Weak coherence,no theory of mind,or executive dysfunction? Solving the puzzle of pragmatic language disorders

Deficits in pragmatic language ability are common to a number of clinical populations, for example, right-hemisphere damage (RHD), Autism and traumatic brain injury (TBI). In these individuals the basic structural components of language may be intact, but the ability to use language to engage socially is impaired. Despite the nature of these difficulties being well documented, exactly what causes these difficulties is less clear. Furthermore, the current status of causal explanations for pragmatic difficulties across these populations is divergent and sometimes contradictory. This paper explores the empirical validity of three theories that attempt to explain pragmatic language impairment. It is recommended that a new, more convergent approach to investigating the causes of pragmatic language disability be adopted.     

Brain activation during spatial updating and attentive tracking of moving targets

Keeping aware of the locations of objects while one is moving requires the updating of spatial representations. As long as the objects are visible, attentional tracking is sufficient, but knowing where objects out of view went in relation to one's own body involves an updating of spatial working memory. Here, multiple object tracking was employed to study spatial updating and its neural correlates. In a dynamic 3D-scene, targets moved among visually indistinguishable distractors. The targets and distractors either stayed visible during continuous viewpoint changes or they turned invisible. The parametric variation of tracking load revealed load-dependent activations of the intraparietal sulcus, the superior parietal lobule, and the lateral occipital cortex in response to the attentive tracking task. Viewpoint changes with invisible objects that demanded retention and updating produced load-dependent activation only in the precuneus in line with its presumed involvement in updating spatial working memory.     

Development and validation of a revised measure of codependency

This study assessed the factor structure, internal consistency, and concurrent validity of a revised instrument, the Composite Codependency Scale (CCS), a 19‐item measure designed to assess codependent traits. Exploratory factor analysis of the CCS, using data from 301 adults from the general population and 49 attending members of Codependents Anonymous (CoDA), yielded three factors: self‐sacrifice, interpersonal control, and emotional suppression. The scale and its subscales exhibited good internal consistency. Consistent with the tenets of the codependency model, higher codependency scores were significantly associated with higher levels of depression, anxiety, stress, and familial dysfunction and lower levels of narcissistic tendencies, self‐esteem, and emotional expressivity. Furthermore, the revised measure effectively discriminated members of CoDA from those in the general population.     

The contribution of executive control to semantic cognition: Convergent evidence from semantic aphasia and executive dysfunction

Semantic cognition, as described by the controlled semantic cognition (CSC) framework (Rogers et al., 2015 , Neuropsychologia, 76, 220), involves two key components: activation of coherent, generalizable concepts within a heteromodal ‘hub’ in combination with modality‐specific features (spokes), and a constraining mechanism that manipulates and gates this knowledge to generate time‐ and task‐appropriate behaviour. Executive–semantic goal representations, largely supported by executive regions such as frontal and parietal cortex, are thought to allow the generation of non‐dominant aspects of knowledge when these are appropriate for the task or context. Semantic aphasia (SA) patients have executive–semantic deficits, and these are correlated with general executive impairment. If the CSC proposal is correct, patients with executive impairment should not only exhibit impaired semantic cognition, but should also show characteristics that align with those observed in SA. This possibility remains largely untested, as patients selected on the basis that they show executive impairment (i.e., with ‘dysexecutive syndrome’) have not been extensively tested on tasks tapping semantic control and have not been previously compared with SA cases. We explored conceptual processing in 12 patients showing symptoms consistent with dysexecutive syndrome (DYS) and 24 SA patients, using a range of multimodal semantic assessments which manipulated control demands. Patients with executive impairments, despite not being selected to show semantic impairments, nevertheless showed parallel patterns to SA cases. They showed strong effects of distractor strength, cues and miscues, and probe–target distance, plus minimal effects of word frequency on comprehension (unlike semantic dementia patients with degradation of conceptual knowledge). This supports a component process account of semantic cognition in which retrieval is shaped by control processes, and confirms that deficits in SA patients reflect difficulty controlling semantic retrieval.     

EDITORIAL

The aim of the present study was to evaluate the usefulness of Barkley’s (1997a) model of inhibition and executive functioning in describing the deficits associated with Attention Deficit Hyperactivity Disorder (ADHD). Besides group differences, the present study addressed the question of independent effects of inhibition and the other executive functions in discriminating between children with ADHD and controls and how well, in terms of sensitivity and specificity, these measures can classify the children into the correct group. The results showed that children with ADHD differed significantly from controls with regard to measures of inhibition as well as all other executive function measures, except repetition of hand movements. In logistic regression models, three different measures tapping inhibition, working memory and emotion regulation were shown to be significant independent predictors of group membership. The sensitivity for these three variables as a set was 76.2, the specificity was 90.5, with a total of 86% of the sample correctly classified. When excluding the parental rating of emotion regulation, the overall classification rate decreased some, but was still relatively high in comparison with previous studies within this area of research.     

The role of psychological processes in estimates of stuttering severity

Purpose

To examine the associations of trait anxiety (STAI), social anxiety (SIAS), depression (BDI-II), and personality features (ADP-IV) with three measures of stuttering severity: %SS, Stuttering Severity, Instrument, and the Overall Assessment of the Speaker's Experience of Stuttering.

Method

Fifty adults with a history of stuttering served as participants. Participant scores on trait, anxiety, social anxiety, depression, and personality features were entered into a regression analysis, with the criterion variables (DVs) being: %SS, SSI-3, OASES total score. In order to explore the OASES, further, each of the four OASES subscales were also examined. A separate regression was conducted for, each dependent variable.

Results

The OASES total score model was significant (p < .0001) and revealed that social anxiety and, trait anxiety were the only significant predictors, with medium effect sizes noted for both variables. In contrast, percent syllables stuttered and the SSI were not significantly associated with psychological, variables, suggesting that anxiety may not always be related to overt indicators of stuttering. Depression and personality dysfunction were not significantly associated with any measure of, stuttering severity.

Conclusion

Anxiety in the form of social and trait anxiety are significantly associated with stuttering, severity as indicated by the OASES. Traditional procedures for assigning severity ratings to individuals, who stutter based on percent syllables stuttered and the Stuttering Severity Instrument are not, significantly related to psychological processes central to the stuttering experience. Depression and, personality characteristics do not meaningfully account for stuttering.Educational objectives: The reader will be able to: (a) differentiate forms of anxiety that are likely to be associated with stuttering (b) understand the importance of determining features of stuttering that go beyond the obvious, surface characteristics of stuttering frequency, and (c) discuss the important clinical and theoretical implications for understanding the degree of psychological dysfunction that is likely to be characteristic of those who stutter.     

What's in a Disorder

Abstract

This paper analyzes the emergence of two FDA-approved products to treat “sexual disorders”: Viagra, a drug prescribed for the treatment of erectile dysfunction, and the Eros, a device prescribed for the treatment of female sexual dysfunction. Through an analysis of advertising and promotional materials for Viagra and the Eros, we argue that these pharmaceutical devices and the discourses they circulate reinforce normative gender ideals by enacting dominant cultural narratives of masculinity, femininity, and male and female sexuality. These cultural narratives of normative gender structure sexuality in such a way that reinforces certain kinds of masculinity, femininity, and (hetero)sexuality, thereby rendering “atypical” gender and sexual expressions, desires, and appearances invisible and marginal. We argue that these constructions reify cultural ideologies about “what counts” as legitimate and appropriate sexuality and that these constructions have profound implication for social actors, sexologists, and therapists.     

Neural correlates of stimulus response and stimulus outcome shifting in healthy participants and MS patients

Introduction

Adaptation to changing situations can be mediated by two strategies: (1) Evaluation of a response and (2) Evaluation of outcome values in relation to objects. Previous studies indicate that response shifting is associated with a network comprising the left frontal cortex and parietal cortex connected by the superior longitudinal fascicle, whereas outcome evaluation is associated with a network consisting of the orbitofrontal cortex, amygdala and uncinate fascicle. However, these studies rarely compared both kinds of adaptation directly and existing fMRI studies with healthy subjects are not informative about the role of the two fiber systems.

Methods

We analyzed stimulus response shifting and stimulus outcome shifting in two studies, one fMRI-study on healthy participants and one study on patients with MS involving structural MRI (Diffusion Tensor Imaging, Voxel Based Morphometry, Ventricular volumetry). Two tasks were used, identical in presentation but different in instruction, controlling for effects of lower level processing. In the SRS task, participants had to perform a “Go” or “NoGo” response depending on a stimulus change: if the stimulus remained the same, they had to continue with the former type of response, if it changed they had to adapt their response pattern. In the SOS task they had to perform a “Go” response only if the presented stimulus corresponded to that of an internal alternating series.

Results

fMRI findings showed that SRS is related to a bilateral parietal-premotor network. In the left hemisphere the prefrontal cortex was also involved. SOS was lateralized to the right hemisphere, particularly to the anterior temporal pole and amygdala, and the inferior parietal cortex. MS patients impaired on this task suffered from lesions in the right uncinate fascicle and showed an enlarged right frontal lateral ventricle.

Conclusion

With physically identical tasks, a functional neuronal segregation can be demonstrated for stimulus response shifting (bilateral activations with a focus in the left prefrontal cortex) and stimulus outcome shifting (right anterior temporal lobe and right supramarginal gyrus).     

Attentional deficits in fibromyalgia and its relationships with pain,emotional distress and sleep dysfunction complaints

Cognitive complaints are common among subjects with fibromyalgia (FM). Yet, few studies have been able to document these deficits with cognitive tasks. A main limitation of existing studies is that attention has been broadly defined and the tasks used to measure attention are not designed to cover all the main components of the attentional system. Research on attention has identified three primary functions of attention, known as alerting, orienting and executive functioning. This study used the attentional network test-interactions task to explore whether and which of the three attentional networks are altered in FM. Results showed that FM patients have impaired executive control (greater interference), reduced vigilance (slower overall reaction time) and greater alertness (higher reduction in errors after a warning cue). Vigilance and alertness showed several relations with depression, anxiety and sleep quality. Sleep dysfunction was a significant predictor for alertness, whereas there were no significant predictors for vigilance. These findings highlight that the treatment of sleep difficulties in FM patients may help with some of their cognitive complaints.