See What I’m Saying? Expertise and Verbalisation in Perception and Imagery of Complex Scenes

How does describing a previously viewed picture affect our memory for it? Does verbalisation affect our eye movements even when the picture has disappeared? When viewing a photograph, the sequences of eye movements we make (‘scanpaths’) are influenced by both bottom-up visual saliency and top-down cognitive knowledge. Recognition memory is enhanced and the similarity of scanpaths at encoding and recognition is greater for domain-specific pictures. A similarity in scanpaths is also observed during imagery but to a greatly reduced degree. This study explored whether scanpath similarity could be improved by verbalising one’s memory of the picture and whether the previously observed domain-specific advantage was still present when no bottom-up information was available. Specialists and controls were shown a set of photographs, and after each one had to either visualise it or describe it from memory. The stimuli were complex scenes, half of which contained a domain-specific object. Recognition accuracy was increased by post-stimulus verbalisation, and specialists demonstrated an advantage for stimuli that contained domain-relevant information. Saliency influenced both verbal feedback and eye movements but was moderated by domain expertise. Scanpaths were more similar when pictures were described compared to when imagined, and specialists produced more similar scanpaths when describing domain-specific pictures, compared to control pictures and control participants.     

I’m not alone,’ said the boy. ‘I’ve got a puppy

European Child & Adolescent Psychiatry -     

Divorce and Children’s Adjustment Problems at Home and School: The Role of Depressive/Withdrawn Parenting

This study examined linkages between divorce, depressive/withdrawn parenting, and child adjustment problems at home and school. Middle class divorced single mother families (n=35) and 2-parent families (n=174) with a child in the fourth grade participated. Mothers and teachers completed yearly questionnaires and children were interviewed when they were in the fourth, fifth, and sixth grades. Structural equation modeling suggested that the association between divorce and child externalizing and internalizing behavior was partially mediated by depressive/withdrawn parenting when the children were in the fourth and fifth gradesThis study was supported by a grant (R29-48595) from the National Institute of Mental Health awarded to Rena Repetti; Jeffrey Wood was supported by a training grant from the National Institute of Mental Health (Biobehavioral Issues in Physical and Mental Health; MH15750) and a UCLA Research Fellowship. We are very grateful to the children, teachers, and school administrators who participated in the study, and to the many research assistants who helped to collect the data.     

But do you think I’m cool?: Developmental differences in striatal recruitment during direct and reflected social self-evaluations

The current fMRI study investigates the neural foundations of evaluating oneself and others during early adolescence and young adulthood. Eighteen early adolescents (ages 11–14, M = 12.6) and 19 young adults (ages 22–31, M = 25.6) evaluated whether academic, physical, and social traits described themselves directly (direct self-evaluations), described their best friend directly (direct other-evaluations), described themselves from their best friend's perspective (reflected self-evaluations), or in general could change over time (control malleability-evaluations). Compared to control evaluations, both adolescents and adults recruited cortical midline structures during direct and reflected self-evaluations, as well as during direct other-evaluations, converging with previous research. However, unique to this study was a significant three-way interaction between age group, evaluative perspective, and domain within bilateral ventral striatum. Region of interest analyses demonstrated a significant evaluative perspective by domain interaction within the adolescent sample only. Adolescents recruited greatest bilateral ventral striatum during reflected social self-evaluations, which was positively correlated with age and pubertal development. These findings suggest that reflected social self-evaluations, made from the inferred perspective of a close peer, may be especially self-relevant, salient, or rewarding to adolescent self-processing – particularly during the progression through adolescence – and this feature persists into adulthood.     

‘Help me! I’m old!’ How negative aging stereotypes create dependency among older adults

Objectives: This study examined the effects of negative aging stereotypes on self-reported loneliness, risk-taking, subjective health, and help-seeking behavior in a French sample of older adults. The aim of this study was to show the detrimental effects of negative aging stereotypes on older adults’ self-evaluations and behaviors, therefore contributing to the explanations of the iatrogenic effect of social environments that increase dependency (e.g., health care institutions).

Method: In the first experiment conducted on 57 older adults, we explored the effects of positive, neutral, or negative stereotype activation on the feeling of loneliness and risk taking decision. The second experiment (n = 60) examined the impact of stereotype activation on subjective health, self-reported extraversion as well as on a genuine help-seeking behavior, by allowing participants to ask for the experimenter's help while completing a task.

Results: As predicted, negative stereotype activation resulted in lower levels of risk taking, subjective health and extraversion, and in higher feelings of loneliness and a more frequent help-seeking behavior.

Conclusion: These findings suggest that the mere activation of negative stereotypes can have broad and deleterious effects on older individuals’ self-evaluation and functioning, which in turn may contribute to the often observed dependency among older people.     

Parenting Influences on Latino Children’s Social Competence in the First Grade: Parental Depression and Parent Involvement at Home and School

Although it is widely accepted that parental depression is associated with problems with children’s socioemotional adjustment, the pathways by which parental depression influences children’s adjustment, particularly in low-income Latino children are not fully understood. In our investigation of 1,462 low-income Latino children in the first grade and their Spanish- and English-dominant parents, a factor analysis revealed three main pathways of possible influence of parent involvement in children’s social development: emotional involvement and educational involvement at home and at school. The findings from multigroup structural equation modeling revealed that whereas the first two pathways mediated the effect of parental depression on child social competence for Spanish-dominant parents, only emotional involvement explained parental depression effects for English-dominant parents. Parent educational involvement at school did not mediate parental depression effects for either Spanish- or English-dominant Latino parents. Discussion and implications of findings with respect to research, practice, and policy with Latinos follow.     

L’empathie en médecine

ObjectivesEmpathy is everywhere. It has become a major topic of interest in many disciplines and professions. Cultivating empathy has been prescribed as a solution to numerous social ailments and political problems. One reason for such a proliferation of attention is the lack of a clear conceptual taxonomy and the use of empathy as an umbrella under which definitions vary enormously. It is widely acknowledged that empathy plays a critical role in the physician-patient relationship and has a positive impact in clinical practice. However, the medical profession is struggling to achieve an appropriate balance between clinical distance and empathy. Too much sensitivity to negative affect expressed by patients, without proper emotion regulation, may lead to anxiety and personal distress, which is detrimental to efficient cognitive functioning and can take a toll on the well-being of physicians. Too little empathy may lead to an underestimation of the pain of others and poor rapport with patients. As the field of empathy expands, the lack of conceptual coherence challenges advances in medicine. Moreover, in some cases there is little added theoretical or clinical value in applying the broad/all-encompassing term of empathy, which is by nature multidimensional and interpersonal.MethodsThe number of competing conceptualizations of empathy circulating the literature has created a serious problem by making it difficult to keep track of which process or mental state this neologism refers to in any given discussion. Multiple definitions limit progress in the role of empathy in medicine, and which instruments are appropriate to assess its function and utility. Keeping track is important because the different conceptualizations refer to distinct psychological processes that vary, sometimes widely, in their function, phenomenology, biological mechanisms, and effects on interpersonal relationships. In this article, after considering the polysemic nature of empathy, I briefly review the functions attributed to empathy in medicine. Then I explain how theoretical clarity may be improved by examining knowledge from empirical investigations in psychology and social neuroscience which has led to better define the different components of empathy as well as their neurological mechanisms. One section critically reviews the functional neuroimaging studies that have been specifically designed to examine patterns of brain response in physicians and health professionals. A separate section addresses how social and relational factors, particularly group membership, may impact the expression and effect of empathy in medical care. This new perspective, based on advances in scientific psychology and social neuroscience, has the potential to reduce confusion and ambiguity. This critical and informed analysis of empirical studies in functional neuroimaging with health professionals calls for a nuanced assessment of empathy's functions, that are not necessarily a panacea as some seem to think.ConclusionA provocative and more sober view on the value and the very interest in the notion of empathy in medicine is proposed. Ultimately, cultivating empathic concern (sympathy or compassion in today's medicine) seems more important than other aspects, particularly affect sharing or putting oneself in the patient's shoes.     

Bickerstaff’s brainstem encephalitis: case report and Tc99m brain SPECT findings

A 21-year-old healthy female suffered from an upper respiratory tract infection and 2 days later developed diplopia, unsteady gait, dysarthria and a profound disturbance of consciousness with rapid development of coma. Brain MRI and Tc99m brain perfusion SPECT, EEG, neurophysiological tests and CSF analysis results were unspecific. The detection of serum anti-GQ1b IgG autoantibodies at high titre led to the diagnosis of Bickerstaff’s brainstem encephalitis (BBE). Clinical symptoms resolved after treatment with plasma exchange and the outcome was good. Brain MRI was normal, and Tc99m brain perfusion SPECT demonstrated hypoperfusion of the whole cerebral hemispheres and basal ganglia with relative sparing of the thalami and the brainstem. Similar to brain MRI, the sensitivity of Tc99m brain perfusion SPECT in detecting brainstem lesions in typical BBE patients seems to be low.     

Counselors’ attachment anxiety and avoidance and the congruence in clients’ and therapists’ working alliance ratings

Objective: To determine how counselors’ attachment anxiety and avoidance related to congruence between counselors’ and clients’ Working alliance (WA) ratings. Congruence strength was defined as the regression coefficient for clients’ WA ratings predicting counselors’ WA ratings. Directional bias was defined as the difference in level between counselors’ and clients’ WA ratings. Method: Twenty-seven graduate student counselors completed an attachment measure and they and their 64 clients completed a measure of WA early in therapy. The truth-and-bias analysis was adapted to analyze the data. Results: As hypothesized counselors’ WA ratings were significantly and positively related to clients’ WA ratings. Also as hypothesized, counselors’ WA ratings were significantly lower than their clients’ WA ratings (directional bias). Increasing counselor attachment anxiety was related to increasing negative directional bias; as counselors’ attachment anxiety increased the difference between counselors and clients WA ratings became more negative. There was a significant interaction between counselor attachment anxiety and congruence strength in predicting counselor WA ratings. There was a stronger relationship between client WA ratings and counselor WA ratings for counselors low versus high in attachment anxiety. Conclusion: Counselors’ attachment anxiety is realted to their ability to accurately percieve their clients’ WA.     

Parents’ mental health and children’s cognitive and social development

Background  

The development of children of parents who are experiencing mental health difficulties is a continuing cause of concern for professionals working in health, social care and education as well as policy makers. In light of this interest our study investigates the interplay between the mental health of mothers and fathers and family socioeconomic resources, and the impact for children’s cognitive and social development.     

Leaving “Home”

The space between the importance (the ethical necessity) of living together in difference and the difficulty of actually doing so is a fertile area for psychoanalytic relational exploration. In this article, to explore some of the psychoanalytic implications of the psychological and emotional challenges of living with radical cultural difference, I use empirical data about the experiences of men and women who are, or have been, in intercultural marriages and relationships. I argue that the experiences narrated by participants in radically “othered” intercultural marriages and relationships are a microcosm of wider transglobal clashes, configurations, inequalities, and connections, and that these experiences highlight the necessity of theorizing and practicing a process-oriented psychoanalysis that eschews single, preemptive answers to the complex questions of living together in difference and takes seriously the ethical question of the capacity and willingness to live with degrees of lack, dislocation, uncertainty, and alienation.     

High-sensitivity cardiac troponin I and NT-proBNP as predictors of incident dementia and Alzheimer’s disease: the FINRISK Study

Cardiac troponin and N-terminal pro-brain natriuretic peptide (NT-proBNP) are known to associate with incident dementia. The purpose of our study was to examine whether high-sensitivity cardiac troponin I (hs-TnI) and NT-proBNP are associated with incident dementia and Alzheimer’s disease (AD) independently of each other. Our study was a part of the national population-based health examination survey, FINRISK 1997, with a total sample of 7114 subjects, including 407 incident dementia cases and 319 AD cases during the follow-up time of 18 years. Using multivariate Cox regression analyses, we calculated the hazard ratios (HR) for hs-TnI and NT-proBNP. Analyses were adjusted for the previously known dementia/AD risk factors, including the apoE genotype. NT-proBNP was independently associated with incident dementia (HR 1.32, 95% CI 1.17–1.49) and AD (HR 1.30, 95% CI 1.13–1.5). Hs-TnI was also associated with incident dementia (HR 1.12, 95% CI 1.02–1.23), but not independent of NT-proBNP (HR 1.10, 95% CI 0.99–1.21). Hs-TnI was not associated with incident AD. The results remained similar in cause-specific Cox regression models and among subjects over 40 years of age. NT-proBNP and hs-TnI improved the reclassification of dementia risk in 10 years follow-up, and hs-TNI also in 18 years of follow-up. Neither hs-TnI nor NT-proBNP was able to outperform each other in risk reclassification of dementia. Both cardiovascular biomarkers, NT-proBNP and hs-TnI, were associated with incident dementia independently of traditional dementia risk factors including the apoE genotype. NT-proBNP was also associated with AD. Both markers offered a better dementia risk reclassification compared with traditional risk factors.     

Parkinson’s disease: lesions in dorsal horn layer I,involvement of parasympathetic and sympathetic pre- and postganglionic neurons

Clinical signs frequently recognized in early phases of sporadic Parkinson’s disease (PD) may include autonomic dysfunctions and the experience of pain. Early disease-related lesions that may account for these symptoms are presently unknown or incompletely known. In this study, immunocytochemistry for α-synuclein was used to investigate the first relay stations of the pain system as well as parasympathetic and sympathetic pre- and postganglionic nerve cells in the lower brainstem, spinal cord, and coeliac ganglion in 100 μm polyethylene glycol embedded sections from six autopsy individuals, whose brains were staged for PD-associated synucleinopathy. Immunoreactive inclusions were found for the first time in spinal cord lamina I neurons. Lower portions of the spinal cord downwards of the fourth thoracic segment appeared to be predominantly affected, whereas the spinal trigeminal nucleus was virtually intact. Additional involvement was seen in parasympathetic preganglionic projection neurons of the vagal nerve, in sympathetic preganglionic neurons of the spinal cord, and in postganglionic neurons of the coeliac ganglion. The known interconnectivities between all of these components offer a possible explanation for their particular vulnerability. Lamina I neurons (pain system) directly project upon sympathetic relay centers, and these, in turn, exert influence on the parasympathetic regulation of the enteric nervous system. This constellation indicates that physical contacts between vulnerable regions play a key role in the pathogenesis of PD.     

Moderators of the Relations Between Mothers’ and Fathers’ Parenting Practices and Children’s Prosocial Behavior

Using multilevel modeling, we separately examined the relations between mothers’ and fathers’ parenting practices and children’s prosocial behavior, as well as the moderating roles of child sex, age, and ethnicity. Participants included a diverse community sample of 129 cohabiting couples with a child aged 6–17. Results indicated that paternal positivity and corporal punishment were significantly related to girls’, but not boys’, prosocial behavior, and paternal involvement was related to prosocial behavior in school-aged children but not adolescents. Greater levels of positivity in both parents were related to more prosocial behavior in Caucasian children and less in African American children. Overall, the findings suggest that fathers’ parenting is important and may differentially influence children of different sexes and ages, underscoring the importance of examining both mothers’ and fathers’ parenting in relation to child outcomes and with diverse samples. Findings also highlight the need for culturally appropriate measures of parenting.     

Cognitive and behavioral disorders in Parkinson’s disease: an update. I: cognitive impairments

Parkinson’s disease (PD) is a progressive neurodegenerative disease characterized by motor symptoms such as rigidity, rest tremor, and bradykinesia. However, a growing body of evidence demonstrated that PD encompasses several non-motor disturbances as well, such as cognitive impairment. Cognitive defects can be present since early stages of the disease but tend to dominate the clinical picture as the disease progresses. Around 40% of patients with PD present with cognitive impairments in several cognitive domains including attention, working memory and executive functions, language, visuospatial skills, and episodic memory; in later stages of the disease, cognitive defects and associated behavioral disorders concur to determine clinically relevant PD-associated dementia. Part of these defects is ascribed to a dopamine-dependent dysfunction of fronto-striatal pathways, but there is a considerable heterogeneity in the cognitive impairments as well as a suggestion of the role of other neurotransmitter systems, such as the cholinergic one, mainly responsible for Parkinson-dementia syndrome. In this paper, we review recent literature with particular attention to the last 5 years on the main cognitive deficits described in PD patients as well as on the hypothesized neuro-functional substrate of such impairments. Finally, we provide some suggestions on how to test cognitive functions in PD appropriately.     

Living in Difference: A Commentary on Annie Stopford's “Leaving ‘Home’”

This commentary opens in strong agreement with Annie Stopford's project, to contemplate the prospect of a non-normative psychoanalysis. Reflecting on the complexities inherent in psychoanalysis' dual nature as both a theory of subjectivity and an agent of given social discourses, I focus on the psychoanalytic tendency to conflate the notion of the right with that of the normative; particularly in the context of developmental theory. Elaborating on Stopford's rendering of the relations between the subject and normative collective discourses, I suggest that we think of these relations as less deterministic. We all find ourselves under the sway of a cacophony of different, sometimes conflicting social narratives. Moreover, our relations with these narratives are themselves dynamic. Considering this multiplicity, I suggest that the subject, even as seen in the grip of powerful social forces, has significant power of resistance and agency.     

Depression and Parkinson’s disease

Abstract.   Depression occurs in approximately 45% of all patients with Parkinsons disease (PD), reduces quality of life independent of motor symptoms and seems to be underrated and undertreated. Characteristics of symptoms differ from major depression. Because of overlapping clinical symptoms, diagnosis is based on subjectively experienced anhedonia and feeling of emptiness. Available rating scales for major depression may not be adequate to correctly measure severity of depression in PD. Anxiety and depression may manifest as first symptoms of PD many years before motor symptoms. Serotonergic, noradrenergic and dopaminergic mechanisms play key roles in the etiology of depression in PD. Tricyclic and newer, selective antidepressants including serotonin and noradrenaline reuptake inhibitors (SSRI, SNRI) appear to be effective in treating depression in PD. Selective reuptake inhibitors seem to have a favorable side effect profile. Recent controlled studies show antidepressant effects of pramipexole in bipolar II depression. New dopamine agonists pramipexole and ropinirole appear to ameliorate depressive symptoms in PD in addition to effects on motor symptoms. There is a lack of appropriate rating scales and controlled studies regarding depression in PD.