of wearing orthopedic devices, and fear of progressive disability. Our findings suggest that that there are emotional and psychosocial issues specific to affected individuals at different life stages and genetic counselors need to be aware of these issues in order to provide age appropriate support and advice to individuals affected by CMT.