Quality of Life and Resilience of Patients With Juvenile Stroke: A Systematic Review

BackgroundThe incidence of juvenile stroke is increasing. Considering younger age of patients and the potential long-lasting disability, the consequences of juvenile stroke may have a greater societal impact than those of stroke in elder population.MethodsA systematic review was performed in order to evaluate quality of life in juvenile stroke. All studies on quality of life in juvenile stroke published in PUBMED before March 1st, 2020. The search terms were “stroke”, “juvenile”, “young”, “adult”, “quality of life” and “resilience” were considered. After the abstract evaluation of 748 hits only six studies we identified as appropriate for the review. The age criterion for juvenile stroke was set as 55 years and younger.ResultsThe studies have shown a decline of quality of life in at least 46% of patients with juvenile stroke. On average, quality of life was reduced by 37%. The following domains as measured on SF-36 were particularly impaired: physical role, physical functioning and emotional role. The factors influencing the quality of life in juvenile stroke were ability to return to work, post-stroke depression, functional outcome, level of education and age of stroke onset.ConclusionsThis systematic review shows a decline of quality of life in patients with juvenile stroke. Rehabilitation programs should consider the factors influencing quality of life in these patients in order to improve outcome of juvenile stroke. Patients who are unable to return to work should receive necessary social support. In addition, our data underline the importance of screening procedures for post-stroke depression in this population.     

How temperament and character affect our career,relationships, and mental health

BackgroundOn the way toward an agreed dimensional taxonomy for personality disorders (PD), several pivotal questions remain unresolved. We need to know which dimensions produce problems and in what domains of life; whether impairment can be found at one or both extremes of each dimension; and whether, as is increasingly advocated, some dimensions measure personality functioning whereas others reflect style.MethodTo gain this understanding, we administered the Temperament and Character Inventory to a sample of 862 consecutively attended outpatients, mainly with PDs (61.2%). Using regression analysis, we examined the ability of personality to predict 39 variables from the Life Outcome Questionnaire concerning career, relationships, and mental health.ResultsPersistence stood out as the most important dimension regarding career success, with 24.2% of explained variance on average. Self-directedness was the best predictor of social functioning (21.1%), and harm avoidance regarding clinical problems (34.2%). Interpersonal dimensions such as reward dependence and cooperativeness were mostly inconsequential. In general, dimensions were detrimental only in one of their poles.ConclusionsAlthough personality explains 9.4% of life problems overall, dimensions believed to measure functioning (character) were not better predictors than those measuring style (temperament). The notion that PD diagnoses can be built upon the concept of “personality functioning” is unsupported.     

Les tuteurs de résilience dans un univers juif orthodoxe. Partie II

After defining the salient features (“marqueurs”) of a Jewish orthodox society (part I) we try to expose the resilient factors for this microsociety. To this end, we are reflecting on the link between salient features (“marqueurs”) and resilient factors (“facteurs de resilience”).ObjectivesWe emphasize this microsociety's resilient factors and we hypothesize the following idea: what about disembodied tutors? the resilient factors could be not embodied values in a world merely based on belief.MethodAfter describing this world (“Resilience tutors … - part I”), we asked them about a difficult par of their life: the Holocaust. Thus, in a situation of transmission to their children, we perceive the resilient features. They exercised self-censorship (don’t speak about the worst events, the worst sensations, the worst feelings), but they wish to express the basis of their strength, that we called resilient factors.ResultsWe propose four “concepts-resilient factors” (“concepts-tuteurs de résilience”): (1) the silence of the spouse, (2) the law, (3) the filiation, (4) the daily ritual based on practicticing jewish life.DiscussionThe notion of “concept-resilient factors” is not linked to a human being who knew how to overcome the lack of an attachment pattern but to an absolute element of faith, which would give to this microsociety the ways to its proper resilience.ConclusionTo validate this hypothesis, we should generalize the study the link between faith and religion. Otherwise, the idea of conceptualized tutor is particularly interesting in a context where it's merely the faith, which put them in considerable danger.     

Les tuteurs de résilience dans un univers juif orthodoxe. Partie I

This reflection comes from interviews with survivors of the Holocaust. Some survivors arise from a profoundly religious environment. We noticed that the environment, the tools set up to take (bring) out there were different (because of the context) from what we had met until now. The concept of resilience is dynamic and must inevitably consider the environment and the context of their life. We hypothesize that for each micro society must be found its own strength, which induce its way of being resilient.ObjectivesWe hypothesis that this microsociety developed in itself the way to get out of its traumatic events. To showcase these resilience factors (part II) we try to define the salient features of those members (les “marqueur”).MethodWe had about twenty semi-directed interviews on the subject of the WWII and its transmission to the children of survivors. Working on this population is innovative. This microsystem is not interested in university, and Holocaust is not either a matter of subject. At first, we propose five defining criterias for this microsystem: (1) god's place and faith (2) exiles and sufferings (3) the strength of the law, (4) ancestry and filiation (5) grouping around a “Rebbe”. Then, we will discuss about the “resilience's tutors” for this microsociety.ResultsWe propose four resilience's tutors, and each of them is conceptual, not ingrown: (1) the silent of the spouse, (2) law, (3) filiation, (4) daily rite.DiscussionThe notion of “concept-tuteur de resilience” refers not in human being who could palliate lack of figure of attachment but to an absolute figure of faith which would give to this microsystem the ways of resilience.ConclusionWe should, to validate this notion, diply study the relation between faith and resilience. It makes sens for the microsystem because faith and Jewish identity are exactly the reason, which officially put them in danger.     

Migrations,trauma and mental health: A literature update on psychological assessment

IntroductionMigrants and refugees often face potentially traumatic events and post-migratory stressors. Upon arrival in the host country, they can be referred to mental health services to assess the impact of their previous experiences. These cross-cultural clinical encounters may raise questions, particularly regarding the assessment of mental health using models based on Western conceptions of psychopathology.Objectives and methodThe objective of the present non-systematic review of the literature is to discuss the psychological evaluation of post-traumatic reactions in migrants and refugees. More specifically, we present current research on psychopathology, resilience and post-traumatic development (PTG) among the migrant and refugee population. We also examine the cross-cultural validity of concepts such as Post-Traumatic Stress Disorder, resilience and PTG. Finally, we describe the most frequently used tools in cross-cultural psychological assessment and briefly reflect on the question of cultural sensitivity of mental health professionals. A bibliographic search was carried out using the databases: PILOTS, Pubmed, APA PsycNET, and Google Scholar using the following keywords: “migrants”, “refugees”, “posttraumatic stress disorder”, “mental health”, “Psychopathology”, “risk factors”, “protection factors”, “posttraumatic growth” and “resilience”. We have also reviewed the reference lists of articles encountered from database searches.ResultsResponses to a potentially traumatic situation are multiple. Regarding the migrant and refugee population, the reviewed articles studied different post-traumatic reactions such as resilience, post-traumatic development, and psychopathologies. The most studied psychopathological responses were depression, anxiety and Post-traumatic Stress Disorder. After reviewing these studies, we asked the following question: considering the complexity of the migration process, what are the factors associated with the development of these different post-traumatic responses? Indeed, several individual and social factors before, during and after migration influence the mental health of individuals in a migration situation. Among the most cited risk factors identified were: to be a victim of or witness to violence in the country of origin and, after migration, to face post-migration difficulties such as asylum denial, to be in a precarious situation with regard to housing and work, as well as the difficulties linked to adaptation to the new culture. We have also described protective factors for the mental health of this population, such as: social support, psychological support, and a good quality of life in the host country. The reviewed articles also describe an important influence of cultural aspects on mental health, such as the perception of an event as traumatic. Although the authors of the reviewed articles accept this influence of culture on post-traumatic responses, most of the tools used to assess the mental health of migrants and refugees were created in a Western context. Studies show a growing concern with these cultural aspects, and certain tools that allow a more culturally sensitive evaluation, such as the “Cultural Formulation Interview”, are being developed.Discussion and conclusionEven if the concern with the sensitivity of the tools used in cross-cultural assessment seems to be more present in the international literature, researchers seem to encounter difficulties in better understanding the effects of culture on the mental health of individuals. With increasingly diverse societies, new research should not be based on participants’ geographic or ethnic origins, but rather try to “unpack” culture with, for example, the exploration of the relationships between certain values or orientations and the different expressions of psychological distress. Finally, given the still lacking development in the field of cross-cultural research, certain practices, such as the participation of interpreters, the supervision of cultural mediators or the use of culturally sensitive tools, can help the clinician to maintain good practices with patients from different cultures in the diagnostic and psychotherapeutical processes.     

Management of Paranoid Trends in Treatment of a Post-Psychotic Obsessional Condition†

Abstract

In Vivo Amplified Skills Training, IVAST, functions to bridge the gap between clinic-based skills training and use of social and independent living skills in everyday life for persons with schizophrenia and other serious and persistent mental illness. IVAST utilizes a specialist case manager who provides individualized, community based teaching using behavioral techniques to promote clients' use of skills that were learned in classroom group sessions. The IVAST trainer also liaises with the client's psychiatrist and other clinic-based staff, family members, and community agencies to create opportunities, encouragement and reinforcement for the client's independent use of skills in the community.

The aim of IVAST is to accelerate autonomous functioning of persons with mental disabilities in the community and thereby reduce their dependency on case managers and other therapists. To the extent that IVAST can empower clients to solve their own problems and attain their personal goals, enduring improvements in social role functioning and quality of life should ensue. A controlled study of IVAST has documented improvements in social adjustment when behavioral learning techniques are employed in the community settings of the clients.

An IVAST case study is presented to illustrate the community-based use of medication management, symptom management, and social problem solving in the attainment of personally relevant goals. Obstacles to success of IVAST may derive from deficits in personal motivation, family involvement, community support, financial resources, premorbid functioning, and medication compliance.     

Étude CONFAMI : effets du confinement durant l’épidémie de la COVID-19 sur la vie des enfants et leur famille

ObjectivesThe aim of this study is to understand the changes within families during confinement motivated by the COVID-19 pandemic and to explore the psycho-emotional experiences of children and their parents in this new situation. Confinement necessarily induced significant changes in daily family routines, particularly for work, education, leisure and social activities. In the more vulnerable pediatric population, several authors have warned of the need to consider the impact of lockdown measures during COVID-19 on the psychological impact and well-being.MethodThis is an anonymous online survey with methodology combining quantitative and qualitative analyses. The questions targeted several themes such as life context, emotional experience and the impact on daily habits in children and adolescents, as perceived by parents. Participants are adults and parents of at least one child. They were recruited through social media and email.ResultsA total of 439 parents responded to the questionnaire. The families generally stayed in their usual place of residence and managed to adapt well. On average, the children's level of worry (as estimated by parents) was lower than the level of worry parents attributed to themselves. For the majority, the parents did not observe any change, the psychological state of the children and adolescents was generally stable, but for those who experienced more negative emotions than usual, it was an increase in boredom, irritability and anger. A decrease in the quality of sleep was also observed by a third of the respondents. On the other hand, an increase in autonomy was noted. Regarding the quality of family cohabitation, an important result showed that confinement had improved family relationships for 41% parents but at the expense of usual social ties inducing a feeling of deprivation. Indeed, the participants evoke a lack of “social link” and “social contact with friends”. Lack became synonymous with absence, a feeling of loneliness and separation.ConclusionOur results confirm European and international data collected in children in countries where strict lockdown measures have been applied. Despite the negative emotions felt in some children, confinement has helped develop new resources in most families. Families seem to have been successful in maintaining a stable and secure routine which has certainly been a protective factor against anxiety. Some reported factors, such as bonding, could be protective factors and constitute good leads in interventions to be offered to children and their families.     

Working with Abusing Families

Abstract

Growing up in a context of violence has pervasive effects on children and young people's development, causing significant deleterious effects to the capacities to attach, to manage and regulate emotional lives, and to develop a sense of self and capacity to relate. The intergenerational effects of abuse have been shown to be extensive. The question is how best to intervene with abusive families. A model is presented which distinguishes between “family work,” an integrated systems approach which links protective and therapeutic work for individuals, groups, and families, where the courts and community are the client, and “family therapy” where the family itself is the client. The assessment of prognosis for work is outlined as well as the stages of therapeutic work including the stage of disclosure, work in a context of protection, rehabilitation, and a new family placement when rehabilitation cannot be achieved.     

Cognitive modifiability of children with developmental disabilities: A multicentre study using Feuerstein's Instrumental Enrichment—Basic program

The study aimed at exploring the effectiveness of cognitive intervention with the new “Instrumental Enrichment Basic” program (IE-basic), based on Feuerstein's theory of structural cognitive modifiability that contends that a child's cognitive functioning can be significantly modified through mediated learning intervention. The IE-basic progam is aimed at enhancing domain-general cognitive functioning in a number of areas (systematic perception, self-regulation abilities, conceptual vocabulary, planning, decoding emotions and social relations) as well as transferring learnt principles to daily life domains. Participants were children with DCD, CP, intellectual impairment of genetic origin, autistic spectrum disorder, ADHD or other learning disorders, with a mental age of 5–7 years, from Canada, Chile, Belgium, Italy and Israel. Children in the experimental groups (N = 104) received 27–90 h of the program during 30–45 weeks; the comparison groups (N = 72) received general occupational and sensory–motor therapy. Analysis of the pre- to post-test gain scores demonstrated significant (p < 0.05) advantage of experimental over comparison groups in three WISC-R subtests (“Similarities”, “Picture Completion”, “Picture Arrangement”) and Raven Coloured Matrices. Effect sizes ranged from 0.3 to 0.52. Results suggest that it is possible to improve cognitive functioning of children with developmental disability. No advantage was found for children with specific aetiology. Greater cognitive gains were demonstrated by children who received the program in an educational context where all teachers were committed to the principles of mediated learning.     

Nonepileptic seizures in the pediatric population: A qualitative study of patient and family experiences

ObjectiveThe objective of this study was to characterize the experience of nonepileptic seizures (NES) in young people (0–19 years) and their families, referred to a UK specialist (tertiary) pediatric hospital. The topics investigated include: accessing healthcare, how the diagnosis was first explained, impact on home life and school, coping strategies, and ideas about naming and causes.MethodsTen young people with NES and 29 family members took part in focus groups and telephone interviews. The data generated were analyzed qualitatively with thematic analysis.ResultsSix themes were identified from participant experiences: upset and afraid, missing out, feeling misunderstood, confusion and uncertainty, less than epilepsy, and making sense and moving on. Participants described severe disruption to multiple domains of functioning at home, educationally, and in social activities. Young people felt guilty but also overprotected, while family members felt that they were failing as parents. The journey to diagnosis and treatment was seen as unnecessarily tortuous, with access to care and treatment pathways poorly defined. Participants described feeling that a wide variety of professionals did not believe their experiences, showed pejorative attitudes, and left them feeling isolated and marginalized. The young people and family members found NES a difficult disorder to understand and sometimes could not differentiate it from epilepsy. Epilepsy was used as a benchmark for several comparisons, including highlighting the lack of support for and information about NES. Families disliked being told that it was “good news” that their child did not have epilepsy and questioned if their child should be present during initial diagnostic discussions. Participants described stressful situations as a common trigger for NES. Young people showed ambivalence towards the need to understand the condition or the choice of name used for it, whereas family members considered this crucial for achieving recovery.ConclusionsYoung people and families who live with NES experience considerable distress and impairment. Pathways to diagnosis need to be streamlined, and better integration of pediatric, mental health, and educational services is required. The use of the “good news” story to discuss the diagnosis with families should be reconsidered, as families seem to interpret this as indicating that there is no effective treatment. Educational resources and support groups for young people and families are needed. Greater understanding of experiences may allow investigation of the pathogenic mechanism and inform possible management approaches. Training of health professionals in communicating with young people and families with NES must be improved.     

Caring for stroke survivors: experiences of family caregivers in Sri Lanka – a qualitative study

Background: Stroke is a life-changing event for both stroke survivors and their family caregivers. After receiving acute care at the hospital, family members are expected to take care of stroke survivors at home and to continue treatment and rehabilitation. The new role of “informal caregiver” is a challenge that creates many difficulties for family caregivers that are not explicit in the Sri Lankan context.

Objectives: This study aimed at exploring family caregivers’ experiences of providing informal care for dependent stroke survivors.

Methods: The sample was chosen by purposive sampling with a maximum variation by age, ethnicity, religion, educational level, relationship, and monthly income. Ten informal family caregivers to stroke survivors with hemiplegia who had been treated at the National Hospital of Sri Lanka participated in in-depth interviews analyzed using conventional content analysis.

Results: Qualitative content analysis of data resulted in an overriding theme, “Caring with love, against all odds,” along with four categories, “Life alterations,” “Lack of resources,” “Compassionate care,” and “Coping strategies.” Although the increased workload, restricted social life, physical problems, and knowledge and financial deficits were challenging for the family caregivers, self-strength and supportive social networks helped them to compassionately care for their stroke survivor.

Conclusions: The phenomenon of family caregivers providing informal care for stroke survivors was explicated as compassionate care, notwithstanding numerous difficulties. The findings motivate further research and strategies to minimize family caregivers’ burden and facilitate the positive aspects of caregiving to promote the health and well-being of both stroke survivors and their families.     

Perception of faces in schizophrenia: Subjective (self-report) vs. objective (psychophysics) assessments

ObjectivesFace perception impairment in schizophrenia has been demonstrated, mostly through experimental studies. How this laboratory-defined behavioral impairment is associated with patients’ perceptual experience of various faces in everyday life is however unclear. This question is important because a first-person account of face perception has direct consequences on social functioning of patients. In this study, we adapted and administered a self-reported questionnaire on narrative perceptual experience of faces along with psychophysical assessments of face perception in schizophrenia.MethodsThe self-reported questionnaire includes six rating items of face-related functioning in everyday life, providing a subjective measure of face perception. The psychophysical assessment determines perceptual threshold for discriminating different facial identities, providing an objective measure of face perception.ResultsCompared to controls (n = 25), patients (n = 35) showed significantly lower scores (worse performance) in the subjective assessment and significantly higher thresholds (worse performance) in the objective assessment. The subjective and objective face perception assessments were moderately correlated in controls but not in patients. The subjective face perception assessments were significantly correlated with measurements of a social cognitive ability (Theory of Mind), again in controls but not in patients.ConclusionThese results suggest that in schizophrenia the quality of face-related functioning in everyday life is degraded and the role that basic face discrimination capacity plays in face-related everyday functioning is disrupted.     

Differences in Assessment of Everyday Preferences Between People With Cognitive Impairment and Their Care Partners: The Role of Neuropsychiatric Symptoms

ObjectiveAs cognitive impairment progresses, people with dementia increasingly rely on surrogate decision-makers for everyday activities. Yet, little is known about concordance on everyday preferences between persons with cognitive impairment and their care partners.MethodsThe sample included 69 dyads of persons with cognitive impairment (Clinical Dementia Rating Scale ≥0.5) and their care partners. We used the Preferences for Everyday Living Inventory (PELI) to assess preferences for activities and lifestyle choices among persons with cognitive impairment. The PELI was concurrently but separately administered to care partners, who answered as surrogate decision-makers. Factor analysis was used to ascertain factor structure of the PELI; reliability measures were computed within the sample. Paired sample t-tests were used to estimate differences in scores of corresponding PELI items for each factor. Multiple regression models were used to relate predictors, including neuropsychiatric symptoms, to agreement levels.ResultsFour factors were identified from the PELI: autonomous choice, social engagement, personal growth, and keeping a routine. Significant participant-care partner discrepancy was found in “social engagement” preferences (e.g., regular contact with family, meeting new people, volunteering). Geriatric Depression Scale-15 score and care partner sex were significantly associated with participant-care partner discrepancies in “social engagement” preferences.ConclusionThis study yields new insights regarding the most important preferences for persons with cognitive impairment and clarifies a path to optimizing surrogate decision-making around everyday preferences by highlighting areas of apparent disagreement and identifying potential predictors of discrepancy.     

“The Elements”

On the 17th and 18th February 1982, the residents of Starcross Hospital performed a masked drama entitled “The Elements” at the Northcott Theatre, Exeter. This formed part of a larger programme aimed towards emphasising the Theatre's role as a community arts centre. The programme, under the title “A Community Tour-In”, consisted of small groups of amateur and professional performers, whose work was specifically geared towards integrating the theatre arts into the social structure of everyday life.     

Rémission symptomatique et sa relation avec le fonctionnement social chez des patients tunisiens suivis pour schizophrénie

IntroductionThe concept of symptomatic and functional remission represents an important challenge in the care of the mentally ill, particularly in patients with schizophrenia. Operational criteria for symptomatic remission in schizophrenia have been proposed by Andreasen et al. (2005). Over the last decade, these criteria have been widely validated; however few studies have been conducted outside developed countries. Moreover, the association of symptomatic remission with functional outcome has not yet been established in developing countries including Tunisia, as there may be variability in the social and familial environment.ObjectivesTo determine the frequency and associated factors of symptomatic remission in a sample of Tunisian out-patients with schizophrenia and to explore the relationship between symptomatic remission and some indicators of social functioning.MethodsA cross-sectional study was carried-out on 115 out-patients with schizophrenia (87 males, 28 females, mean age = 37.56 ± 10.2 years) in the psychiatry department of the university hospital in Monastir (Tunisia). Nearly all of the patients (98.26%) had been hospitalized at least once in a psychiatric unit. The last hospitalization dated back to 39 months on average (range = 6 months to 16 years). Symptomatic remission was assessed by the eight core items of the positive and negative syndrome scale (PANSS). These are the items P1 “Delusions”; P3 “Hallucinatory behavior” and G9 “Unusual thought content” for the positive dimension, the items P2 “Conceptual disorganization” and G5 “Mannerism and disorders of posture” for the disorganization dimension and the items N1 “Blunted affect”, N4 “Social withdrawal” and N6 “Lack of spontaneity and flow of conversation” for the negative dimension. A score of mild or less on all eight-core symptoms constitutes symptomatic remission. This symptom level should have been maintained for six months. The social functioning was assessed by the Social and Occupational Functioning Assessment Scale (SOFAS) and the Social Autonomy Scale (SAS) exploring personal care, management of daily life, resource management, the relationship with the outside and the emotional life and relationships social. A multivariate analysis using a binary logistic regression was conducted with as a dependent variable “symptomatic remission” and as explanatory variables the associated variables with symptomatic remission in bivariate analysis with age and gender.ResultsThe symptomatic remission was observed in 50.4% of patients. The items corresponding to positive dimension (P1, P3 and G9) and the item P2 “conceptual disorganization” had a better predictive value of symptomatic remission. After multivariate analysis, the associated factors of symptomatic remission were the acute of onset (P = 0.026), the low score of negative symptoms during the last hospitalization (P = 0.017) and the episodic course (P < 0.0001). However, age or gender of the patients, educational or socioeconomic level, psychiatric family history, age of onset, duration of untreated psychosis, number and duration of previous hospitalizations, antipsychotic treatment dosage were not associated with symptomatic remission in our sample. The mean score of the SOFAS was 48.47 ± 14.44, and the mean score of the SAS was 56.6 ± 16.84. A significant association was shown between the SOFAS score and the symptomatic remission (P < 0.0001) and between the SAS score and the symptomatic remission (P < 0.0001). Moreover, a significant association was found between symptomatic remission and occupational activity (P = 0.03).ConclusionThe frequency of symptomatic remission according the PANSS criteria in our sample is above the average of the reported rates in literature (30 to 60%). This can be explained by the frequency of symptomatic remission in outpatient versus inpatients, or in relation to the notion of a more favorable course of schizophrenia in developing countries, although this notion is controversial. Remitter patients had significantly an acute onset of disorders, a low score of negative symptoms during the last hospitalization and an episodic course. They also showed a significant trend for better social functioning. In fact, a significant association was shown in our sample between symptomatic remission and social functioning. These results suggest that the concept of remission has important implications for the treatment of patients with schizophrenia.     

Factors involved in the level of functioning of patients with schizophrenia according to latent variable modeling

PurposeThis study aimed at using latent variable modelling to explore the significantly contributing variables to functioning in schizophrenia patients.MethodsThe study cohort comprised 296 schizophrenia patients evaluated once for demographic characteristics, functioning (FROGS, SWN-K, QLS) and symptomatology (Positive and Negative Syndrome Scale [PANSS]). First exploratory multivariate analyses were conducted and then a model with functioning as a latent variable was proposed and tested with the data.ResultsSymptomatology as negative, cognitive and excitation factor are significant predictors of functioning assessed through FROGS (P < 0.0001), SWN-K and QLS (P < 0.001). The model was constructed with functioning defined as a latent variable, indicators are subscores on FROGS, SWN-K, QLS and exogenous variable included symptomatology, Duration of Untreated Psychosis (DUP) and educational level.ConclusionUsing the five clinical dimensions of the PANSS, (Positive, Negative, Cognitive, Anxiety/Depression and Excitation) the negative and cognitive dimensions are highly correlated via the latent variable to the three dimensions of functioning evaluated by the FROGS: “daily life”, “social functioning” and “treatment” and the QLS subscores (interpersonnal, common object, instrumental role). Educationnal level is positively linked to functioning but not DUP. The model emphasizes the need for treatment strategies that have an effect on cognitive-factors, to improve functioning in schizophrenia.     

Memory for friends or foes: The social context of past encounters with faces modulates their subsequent neural traces in the brain

Abstract

Every day we encounter new people, interact with them, and form person impressions based on quick and automatic inferences from minimal contextual information. Previous studies have identified an extensive network of brain areas involved in familiar face recognition, but there is little evidence to date concerning the neural bases of negative vs. positive person impressions. In the present study, participants were repeatedly exposed to 16 unfamiliar face identities within a pseudo-interactive game context to generate a perception of either “friends” or “foes”. Functional magnetic resonance imaging (fMRI) was then performed during an old/new memory task to assess any difference in brain responses to these now familiar face identities, relative to unfamiliar faces. Importantly, whereas facial expressions were always emotional (either smiling or angry) during the encoding phase, they were always neutral during the memory task. Our results reveal that several brain regions involved in familiar face recognition, including fusiform cortex, posterior cingulate gyrus, and amygdala, plus additional areas involved in motivational control such as caudate and anterior cingulate cortex, were differentially modulated as a function of a previous encounter, and generally more activated when faces were perceived as “foes” rather than “friends”. These findings underscore that a key dimension of social judgments, based on past impressions of who may be supportive or hostile, may lead to long-lasting effects on memory for faces and thus influence affective reactions to people during a subsequent encounter even in a different (neutral) context.     

Change in child psychopathology with improvement in parental depression: a systematic review

ObjectiveTo systematically review current research evidence of associations between improvement in parents' depression and their children's psychopathology.MethodRelevant studies were identified using PsycINFO (1806-2007) and Medline (1950-2007). The search terms used were “depression,” “postpartum depression,” “treatment,” “mothers,” “fathers,” “parents,” “offspring,” “mother child relations,” and “father child relations.” The reference sections of identified articles were also examined for additional relevant articles. Open and controlled clinical trials and observational studies of depressed parents that also included psychological and behavioral assessments of offspring 18 years of age or younger were included in the review.ResultsTen studies meeting broad criteria for inclusion were reviewed. These studies varied considerably in sample, treatment, assessment, and analysis. Based on the few studies, there is some evidence of associations between successful treatment of parents' depression and improvement in children's symptoms and functioning, but treatment of postpartum depression may not be sufficient for improving cognitive development, attachment, and temperament in infants and toddlers.ConclusionsDue to the public health implications of the findings, further study of the effects of improvement in parental depression on child psychopathology is warranted. These studies need to examine the precise relation between parental and child symptoms, the differential effect of parents' treatment with psychotherapy versus medication, the effect of fathers' as well as mothers' symptomatic improvement on children, and mediators and moderators of the relation between parental improvement and child psychopathology.     

The Theme of the Family in Contemporary Society and Positive Family Psychology

Abstract

Social observers agree that a family is a focus for contemporary concerns. The author suggests that relying on the value dimension of the field of family therapy, which means working with such positive concepts as family resilience, reconciliation can help to defend families against their vulnerability to manipulation. New, positive forms of psychological practice are needed to work at the level of the family. The author also stresses the importance of reflecting on the family theme in psychology and blending ideas from positive psychology and family psychology. As both disciplines are rather new, they can benefit from constructive interaction. Some illustrations concerning the author's work with Russian families and Russian family culture are included.     

Language,meaning, context,and functional communication

Background : In the 1970s Audrey Holland first emphasised the importance of “functional communication” rather than “linguistic accuracy” for individuals with aphasia, noting that they could often “communicate” better than they could “talk”. Her approach inspired many to explore why and how this could be so, and to look for avenues that tapped everyday communication skills, rather than the person with aphasia's performance on decontextualised language tests.

Aims: This paper addresses the kinds of issues that are involved in “functional communication” and specifically addresses the role of language in this endeavour. It aims to highlight language as a set of “meaning-making resources” rather than as a set of syntactic/semantic constructs that exist outside of the communicator's everyday environment, that have to be mastered before being put into practice and that exist regardless of specific contexts.

Main Contribution: The paper discusses language's role in social life in which speakers not only convey information to each other but also maintain social relationships through communication. A taxonomy of the different kinds of social meanings that speakers use to communicate is proposed for use in aphasia research, based on the work of Halliday (1994 Halliday, M.A. K. 1994. An introduction to functional grammar, 2nd, London: Arnold.  [Google Scholar])—those related to conveying ideas and experiences (e.g., vocabulary related to particular experiences, topics), those related to interpersonal relationships (e.g., speech acts, evaluative language devices, exchange structure), and those related to maintaining continuity and coherence across the speaker's discourse (e.g., cohesion). In addition, the systematic relationship existing between language and context and its clinical implications are explored.

Conclusions: Language as information is only one form of language use. The paper argues for further consideration in aphasiology of the importance of multiple language uses and their relation to context. It is proposed that regarding language forms from these different perspectives of use will enable clinicians to further address the different aspects of communication required for meaningful and satisfying interactions in everyday social life.