Residential mental health assessment within Dutch criminal cases: a discussion

In Dutch criminal cases in which doubts arise about the defendant's mental health, a forensic assessment will be requested. This is provided either by the multidisciplinary staff of residential clinics who conduct forensic evaluations for the court, or by mental health professionals contracted on a part-time basis by district courts. This article discusses the procedures applied in such cases as well as the relevant legal provisions. It focuses particularly on the clinical observation, evaluation, and reporting that is carried out over a number of weeks in the residential setting of the Pieter Baan Centrum. Specific attention is paid to procedures applied in this clinic. It is suggested that Dutch procedures for the use of mental health expertise can best be characterized by three aspects: multidisciplinary observation and reporting, the use of a sliding scale for indicating degree of responsibility, and, finally, the involvement and payment of experts by the state as such, rather than by the prosecution and/or the defense. Copyright © 2001 John Wiley & Sons, Ltd.     

Dynandcs in cancer caregiver's health over time: Gender-specific patterns and determinants

Abstract

This study exandned patterns and determinants of three dimensions of caregiver's health of newly diagnosed colorectal cancer patients, i.e. physical, mental and social functioning (N= 148). Physical functioning declined within a 6-month period in female caregivers, while no change was observed in male caregivers. For mental and social functioning, an improvement was observed in male and female caregivers. Change in physical functioning was associated with gender, age, income and initial level. Change in mental functioning was predicted by initial status and positive as well as negative caregiver experiences. Change in social functioning was mainly predicted by initial level and change in patient's dependency. Physical and mental functioning showed the least favorable patterns in female caregivers. The study shows that caregiving may lead to positive health consequences, and underlines the importance of making a distinction between male and female caregivers and of studying caregiver outcomes by using multidimensional assessments.     

Multisensory Stimulation to Improve Low- and Higher-Level Sensory Deficits after Stroke: A Systematic Review

The aim of this systematic review was to integrate and assess evidence for the effectiveness of multisensory stimulation (i.e., stimulating at least two of the following sensory systems: visual, auditory, and somatosensory) as a possible rehabilitation method after stroke. Evidence was considered with a focus on low-level, perceptual (visual, auditory and somatosensory deficits), as well as higher-level, cognitive, sensory deficits. We referred to the electronic databases Scopus and PubMed to search for articles that were published before May 2015. Studies were included which evaluated the effects of multisensory stimulation on patients with low- or higher-level sensory deficits caused by stroke. Twenty-one studies were included in this review and the quality of these studies was assessed (based on eight elements: randomization, inclusion of control patient group, blinding of participants, blinding of researchers, follow-up, group size, reporting effect sizes, and reporting time post-stroke). Twenty of the twenty-one included studies demonstrate beneficial effects on low- and/or higher-level sensory deficits after stroke. Notwithstanding these beneficial effects, the quality of the studies is insufficient for valid conclusion that multisensory stimulation can be successfully applied as an effective intervention. A valuable and necessary next step would be to set up well-designed randomized controlled trials to examine the effectiveness of multisensory stimulation as an intervention for low- and/or higher-level sensory deficits after stroke. Finally, we consider the potential mechanisms of multisensory stimulation for rehabilitation to guide this future research.     

Dynamic testing of learning potential in adults with cognitive impairments: A systematic review of methodology and predictive value

Dynamic testing includes procedures that examine the effects of brief training on test performance where pre‐ to post‐training change reflects patients’ learning potential. The objective of this systematic review was to provide clinicians and researchers insight into the concept and methodology of dynamic testing and to explore its predictive validity in adult patients with cognitive impairments. The following electronic databases were searched: PubMed, PsychINFO, and Embase/Medline. Of 1141 potentially relevant articles, 24 studies met the inclusion criteria. The mean methodological quality score was 4.6 of 8. Eleven different dynamic tests were used. The majority of studies used dynamic versions of the Wisconsin Card Sorting Test. The training mostly consisted of a combination of performance feedback, reinforcement, expanded instruction, or strategy training. Learning potential was quantified using numerical (post‐test score, difference score, gain score, regression residuals) and categorical (groups) indices. In five of six longitudinal studies, learning potential significantly predicted rehabilitation outcome. Three of four studies supported the added value of dynamic testing over conventional testing in predicting rehabilitation outcome. This review provides preliminary support that dynamic tests can provide a valuable addition to conventional tests to assess patients’ abilities. Although promising, there was a large variability in methods used for dynamic testing and, therefore, it remains unclear which dynamic testing methods are most appropriate for patients with cognitive impairments. More research is warranted to further evaluate and refine dynamic testing methodology and to further elucidate its predictive validity concerning rehabilitation outcomes relative to other cognitive and functional status indices.     

Route learning in Korsakoff's syndrome: Residual acquisition of spatial memory despite profound amnesia

Korsakoff's syndrome (KS) is characterized by explicit amnesia, but relatively spared implicit memory. The aim of this study was to assess to what extent KS patients can acquire spatial information while performing a spatial navigation task. Furthermore, we examined whether residual spatial acquisition in KS was based on automatic or effortful coding processes. Therefore, 20 KS patients and 20 matched healthy controls performed six tasks on spatial navigation after they navigated through a residential area. Ten participants per group were instructed to pay close attention (intentional condition), while 10 received mock instructions (incidental condition). KS patients showed hampered performance on a majority of tasks, yet their performance was superior to chance level on a route time and distance estimation tasks, a map drawing task and a route walking task. Performance was relatively spared on the route distance estimation task, but there were large variations between participants. Acquisition in KS was automatic rather than effortful, since no significant differences were obtained between the intentional and incidental condition on any task, whereas for the healthy controls, the intention to learn was beneficial for the map drawing task and the route walking task. The results of this study suggest that KS patients are still able to acquire spatial information during navigation on multiple domains despite the presence of the explicit amnesia. Residual acquisition is most likely based on automatic coding processes.     

Does prism adaptation affect visual search in spatial neglect patients: A systematic review

Prism adaptation (PA) is a widely used intervention for (visuo‐)spatial neglect. PA‐induced improvements can be assessed by visual search tasks. It remains unclear which outcome measures are the most sensitive for the effects of PA in neglect. In this review, we aimed to evaluate PA effects on visual search measures. A systematic literature search was completed regarding PA intervention studies focusing on patients with neglect using visual search tasks. Information about study content and effectiveness was extracted. Out of 403 identified studies, 30 met the inclusion criteria. The quality of the studies was evaluated: Rankings were moderate‐to‐high for 7, and low for 23 studies. As feature search was only performed by five studies, low‐to‐moderate ranking, we were limited in drawing firm conclusions about the PA effect on feature search. All moderate‐to‐high‐ranking studies investigated cancellation by measuring only omissions or hits. These studies found an overall improvement after PA. Measuring perseverations and total task duration provides more specific information about visual search. The two (low ranking) studies that measured this found an improvement after PA on perseverations and duration (while accuracy improved for one study and remained the same for the other). This review suggests there is an overall effect of PA on visual search, although complex visual search tasks and specific visual search measures are lacking. Suggestions for search measures that give insight in subcomponents of visual search are provided for future studies, such as perseverations, search path intersections, search consistency and using a speed–accuracy trade‐off.     

Seeing red primes tomato: evidence for comparable priming from colour and colour name primes to semantically related word targets

There is ample evidence that an independent processing stream exists that subserves the perception and appreciation of colour. Neurophysiological research has identified separate brain mechanisms for the processing of wavelength and colour, and neuropsychological studies have revealed selective colour disorders, such as achromatopsia, colour agnosia, and colour anomia. The aim of the present study is to investigate whether the perception of colour may, despite its independent processing, influence other cognitive functions. Specifically, we investigate the possibility that the perception of a colour influences higher order processes such as the activation of semantically related concepts. We designed an associative priming task involving a colour prime (e.g. a red patch or the word RED) and a lexical decision response to a semantically related (‘tomato’ vs. ‘timato’) or unrelated (‘grass’ vs. ‘griss’) word target. The results of this experiment indicate that there is comparable facilitation of accessing colour-related semantics through the perception of a colour or the reading of a colour name. This suggests that colour has a direct effect on higher order level, cognitive processing. These results are discussed in terms of current models of colour processing.     

Exogenous orienting of crossmodal attention in 3-D space: Support for a depth-aware crossmodal attentional system

The aim of the present study was to investigate exogenous crossmodal orienting of attention in three-dimensional (3-D) space. Most studies in which the orienting of attention has been examined in 3-D space concerned either exogenous intramodal or endogenous crossmodal attention. Evidence for exogenous crossmodal orienting of attention in depth is lacking. Endogenous and exogenous attention are behaviorally different, suggesting that they are two different mechanisms. We used the orthogonal spatial-cueing paradigm and presented auditory exogenous cues at one of four possible locations in near or far space before the onset of a visual target. Cues could be presented at the same (valid) or at a different (invalid) depth from the target (radial validity), and on the same (valid) or on a different (invalid) side (horizontal validity), whereas we blocked the depth at which visual targets were presented. Next to an overall validity effect (valid RTs < invalid RTs) in horizontal space, we observed an interaction between the horizontal and radial validity of the cue: The horizontal validity effect was present only when the cue and the target were presented at the same depth. No horizontal validity effect was observed when the cue and the target were presented at different depths. These results suggest that exogenous crossmodal attention is “depth-aware,” and they are discussed in the context of the supramodal hypothesis of attention.     

Delayed oculomotor inhibition in patients with lesions to the human frontal oculomotor cortex: Evidence from a study on saccade averaging

The frontal oculomotor cortex is known to play an important role in oculomotor selection. The aim of the current study was to examine whether previously observed findings concerning the role of the frontal oculomotor cortex in the speed of saccade initiation and oculomotor inhibition might be related to a common underlying role of these areas in oculomotor selection. To this end, six patients with lesions to the frontal oculomotor cortex performed a double stimulus paradigm in which two elements were presented simultaneously in close proximity. Patients performed a block in which no specific task instruction was given and a block in which an instruction was provided about which of the two elements was the target. The rationale behind this manipulation was that the introduction of a specific task instruction would require a stronger involvement of top-down factors. In contrast to the block without a specific task instruction, saccade latencies to the contralesional visual field were longer than the ipsilesional visual field when a task instruction was given. This effect was strongest for saccades that landed away from the target and the distractor, reflecting trials in which strong oculomotor inhibition was applied. The observed deficits can be explained in terms of a slowing of the inhibitory signals associated with the rejection of a distractor. Given the known role of the Frontal Eye Fields and the location of the lesions, we attribute these findings to the Frontal Eye Fields, revealing their important role in the voluntary control of eye movements.