Stress in the Courtroom: Call for research

Recent acts of violence against judges highlight the growing number of occupational stressors that judges encounter. In addition to threats of violence, judges often deal with substantial workloads, traumatic cases, and the pressure of making significant decisions. It is important to understand these stressors, because they could negatively affect judges' abilities to handle evidence, protect jurors, and make decisions. Approaches (work-related burnout, compassion fatigue, and vicarious traumatization) to assessing work-related stress, and their corresponding scales (Maslach Burnout Inventory, Compassion Fatigue Self-Test, Traumatic Stress Institute Belief Scale), are presented, as a first step in developing a scale to assess the extent and prevalence of judge stress. Following assessment research, researchers should develop intervention strategies to alleviate problematic sources of stress for judges.     

Juror perceptions of false confessions versus witness recantations

In false confessions, someone confesses to a crime but then later retracts that confession, whereas in witness recantations, an eyewitness testifies but then later revokes that testimony. The revocations are conceptually similar, but they differ in the author of the revocation – the defendant versus a third party. The current study examines differences in juror perceptions of the legitimacy of false confessions versus witness recantations, and also takes contextual influences (coercion and crime severity) into account. False confessions were found to be judged more harshly than witness recantations, but, surprisingly, levels of coercion and the severity of the crime did not influence decision-making in the manner that the original hypotheses predicted. Implications for the application of this research are discussed.     

Exome sequencing in familial corticobasal degeneration

BackgroundCorticobasal degeneration (CBD) is a neurodegenerative, sporadic disorder of unknown cause. Few familial cases have been described.ObjectiveWe aim to characterize the clinical, imaging, pathological and genetic features of two familial cases of CBD.MethodsWe describe two first cousins with CBD associated with atypical MRI findings. We performed exome sequencing in both subjects and in an unaffected first cousin of similar age.ResultsThe cases include a 79-year-old woman and a 72-year-old man of Native American and British origin. The onset of the neurological manifestations was 74 and 68 years respectively. Both patients presented with a combination of asymmetric parkinsonism, apraxia, myoclonic tremor, cortical sensory syndrome, and gait disturbance. The female subject developed left side fixed dystonia. The manifestations were unresponsive to high doses of levodopa in both cases. Extensive bilateral T1-W hyperintensities and T2-W hypointensities in basal ganglia and thalamus were observed in the female patient; whereas these findings were more subtle in the male subject. Postmortem examination of both patients was consistent with corticobasal degeneration; the female patient had additional findings consistent with mild Alzheimer's disease. No Lewy bodies were found in either case. Exome sequencing showed mutations leading to possible structural changes in MRS2 and ZHX2 genes, which appear to have the same upstream regulator miR-4277.ConclusionsCorticobasal degeneration can have a familial presentation; the role of MRS2 and ZHX2 gene products in CBD should be further investigated.     

Neuropsychological test performance before and after HIV-1 seroconversion: the Multicenter AIDS Cohort Study

The objective of this study is to compare neuropsychological test performance before and after HIV-1 seroconversion in order to identify possible acute changes in psychomotor speed, memory, attention, and concentration secondary to seroconversion. The study utilized mixed effects models to examine longitudinal neuropsychological test data. We conducted a nested cohort study of 362 male HIV-1 seroconverters enrolled in the Multicenter AIDS Cohort Study. We used linear mixed models with random subject effects to compare repeated neuropsychological test outcomes from 5 years before seroconversion to 2 years after seroconversion on the Trail Making Test (parts A and B), Symbol-Digit Test, Grooved Pegboard (dominant and non-dominant hands), Stroop Color-Interference Test, Rey Auditory Verbal Learning Test, and the CalCAP Reaction Time Test. We found no significant changes in the time-dependent score after seroconversion for the majority of neuropsychological tests used in the Multicenter AIDS Cohort Study. There was a significant change in time trend after seroconversion on part B of the Trail Making Test (p?=?0.042), but the difference only represented a 2 % decrease in performance. We found the following characteristics to be associated with worse neuropsychological test performance: lower education levels, history of depression, older age, and no previous neurocognitive testing (p?<?.05). Our results suggest that despite a 50 % decrease in CD4 cell count immediately following infection, HIV-1 does not appear to have a measurable effect on psychomotor or complex cognitive processing for up to 2 years following infection, using this set of neurocognitive measures.     

Pleasurable emotional response to music: A case of neurodegenerative generalized auditory agnosia

Recent functional neuroimaging studies implicate the network of mesolimbic structures known to be active in reward processing as the neural substrate of pleasure associated with listening to music. Psychoacoustic and lesion studies suggest that there is a widely distributed cortical network involved in processing discreet musical variables. Here we present the case of a young man with auditory agnosia as the consequence of cortical neurodegeneration who continues to experience pleasure when exposed to music. In a series of musical tasks, the subject was unable to accurately identify any of the perceptual components of music beyond simple pitch discrimination, including musical variables known to impact the perception of affect. The subject subsequently misidentified the musical character of personally familiar tunes presented experimentally, but continued to report that the activity of ‘listening’ to specific musical genres was an emotionally rewarding experience. The implications of this case for the evolving understanding of music perception, music misperception, music memory, and music-associated emotion are discussed.     

A case study of an emerging visual artist with frontotemporal lobar degeneration and amyotrophic lateral sclerosis

Patients presenting with left-sided FTLD syndromes sometimes develop a new preoccupation with art, greater attention to visual stimuli, and increased visual creativity. We describe the case of a 53-year-old, right-handed man with a history of bipolar disorder who presented with language and behavior impairments characteristic of FTLD, then developed motor symptoms consistent with a second diagnosis of amyotrophic lateral sclerosis. Though the patient had never created visual art before, he developed a compulsion for painting beginning at the earliest stages of his disease, and continued producing art daily until he could no longer lift a paintbrush because of his motor deficits. Upon autopsy, he was found to have ubiquitin and TDP43-positive inclusions with MND pathology. This case study details the patient's longitudinal neuropsychological, emotional, behavioral, and motor symptoms, along with structural imaging, neurologic, and neuropathologic findings. Multiple examples of the patient's art are depicted throughout all stages of his illness, and the possible cognitive, behavioral, and neurologic correlates of his new-onset visual artistry are discussed.     

Clinical,Cognitive and Anatomical Evolution from Nonfluent Progressive Aphasia to Corticobasal Syndrome: A Case Report

Abstract

Recent clinical and pathological studies have suggested that frontotemporal lobar degeneration (FTLD) and corticobasal syndrome (CBS) show clinical and pathological overlap. We present four years of longitudinal clinical, cognitive and anatomical data in the case of a 56-year-old woman, AS, whose clinical picture evolved from FTLD to CBS. For the first three years, AS showed a progressive speech and language disorder compatible with a diagnosis of the nonfluent aphasia variant of FTLD. At year four, 10 years after her first symptom, AS developed the classical clinical signs of CBS, including alien limb phenomenon and dystonia. Voxel-based morphometry (VBM) applied to AS's four annual scans showed progression of atrophy from the inferior posterior frontal gyrus, to the left insula and finally to the medial frontal lobe. This case demonstrates the clinical overlap between FTLD and CBS and shows that the two can appear in the same patient at different stages of the disease in relation to the progression of anatomical damage.     

Variability in Stroop Task Performance and Functional Activation among a Small Brain-Injured Group

This study evaluated the effects of moderate to severe brain injury on cognitive task performance and cortical activation. Five participants completed a Stroop task while undergoing functional magnetic resonance imaging (fMRI) at two time points post-injury. Results revealed activation within regions typically activated during a Stroop task (the region of interest: ROI), though variability among participants was evident. Regions outside of the ROI were activated among all participants, to a greater degree than was present within the ROIs. This finding may indicate that recruitment of outside regions was necessary for successful task completion at both time points, and may suggest functional plasticity in cognitive task completion.     

Parental influence,pessimism and adolescent suicidality

Abstract

As part of a series of studies into the early detection of suicidal behaviour in adolescence, this study investigated relationships between adolescents' self-reports of perceived parental style, pessimism, and the spectrum of suicidal behaviour in a sample of Australian high school students (Mean age = 15.8). Three hundred and seven students completed a questionnaire that included demographic details. the Influential Relationships Questionnaire (IRQ), the Beck Hopelessness Scale, and the Adolescent Suicide Questionnaire. There was a high level of suicidal behaviour reported with suicidal adolescents perceiving their pants to be significantly more critical, less caring and more overprotective. Multiple regression analyses examining a proposed pathway from perceived parental style to suicidality through the mediation of hopelessness found that both parental style and hopelessness made unique contributions to a composite suicidality score. The quality of parenting is relevant to the assessment of adolescent suicidality and the KRQ may be useful for the detection of perceived parenting difficulties in suicide prevention programmes.