Impact of persistent substance misuse on 1-year outcome in first-episode psychosis

Background: Substance misuse is a common comorbid problem in people presenting with first-episode psychosis and is associated with a poor short-term outcome.

Aims: The aim of this study is to examine differences in baseline characteristics and 1-year outcome between individuals with first-episode psychosis who have never misused substances, those who stop misusing substances after initial presentation and those who persistently misuse substances over the 1-year assessment period.

Method: Patients were recruited to the Northern Ireland First Episode Psychosis Study (n=272). Clinical assessments were performed at baseline and at 1 year (n=194) and data were collected from the case notes.

Results: Individuals with persistent substance misuse had more severe depression, more positive symptoms, poorer functional outcome and greater rates of relapse at 1 year than those who stopped and those who had never misused substances. There were no differences in outcome between people who had never misused substances and those who stopped misusing after presentation.

Conclusions: These results support assertive intervention targeted at comorbid substance misuse in individuals with first-episode psychosis.

Patterns of neurocognitive impairment in first-episode bipolar disorder and schizophrenia.

BACKGROUND:
Researching psychotic disorders in unison rather than as separate diagnostic groups is widely advocated, but the viability of such an approach requires careful consideration from a neurocognitive perspective.
AIMS:
To describe cognition in people with bipolar disorder and schizophrenia and to examine how known causes of variability in individual's performance contribute to any observed diagnostic differences.
METHOD:
Neurocognitive functioning in people with bipolar disorder (n = 32), schizophrenia (n = 46) and healthy controls (n = 67) was compared using analysis of covariance on data from the Northern Ireland First Episode Psychosis Study.
RESULTS:
The bipolar disorder and schizophrenia groups were most impaired on tests of memory, executive functioning and language. The bipolar group performed significantly better on tests of response inhibition, verbal fluency and callosal functioning. Between-group differences could be explained by the greater proclivity of individuals with schizophrenia to experience global cognitive impairment and negative symptoms.
CONCLUSIONS:
Particular impairments are common to people with psychosis and may prove useful as endophenotypic markers. Considering the degree of individuals' global cognitive impairment is critical when attempting to understand patterns of selective impairment both within and between these diagnostic groups.

Cue Competition Effects and Young Children's Causal and Counterfactual Inferences

The authors examined cue competition effects in young children using the blicket detector paradigm, in which objects are placed either singly or in pairs on a novel machine and children must judge which objects have the causal power to make the machine work. Cue competition effects were found in a 5- to 6-year-old group but not in a 4-year-old group. Equivalent levels of forward and backward blocking were found in the former group. Children's counterfactual judgments were subsequently examined by asking whether or not the machine would have gone off in the absence of I of 2 objects that had been placed on it as a pair. Cue competition effects were demonstrated only in 5- to 6-year-olds using this mode of assessing causal reasoning.

Temporal information and children's and adults' causal inferences

Three experiments examined whether children and adults would use temporal information as a cue to the causal structure of a three-variable system, and also whether their judgements about the effects of interventions on the system would be affected by the temporal properties of the event sequence. Participants were shown a system in which two events B and C occurred either simultaneously (synchronous condition) or in a temporal sequence (sequential condition) following an initial event A. The causal judgements of adults and 6-7-year-olds differed between the conditions, but this was not the case for 4-year-olds' judgements. However, unlike those of adults, 6-7-year-olds' intervention judgements were not affected by condition, and causal and intervention judgements were not reliably consistent in this age group. The findings support the claim that temporal information provides an important cue to causal structure, at least in older children. However, they raise important issues about the relationship between causal and intervention judgements.

Memory retrieval as temporal discrimination

Temporal distinctiveness models of memory retrieval claim that memories are organised partly in terms of their positions along a temporal dimension, and suggest that memory retrieval involves temporal discrimination. According to such models the retrievability of memories should be related to the discriminability of their temporal distances at the time of retrieval. This prediction is tested directly in three pairs of experiments that examine (a) memory retrieval and (b) identification of temporal durations that correspond to the temporal distances of the memories. Qualitative similarities between memory retrieval and temporal discrimination are found in probed serial recall (Experiments 1 and 2), immediate and delayed free recall (Experiments 3 and 4) and probed serial recall of grouped lists (Experiments 5 and 6). The results are interpreted as consistent with the suggestion that memory retrieval is indeed akin to temporal discrimination. (C) 2008 Elsevier Inc. All rights reserved.

Temporal Decentering and the Development of Temporal Concepts

This article reviews some recent research on the development of temporal cognition, with reference to Weist's (1989) account of the development of temporal understanding. Weist's distinction between two levels of temporal decentering is discussed, and empirical studies that may be interpreted as measuring temporal decentering are described. We argue that if temporal decentering is defined simply in terms of the coordination of the temporal locations of three events, it may fail to fully capture the properties of mature temporal understanding. Characterizing the development of mature temporal cognition may require, in addition, distinguishing between event-dependent and event-independent thought about time. Experimental evidence relevant to such a distinction is described; these findings suggest that there may be important changes between 3 and 5 years in children's ability to think about points in time independently of the events that occur at those times.

Searching and planning: Young children's reasoning about past and future event sequences

Six experiments examined children's ability to make inferences using temporal order information. Children completed versions of a task involving a toy zoo; one version required reasoning about past events (search task) and the other required reasoning about future events (planning task). Children younger than 5 years failed both the search and the planning tasks, whereas 5-year-olds passed both (Experiments 1 and 2). However, when the number of events in the sequence was reduced (Experiment 3), 4-year-olds were successful on the search task but not the planning task. Planning difficulties persisted even when relevant cues were provided (Experiments 4 and 5). Experiment 6 showed that improved performance on the search task found in Experiment 3 was not due to the removal of response ambiguity.

Young children's reasoning about the order of past events

Four studies are reported that employed an object location task to assess temporal-causal reasoning. In Experiments 1-3, successfully locating the object required a retrospective consideration of the order in which two events had occurred. In Experiment 1, 5- but not 4-year-olds were successful; 4-year-olds also failed to perform at above-chance levels in modified versions of the task in Experiments 2 and 3. However, in Experiment 4, 3-year-olds were successful when they were able to see the object being placed first in one location and then in the other, rather than having to consider retrospectively the sequence in which two events had happened. The results suggest that reasoning about the causal significance of the temporal order of events may not be fully developed before 5 years. (C) 2007 Elsevier Inc. All rights reserved.

Probed serial recall in Williams syndrome: Lexical influences on phonological short-term memory

Williams syndrome is a genetic disorder that, it has been claimed, results in an unusual pattern of linguistic strengths and weaknesses. The current study investigated the hypothesis that there is a reduced influence of lexical knowledge on phonological short-term memory in Williams syndrome. Fourteen children with Williams syndrome and 2 vocabulary la matched control groups, 20 typically developing children and 13 children with learning difficulties, were tested on 2 probed serial-recall tasks. On the basis of previous findings, it was predicted that children with Williams syndrome would demonstrate (a) a reduced effect of lexicality on the recall of list items, (b) relatively poorer recall of list items compared with recall of serial order, and (c) a reduced tendency to produce lexicalization errors in the recall of nonwords. in fact, none of these predictions were supported. Alternative explanations for previous findings and implications for accounts of language development in Williams syndrome are discussed.

A timing-specific memory distortion effect in young children

It has been suggested that there are systematic distortions in children's memory for temporal durations, such that children's memory is not just less accurate than that of adults but qualitatively different. Experiment I replicated the memory distortion effect by demonstrating developmental change in the tendency to confuse a reference duration with one that is shorter rather than longer than it. When the long-term memory demands of the task were reduced by providing reminders of the reference duration on every trial, there were no such qualitative changes in error patterns (Experiment 2). Further evidence for developmental changes in memory distortion was found in the temporal generalization task of Experiment 3, in which stimuli were spaced logarithmically rather than linearly. In Experiment 4, a similar distortion pattern was absent in a task in which children made judgments about the pitch rather than the duration of stimuli, suggesting the effect may be specific to time estimation. (C) 2003 Elsevier Inc. All rights reserved.

Temporal concepts and episodic memory: A response to Hoerl

Hoerl claims that episodic memory is necessary for a concept of the past, and that we should consider some severely amnesic patients as lacking such a concept. I question whether this description of such patients is plausible, and whether it helps us understand lack of insight in amnesia. I finish by arguing that Hoerl's analysis of what constitutes a concept of the past raises interesting developmental issues.

Uso del arte y de la creatividad en las terapias psicosociales. Estudio y valoración de resultados de la utilización de la fotografía con pacientes con un trastorno grave y crónico

This article will reveal the experiment and the subsequent investigation work carried out with patients having chronic and severe mental illness at the Creativity and Rehabilitation Workshop of the Mental Health Service at the Health Department no. 12 of the Hospital Francisco de Borja of Gandia, Spain. The course focuses on patient training in the use of photography and image as a means of expression and as a part of psychosocial therapies to improve patients’ quality of life in front of the society. In addition, it tries to enhance the analytic capacity of the patient not only with regards to the photography aesthetically, but also personally. There are many international scientific surveys backing up the knowledge and use of Artistic and Creative Therapy in chronic patients; however, these activities are seen as pioneering actions in Spain given the current health structure, which includes few national psychiatric centers developing them continuously and being temporally monitored. This experiment demonstrates that photography significantly improves the quality of life of chronic patients and motivates them socially to communicate themselves through art, just as it helps them using creativity as a tool for social action.

El diagnóstico de la crisis de la cultura en España: del recorte público a la crisis sistémica

Desde su invención en los años cincuenta, la política cultural ha sido objeto de análisis y reflexión por parte de las ciencias sociales. No obstante, en España presenta una serie de características diferenciadoras frente a las democracias occidentales europeas como consecuencia del periodo franquista. Con la recuperación de la democracia España adquiere el paradigma dominante de una política cultural democrática basada en la libertad, el pluralismo y el derecho a la cultura. Sin embargo, tras décadas de gobiernos democráticos el diagnóstico de la política cultural en España presenta rasgos de crisis sistémica, además de los efectos de la crisis global financiera de inicios del siglo XXI. En este contexto, los autores diagnostican, aplicando la metodología Delphi y recurriendo a fuentes secundarias, un conjunto de discursos sociales y narrativas que parecen funcionar como recursos cognitivos solucionistas en la esfera artística y cultural y que no están exentos de contradicciones y aporías, fruto de su contraste empírico.

Death Aesthetization in Contemporary Artistic Practices

Starting from the famous and enigmatic quotation of the Aristotle’s Poetics, who argues that the human has a natural desire and pleasure to see corpses if mediated by art, is intended to show the relationship between the attraction for the horror and some contemporary art practices surrounding the depiction of death, particularly with regard to the ultimate use of the human corpse as an artistic resource. Avoiding any kind of ethical approach or questioning of the limits of the artistic production, is meant to highlight the phenomenon through the examples brought out by the work of some contemporary artists such as Andy Warhol, Eric Fischl, Damien Hirst, Von Hagens, Andres Serrano, Joel-Peter Witkin and Teresa Margolles: From those who use the corpse in and turn it in something aesthetically pleasant, to others who turn human corpses in sculptures of scientific value, and further other kind of artists who assume the morbid and dramatic life of the corpse in their art production as something structural.