Self-reference and the encoding of personal information in depression

This paper questions for the first time whether a negative self-schema is a regular symptom of depression. An alternative position derives from clinical evidence suggesting that many depressed persons describe themselves inconsistently. A distinction between schema- and non-schema-based responding is proposed and tested with the spread of processing model: Depressed and nondepressed subjects are compared for incidental recall of personal adjectives under a self-reference encoding task, a semantic task, and two other lower level encoding tasks. As expected, the groups differed significantly only on self-reference recall; depressives showed significantly weaker recall on this task. Duration of depression significantly predicted the strength of self-reference recall. The results are interpreted in a developmental framework, which suggests that a self-schema in depression develops, as does any schema, over time and repeated use.Appreciation is expressed to P. Eaton and T. B. Rogers for critical commentary and encouragement during the preparation of this research.     

Social cognition in cynical hostility

Cynical hostility, as measured by the Cook and Medley Hostility (Ho) scale, has been found to predict illness and premature death. A variety of models of the potential links between hostility and health have suggested that cynically hostile people have a unique cognitive style in social contexts. To avoid the methodological limitations of previous self-report methods for assessing the cognitive correlates of cynical hostility, the present study employed an information-processing procedure. High- and low-Ho males engaged in either a neutral or hostile social interaction with a confederate, and then rated him on a series of trait adjectives. In a subsequent incidental recall task, cynically hostile individuals showed enhanced recall of hostile trait adjectives following the hostile social interaction. Consistent with theory, these results suggest a hostile other schema, which can be activated by antagonistic interactions.This paper is based on the dissertation of the first author, conducted under the supervision of the second.     

Use of a Modified Stroop Task to Examine Appearance-Schematic Information Processing in College Women

A computerized Stroop color-naming task was usedto compare the information processing of 55appearance-schematic and 50 appearance-aschematic women,based on their scores on the Appearance SchemasInventory (ASI). Participants color-named appearancewords (e.g., OVERWEIGHT, LIPSTICK ) and nonappearancewords (e.g., OBNOXIOUS, BRIDEGROOM ) after exposure toeither a neutral condition or a "priming" condition that emphasized their bodysize/appearance. Primed schematic persons exhibitedgreater Stroop interference in color-naming appearanceversus nonappearance words compared to nonprimedschematics and both primed and nonprimed aschematics. Onan incidental recall task, a modest but significantpositive correlation was observed between ASI scores andthe percentage of appearance words among words subsequently recalled. These and other findingsprovide evidence of the construct validity of the ASI ina nonclinical population and offer a foundation on whichto advance the study of cognitive models of body image and clinical body-imagedisturbances.     

II. PET Studies of Memory: Novel versus Practiced Free Recall of Word Lists

Positron emission tomography (PET) with the tracer Ha₂¹⁵O was used to measure regional cerebral blood flow in 13 healthy volunteers while they engaged in free recall of 15-item word lists from the Rey Auditory Verbal Learning task. The study was designed so that recall of well-practiced versus novel material could be compared. One week before the PET study, subjects were trained to perfect recall of List A, while they were exposed to list B only 60s prior to PET data acquisition. As in the companion study of free recall of complex narratives, we observed that practice tended to decrease the size of activations in regions involved in the memory component of the task; we also observed that the novel recall task produced greater activation in left frontal regions, probably due to active encoding. A commonality of other regions observed in this pair of studies, as well as other studies of memory in the literature, suggests that the human brain may contain a distributed multinodal general memory system. Nodes on this network include the frontal, parietal, and temporal cortices, the thalamus, the anterior and posterior cingulate, the precuneus, and the cerebellum. There appears to be a commonality of components across tasks (e.g., retrieval, encoding) that is independent of content, as well as differentiation of some components that may be content-specific or task-specific. In addition, these results support a significant role for the cerebellum in cognitive functions such as memory.     

Information processing biases among chronic pain patients and ankylosing spondylitis patients: the impact of diagnosis.

The aim of this research was to explore the impact that diagnostic status has on information processing biases among chronic pain (CP) and ankylosing spondylitis (AS) patients. AS patients, CP patients, and healthy hospital staff controls, completed a questionnaire and short computer task. During the computer task participants endorsed sensory, depression, illness, and neutral adjectives, following a cue question (which facilitated encoding of the adjectives in relation to the self). They were then asked to recall the adjectives in a surprise memory task. Diagnosed CP patients demonstrated a recall bias away from depression related stimuli, whilst the non-diagnosed CP patients did not. The results also suggest an association between receipt of a diagnosis and better psychological outcome in terms of information processing biasing. It was questioned whether the presence of a diagnosis among CP patients who are not currently depressed may protect or 'buffer' them against cognitive biasing towards classic depression related stimuli. The diagnosed AS group showed a bias towards sensory stimuli, perhaps reflecting the presence of an enduring and over-riding pain schema. The non-pain control group also displayed a sensory bias, which was attributed to a frequency effect as a result of working in an environment where they were regularly exposed to sensory language. The results are discussed in relation to existing literature in this area and implications for clinical practice are provided.     

Dysthymic and hypomanic self-referent effects associated with depressive illness and recovery

Cognitive bias in severe depression was examined using the self-referent intentional recall depth of processing paradigm. Depressive and normal subjects were required to recall dysthymic and hypomanic adjective stimuli that had previously been encoded under self-referent or semantic instructions. Depressives recalled essentially the same number of dysthymic adjectives under the self-reference instructional set with the syndrome present and during remission. Depressives also did not differ from controls in their recall of dysthymic adjectives. Of greater difference between the groups and conditions was the recall effect based on the hypomanic adjectives. Depressives showed a clear absence of recall of hypomanic adjectives during depression, followed by a significant increase in the recall of the same type of adjectives during remission. The results were interpreted as supporting the need for further study of the cognitive processes leading to inhibition and recovery of positive recall in depressives.     

Schematic processing of smoking information by smokers and never-smokers

The present study was designed to assess whether smokers and never-smokers differ in the manner in which they process smoking-related information. Twenty-four smokers and 29 never-smokers participated in a schema reaction time task, in which judgments were made as to the applicability of a series of attributes to smoking (as well as two sets of control stimuli). One-half the subjects rated these attributes with respect to smoking in general, while the rest of the subjects did so in a condition designed to enhance self-referent processing. For all groups, an incidental recall test followed the presentation of smoking stimuli. Results indicated that while groups did not differ in their responses to control stimuli, there were reliable differences between smokers' and never-smokers' responses to smoking attributes on all dependent measures (i.e., latency, confidence ratings, and number of endorsements). Smokers responded in a manner indicative of schematic processing to positively valenced attributes, while never-smokers demonstrated facilitated processing of negatively valenced attributes. However, neversmokers demonstrated expected within-group differences, while smokers did not. In addition, no effect for the self-referencing manipulation was evident. These findings are discussed with regard to the nature of information processing in smokers.We would like to extend our appreciation to Ian Evans and Phillip Harvey for their editorial assistance and helpful suggestions in the design of this study. Special thanks to Aileen Goldstein and Sharon Yohai, who spent many hours running subjects and collecting data.     

Memory Bias for Forbidden Food Cues in Restrained Eaters

Research on the cognitive patterns characteristic of women high in dietary restraint indicates an attentional bias favoring the early-stage selective processing of forbidden food words. The current study was conducted to determine whether highly restrained women also show a later stage memory bias for forbidden food words. Sixty-seven university females encoded a list of 30 words (15 forbidden food words, 15 animal control words) presented in an incidental learning task. Participants were then asked to freely recall as many words as they could remember. Scores on the Restraint Scale were used to classify participants as either high (N = 29) or low (N = 38) in dietary restraint. Contrary to prediction, high-restraint women did not remember more forbidden food words than low-restraint women. High-restraint women did, however, remember fewer animal control words than low-restraint women, suggesting a deficit in memory for material outside of the food-schema domain in restrained eaters relative to nonrestrained eaters. Consistent with hypothesis, only women in the high-restraint group remembered more forbidden food than animal control words, indicating a relative memory bias for forbidden food words only among restrained eaters. The results thus provide only partial support for Bemis-Vitousek and Hollon's theory that restrained eaters have cognitive structures (schema) which may support more elaborative encoding and/or greater memory accessibility of personally relevant (i.e., forbidden food) information and which may underlie self-reported food preoccupation among clinical and nonclinical restrained eaters.     

Effects of a dual task and different levels of divided attention on motor-related cortical potential

[Purpose] The aim of this study was to investigate the effect of divided attention on motor-related cortical potential (MRCP) during dual task performance while the difficulty of the secondary task was altered. [Participants and Methods] Twenty-two right-handed healthy volunteers participated in the study. MRCPs were recorded during two tasks, a single task (ST) and a simple (S-DT) or complex dual task (C-DT). The ST involved a self-paced tapping task in which the participants extended their right index finger. In the dual task, the participants performed the ST and a visual number counting task simultaneously. [Results] The amplitude and integral value of MRCP from electroencephalography electrode C3 was significantly higher in the S-DT than in the ST, whereas they were similar between the C-DT and the ST. Medium-load divided attention (i.e., S-DT) led to significantly more changes in the MRCP magnitude than did low-load divided attention (i.e., ST). However, the MRCP of high-load divided attention (i.e., C-DT) was similar to that of low-load divided attention. [Conclusion] These results suggest that MRCP reflects the function of or network between the supplementary motor area and the dorsolateral prefrontal cortex, and may serve as a marker for screening the capacity of individuals to perform dual tasks.Key words: MRCP, Bereitschaftspotential, Dual-task interference     

Interpersonal strategies associated with the discussion of AIDS

The disease, AIDS (i.e., acquired immune deficiency syndrome), has raised concern among many people throughout the world. Although medical attention has been focused for some time on identifying the causes and cures of this deadly disease, research designed to examine the psychological aspects of AIDS has just begun. Within this context, two investigations were conducted to construct and validate the AIDS Discussion Strategy Scale (ADSS), an objective self-report instrument designed to measure the types of interpersonal discussion strategies that women and men use if they want to discuss AIDS with an intimate partner. A factor analysis conducted in Study I provided evidence for six AIDS-related discussion strategies: rational, manipulation, withdrawal, charm, subtlety, and persistence. Reliability analyses indicated more than adequate internal consistency for the resulting ADSS subscales (alphas from .74 to .96). Other findings revealed that, relative to males, females reported they would be more likely to use rational types of AIDS discussion strategies with an intimate partner. Additionally, it was found that research participants' stereotypes about AIDS influenced the types of strategies they were likely to use in discussing the topic of AIDS within a close relationship. Other results in Study II provided evidence that men's and women's willingness to discuss AIDS with a potential sexual partner was related to cognitive, behavioral, and affective aspects of their sexuality.     

Identifying Factors that Predict Women's Inability to Maintain Separation from an Abusive Partner

In this study, the extent to which nine indicators of intrusion (i.e., unwanted interference in everyday life) predicted the odds of women maintaining separation from an abusive partner was examined using data from a community sample of 286 Canadian women. Higher levels of depression and PTSD symptoms significantly and independently increased women's risk of being unable to maintain separation from a former or new abusive partner over a 12-month period (Odds Ratios 4.6 and 2.7, respectively). These finding underscore the importance of supporting women to identify and manage mental health problems as a means of enhancing their safety.     

Alternatives to the QALY measure for economic evaluations

Economic analyses (i.e., analyses that are concerned primarily with questions of resource allocation) are becoming more common in health care in general and care of cancer patients in particular. The most commonly used measure for the valuation of outcome in such analyses is the QALY (quality-adjusted life-years), which combines qualitative (i.e., quality of life) and quantitative (i.e., survival) aspects of the outcome into one dimension. Using economics (i.e., the discipline) as the mode of thinking to help solve problems of resource allocation in health, this paper describes a framework to evaluate the appropriateness of use of a measure of outcome in the context of an economic evaluation. This framework will be used to critically appraise the use of the QALY measure and of two alternative measures, HYE (healthy years equivalent) and WTP (willingness to pay), in economic evaluations of health care interventions. The paper also describes a practical tool that can be used to measure individuals' WTP in the context of public decision making. This tool involves modifying the decision board, a tool developed (originally in the cancer area) to help clinicians present information to patients. The intent is to show that the use of a theoretically superior measure of outcome need not always be empirically restrictive.Presented as an invited lecture at the 8th International Symposium: Supportive Care in Cancer, Toronto, Canada, 19–22 June 1996     

A Comparison between iPad-Assisted and Teacher-Directed Reading Instruction for Students with Autism Spectrum Disorder (ASD)

We conducted an alternating treatment research design to investigate the effects of a multicomponent reading comprehension intervention on reading comprehension performance and task refusal behavior of three elementary students with autism spectrum disorder (ASD). This study also sought to investigate the effects of utilizing teacher-directed instruction (TDI) in comparison to iPad® -assisted instruction (IAI) as the primary mode of instructional delivery during reading sessions. The multicomponent intervention during the TDI sessions consisted of teaching text preview strategy (i.e., looking at text and picture, making predictions), identifying the main idea of each paragraph using a graphic organizer, and the use of a token economy system. Whereas IAI treatment sessions consisted of the use of an iPad® application that focused on identifying main idea paired with implementing a token economy system for task completion. Three elementary students identified with ASD participated in this study. Results indicate that the multicomponent intervention implemented during both conditions was associated with improved performance on curriculum-based measure (CBM) probes during TDI and IAI treatments, with an indication that the TDI treatment was more effective in increasing accuracy of responding on CBM probes in comparison to the IAI condition. Findings from this study also indicate that both treatment conditions (TDI and IAI) were associated with a reduction of task refusal for the three participants with fewer occurrences of the challenging behavior during IAI in comparison to TDI treatment.     

Content-specific activation during associative long-term memory retrieval

We tested whether visual stimulus material that is assumed to be processed in different cortical networks during perception (i.e., faces and spatial positions) is also topographically dissociable during long-term memory recall. With an extensive overlearning procedure, 12 participants learned paired associates of words and faces and words and spatial positions. Each word was combined with either one or two positions or one or two faces. fMRI was recorded several days later during a cued recall test, in which two words were presented and the participants had to decide whether these were linked to each other via a common mediator, i.e., a face or a position. This paradigm enforces retrieval from long-term memory without confounding recall with perceptual processes. A network of cortical areas was found to be differently activated during recall of positions and faces, including regions along the dorsal and ventral visual pathways, such as the parietal and precentral cortex for positions and the left prefrontal, temporal (including fusiform gyrus) and posterior cingulate cortex for faces. In a subset of these areas, the BOLD response was found to increase monotonically with the number of the to-be-re-activated associations. These results show that material-specific cortical networks are systematically activated during long-term memory retrieval that overlap with areas also activated by positions and faces during perceptual and working memory tasks.     

Interaction between stimulus intensity and perceptual load in the attentional control of pain

The interaction between intensity of nociceptive stimuli and cognitive load in a concomitant task is still a challenging and complex topic. Here, we investigated the interaction between top-down factors (i.e., perceptual load), induced by a visual task, and bottom-up factors (i.e., intensity of nociceptive stimuli that implicitly modifies saliency of input). Using a new experimental paradigm, in which perceptual load is varied while laser heat stimuli of different intensities are processed; we show a significant interaction between intensity of nociceptive stimuli and perceptual load on both pain ratings and task performance. High perceptual load specifically reduced intensity ratings of high intensity stimuli. However, under this condition, task performance was impaired, regardless of interindividual differences in motivation and pain catastrophizing. Thus, we showed that pain ratings can be reduced by increasing the load of attentional resources at the perceptual level of a non–pain-related task. Nevertheless, the disruptive effect of highly intensive nociceptive stimuli on the performance of the perceptual task was evident only under high load.     

Increased Attention Regulation from Emotion Regulation Therapy for Generalized Anxiety Disorder

Dysfunction in the ability to sustain, shift and broaden attention has been proposed as a mechanism of normative emotion regulation that is a common target of cognitive-behavioral therapies. Attention regulation deficits are central to generalized anxiety disorder (GAD) and may contribute to a generally rigid, avoidant, response style that produces substantial decrements in well-being and functioning. Emotion Regulation Therapy draws upon mindfulness-based regulatory skills to facilitate attentional change during an initial phase of treatment. Two studies examined task-based changes in flexibly shifting attention in response to conflicting emotional contexts and sustaining attention despite distressing emotional contexts. In Study 1, at pre-treatment, patients with GAD, as compared to controls performed significantly more poorly on an emotional conflict adaptation task (i.e., less ability to flexibly shift attention) and improved in conflict adaptation by mid-treatment (when attention regulation skills were being trained). This task-related change predicted increases in mindful observing abilities over the course of acute treatment but was not directly associated with clinical outcomes. In Study 2, a choice reaction time (RT) task was utilized to measure the ability to sustain attention by discriminating between two tones while overcoming the interference of aversive visual stimuli. At pre-treatment, participants with GAD demonstrated slower RTs (i.e., more difficulty sustaining attention on the tonal prompt) compared to controls and demonstrated more rapid RTs from pre- to mid-treatment. This improved task performance was related to clinical improvement and decreased functional impairment. RT change was also associated with greater nonreactivity towards experiences. Overall, these findings suggest that targeting mindful regulation skills improve attention regulation in individuals with GAD and may partially account for efficacious clinical outcomes throughout treatment.