Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease.

Although visuoconstructive impairment has been reported in both Alzheimer's (DAT) and Huntington's (HD) disease, there is little knowledge concerning how this cognitive deficit differs quantitatively and qualitatively in these two progressive dementias. To address this issue, the present study compared performances on the Clock Drawing Test (CDT: command and copy) of 25 DAT patients, 25 equally demented HD patients, and 25 elderly normal controls (NC). In the command condition, both patients groups were significantly impaired compared to the NC group. Although there was no significant difference between DAT and HD patients' total quantitative scores, a qualitative error analysis revealed a number of dissociations between the two patient groups. Graphic difficulties, very common in HD patients, were virtually absent in DAT patients; in contrast, conceptual errors were almost exclusively seen in DAT patients and were related to the severity of their dementia. Perseveration and "stimulus-bound" responses were also more frequent in DAT patients, and both groups made visuospatial errors. In the copy condition, the DAT, but not the HD, patients evidenced a marked improvement in performance. These results indicate that while both DAT and HD patients have significant visuoconstructive difficulties even in the early stages of their disorders, the specific cognitive processes underlying their quantitative impairments are quite different. It is possible that the DAT patients' conceptual errors are yet another indicator of the deterioration of their semantic knowledge.     

The effect of associations and expectations on lexical decision making in normals, alcoholics, and alcoholic Korsakoff patients

This study examined whether patients with Korsakoff's disease suffer from increased PI during encoding. The ability of the name of one category, e.g., BIRD, to prime the processing of members of another category, e.g., BODY PARTS, in a lexical decision task was used to assess the amount of PI during encoding. This task required a subject to inhibit the normal associations to BIRD. Young normals (25 years), older normals (48 years), alcoholics (45 years), and alcoholic Korsakoff patients (59 years) performed two lexical decision tasks. In the first experiment, the appearance of the neutral prime XXX 750 msec before the probe signaled that if the probe was a word, there was a 75% chance that it was from a particular category (e.g., BODY PARTS). The prime facilitated reaction time for words from the expected category for all four groups. The prime slowed reaction time for words that were not from the expected category for the young normals but did not influence reaction time for unexpected words for the three older groups. The second experiment was identical to the first except that a category word was used as the prime. The category word used as the prime was unrelated to the category of the words that were likely to follow it. For example, BIRD might be used to signal the likelihood that the word would be from the category, BODY PARTS. Again, young normals were slower to respond to unexpected probe words, but the three older groups were not. Again, the prime facilitated reaction time for expected words for the young normals, older normals, and alcoholics. However, the word prime did not facilitate reaction time for expected words for the alcoholic Korsakoff patients. That the word prime did not facilitate reaction time for the Korsakoff patients was viewed as evidence that they were unable to inhibit its normal associations and were more sensitive to PI from these associations than the other subjects.     

Patterns of memory failure after scopolamine treatment: implications for cholinergic hypotheses of dementia

To test the idea that scopolamine provides a suitable pharmacological model of the memory defects associated with cortical or subcortical dementias, we assessed memory on a battery of tasks in healthy young normal subjects who received 0.5 mg scopolamine, 0.1-0.2 mg glycopyrrolate or physiological saline, once each on three separate occasions, and compared the pattern of memory failure induced by scopolamine to that observed on the same tasks in patients with Alzheimer's disease (AD) or Huntington's disease (HD). In agreement with previous reports, scopolamine impaired acquisition and delayed recall of a 14-word list and disrupted retention on the Brown-Peterson distractor task, whereas the peripherally active anticholinergic glycopyrrolate was without effect. However, under scopolamine the pattern of errors made on these memory tasks was quite different from that seen in patients with AD. Scopolamine did not increase the number of false positive errors on delayed recognition of the word list and also failed to increase the number of prior-item intrusions on the Brown-Peterson task. Also, scopolamine did not impair learning of a symbol-digit paired-associate task, and did not reduce the number of words retrieved or increase the number of words repeated on a standardized verbal fluency test. When the effects of scopolamine on memory were compared to the pattern of impairments observed in demented patients with HD, several differences were found. Although scopolamine clearly produces deficits on some measures of anterograde memory, the present findings question whether anticholinergic drugs adequately mimic the full range of memory impairments observed in cortical or subcortical dementias.     

The intergenerational transmission of relationship instability: A focus on emerging adult on-off relationships

This study extends prior research on the intergenerational transmission of relationship instability by examining parents' history of on-off relationships as a predictor of emerging adults' own cycling (i.e., breaking up and renewing with the same romantic partner). Data were collected at a large mid-western university from 702 emerging adults (18–25 years old). Multinomial logistic regression was used to predict the likelihood that participants had cycled in a past or current relationship. Results show that parental cycling increased the likelihood of offspring cycling in a past or current relationship relative to never cycling, and greater uncertainty about the future of the relationship was a mechanism through which such transmission occurred. Findings from this study demonstrate that parental relationship instability can even be consequential for the transient relationships within emerging adulthood, making family history a productive area to explore for practitioners working with cyclical partners and/or emerging adults.     

A comparison of differential reinforcement procedures for treating automatically reinforced behavior

Children diagnosed with autism spectrum disorder (ASD) often exhibit stereotypy, which can be socially stigmatizing, interfere with daily living skills, and affect skill acquisition. We compared differential reinforcement of alternative behavior (DRA) and differential reinforcement of other behavior (DRO) when neither procedure included response blocking or interruption for (a) reducing stereotypy, (b) increasing task engagement, and (c) increasing task completion. DRA contingencies yielded superior outcomes across each measure when evaluated with 3 individuals with autism spectrum disorder.     

Prior Allegations of Harassment Impact Mock Jurors’ Perceptions of Sexual Harassment in a Criminal Trial

The current study examined factors that may influence jurors’ judgments in a criminal sexual harassment case with Canadian undergraduate students. Undergraduate students (n?=?268) examined whether defendant’s gender, victim’s gender, and whether the victim had made similar accusations in the past were influential in mock jurors’ judgments. Participants read a case summary describing an alleged sexual harassment and answered questions concerning defendant’s guilt, defendant’s culpability, and perceptions of the victim. Additionally, attitudes concerning sexual harassment and sexism were measured. The presence of prior allegations was a driving force in mock juror decisions, with mock jurors providing more guilty verdicts, more favorable perceptions of the victim, and less favorable perceptions of the defendant when no prior allegations of harassment had been made by the victim. The results of the current study suggest that the presence of prior allegations have a large impact on mock jurors’ decisions, suggesting that prior allegations may need to be considered more closely in court before they can be used as evidence.

     

Health Focused Psychotherapy In Treating a Dual Diagnosed Patient

Health-focused psychotherapy offers a contemporary model used in assessment, treatment planning and evaluation in addressing patients with both medical and psychiatric diagnoses. Clinicians in the health and mental health disciplines must know and understand the importance of standards of care and models of intervention and evaluation in clinical practice for this type of patient. Examined is the use of a specific model providing a tailored orientation to patient education, along with the development and use of a clinical algorithm and care pathway for clinical practice. Provided is a case study for applying the development and use of a clinical algorithm and care pathway for a dual diagnosed patient receiving health-focused psychotherapy.     

The deterioration of semantic memory in Alzheimer's disease.

Semantic memory impairment is a common feature of dementia of the Alzheimer type (DAT). Recent research has shown that patients with DAT are more impaired (relative to non-demented controls) in generating exemplars from a particular semantic category (e.g., animals) than words beginning with a particular letter, exhibit an altered temporal dynamic during the production of category exemplars, are impaired on confrontation naming tasks and make predominantly superordinate or semantically related errors, consistently misidentify the same objects across a variety of semantic tasks, and have alterations in multi-dimensional scaling models of their semantic network that are indicative of a loss of concepts and associations. These results are consistent with the view that Alzheimer's disease results in a breakdown in the organization and structure of semantic knowledge as neurodegeneration spreads to the association cortices that presumably store semantic representations.     

The detection of feigned disabilities: the effectiveness of the Personality Assessment Inventory in a traumatized inpatient sample

Research on feigned mental disorders indicates that severe psychopathology coupled with significant trauma histories often complicate feigning determinations, resulting in inaccuracies on otherwise effective measures. As part of malingering assessments, the Personality Assessment Inventory (PAI) is often used because of its excellent validation and the availability of three feigning indicators (Negative Impression, Malingering Index, and Rogers Discriminant Function), which have evidenced large effect sizes and clinically useful cut scores. The current study examined the effectiveness of the PAI in a traumatized inpatient sample using a between-subjects simulation design. Although Negative Impression appeared affected by trauma--especially in conjunction with dissociative symptoms--very positive results were found for Malingering Index and Rogers Discriminant Function. They remained relatively unelevated under honest conditions, despite posttraumatic stress disorder and extensive comorbidity. Using single-point cut scores provided moderately good classification of feigned and genuine PAI profiles. For purposes of classification, the authors operationally defined small indeterminate groups that were considered too close to classify (i.e., ±5T of the cut scores). With indeterminate cases removed, the overall classification rates improved modestly. However, the more important finding involved the error rates for the indeterminate group, which exceeded 50%. Directions for further research are discussed.