Are Inner Context Factors Related to Implementation Outcomes in Cognitive-Behavioral Therapy for Youth Anxiety?

Among the challenges facing the mental health field are the dissemination and implementation of evidence-based practices. The present study investigated the relationships between inner context variables (i.e., adopter characteristics and individual perceptions of intra-organizational factors) and two implementation outcomes—independently rated therapist fidelity on a performance-based role-play (i.e., adherence and skill) and self-reported penetration of cognitive behavioral therapy for youth anxiety following training. A significant relationship was found between inner context variables and fidelity. Specifically, adopter characteristics were associated with adherence and skill; individual perceptions of intra-organizational factors were associated with adherence. Inner context variables were not associated with penetration. Future directions are discussed.     

How do we process event‐based and time‐based intentions in the brain? an fMRI study of prospective memory in healthy individuals

Prospective memory (PM) refers to the ability to remember to do something in the future, either in response to an event (event‐based) or after a certain amount of time has elapsed (time‐based). While the distinction between event‐ and time‐based PM is widely acknowledged in the literature, little is known about the processes they share and those they do not. This is particularly true concerning their brain substrates, as almost all neuroimaging studies so far have focused on event‐based PM. We proposed a functional magnetic resonance imaging paradigm assessing both event‐based and time‐based PM to 20 healthy young individuals. Analyses revealed that event‐ and time‐based PM both induced activation in the posterior frontal and parietal cortices, and deactivation in the medial rostral prefrontal cortex. In addition, activation more specific to each condition, which may underlie differences in strategic monitoring, was highlighted. Thus, occipital areas were more activated during event‐based PM, probably reflecting target‐checking, while a network comprising the dorsolateral prefrontal cortex, the cuneus/precuneus and, to a lesser extent, the inferior parietal lobule, superior temporal gyrus, and the cerebellum, was more activated in time‐based PM, which may reflect the involvement of time‐estimation processes. These results confirm the allocation of attentional resources to the maintenance of intention for event‐based and time‐based PM, as well as the engagement of distinct mechanisms reflecting the monitoring strategies specific to each condition. Hum Brain Mapp 35:3066–3082, 2014. © 2013 Wiley Periodicals, Inc.     

Abnormal synchrony of resting state networks in premanifest and symptomatic Huntington disease: the IMAGE-HD study

Background

Functional neural impairments have been documented in people with symptomatic Huntington disease (symp-HD) and in premanifest gene carriers (pre-HD). This study aimed to characterize synchrony in resting state cerebral networks in both pre-HD and symp-HD populations and to determine its association with disease burden and neurocognitive functions.

Methods

We acquired functional magnetic resonance imaging (fMRI) data from pre-HD, symp-HD and healthy control participants. The fMRI data were analyzed using multisubject independent component analysis and dual regression. We compared networks of interest among the groups using a nonparametric permutation method and correcting for multiple comparisons.

Results

Our study included 25 people in the pre-HD, 23 in the symp-HD and 18 in the healthy control groups. Compared with the control group, the pre-HD group showed decreased synchrony in the sensorimotor and dorsal attention networks; decreased level of synchrony in the sensorimotor network was associated with poorer motor performance. Compared with the control group, the symp-HD group showed widespread reduction in synchrony in the dorsal attention network, which was associated with poorer cognitive performance. The posterior putamen and superior parietal cortex were functionally disconnected from the frontal executive network in the symp-HD compared with control and pre-HD groups. Furthermore, the left frontoparietal network showed areas of increased synchrony in the symp-HD compared with the pre-HD group.

Limitations

We could not directly correct for influence of autonomic changes (e.g., heart rate) and respiration on resting state synchronization.

Conclusion

Our findings suggest that aberrant synchrony in the sensorimotor and dorsal attention networks may serve as an early signature of neural change in pre-HD individuals. The altered synchrony in dorsal attention, frontoparietal and corticostriatal networks may contribute to the development of clinical symptoms in people with Huntington disease.     

Effects of Equine Assisted Activities on Autism Spectrum Disorder

Quality of life assessments were used in this study to determine the behavioral changes of children diagnosed with autism spectrum disorder (ASD) who participated in equine assisted activities. Behavioral changes of children with ASD participating in 9 weeks of equines assisted activities (EAA) (N = 10) were compared to behavioral changes of children who participated in a non-equine intervention (N = 8). Parents noted significant improvements in their child’s physical, emotional and social functioning following the first 6 weeks of EAA. The children participating in the non-equine program also demonstrated improvement in behavior, but to a lesser degree. The favorable outcome of this study lends support for continuation of programs utilizing EAA in the treatment of children with ASD.     

Shall we use non-verbal fluency in schizophrenia? – A pilot study

Over the last few years, numerous studies have attempted to explain fluency impairments in people with schizophrenia, leading to heterogeneous results. This could notably be due to the fact that fluency is often used in its verbal form where semantic dimensions are implied. In order to gain an in-depth understanding of fluency deficits, a non-verbal fluency task – the Five-Point Test (5PT) – was proposed to 24 patients with schizophrenia and to 24 healthy subjects categorized in terms of age, gender and schooling. The 5PT involves producing as many abstract figures as possible within 1 min by connecting points with straight lines. All subjects also completed the Frontal Assessment Battery (FAB) while those with schizophrenia were further assessed using the Positive and Negative Syndrome Scale (PANSS). Results show that the 5PT evaluation differentiates patients from healthy subjects with regard to the number of figures produced. Patients? results also suggest that the number of figures produced is linked to the “overall executive functioning” and to some inhibition components. Although this study is a first step in the non-verbal efficiency research field, we believe that experimental psychopathology could benefit from the investigations on non-verbal fluency.     

Brief Report: Diminishing Geographic Variability in Autism Spectrum Disorders Over Time?

We investigated differences in the geographic distribution of autism spectrum disorders (ASD) over time in central North Carolina with data from the Autism and Developmental Disabilities Monitoring Network. Using generalized additive models and geographic information systems we produced maps of ASD risk in 2002–2004 and 2006–2008. Overall the risk of ASD increased 52.9 % from 2002–2004 to 2006–2008. However, the magnitude of change in risk was not uniform across the study area; while some areas experienced dramatic increases in ASD risk (>400 %), others experienced slight decreases. Generally, areas with the lowest risk in 2002–2004 experienced the greatest increases over time. Education and outreach efforts in North Carolina expanded during this period, possibly contributing to the observed leveling of risk over time.     

Virtual Reality Job Interview Training in Adults with Autism Spectrum Disorder

The feasibility and efficacy of virtual reality job interview training (VR-JIT) was assessed in a single-blinded randomized controlled trial. Adults with autism spectrum disorder were randomized to VR-JIT (n = 16) or treatment-as-usual (TAU) (n = 10) groups. VR-JIT consisted of simulated job interviews with a virtual character and didactic training. Participants attended 90 % of laboratory-based training sessions, found VR-JIT easy to use and enjoyable, and they felt prepared for future interviews. VR-JIT participants had greater improvement during live standardized job interview role-play performances than TAU participants (p = 0.046). A similar pattern was observed for self-reported self-confidence at a trend level (p = 0.060). VR-JIT simulation performance scores increased over time (R ² = 0.83). Results indicate preliminary support for the feasibility and efficacy of VR-JIT, which can be administered using computer software or via the internet.     

Predicting One and Three Month Postoperative Somatic Concerns,Psychological Distress,and Maladaptive Eating Behaviors in Bariatric Surgery Candidates with the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF)

Background

Presurgical psychological screening of bariatric surgery candidates includes some form of standardized psychological assessment. However, associations between presurgical psychological screening and postoperative outcome have not been extensively studied. Here, we explore associations between presurgical Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) scores and early postoperative Somatic Concerns, Psychological Distress, and Maladaptive Eating Behaviors.

Methods

The sample consisted of male (n?=?238) and female (n?=?621) patients who were administered the MMPI-2-RF at their presurgical psychological evaluation and received bariatric surgery. Patients were evaluated at their 1- and 3-month postoperative appointments.

Results

Confirmatory factor analysis indicated that three latent constructs—somatic concerns, psychological distress, and maladaptive eating behaviors—were represented by responses to a postoperative assessment and that these constructs could be measured consistently over time. Presurgical scores on MMPI-2-RF scales measuring internalizing dysfunction were associated with more psychological distress at postoperative follow-ups, scores on scales measuring somatization were associated with more postoperative somatic concerns, and scores on scales assessing emotional/internalizing, behavioral/externalizing, cognitive complaints, and thought dysfunction prior to surgery were associated with maladaptive eating behaviors after surgery.

Conclusions

In conjunction with a presurgical psychological interview, the MMPI-2-RF provides information that can assist in anticipating postoperative outcomes and inform efforts to prevent them.