Pragmatic Assessment and Therapy for Persons with Brain Damage: What Have Clinicians Gleaned in Two Decades?

Pragmatic competence comprises a number of interrelated skills which manifest in real-time in a range of adaptive behaviors and which are driven by underlying cognitive processes that appear to be variably compromised in brain damage. Differential neurological profiles reflect different pragmatic outcomes. The essence of pragmatic assessment and therapy for clinicians is therefore to capture accurately, measure, and, where possible, enhance the ability of the individual to adapt to a changing communicative environment. Assessment measures differ along a number of dimensions. A distinction is drawn between testing and assessment and the argument proposed that for clinical purposes, it is helpful to keep the notions of functional and pragmatic distinct.     

Understanding of Genetic Inheritance among Xhosa-Speaking Caretakers of Children with Hemophilia

Hemophilia A and B are X-linked recessive inherited bleeding disorders that have a profound impact on the family of affected individuals. Education is vital to enable women to appreciate the implications of being a carrier and the implications for a prospective child. Prior research has shown that cultural, socio-economic and linguistic issues in South Africa are major barriers to communication for first-language Xhosa-speakers. This exploratory study aimed to investigate the basic knowledge of genetic inheritance among this cultural group in order to promote culturally-sensitive, effective genetic counseling. Ten in-depth interviews were conducted with Xhosa-speaking mothers or caregivers of boys with hemophilia. Results suggest that the participants had a very limited understanding of the clinical management, genetic consequences and cause of hemophilia. While treatment and care by health care service providers was fully accepted, several participants believed that traditional methods would provide them with more satisfactory explanations. These findings suggest that there is a critical need for socio-culturally tailored, language-specific education for families with hemophilia.     

Comparative Diagnostic Judgments from the Rorschach and the MMPI

Three experienced psychologists made diagnostic judgments from the Rorschach, the MMPI, and gave an overall diagnostic impression for 50 male and 48 female patients. Judgment on the first test viewed was given before looking at the second test. Order of viewing the tests and sex of patient were counterbalanced. The results indicated (a) the judges consistently rated the tests on a given individual as agreeing on diagnostic impression significantly more often than disagreeing; (b) interjudge agreement was low but significant for the MMPI and overall impressions, not significant for the Rorschach impressions; (c) in cases of disagreement, there was a highly significant tendency for the Rorschach to be seen as indicating more pathology than the MMPI.     

Grandmothers as Gems of Genetic Wisdom: Exploring South African Traditional Beliefs About the Causes of Childhood Genetic Disorders

With its diverse cultural and linguistic profile, South Africa provides a unique context to explore contextual influences on the process of genetic counseling. Prior research suggests intergenerational differences regarding models of causation which influence treatment-seeking paths. This pilot study therefore aimed to explore South African traditional beliefs regarding common childhood genetic disorders. Three focus groups were conducted with fifteen grandmothers from different cultural backgrounds in an urban community. Questions pertained to the role of the grandmother, traditional beliefs regarding causes of genetic disorders, explanations of heredity, and prevention and management of genetic disorders. Results indicate a variety of cultural explanations for causes of childhood genetic disorders. These causes can be classified into categories related to lifestyle, behavior, social issues, culture, religion, genetic, and familial causes. Prevention and treatment issues are also highlighted. These findings have implications for genetic counseling practice, which needs to include a greater focus on cultural issues.     

Neurobiological correlates of autism: a review of recent research.

This review paper integrates recent structural and functional imaging, postmortem, animal lesion, and neurochemical research about the pathophysiology of autism. An understanding of the neurobiological correlates of autism is becoming increasingly important as more children are diagnosed with the condition and funding for well-targeted interventions increases. Converging evidence suggests that autism involves abnormalities in brain volume, neurotransmitter systems, and neuronal growth. In addition, evidence firmly links autism with abnormalities in the cerebellum, the medial temporal lobe, and the frontal lobe. Potential implications of these findings and suggestions for future research are reviewed.     

Familiarity with proverbs and performance of a black population on Gorham's Proverbs Test

The Gorham Proverbs Test was administered to 278 black participants residing in a large metropolitan area in Southern California. Respondents were also asked to indicate whether they were familiar with each of the 40 proverbs in the test. Scores were significantly affected by respondents' ages, education, and perceived childhood socioeconomic status. Familiarity with a proverb increased the probability of its correct interpretation. Familiarity of proverbs and attempts to interpret them were significantly associated, that is, respondents tended not to attempt interpretation of unfamiliar proverbs. The number of familiar proverbs per test was not significantly associated with respondents' test scores. The mean Abstract score obtained in this study was comparable to mean scores previously reported in the literature, suggesting that ethnic differences do not significantly affect performance on the Proverbs Test.     

Presence and television.

Film and a number of emerging entertainment technologies offer media consumers an illusion of nonmediation known as presence. To investigate the possibility that television can evoke presence, 65 undergraduate students were shown brief examples of rapid point‐of‐view movement from commercially available videotapes on a television with either a small screen (12 inches [30.5 cm], measured diagonally) or a large screen (46 inches [116.8 cm]). Participants' responses were measured via a questionnaire and a computer‐based recording of arousal (electrodermal activity). Viewers of both televisions reported an enjoyable sense of physical movement, excitement, involvement, and a sense of participation. Furthermore, as predicted, participants who watched the large screen television thought the movement in the scenes was faster, experienced a greater sense of physical movement, enjoyed the movement to a greater extent, found the viewing experience more exciting, and were more physiologically aroused. Practical and theoretical implications are discussed.     

Emotion recognition in schizophrenia: further investigation of generalized versus specific deficit models

In this study, the authors examined the nature of emotion perception in schizophrenia. Two samples of people with schizophrenia, one receiving acute care for a recent exacerbation of symptoms and the other receiving extended care, were compared with a nonclinical control group on emotion perception and general perception measures. The nonclinical control group obtained the highest scores on all of the study measures, and the acutely ill group obtained the lowest scores. Furthermore, the acutely ill sample had a specific deficit in emotion perception that remained present after controlling for performance on the general perception tasks. Conversely, the deficits in emotion discrimination in the extended-care sample reflected generalized poor performance. Differences in performance on the emotion identification task between the 2 clinical groups were reduced when controlling for active symptoms.