Book reviews

Arnold, M. Memory and the brain. Hillsdale, N. J.: Lawrence Erlbaum Associates. 1984. Pp. 532. ISBN 0-89859-290-9. £47.90.

Green, T. R. G., Payne, S. P. and van der Veer, G. C. (Eds.). The psychology of computer use.. London: Academic Press. 1983. Pp. 225. ISBN 0-12-2974204. $9.50.

Stunkard, A. J. and Stellar, E. (Eds.). Eating and its disorders. New York: Raven Press. 1984. Pp. 302. ISBN 0-89004-891-6. $58.50.

Spillmann, L. and Wooten, B. R. (Eds.) Sensory experience, adaptation, and perception: Festschrift for Zero Kohler. Hillsdale, N. J.: Lawrence Erlbaum Associates. 1984. Pp. xxvii + 748. ISBN 0 8985-3-218-6. £70.85.

Geschwind, N. and Galaburda, A. M. (Eds.)Cerebral dominance: The biological foundations. Cambridge, Mass.: Harvard University Press. 1984. Pp. 232. ISBN 0-674-10658-X. £24.35.

Annett, M. Left, right, hand and brain: The right shift theory. 1985. London and Hillsdale, N. J.: Lawrence Erlbaum Associates. Pp. xiii + 474. ISBN 0-86377418-5 £29.95.

Ericsson, K. A. and Simon, H. A. Protocol analysis: Verbal reports as data. Cambridge, Mass.: The M.I.T. Press. 1984. Pp. 426. ISBN 0-262-05029-3. £28.95.     

Spirituality and spiritual care – missing concepts from core undergraduate children’s nursing textbooks

Background: Spiritual care is espoused to be fundamental in children’s nursing; however, the extent to which current fundamental children’s nursing textbooks support and advocate spiritual care delivery by children’s nurses and nursing students is unknown. Aim and objectives: To examine whether or not fundamental undergraduate children’s nursing textbooks include spiritual care content. Methods: Five hundred and nineteen books were sampled from the Nursing and Midwifery Core Collection list (UK) using a survey, the Spirituality Textbook Analysis Tool (STAT) to collect data. Analysis and Results: 519 books were included in the study using the STAT and 13 books included content on children’s spirituality. There were a variety of textbooks in the audit of those that made reference to the search terms in the STAT, it was found that content mainly addressed only two areas; religious faiths and the dying child. Recommendations: Children’s nurses require education about children’s spiritual developmental stage and age appropriate spiritual assessment. A lack of detailed information in core children’s nursing textbooks means that this area of nursing practice may be taught as an adjunct to care and not as an element of holistic care which is the gold standard that children’s nurses should strive for.     

Implementation of Cognitive Therapy for PTSD in routine clinical care: Effectiveness and moderators of outcome in a consecutive sample

ObjectiveTrauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area.MethodA consecutive sample of 330 patients with PTSD (age 17–83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects.ResultsCT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M = 280 days, n = 220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience.ConclusionsThe results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.     

Patterns of paralexia: A psycholinguistic approach

A sample of the literature on acquired dyslexia is reviewed with special reference to the nature of paralexic errors. Linguistic studies of six cases of dyslexia are presented, with appropriate neurological and psychological details; there are two cases of each of three hypothesized types of impairment, visual dyslyxia, surface (grapheme-phoneme) dyslexia, and deep (syntactico-semantic) dyslexia. Finally, a scheme for acquired dyslexia is proposed and related to the error patterns observed in normal adult readers and in children learning to read; our approach to lexical look-up is one that the diagram makers may have found sympathique.This is a revised version of paper presented at the International Neuropsychology Symposium, Engelberg, Switzerland, June 1971.     

Understanding Continuity to Recognize Discontinuity

In this paper the author comments on the contribution by António P. Ribeiro and Miguel M. Gonçalves (in this journal) that offer a creative and unique perspective on maintenance and transformation of problematic self-narrative. From here the author contributes to the topic through the exploration of some issues: a) the relation, in the dialogical process of self-narrative construction, between semiotic processes that give voice to the semantic opposition and semiotic processes that give voice to the contradictory; b) the relation between sameness and ipseity in the self-narrative process; c) the role of a pathemic axis of meaning in the generation process of self-narratives. A final reflection is done on narrative as a device of clinical intervention in which the author makes a distinction between methods based on the recognition and extension of variability and methods based on the recognition of permanency so to get to variability.     

Auditory neuropathy/dys-synchrony: diagnosis and management

Auditory brainstem responses (ABRs) and otoacoustic emissions (OAEs) are objective measures of auditory function, but are not hearing tests. Normal OAEs reflect normal cochlear outer hair cell function, and an ABR indicates a synchronous neural response. It is quite possible for a patient to have normal OAEs but absent or grossly abnormal ABR and a behavioral audiogram that is inconsistent with either test. These patients, who may constitute as much as 10% of the diagnosed deaf population, have auditory neuropathy/dys-synchrony (AN/AD). To diagnose AN/AD accurately, ABRs are obtained in response to condensation and rarefaction clicks to distinguish cochlear microphonics (CM) from neural responses. Appropriate management is confounded by variation among patients and changes in auditory function in some patients over time. Recommendations for management include visual language exposure through methods such as American Sign Language (ASL), Cued Speech, or baby signs, and closely following patients.     

Neuropsychological Impairment of Face Recognition Units

Despite the absence of “conscious”, overt identification, some patients with face recognition impairments continue covertly to process information regarding face familiarity. The fact that by no means all patients show these covert effects has led to the suggestion that indirect recogntion tasks may help in identifying different types of face recognition impairment. The present report describes a number of experiments with the patient NR, who, after a closed head injury, has been severely impaired at recognizing familiar faces. Investigations mostly failed to show overt or covert face recognition, but NR performed at an above-chance level in selecting the familiar face on a task requiring a forced-choice between a familiar and an unfamiliar face. This discrepancy between a degree of rudimentary overt recognition and absence of covert effects on most indirect tests was addressed using a cross-domaim identity priming paradigm. This examined separately the possibility of preserved recognition for faces that NR consistently chose correctly in a forced-choice familiarity decision and those on which he performed at chance level. Priming effects were apparent only for the faces that were consistently chosen as “familiar” in forced-choice. We suggest that NR's stored representations of familiar faces are degraded, so that face recognition is possible only via a limited set of relatively preserved representations able to support a rudimentary form of overt recognition and to facilitate performance in matching and priming tasks.