Schizophrenia and communication efficiency

An earlier study (Sølvberg & Blakar (1975)) testified to subtle differences in communication efficiency over different communication situations by parental couples with and without schizophrenic offspring. The present study is offered as a replication of this study, but whereas the participating couples in the original study were recruited from a big city (Oslo), the parental couples in the present replication come from a typical rural district. The main findings of the original study are reproduced, but the very same method which was sensitive with respect to > the “normality-schizophrenia” variable, also proved to be highly sensitive with regard to the cultural variation represented by the rural-urban dimension. There-fore, the present study is used as basis for discussing more general methodological problems involved in communication-oriented studies on psychopathology. In particular the underlying (often implicit) model of “normal communication”, from which pathological communication deviates, is seriously questioned.     

An analysis of the effects of functional communication and a Voice Output Communication Aid for a child with autism spectrum disorder

The purpose of this study was to examine the effects of Functional Communication Training (FCT) and a Voice Output Communication Aid (VOCA) on the challenging behavior and language development of a 4-year-old girl with autism spectrum disorder. The participant's mother implemented modified functional analysis (FA) and intervention procedures in Kerri's home. A multiple probe design across activities was used to analyze intervention effectiveness. FCT with a VOCA successfully decreased Kerri's challenging behavior and increased VOCA use. A secondary analysis revealed that Kerri increased her use of correct pronouns. Kerri's mother implemented modified FA and intervention procedures with a high level of fidelity. Social validity data indicated that Kerri's mother believed the intervention to be acceptable and effective.     

Paternal depression: an examination of its links with father, child and family functioning in the postnatal period

Background: Maternal depression is common and is known to affect both maternal and child health. One of the mechanisms by which maternal depression exerts its effects on child health is through an increased rate of parental disharmony. Fathers also experience depression, but the impact of this on family functioning has been less studied. The aim of this study was to investigate the association between paternal depressive disorder and family and child functioning, in the first 3 months of a child's life. Methods: A controlled study comparing individual and familial outcomes in fathers with (n=54) and without diagnosed depressive disorder (n=99). Parental couple functioning and child temperament were assessed by both paternal and maternal report. Results: Depression in fathers is associated with an increased risk of disharmony in partner relationships, reported by both fathers and their partners, controlling for maternal depression. Few differences in infant's reported temperament were found in the early postnatal period. Conclusions: These findings emphasize the importance of considering the potential for men, as well as women, to experience depression in the postnatal period. Paternal symptoms hold the potential to impact upon fathers, their partners, and their children. Depression and Anxiety, 2011. © 2011 Wiley‐Liss, Inc.     

Phenotypic variability in the brains of a family with a prion disease characterized by a 144-base pair insertion in the prion protein gene

The use of prion protein (PrP) immunohistochemistry in neuropathology has allowed identification of prion diseases with otherwise atypical histological features. The brains from family members with familial prion diseases can show marked histological variation. A histological and immunohistochemical study was performed on 10 brains of patients with a familial prion disease caused by a 144-base pair (bp) insertion in the prion protein gene. The histology from the cases showed variability in the severity of spongiform change and astrocytosis in both the cerebellum and the cerebrum. There was also variability in the density of microglial cells. The PrP immunohistochemistry revealed that in nine cases there was a similar patch-like deposition of PrP within the molecular layer of the cerebellum. Although in the cerebellum there did seem to be some correlation between the severity of spongiform change, astrocytosis and the density of microglial cells, there was no such correlation between any of these three parameters and the density of PrP staining. There was deposition of beta-amyloid precursor protein (beta-APP) in the cerebellum, suggesting that disrupted axonal transport had a possible role in the evolution of the disease. The cases illustrate the histological variability that can occur in familial prion diseases despite similarity in PrP staining. They also reveal that the relationship between PrP deposition and cerebral or cerebellar damage might be complex.     

The role of parental psychopathology and family environment for social phobia in the first three decades of life

Background: To examine the role of parental psychopathology and family environment for the risk of social phobia (SP) in offspring from childhood to early adulthood, encompassing the high risk period for SP. Methods: A community sample of 1,395 adolescents was prospectively followed‐up over 10 years. Offspring and parental psychopathology were assessed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV) using the Munich Composite International Diagnostic Interview (M‐CIDI), and direct diagnostic interviews in parents were supplemented by family history reports. Parental rearing was assessed by the Questionnaire of Recalled Rearing Behavior administered to offspring. Family functioning was assessed by the McMaster Family Assessment Device administered to parents. Results: Parental SP was associated with offspring's risk to develop SP (OR=3.3, 95%CI:1.4–8.0). Other parental anxiety disorders (OR=2.9, 95%CI:1.4–6.1), depression (OR=2.6, 95%CI:1.2–5.4), and alcohol use disorders (OR=2.8, 95%CI:1.3–6.1) were also associated with offspring SP. Parental rearing styles of overprotection, rejection, and lack of emotional warmth were associated with offspring SP. Family functioning measures were not associated with offspring SP. Analyses of interaction of parental psychopathology and parental rearing indicated combined effects on the risk for offspring SP. Conclusions: Parental psychopathology and rearing were associated with offspring SP, independently as well as in their interaction. Further delineation of these associations is warranted as malleable components of these risk factors may provide potential targets for prevention programs. In addition, parent‐to‐offspring transmission of other internalizing disorders should be considered to examine the degree of diagnostic specificity. Depression and Anxiety, 2009. © 2008 Wiley‐Liss, Inc.     

Effects on Communicative Requesting and Speech Development of the Picture Exchange Communication System in Children with Characteristics of Autism

Few studies on augmentative and alternative communication (AAC) systems have addressed the potential for such systems to impact word utterances in children with autism spectrum disorders (ASD). The Picture Exchange Communication System (PECS) is an AAC system designed specifically to minimize difficulties with communication skills experienced by individuals with ASD. The current study examined the role of PECS in improving the number of words spoken, increasing the complexity and length of phrases, and decreasing the non-word vocalizations of three young children with ASD and developmental delays (DD) with related characteristics. Participants were taught Phases 1-4 of PECS (i.e., picture exchange, increased distance, picture discrimination, and sentence construction). The results indicated that PECS was mastered rapidly by the participants and word utterances increased in number of words and complexity of grammar.     

Parenting stress in mothers of children with an intellectual disability: the effects of parental cognitions in relation to child characteristics and family support

Background Recent theories of stress and coping in parents of children with intellectual disabilities (ID) emphasize the importance of cognitive appraisals in influencing parents’ levels of stress and their adaptations to difficulties presented by the children. This study investigated the relationships between parental cognitions, child characteristics, family support and parenting stress. The aspects of cognitions studied were: parenting self-esteem (including efficacy and satisfaction) and parental locus of control. Methods The group studied consisted of 46 mothers of children with ID. The Vineland Adaptive Behavior Scales and Maladaptive Behavior Domain were administered by interview. Mothers also completed four questionnaires: the Family Support Scale, the Parenting Sense of Competence Scale, a shortened form of the Parental Locus of Control Scale and the Parenting Stress Index (Short Form). Results Data were analysed using Pearson's correlation coefficients, partial correlations and a regression analysis. The results indicated that most of the variance in parenting stress was explained by parental locus of control, parenting satisfaction and child behaviour difficulties. Whilst there was also a strong correlation between family support and parenting stress, this was mediated by parental locus of control. Conclusions The results demonstrate the potential importance of parental cognitions in influencing parental stress levels. It is argued that these results have implications for clinical interventions for promoting parents’ coping strategies in managing children with ID and behavioural difficulties.     

Incorporating principles of the collaborative contextualised intervention approach with the empirical study of learning and communication in traumatic brain injury

Background: Ylvisaker et al. argue that traumatic brain injury (TBI) intervention is most effective using a collaborative contextualised approach. However, few research protocols have implemented the principles of this approach in empirical studies. The development of such research paradigms would promote tighter integration of empirical findings with theoretical models and between research and current clinical practice.

Aims: This preliminary study sought to examine learning and communication in social interaction in individuals with TBI interacting with their familiar partners using a research protocol that incorporates many principles of the collaborative contextualised intervention approach and that has been shown to promote learning and social interaction in patients with circumscribed memory impairments.

Methods & Procedures: Using a collaborative referencing task presented as a matching game, we assessed the ability of five individuals with moderate to severe TBI and five matched healthy comparison participants to engage in repeated social interaction with a familiar partner. Quantitative and qualitative measures of learning and social communication success were used to assess the development and use of referential labels for novel shapes during the sessions.

Outcomes & Results: All pairs successfully completed the task. As a group, the performance of four of the five TBI pairs did not differ from healthy comparison pairs on any measures. Participant 3591, however, differed from all other pairs on both quantitative and qualitative measures. Speculating Participant 3591’s partner contributed to their poor performance, we assigned Participant 3591 a new partner in a subsequent study. The results were striking: Participant 3591 and her new partner were as successful as other pairs on all learning measures.

Conclusions: Given the complex and often heterogeneous nature of impairment associated with TBI, the findings here that all participants with TBI were successful provide further evidence that these interactive sessions can be potent learning environments and suggest that this may be a fruitful way to deploy Ylvisaker’s contextualised intervention approach in more controlled research settings. Furthermore, these results demonstrate the important role partners play in the communicative successes and failures of individuals with TBI in everyday interactions.     

Dysfunction of the social brain in schizophrenia is modulated by intention type: An fMRI study

In this fMRI study, we investigated theory of mind (ToM) in patients with paranoid schizophrenia. We hypothesized that the network supporting the representation of intentions is dysfunctional in patients with schizophrenia dependent on the type of intention involved. We used a paradigm including a control condition (physical causation) and three intention conditions (private intention, prospective social intention and communicative intentions) differing in the degree of social interaction. In all four experimental conditions patients performed worse than controls regarding accuracy and reaction time. They showed significantly less activation in three regions typically activated in ToM tasks, i.e. paracingulate cortex and bilateral temporo-parietal junctions. However, this dysfunction was dependent on the type of intention represented, i.e. was present only for social but not for non-social intentions. Moreover, part of the reduced activation was related to the fact that there was no signal drop in these regions for the physical causality condition as usually found in controls. This may be due to the tendency of schizophrenic patients to attribute intentionality to physical objects. Our findings have implications for the study and understanding of ToM in schizophrenia but also in other disorders like autism.     

Tripartite assessment of the effects of systematic desensitization in a multi-phobic child: An experimental analysis

A multiple baseline design was used to evaluate the effects of relaxation training and systematic desensitization in an 11-yr-old, multi-phobic child. Responses on motoric, cognitive, and physiological channels were assessed. While change was minimal during relaxation, substantial improvement was shown in motoric and cognitive systems with sequential introduction of desensitization. Changes on physiological measures were less substantial. All gains were maintained over 1, 4 and 6-month follow-up periods.     

The Classroom Observation Schedule to Measure Intentional Communication (COSMIC): An Observational Measure of the Intentional Communication of Children with Autism in an Unstructured Classroom Setting

The Classroom Observation Schedule to Measure Intentional Communication (COSMIC) was devised to provide ecologically valid outcome measures for a communication-focused intervention trial. Ninety-one children with autism spectrum disorder aged 6 years 10 months (SD 16 months) were videoed during their everyday snack, teaching and free play activities. Inter-rater reliability was high and relevant items showed significant associations with comparable items from concurrent Autism Diagnostic Observation Schedule—Generic (Lord et al. 2000, J Autism Dev Disord 30(3):205–223) assessments. In a subsample of 28 children initial differences in rates of initiations, initiated speech/vocalisation and commenting were predictive of language and communication competence 15 months later. Results suggest that the use of observational measures of intentional communication in natural settings is a valuable assessment strategy for research and clinical practice.

Laminar specific loss of isocortical presenilin 1 immunoreactivity in Alzheimer's disease. Correlations with the amyloid load and the density of tau-positive neurofibrillary tangles

Presenilin 1 has been shown to be mutated in a high proportion of cases of familial Alzheimer's disease. Immunoreactive epitopes of the protein have been found mainly in neurones devoid of neurofibrillary tangles - an observation that has led to the conclusion that presenilin 1 could have a protective role. In this study, the relationship between deposits of Abeta peptide (both the 40 and 42 isoforms), tau positive neurofibrillary tangles and presenilin 1-positive neuronal profiles were analysed in three cases of presenilin 1 mutation, four cases of sporadic Alzheimer's disease and five controls. Immunohistochemistry was performed in a sample from the supramarginal gyrus. The proportion of volume occupied by the Abeta1-40 and Abeta1-42 deposits (amyloid load) was evaluated by a point-counting technique. Tau-positive neurofibrillary tangles, and presenilin 1-positive neuronal profiles were directly counted. The location of the lesions in the thickness of the cortex was recorded. The density of PS1-positive neuronal profiles in Alzheimer's disease cases was lower than in the controls. The deficit was significant only in the upper layers of the cortex. The density of presenilin 1 neuronal profiles was negatively correlated with Abeta1-40 and Abeta1-42 loads, and with the density of tau-positive neurofibrillary tangles. Multivariate analysis showed that the Abeta1-42 load was the best determinant of the decrease in presenilin 1-positive neuronal profiles. Presenilin 1-positive neurones appear to be lost rather than protected in the course of Alzheimer disease.     

An integrated approach to the assessment of family adjustment to acute lymphocytic leukemia in children

This study evaluated psychological distress, social support and adjustment to the disease of 69 parents of 35 children suffering from acute lymphocytic leukemia. The study dealt with the initial phase of the disease. The following rating scales were used: the Symptom Distress Checklist-90, the Social Support Questionnaire and the Family Adjustment Scale. Psychological distress of the mothers was negatively correlated with their and their child's adjustment to the disease. A similar trend was found for fathers but the correlations reached statistical significance only for fathers' adjustment. Social support as evaluated by the 2 parents was positively correlated with their and their child's adjustment to the disease experience.     

Cardiac conduction alterations in a French family with amyloidosis of the Finnish type with the p.Asp187Tyr mutation in the GSN gene

Familial amyloidosis of the Finnish type (FAF) is a rare autosomal-dominant disorder caused by the accumulation of a 71-amino acid amyloidogenic fragment of mutant gelsolin, an actin-modulating protein. The main symptoms include corneal lattice dystrophy, progressive cranial and peripheral neuropathy, and skin changes. To date, only two mutations in the GSN gene have been described: the p.Asp187Asn mutation in most patients and the p.Asp187Tyr mutation in a Danish and Czech family. We report on the third family with the p.Asp187Tyr mutation and the first French FAF family. Severe cardiac conduction alterations in three patients were mainly caused by cardiac sympathetic denervation. These findings demonstrate the cardiological involvement of the FAF phenotype and suggest that cardiological follow-up is required in FAF patients.     

The Social Communication Assessment for Toddlers with Autism (SCATA): An Instrument to Measure the Frequency,Form and Function of Communication in Toddlers with Autism Spectrum Disorder

The Social Communication Assessment for Toddlers with Autism (SCATA) was designed to measure non-verbal communication, including early and atypical communication, in young children with autism spectrum disorder. Each communicative act is scored according to its form, function, role and complexity. The SCATA was used to measure communicative ability longitudinally in two samples of toddlers with autism spectrum disorder. Overall frequency of non-verbal communicative acts did not change between the two assessments. However, the form and complexity, the function and the role the child took in the interaction did change with time. Both frequency and function of communicative acts in toddlerhood were positively associated with later language ability: social acts, comments and initiations showed greater predictive association than requests and responses.     

Evaluation of the role of Nurr1 in a large sample of familial Parkinson's disease.

Parkinson's disease (PD) is a common neurodegenerative disorder in humans with wide variability in the age of disease onset. Although the disease has been thought previously to occur sporadically in most patients, there is increasing evidence of a genetic contribution to the disorder. Recently, a polymorphic variant within intron 6 of the Nurr1 gene was reported to be associated with sporadic and familial PD. In an effort to identify susceptibility genes for PD, we have collected 783 PD patients from 372 families and 397 healthy controls from 217 families. PD patients and healthy controls were genotyped for the intron 6 insertion polymorphism by BseRI restriction endonuclease digestion. No significant difference in either homozygosity or heterozygosity for the 7048G7049 (IVS6 1361 +16insG) polymorphism was detected in the PD patient cohort as compared with the panel of healthy controls. Moreover, direct sequencing of exon 1 of the Nurr1 gene in PD patients failed to detect either of the two recently reported Nurr1 mutations identified in a small subset of a PD patient cohort. Taken together, these data suggest that genetic alteration at the Nurr1 locus is not a significant risk factor for the development of Parkinson's disease in our large sample of familial PD patients.