Is Speech Arrest during Wada Testing a Valid Method for Determining Hemispheric Representation of Language?

Background and objective: The intracarotid amobarbital procedure, or Wada test, is the method of choice to determine hemispheric representation of language, and is routinely used in the presurgical evaluation for intractable epilepsy. Some investigators perform comprehensive language assessments, but others base language lateralization solely on speech arrest. This study sought to determine whether speech arrest alone during Wada testing provides valid data regarding language lateralization. Methods: The subjects (previously reported) were 21 patients evaluated for intractable epilepsy, who underwent language lateralization by Wada testing and functional MRI (FMRI). For each patient, language representation was determined by calculating: (1) a Wada laterality index based exclusively on speech arrest; (2) a Wada laterality index based on comprehensive language assessment; and (3) an FMRI laterality quotient. Correlation coefficients and categorical classifications were analyzed. Results: There was no significant correlation between the Wada laterality quotient derived from duration of speech arrest and either the comprehensive Wada language laterality score (r= .35,p= .12) or FMRI language laterality score (r= .32,p= .16). Categorical classification as left, right or bilateral language also showed marked discordance between speech arrest and the other two methods. Conclusion: Duration of speech arrest during Wada testing is not a valid measure of language dominance.     

Does contextual strength modulate the subordinate bias effect? A reply to Kellas and Vu

In their reply to Binder and Rayner (1998), Kellas and Vu (1999) raised questions about the criteria we used to exclude items from the Kellas, Martin, Yehling, Herman, and Vu (1995) stimulus set. In this reply, we further document these criteria and also address the issue of local versus published norms. We continue to believe that the stimulus set used by Kellas et al. (1995) was problematic. We also address the issue of strength of context, a concept used in earlier research that dealt with the subordinate bias effect. We argue that the contexts used by Kellas et al. (1995) were no stronger than the contexts previously used that established this effect. Therefore, we continue to think that our finding that context does not eliminate the subordinate bias effect is valid.     

Clinical Expertise in Psychotherapy: How Expert Therapists Use Theory in Generating Case Conceptualizations and Interventions

Case conceptualization is a primary skill that may be the linchpin of clinical practice as it sets the framework for making sense of a patient’s difficulties and guides a path toward change. Providing meaning and structure to often ambiguous and nuanced clinical information, an apt case conceptualization facilitates the therapist’s complex integration of core therapeutic skills to produce expert performance. Rooted in the cognitive sciences literature on expertise, we introduce the concept of metabolizing theory to capture expert therapists’ capacity to use theoretical and clinical knowledge in an intuitive, flexible manner that responds and adapts to the unique and complex context of the treatment.     

Searching for the enriching sense of otherness: The psychoanalytic psychotherapist as a meaning-bearing other

Abstract

This paper is a theoretical and clinical examination of the patient's search for the otherness of the therapist as a prerequisite for change and development in relational psychoanalytic psychotherapy. A basic assumption is that being in a relationship as well as being a personal self, is to be understood, as being with a “meaning-bearing other”; that is, someone who allows for the possibility of meaningful thoughts and feelings, either through an actual communicative presence or as a consciously, prereflective, or unconsciously imagined communication partner. The term “meaning-bearing other” is used to differentiate distinct, although often synchronic, modes of relatedness. The need for intersubjective “depth”—that is, to discover the otherness of the other, and for oneself to be recognized as an experiencing subject—is regarded as a main motivational force. Winnicott's, as well as Sullivan's developmental approaches, Mitchell and Aron's views on psychoanalytic interaction, and Heidegger and Gadamer's phenomenology and hermeneutics are used as theoretical points of reference for the present discourse. The theoretical points of view are examined and discussed through excerpts from twice-a-week psychotherapy with a six-year old girl.     

Comparison of MMPI-2 profiles of Gulf War veterans with epileptic and nonepileptic seizure patients

As part of a larger study of illnesses related to service in the Gulf War, MMPI-2 profiles of epileptic seizure (ES) patients; nonepileptic seizure (NES) patients; Gulf War veterans with unexplained cognitive, psychological, musculoskeletal, fatigue, or dermatologic symptoms; and asymptomatic Gulf War veterans (Controls) were analyzed. There were 70 people in each group. Seizure diagnosis was based upon intensive EEG monitoring. Gulf War cases were mildly abnormal on MMPI-2 Scales Hs and D and significantly higher than controls on 8 of 10 MMPI-2 clinical scales, but they were significantly lower than NES patients on several scales including Hs and Hy.     

Sentential and discourse topic effects on lexical ambiguity processing: an eye movement examination

Models of lexical ambiguity resolution posit a role for context, but this construct has remained relatively undefined in the literature. The present study isolated two different forms of contextual constraint and examined how these sources of information might differentiate between a selective access and a reordered access model of ambiguity processing. Eye movements were monitored as participants read passages that contained either a balanced or a biased ambiguous word. The sentence containing the ambiguous word was held constant and instantiated either the subordinate meaning (Experiment 1) or the dominant meaning (Experiment 2) through the use of local context. These sentences were embedded in passages in which the topic was consistent, inconsistent, or neutral with respect to the meaning biased by the critical sentence. Experiment 1 provided evidence suggesting that the subordinate meaning of an ambiguous word was not selectively accessed even when sentence and discourse topic information biased that meaning. The data from Experiment 2 provided evidence that even the dominant meaning was not selectively accessed. These contextual sources of information were evaluated in terms of the roles they play in models of lexical ambiguity resolution.     

Marketing measurably effective instructional methods

The failure to gain wider acceptance of measurably effective teaching methods by the educational establishment may be due to resistance to behaviorism, in particular, and to a set of contingencies that resist change, in general. The promotion of effective instructional methods is presented in terms of recommended marketing principles, including identifying and solving perceived consumer needs, using plain English, segmenting the marketplace and developing specific solutions, identifying opportunities for greatest impact, creating tangible educational products, seeking new markets, planning marketing strategy and tactics, and writing for non-technical publications. Precision Teaching is presented as a case study in the promotion of effective instructional methods. Although it is a measurably superior instructional methodology, Precision Teaching has not been widely adopted. By applying basic marketing principles and strategic planning, some of its proponents have initiated an ongoing effort of outreach and promotion.