Is Living With Psychosis Demoralizing? Insight, Self-stigma, and Clinical Outcome Among People With Schizophrenia Across 1 Year

Lack of insight is a major target in the treatment of schizophrenia. However, insight may have undesirable effects on self-concept and motivation that can hinder recovery. This study aimed to examine the link between insight, self-stigma, and demoralization as predictors of symptoms and functioning. Insight, self-stigma, depressive and psychotic symptoms, and functioning were assessed among 133 outpatients with schizophrenia at baseline and 12 months later. The data were analyzed by hierarchical multiple linear regressions. More insight at baseline and an increase in self-stigma over 12 months predicted more demoralization at follow-up. Insight at baseline was not associated with any outcome variable, but self-stigma at baseline was related to poorer functioning and more positive symptoms at follow-up. More demoralization at baseline predicted poorer functioning 12 months later. Demoralization did not mediate the relationship between self-stigma at baseline and functioning after 1 year. Given the decisive role of self-stigma regarding recovery from schizophrenia, dysfunctional beliefs related to illness and the self should be addressed in treatment. Different psychotherapeutical approaches are discussed.

Driving and dementia: a clinical decision pathway

OBJECTIVE This study aimed to develop a pathway to bring together current UK legislation, good clinical practice and appropriate management strategies that could be applied across a range of healthcare settings. METHODS The pathway was constructed by a multidisciplinary clinical team based in a busy Memory Assessment Service. A process of successive iteration was used to develop the pathway, with input and refinement provided via survey and small group meetings with individuals from a wide range of regional clinical networks and diverse clinical backgrounds as well as discussion with mobility centres and Forum of Mobility Centres, UK. RESULTS We present a succinct clinical pathway for patients with dementia, which provides a decision-making framework for how health professionals across a range of disciplines deal with patients with dementia who drive. CONCLUSIONS By integrating the latest guidance from diverse roles within older people's health services and key experts in the field, the resulting pathway reflects up-to-date policy and encompasses differing perspectives and good practice. It is potentially a generalisable pathway that can be easily adaptable for use internationally, by replacing UK legislation for local regulations. A limitation of this pathway is that it does not address the concern of mild cognitive impairment and how this condition relates to driving safety. © 2014 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.

The impact of retrieval processes, age, general achievement level, and test scoring scheme for children's metacognitive monitoring and controlling

This multi-phase study examined the influence of retrieval processes on children’s metacognitive processes in relation to and in interaction with achievement level and age. First, N = 150 9/10- and 11/12-year old high and low achievers watched an educational film and predicted their test performance. Children then solved a cloze test regarding the film content including answerable and unanswerable items and gave confidence judgments to every answer. Finally, children withdrew answers that they believed to be incorrect. All children showed adequate metacognitive processes before and during test taking with 11/12- year-olds outperforming 9/10-year-olds when considering characteristics of on-going retrieval processes. As to the influence of achievement level, high compared to low achievers proved to be more accurate in their metacognitive monitoring and controlling. Results suggest that both cognitive resources (operationalized through achievement level) and mnemonic experience (assessed through age) fuel metacognitive development. Nevertheless, when facing higher demands regarding retrieval processes, experience seems to play the more important role.

Language lateralisation increases with age in very preterm born 7-12 year-olds but not in term born control children

Background: Neural structural abnormalities as well as cognitive difficulties in language processing have been described in children born very preterm (<32 weeks of gestational age and/or <1500 g birth weight). These findings raise the question how premature birth is related to neural language organisation and lateralisation. The aim of the study was to test the following hypotheses: a) VPT/VLBW and control children show different language organisation b) language organisation in VPT/VLBW children is more bilateral compared to language organisation in control children c) positive correlations between language performance measures and language lateralisation exist in VPT/VLBW children and controls. Method: Brain activity was measured during a phonologic detection task in 56 very preterm born children and 38 term born control children aged 7 to 12 years using functional Magnetic Resonance Imaging. General IQ, verbal IQ, verbal fluency and reading comprehension were assessed outside the scanner. Results: Language organisation and lateralisation did not differ in very preterm and control children in overall comparisons. However, in very preterm children lateralisation increased between the age of 7 to 12 years. This correlation was not found in control children. Language organisation in very preterm children was bilateral in young children and left-sided in old children, whereas language organisation in control children was left-sided in the young and old age group. Frontal lateralisation correlated with General IQ in controls, but no other correlations between lateralisation and verbal performance were found. Discussion: The results of this study suggest different developmental patterns of language processing in very preterm born and term born control children. While very preterm born children showed atypical language organisation and lateralisation in younger years, typical left-sided patterns were found at the age of 12 years.

The bivalency effect in task switching: General and enduring

The purpose of this study was to investigate the generality and temporal endurance of the bivalency effect in task switching. This effect refers to the slowing on univalent stimuli that occurs when bivalent stimuli appear occasionally. We used a paradigm involving predictable switches between 3 simple tasks, with bivalent stimuli occasionally occurring on one of the tasks. The generality of the bivalency effect was investigated by using different tasks and different types of bivalent stimuli, and the endurance of this effect was investigated across different intertrial intervals (ITIs) and across the univalent trials that followed trials with bivalent stimuli. In 3 experiments, the results showed a general, robust, and enduring bivalency effect for all ITI conditions. Although the effect declined across trials, it remained significant for about 4 trials following one with a bivalent stimulus. Our findings emphasise the importance of top–down processes in task-switching performance. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

"Beyond Freud and Jung": Sabina Spielrein's Contribution to Child Psychoanalysis and Developmental Psychology

Up to the present day, Sabina Spielrein has been seen as a means to deeper understanding of Freud and Jung and, in particular, the relationship between these two “great men”. This is also the reason why her scholarly achievements after her 1912 essay "Destruction as the Cause of Coming Into Being” are hardly taken into account. This study shows that Spielrein's main research work was in the areas of child analysis and developmental psychology—that is, beyond the work and the persons of Freud and Jung—and that she made numerous significant contributions to the field, so many of them ahead of her time.

Individual differences in working memory capacity explain the relationship between general discrimination ability and psychometric intelligence

The close association between psychometric intelligence and general discrimination ability (GDA), conceptualized as latent variable derived from performance on different sensory discrimination tasks, is empirically well-established but theoretically widely unclear. The present study contrasted two alternative explanations for this association. The first explanation is based on what Spearman (1904) referred to as a central function underlying this relationship in the sense of the g factor of intelligence and becoming most evident in GDA. In this case, correlations between different aspects of cognitive abilities, such as working memory (WM) capacity, and psychometric intelligence should be mediated by GDA if their correlation is caused by g. Alternatively, the second explanation for the relationship between psychometric intelligence and GDA proceeds from fMRI studies which emphasize the role of WM functioning for sensory discrimination. Given the well-known relationship between WM and psychometric intelligence, the relationship between GDA and psychometric intelligence might be attributed to WM. The present study investigated these two alternative explanations at the level of latent variables. In 197 young adults, a model in which WM mediated the relationship between GDA and psychometric intelligence described the data better than a model in which GDA mediated the relationship between WM and psychometric intelligence. Moreover, GDA failed to explain portions of variance of psychometric intelligence above and beyond WM. These findings clearly support the view that the association between psychometric intelligence and GDA must be understood in terms of WM functioning.

Altered Electrophysiology of Semantic Word Processing in Alzheimer's Disease and Semantic Dementia

With the progressing course of Alzheimer's disease (AD), deficits in declarative memory increasingly restrict the patients' daily activities. Besides the more apparent episodic (biographical) memory impairments, the semantic (factual) memory is also affected by this neurodegenerative disorder. The episodic pathology is well explored; instead the underlying neurophysiological mechanisms of the semantic deficits remain unclear. For a profound understanding of semantic memory processes in general and in AD patients, the present study compares AD patients with healthy controls and Semantic Dementia (SD) patients, a dementia subgroup that shows isolated semantic memory impairments. We investigate the semantic memory retrieval during the recording of an electroencephalogram, while subjects perform a semantic priming task. Precisely, the task demands lexical (word/nonword) decisions on sequentially presented word pairs, consisting of semantically related or unrelated prime-target combinations. Our analysis focuses on group-dependent differences in the amplitude and topography of the event related potentials (ERP) evoked by related vs. unrelated target words. AD patients are expected to differ from healthy controls in semantic retrieval functions. The semantic storage system itself, however, is thought to remain preserved in AD, while SD patients presumably suffer from the actual loss of semantic representations.

State of the art of integrated therapy approaches in the treatment of schizophrenia: empirical evidence and clinical relevance

Objective: Integrated behavior therapy approaches are defined by the combination of behavioral and or cognitive interventions targeting neurocognition combined with other goal-oriented treatment targets such as social cognition, social skills, or educational issues. The Integrated Psychological Therapy Program (IPT) represents one of the very first behavior therapy approaches combining interventions of neurocognition, social cognition, and social competence. This comprehensive group-based bottom-up and top-down approach consists of five subprograms, each with incremental steps. IPT has been successfully implemented in several countries in Europe, America, Australia and in Asia. IPT worked as a model for some other approaches designed in the USA. IPT was undergone two further developments: based on the social competence part of IPT, the three specific therapy programs focusing residential, occupational or recreational topics were developed. Recently, the cognitive part of INT was rigorously expanded into the Integrated Neurocognitive Therapy (INT) designed exclusively for outpatient treatment: INT includes interventions targeting all neurocognitive and social cognitive domains defined by the NIMH-MATRICS initiative. These group and partially PC-based exercises are structured into four therapy modules, each starting with exercises on neurocognitive domains followed by social cognitive targets. Efficacy: The evidence of integrated therapy approaches and its advantage compared to of one-track interventions was becoming a discussion tool in therapy research as well as in mental health systems. Results of meta-analyses support superiority of integrated approaches compared to one-track interventions in more distal outcome areas such as social functioning. These results are in line with the large body of 37 independent IPT studies in 12 countries. Moreover, IPT research indicates the maintenance of therapy effects after the end of therapy and some evidence generalization effects. Additionally, the international randomized multi-center study on INT with 169 outpatients strongly supports the successful therapy of integrated therapy in proximal and distal outcome such as significant effects in cognition, functioning and negative symptoms. Clinical implication: therapy research as well as expert’s clinical experience recommends integrated therapy approaches such as IPT to be successful agents within multimodal psychiatric treatment concepts. Finally, integrated group therapy based on cognitive remediation seems to motivate and stimulate schizophrenia inpatients and outpatients to more successful and independent life also demanded by the recovery movement.

Mindfulness-based cognitive therapie for depression (MBCT) in clinical practice - baseline patient characteristics, process and outcome

Introduction: Mindfulness based cognitive therapy for depression (MBCT) has shown to be effective for the reduction of depressive relapse. However, additional information regarding baseline patient characteristics and process features related to positive response could be helpful both for the provision of MBCT in clinical practice, as well as for its further development. Method: Baseline characteristics, process data, and immediate outcome (symptom change, change in attitudes and trait mindfulness) of 108 patients receiving MBCT in routine care were recorded. A newly developed self-report measure (Daily Mindfulness Scale, DMS) was applied daily during the MBCT program. Additionally, patients filed daily reports on their mindfulness practice. There was no control group available. Results: Patients with more severe initial symptoms indicated greater amounts of symptom improvement, but did not show great rates of dropout from the MBCT intervention. Younger age was related to higher rates of dropout. Contradictory to some previous data, patients with lower levels of initial trait mindfulness showed greater improvement in symptoms, even after controlling for initial levels of symptoms. Adherence to daily mindfulness practice was high. Consistent with this result, the duration of daily mindfulness practice was not related to immediate outcome. Process studies using multivariate time series analysis revealed a specific role of daily mindfulness in reducing subsequent negative mood. Conclusions: Within the range of patient present in this study and the given study design, results support the use of MBCT in more heterogeneous groups. This demanding intervention was well tolerated by patients with higher levels of symptoms, and resulted in significant improvements regarding residual symptoms. Process-outcome analyses of initial trait mindfulness and daily mindfulness both support the crucial role of changes in mindfulness for the effects of MBCT.

Impacts of a word-picture training on reading in youth with mixed intellectual disabilities. A waiting-list control group comparison

Individuals with intellectual disabilities (ID) often struggle with learning how to read. Reading difficulties seem to be the most common secondary condition of ID. Only one in five children with mild or moderate ID achieves even minimal literacy skills. However, literacy education for children and adolescents with ID has been largely overlooked by researchers and educators. While there is little research on reading of children with ID, many training studies have been conducted with other populations with reading difficulties. The most common approach of acquiring literacy skills consists of sophisticated programs that train phonological skills and auditory perception. Only few studies investigated the influence of implicit learning on literacy skills. Implicit learning processes seem to be largely independent of age and IQ. Children are sensitive to the statistics of their learning environment. By frequent word reading they acquire implicit knowledge about the frequency of single letters and letter patterns in written words. Additionally, semantic connections not only improve the word understanding, but also facilitate storage of words in memory. Advances in communication technology have introduced new possibilities for remediating literacy skills. Computers can provide training material in attractive ways, for example through animations and immediate feedback .These opportunities can scaffold and support attention processes central to learning. Thus, the aim of this intervention study was to develop and implement a computer based word-picture training, which is based on statistical and semantic learning, and to examine the training effects on reading, spelling and attention in children and adolescents (9-16 years) diagnosed with mental retardation (general IQ  74). Fifty children participated in four to five weekly training sessions of 15-20 minutes over 4 weeks, and completed assessments of attention, reading, spelling, short-term memory and fluid intelligence before and after training. After a first assessment (T1), the entire sample was divided in a training group (group A) and a waiting control group (group B). After 4 weeks of training with group A, a second assessment (T2) was administered with both training groups. Afterwards, group B was trained for 4 weeks, before a last assessment (T3) was carried out in both groups. Overall, the results showed that the word-picture training led to substantial gains on word decoding and attention for both training groups. These effects were preserved six weeks later (group A). There was also a clear tendency of improvement in spelling after training for both groups, although the effect did not reach significance. These findings highlight the fact that an implicit statistical learning training in a playful way by motivating computer programs can not only promote reading development, but also attention in children with intellectual disabilities.

Zionism and world politics : a study in history and social psychology

by Horace Meyer Kallen

Improving the dependability of research in personality and social psychology: Recommendations for research and educational practice

In this article, the Society for Personality and Social Psychology (SPSP) Task Force on Publication and Research Practices offers a brief statistical primer and recommendations for improving the dependability of research. Recommendations for research practice include (a) describing and addressing the choice of N (sample size) and consequent issues of statistical power, (b) reporting effect sizes and 95% confidence intervals (CIs), (c) avoiding “questionable research practices” that can inflate the probability of Type I error, (d) making available research materials necessary to replicate reported results, (e) adhering to SPSP’s data sharing policy, (f) encouraging publication of high-quality replication studies, and (g) maintaining flexibility and openness to alternative standards and methods. Recommendations for educational practice include (a) encouraging a culture of “getting it right,” (b) teaching and encouraging transparency of data reporting, (c) improving methodological instruction, and (d) modeling sound science and supporting junior researchers who seek to “get it right.”

Called and Burnout: Integrating career research with occupational health psychology

People are increasingly in search for meaning in their work and private life. They want to increase their self-awareness and reach personal fulfillment. People who are not able to cope with life‘s challenges often suffer from burnout, anxiety and depression. Consequently, the construct of calling becomes more and more important in the occupational context because of its positive consequences regarding numerous work (e.g. organizational commitment) and non-work-related outcomes (e.g. depression, life satisfaction) for individuals as well as for organizations. Building on first promising findings, the aim of the following chapter is to investigate the association of experiencing a calling in one‘s job and burnout (here defined as psychological phenomenon of prolonged exhaustion and disengagement at work, cf., Maslach, Schaufeli, & Leiter, 2001). Our findings suggest that experiencing one‘s work as a calling is negatively related to burnout. Especially with regard to the sub-dimension of disengagement, experiencing a calling turned out to be a protective factor. Further, the burnout sub-dimension of disengagement mediated the relationship between the experience of a calling and job satisfaction. Implications for further research and health-related preventive strategies are discussed.