The role of somatosensory stimulation in social phobia—An analysis of hand coordination in patients and therapeutic dyads during psychodynamic psychotherapy

In the psychotherapeutic treatment of social phobia, the hand movement behaviour exhibited during the interaction provides information about the success of the therapy. In particular, the degree of mutual somatosensory stimulation of the hands (hands moving on each other, as a unit, apart) appears to be relevant regarding the patient's mental state. To test this hypothesis, the present study investigates hand coordination in the course of psychotherapy in patients with and without symptom improvement and in the corresponding therapeutic dyads. Forty-two videos of patient–therapist dyads consisting of 21 patients (n = 11 non-improved; n = 10 improved; according to Liebowitz Social Anxiety Scale self-assessment) from the Social Phobia Research Network project were investigated in early psychotherapy sessions and in pre-last sessions. Hand movements of four randomised video sequences per dyad were analysed with NEUROGES^®-ELAN. Patients with non-improved symptoms displayed shorter act apart coordination and more act on each other coordination than patients with improved symptoms. Patients displayed more act apart and act on each other and less act as a unit coordination than therapists. In therapeutic dyads, act on each other coordination in early sessions, as well as short act apart coordination, was significantly related to non-improvement. Patients with non-improved symptoms are characterised by more hand coordination associated with a high degree of somatosensory stimulation serving self-regulation (act on each other), as well as short complex gestural expressions (act apart). Thus, hand coordination constitutes a progression and outcome parameter informing on somatosensory stimulation.     

Influence of perceived emotion and gender on social motor coordination

Theorists have long postulated that facial properties such as emotion and sex are potent social stimuli that influence how individuals act. Yet extant scientific findings were mainly derived from investigations on the prompt motor response upon the presentation of affective stimuli, which were mostly delivered by means of pictures, videos, or text. A theoretical question remains unaddressed concerning how the perception of emotion and sex would modulate the dynamics of a continuous coordinated behaviour. Conceived in the framework of dynamical approach to interpersonal motor coordination, the present study aimed to address this question by adopting the coupled-oscillators paradigm. Twenty-one participants performed in-phase and anti-phase coordination with two avatars (male and female) displaying three emotional expressions (neutral, happy, and angry) at different frequencies (100% and 150% of the participant's preferred frequency) by executing horizontal rhythmic left-right oscillatory movements. Time to initiate movement (TIM), mean relative phase error (MnRP), and standard deviation of relative phase (SDRP) were calculated as indices of reaction time, deviation from the intended pattern of coordination, and coordination stability, respectively. Results showed that in anti-phase condition at 150% frequency, MnRP was lower with the angry and the female avatar. In addition, coordination was found to be more stable with the male avatar than the female one when both displaying neutral emotion. But the happy female avatar was found to elicit more stable coordination than the neutral female avatar. These results implied that individuals are more relaxed to coordinate with the female than the male, and the sensorimotor system becomes more flexible to coordinate with an angry person. It is also suggested social roles influence how people coordinate, and individuals attend more to interact with a happy female. In sum, the present study evidenced that social perception is embodied in the interactive behaviour during social interaction.     

Effect of Stroke on Joint Control during Reach-to-Grasp: A Preliminary Study

Abstract

We investigated changes in control of inter-segmental dynamics underlying upper extremity dyscoordination caused by stroke. Individuals with stroke and healthy individuals performed a natural reach-to-grasp movement. Kinetic analysis revealed that both groups rotated the shoulder by muscle torque and used interaction torque to rotate the elbow. However, individuals with stroke used interaction torque less than healthy individuals, actively suppressing a substantial portion of it. This resulted in inefficient use of active control and dyscoordination of the upper extremity. The degree of interaction torque suppression and inefficiency of active control at the elbow positively correlated with stroke severity. The increased interaction torque suppression can be a strategy used by individuals with stroke to compensate for deficient feedforward control of this torque.     

Ageing effects on the attention demands of walking

Attention demands of walking were determined in six male and six female young adults (mean 26.3 yr) and 12 gender-matched healthy, active older adults (mean 71.1 yr) using a dual task procedure with a reaction time (RT) secondary task. In three conditions an auditory stimulus, a visual stimulus and both stimuli (auditory/visual) were presented. Relative to no-walking baselines, increased RT was found in all conditions revealing an attentional cost of normal walking. When participants traversed the laboratory walkway and also positioned one of their feet within a target area on the ground, attention demands were greater than in unconstrained walking. In the targeting task, RTs to the visual stimulus were longer than for the auditory stimulus due to the interference associated with viewing both the stimulus monitor and the foot-target. Older participants' RTs in the visual and auditory/visual conditions, but not in the auditory condition, were significantly longer than for the young group in both walking tasks but RTs for young and older adults were not different in no-walking baseline trials. Inspection of mean RT functions at time intervals following gait initiation (0-3000 ms from the first step) suggested a fluctuating attentional cost of walking with increased demands associated with contingencies requiring step length regulation. The findings have applied significance in demonstrating the possibility of increased falls and pedestrian accident risk in older individuals in dual task situations such as road crossing.     

Differences in postural control and movement performance during goal directed reaching in children with developmental coordination disorder

Poor upper-limb coordination is a common difficulty for children with developmental coordination disorder (DCD). One hypothesis is that deviant muscle timing in proximal muscle groups results in poor postural and movement control. The relationship between muscle timing, arm motion and children's upper-limb coordination deficits has not previously been studied. The aim of this study was to investigate the relationship between functional difficulties with upper-limb motor skills and neuromuscular components of postural stability and coordination. Sixty-four children aged 8-10 years, 32 with DCD and 32 without DCD, participated in the study. The study investigated timing of muscle activity and resultant arm movement during a rapid, voluntary, goal-directed arm movement. Results showed that compared to children without DCD, children with DCD took significantly longer to respond to visual signals and longer to complete the goal-directed movement. Children with DCD also demonstrated altered activity in postural muscles. In particular, shoulder muscles, except for serratus anterior, and posterior trunk muscles demonstrated early activation. Further, anterior trunk muscles demonstrated delayed activation. In children with DCD, anticipatory function was not present in three of the four anterior trunk muscles. These differences support the hypothesis that in children with DCD, altered postural muscle activity may contribute to poor proximal stability and consequently poor arm movement control when performing goal-directed movement. These results have educational and functional implications for children at school and during activities of daily living and leisure activities and for clinicians assessing and treating children with DCD.     

Promoting perspective coordination by dilemma discussion. The effectiveness of classroom group discussion on interpersonal negotiation strategies of 12-year-old students

Promoting social competence and social cognition is an important aim of education and socialization. According to theories of social cognitive and moral development, social cognition may be promoted by adolescent peer interaction. In this study, social cognition is theoretically conceptualized by the interpersonal negotiation strategies model of Selman which distinguishes levels of perspective coordination and steps of information processing (identification of a problem, generating negotiation strategies, selection of a strategy, evaluation). In a pre-post control group design this study investigated whether dilemma discussions among peers lead to higher individual levels of perspective coordination compared to an individualistic condition. Members of the discussion-condition exhibited higher gain scores in perspective coordination compared to the control group regarding the information processing steps generating strategies and strategy selection. In order to analyze verbal interaction in the discussion groups, an integrative coding schedule was developed. In addition, trait-like argumentative motives of the participants were assessed. The results of multilevel analyses suggest that progress in posttest-perspective coordination is mediated by the groups consensual solution of the dilemma as well as by an explanation-oriented discussion style, but only if the latter is accompanied by a trait-like subject- and consensus-oriented argumentative motive. Theoretical and practical conclusions are drawn.     

Standing balance of children with developmental coordination disorder under altered sensory conditions

Maintenance of standing balance requires that sensory inputs be organized with the motor system. Current data regarding the influence of sensory inputs on standing balance in children with developmental coordination disorder (DCD) are limited. This study compared the influence of sensory organization and each sensory input on the standing stability between a group of 20 children, 4-6 years old, with DCD and an age- and gender-matched control group of 20 children. Three types of visual inputs (eyes open, eyes closed, or unreliable vision) and two types of somatosensory inputs (fixed or compliant foot support) were varied factorially to yield six sensory conditions. Standing stability was measured with a Kistler force plate for 30s and expressed as the center of pressure sway area. The results showed that the standing stability of the children with DCD was significantly poorer than that of the control children under all sensory conditions, especially when the somatosensory input was unreliable (compliant foot support) compared to when it was reliable (fixed foot support). The effectiveness of an individual sensory system, when it was the dominant source of sensory input, did not significantly differ between the groups. The results suggest that children with DCD experience more difficulty coping with altered sensory inputs, and that such difficulty is more likely due to a deficit in sensory organization rather than compromised effectiveness of individual sensory systems.     

Motor coordination uses external spatial coordinates independent of developmental vision

The constraints that guide bimanual movement coordination are informative about the processing principles underlying movement planning in humans. For example, symmetry relative to the body midline benefits finger and hand movements independent of hand posture. This symmetry constraint has been interpreted to indicate that movement coordination is guided by a perceptual code. Although it has been assumed implicitly that the perceptual system at the heart of this constraint is vision, this relationship has not been tested. Here, congenitally blind and sighted participants made symmetrical and non-symmetrical (that is, parallel) bimanual tapping and finger oscillation movements. For both groups, symmetrical movements were executed more correctly than parallel movements, independent of anatomical constraints like finger homology and hand posture. For the blind, the reliance on external spatial factors in movement coordination stands in stark contrast to their use of an anatomical reference frame in perceptual processing. Thus, the externally coded symmetry constraint evident in bimanual coordination can develop in the absence of the visual system, suggesting that the visual system is not critical for the establishment of an external-spatial reference frame in movement coordination.     

Use of social knowledge in tacit coordination: Social focal points

Social focal point theory predicts that, in matching, people search for a shared characteristic that makes one decision option salient whereas, in mismatching, they search for complementary characteristics that make different options salient for each of the coordinating parties. In two studies, participants learned about a partner’s activity preferences and then tried to either match or mismatch choices on a series of pictures that were remotely associated with one of these preferences. Being the same on a relevant preference facilitated matching whereas being different facilitated mismatching. In the second study, participants also used overall perceived similarity to supplement specific trait information. Coordination performance also affected interpersonal impressions: successful matching increased interpersonal attraction whereas successful mismatching did not. These downstream effects were obtained even when participants had considerable prior social information about their partners. Tacit coordination is compared with mimicry and synchrony, and the implications for coordinated team performance are discussed.     

论以专业照护为依托的多维安宁疗护模式

通过对安宁疗护中患者和家属的双向关怀相关概念及其需求现状进行概述,分析在传统文化影响下我国安宁疗护服务领域中医护人员专业照护的关键主导地位以及家庭照护中患者-家属双向关怀的重要补充作用,强调两者协同提高患者和家属生命质量对于实现安宁疗护“优逝”目标的重要意义,并结合国内外研究和临床实践现状,以家庭系统理论为指导,构建一种以医护专业照护为依托,将患者-家属双向关怀嵌入其中的多维协同创新安宁疗护模式,以期为实现“优逝”目标提供帮助,并为提升我国安宁疗护服务质量提供参考借鉴。