Do implicit and explicit belief processing share neural substrates?

Humans rely on their ability to infer another person's mental state to understand and predict others' behavior (“theory of mind,” ToM). Multiple lines of research suggest that not only are humans able to consciously process another person's belief state, but also are able to do so implicitly. Here we explored how general implicit belief states are represented in the brain, compared to those substrates involved in explicit ToM processes. Previous work on this topic has yielded conflicting results, and thus, the extent to which the implicit and explicit ToM systems draw on common neural bases is unclear. Participants were presented with “Sally‐Anne” type movies in which a protagonist was falsely led to believe a ball was in one location, only for a puppet to later move it to another location in their absence (false‐belief condition). In other movies, the protagonist had their back turned the entire time the puppet moved the ball between the two locations, meaning that they had no opportunity to develop any pre‐existing beliefs about the scenario (no‐belief condition). Using a group of independently localized explicit ToM brain regions, we found greater activity for false‐belief trials, relative to no‐belief trials, in the right temporoparietal junction, right superior temporal sulcus, precuneus, and left middle prefrontal gyrus. These findings extend upon previous work on the neural bases of implicit ToM by showing substantial overlap between this system and the explicit ToM system, suggesting that both abilities might recruit a common set of mentalizing processes/functional brain regions. Hum Brain Mapp 38:4760–4772, 2017. © 2017 Wiley Periodicals, Inc.     

Do people with mental illness deserve what they get? Links between meritocratic worldviews and implicit versus explicit stigma

Meritocratic worldviews that stress personal responsibility, such as the Protestant ethic or general beliefs in a just world, are typically associated with stigmatizing attitudes and could explain the persistence of mental illness stigma. Beliefs in a just world for oneself (“I get what I deserve”), however, are often related to personal well-being and can be a coping resource for stigmatized individuals. Despite these findings in other stigmatized groups, the link between worldviews and the stigma of psychiatric disorders is unknown. We measured just world beliefs for self and others as well as endorsement of the Protestant ethic in 85 people with schizophrenia, schizoaffective or affective disorders and 50 members of the general public. Stigmatizing attitudes toward people with mental illness (perceived responsibility, perceived dangerousness, general agreement with negative stereotypes) were assessed by self-report. Using a response-latency task, the Brief Implicit Association Test, we also examined guilt-related implicit negative stereotypes about mental illness. We found a consistent positive link between endorsing the Protestant ethic and stigmatizing self-reported attitudes in both groups. Implicit guilt-related stereotypes were positively associated with the Protestant ethic only among members of the public. Among people with mental illness, stronger just world beliefs for self were related to reduced self-stigma, but also to more implicit blame of persons with mental illness. The Protestant ethic may increase (self-)stigmatizing attitudes; just world beliefs for oneself, on the other hand, may lead to unexpected implicit self-blame in stigmatized individuals. Public anti-stigma campaigns and initiatives to reduce self-stigma among people with mental illness should take worldviews into account.     

Do people recognise mental illness?

BACKGROUND: Mental health literacy has been defined as the public's knowledge and the beliefs about mental disorders enhancing the ability to recognise specific disorders. AIMS: Firstly, to determine whether the public recognises a person depicted in a vignette as mentally ill or as experiencing a crisis. Secondly, to reveal the factors influencing the correct recognition. METHODS: Multiple logistic regression analysis of an opinion survey conducted in a representative population sample in Switzerland (n=844). RESULTS: The depression vignette was correctly recognised by 39.8% whereas 60.2% of the respondents considered the person depicted as having a 'crisis.' The schizophrenia vignette was correctly identified by 73.6% of the interviewees. A positive attitude to psychopharmacology positively influenced the recognition of the two vignettes whereas a positive attitude to community psychiatry had the inverse effect. Moreover, for the depression vignette previous contact to mentally ill people had a positive influence on the recognition. For the schizophrenia vignette instead, rigidity and interest in mass media had a negative influence, respectively. CONCLUSIONS: The low knowledge about mental disorders, particularly depression, confirms the importance and the need to increase mental health literacy. Furthermore, professionals must openly discuss illness models with their patients, especially emphasising the differences between illness and crisis.     

Life changes. Do people really remember?

The question, "How well do people remember life changes?" was approached in a longitudinal study of nearly 400 healthy men in a responsible profession. Three scales for assessing life changes were administered by questionnaire at two examinations nine months apart. The subjects were asked to report life change events occurring during a specific six-month period--that which immediately preceded the first examination. For all three life change scales there was substantial forgetting over the interval between reports, with a second report yielding total scores 34% to 46% less than those from the first report for the same period. The amount of change over time varied greatly across persons. These findings raise serious questions about the validity of retrospective studies of life change and illness when the period being reported is greater than six months in the past. They do not, however, jeopardize the potential of the method for prospective studies.     

Do people with dementia find lies and deception in dementia care acceptable?

Objectives: Research suggests that the use of lies and deception are prevalent in dementia care settings. This issue has been explored from the view point of carers and professionals, and the acceptability and ethicality of deception in dementia care remains an area of heated debate. This article explored the issue of lies and deception in dementia care from the unique perspective of the people being lied to: People with Dementia.

Method: This study used a qualitative methodology, specifically, Grounded Theory (GT). The study used a two-phased design. Phase one involved a series of one-to-one interviews with People with Dementia. During phase two, the participants were re-interviewed in order to develop the emerging theory.

Results: Lies were considered to be acceptable if told in People with Dementia's best interest. This best interest decision was complex, and influenced by factors such as the person with dementia's awareness of the lie, and the carer's motivation for lying. A model depicting these factors is discussed.

Conclusion: This study enables the perspective of People with Dementia to be considered, therefore providing a more complete understanding of the use of deceptive practices in dementia care settings. This study suggests that the use of lies and deception in dementia care warrants further investigation.     

Do children with developmental dyslexia have an implicit learning deficit?

OBJECTIVE: The purpose of this study was to investigate the effects of specific types of tasks on the efficiency of implicit procedural learning in the presence of developmental dyslexia (DD). METHODS: Sixteen children with DD (mean (SD) age 11.6 (1.4) years) and 16 matched normal reader controls (mean age 11.4 (1.9) years) were administered two tests (the Serial Reaction Time test and the Mirror Drawing test) in which implicit knowledge was gradually acquired across multiple trials. Although both tests analyse implicit learning abilities, they tap different competencies. The Serial Reaction Time test requires the development of sequential learning and little (if any) procedural learning, whereas the Mirror Drawing test involves fast and repetitive processing of visuospatial stimuli but no acquisition of sequences. RESULTS: The children with DD were impaired on both implicit learning tasks, suggesting that the learning deficit observed in dyslexia does not depend on the material to be learned (with or without motor sequence of response action) but on the implicit nature of the learning that characterises the tasks. CONCLUSION: Individuals with DD have impaired implicit procedural learning.     

Do depressive symptoms predict mortality in older people?

Context: Depressive symptoms are common in older persons, and may predict mortality.

Objectives: To determine: (1) If depressive symptoms predict mortality; (2) If there is a gradient in this effect; and (3) Which depressive factors predict mortality.

Population: In 1991–1992, 1751 community-dwelling older persons, sampled from a population-based registry, were interviewed.

Measures: The Center for Epidemiologic Studies – Depression (CES-D), age, gender, the Modified Mini-Mental State Examination, self-rated health, and functional status.

Outcome measure: Time to death.

Analysis: Those scoring 16+ on the CES-D were considered depressed. To determine if a gradient was present, the CES-D was treated as a continuous variable. Four depressive factors from the CES-D (depressed affect, positive affect, somatic, and interpersonal) were analyzed. Cox regression models were constructed.

Results: The mortality in those with depressive symptoms was higher in those without depressive symptoms (Hazard Ratio of 1.71, p < 0.001, Log rank test). In multivariable models, this association was no longer significant after accounting for self-rated health and functional status. There was a gradient in risk of mortality across the range of the CES-D. Somatic factors, depressed affect, and positive affect were all associated with mortality in bivariate analyses, but not in multivariable models adjusting for functional status. Interpersonal factors were not associated with mortality.

Conclusions: Depressive symptoms predict mortality in older persons.     

Do people with schizophrenia comprehend what they read?

Although people with schizophrenia appear to be able to read aloud, their reading comprehension has been little tested. This study asks, Do people with schizophrenia have deficits in reading comprehension compared with well controls and, if so, what are the type and severity of those deficits? The reading comprehension of 30 people with chronic schizophrenia was compared with a group of 30 people without a psychiatric diagnosis. The groups were matched for sex and age and had similar intelligence scores. The Reading Comprehension Battery for Aphasia (RCBA) was used to obtain a profile of reading comprehension skills, and intelligence was estimated using the National Adult Reading Test. Schizophrenia subjects took significantly longer to complete the RCBA and obtained significantly poorer scores than did controls on the RCBA total and on all but one RCBA subtest. Although these findings could have serious implications for the presentation of written material such as consent and information forms, further research is needed to determine how these deficits impact on functional reading and whether or not they can be addressed.     

Do people with epilepsy have a different lifestyle?

BackgroundEpilepsy is one of the most common neurological diseases. Its high prevalence, economic relevance and impact on daily life make it crucial that we study this condition in further detail. Our study seeks to investigate whether the lifestyle of people diagnosed with epilepsy is different to that of people without epilepsy, in order to better understand our patients.MethodsWe designed and delivered a questionnaire about quality of life and daily habits to patients from our hospital's Epilepsy Unit. We also delivered the questionnaire to a control group with similar demographic characteristics. Lifestyle differences between patients and control group members were analyzed. Patients were further divided according to the type of epilepsy, time since diagnosis, seizure frequency and pharmacotherapy.ResultsA total of 278 people were interviewed (85 patients, 193 controls). There was no difference in educational level, marital status and healthy habits (sports, reading and diet) between the groups. However, patients with epilepsy were more often unemployed (p < 0.05) and had a healthier lifestyle (lower body mass index, lower alcohol consumption and a tendency towards smoking less). Anxiolytic-antidepressant intake was higher in patients with epilepsy. In terms of the type of epilepsy, patients with focal epilepsy exercised more than those with generalized epilepsy; no other statistically significant differences were found between the individuals studied.DiscussionEpilepsy diagnosis does not seem to negatively alter the daily life of patients; in fact, many adopt a healthier lifestyle after diagnosis. The risk of antidepressant/anxiolytic intake is, however, higher, which could reflect the impact this chronic condition still has at a social level.     

Do young people with comorbid mental and alcohol disorders experience worse behavioural problems?

This article examines whether young individuals in the general population with comorbid alcohol use and mental health disorders experience worse internalizing and externalizing behaviour problems than those with single disorders. A large cohort of women at the Mater Misericordiae Hospital in Brisbane, Australia, was enroled during pregnancy in a longitudinal study. Mother/offspring dyads were followed over 21 years. At age 21, offspring behaviour problems were examined using the Young Adult Self Report, alcohol and mental health disorders with the Composite International Diagnostic Interview. Associations between comorbidity and behaviour problems were assessed using multinomial logistic regression, accounting for life-course factors. Twelve per cent of young adults had alcohol/mental health DSM-IV disorders with significant temporal overlap. A further 16% had alcohol disorders only and 23% mental health disorders only. The comorbid group scored significantly higher on total and externalizing behaviour problems but not internalizing behaviour problems. Stronger associations of aggression/delinquency with comorbidity were not fully accounted for by factors known to influence separate development of mental health and alcohol disorders. Young adults with comorbid alcohol/mental health disorders experience more, and more severe, behavioural problems than those with single disorder types, indicating an increased burden from comorbidity, with implications for treatment and public order.     

Do mentally handicapped people require specialist community nursing care?

The current trend in the care of mentally handicapped people is to enable them to live in the community alongside their families and friends, rather than banishing them to hospitals miles away from home. However, a family which has to cope with a handicapped member has innumerable problems to face, and it is essential that back-up services are provided. During the past ten years a specialist community nursing service has developed throughout the country to care for the mentally handicapped within their own homes and other residential accommodation in the community. The following article evaluates the role of the community mental handicap nurse.     

Side bias and accidents: are they related?

This study purports to examine the role of different forms of side bias, handedness, footedness, eyedness, and earedness, in eliciting accident-proneness in individuals. A representative sample (N = 150) was administered a Side Bias Questionnaire (Handedness: 22 items, footedness: 5 items, eyedness: 5 items, earedness: 5 items) to ascertain their preferential bias. The questionnaire also required subjects to report the number of accidents committed during their lifetime while performing activities like sports, driving, household work, etc., that required attention of medical professionals. Regression analysis of data indicated that accident-prone behavior was significantly predicted from handedness. Analysis of variance, 3 (Accident groups: low, moderate, high) x 4 (Side bias: hand, foot, eye, ear), indicated that 'mixed' handers committed more accidents as compared with clear handers. The other forms of side bias, foot, ear, and eye were unrelated to frequency of accidents.     

Do Place and Time Make a Difference? Examining Quality of Life Among Homeless Persons in Northwest Arkansas and Birmingham

This study examines the role that life chances and choices play in determining quality of life among homeless people. Given the prominent negative impact of homelessness, this paper specifically examines the impact of length of time homeless and location on adverse quality of life. OLS regression examined quality of life among 264 homeless adults living in Northwest Arkansas and Birmingham, Alabama. Analysis shows no significant impact of life choices on quality of life but a significant impact of life chances including strong social ties and mastery of fate, on adverse quality of life. Length of time homeless was related to adverse quality of life, but location was not, indicating that the homeless experience with regards to subjective quality of life did not vary significantly between Birmingham and Northwest Arkansas.     

Do dissociations between implicit and explicit memory disappear, when reliability of the tests is comparable? An example

Implicit memory measures tend to be less reliable than explicit memory measures. Consequently dissociations can arise as a consequence of differential reliabilities of the tasks. In the present study the effect of a manipulation of levels of processing in an implicit and an explicit memory task were investigated in a sample of 200 students after establishing comparable reliabilities of the memory tasks. A fragmented object-naming test was used as an indirect test and a recognition task was used as a direct test. The reliabilities of these measures were comparable in all conditions. A main effect of levels of processing, but no interaction between type of test and levels of processing, was found. These findings reinforce the necessity of taking into account the reliability of memory measures for the interpretation of dissociations between explicit and implicit memory.     

Eco-crisis and mental health of children and young people: Do child mental health professionals have a role?

Child mental health professionals have an extremely important role to play in their distinct roles as clinicians, therapists, researchers, policy makers, advocates, preventative public health professionals and service developers pertaining to eco-crisis in the child and adolescent populations. This article provides examples of how this can be done.     

Attention and emotion in anosognosia: evidence of implicit awareness and repression?

Accounts of anosognosia for hemiplegia have long suggested some implicit knowledge of deficit, where lack of awareness is driven by the emotionally-aversive consequences of bringing deficit-related thoughts to consciousness. The present study investigates this issue using an attentional-capture paradigm, presenting words associated with hemiplegia-related deficit. As anticipated, non-anosognosics showed reduced latencies (i.e., facilitation) for emotionally threatening words. In striking contrast, anosognosics showed increased latencies (i.e., interference), a finding which supports the claim of implicit awareness. The effect appears to be due to newly-learned associations to disability-related words: where anosognosics show a pattern of performance previously described as repression.