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Computerized tests benefit from automated scoring procedures and standardized administration instructions. These methods can reduce the potential for rater error. However, especially in patients with severe mental illnesses, the equivalency of traditional and tablet-based tests cannot be assumed. The Brief Assessment of Cognition in Schizophrenia (BACS) is a pen-and-paper cognitive assessment tool that has been used in hundreds of research studies and clinical trials, and has normative data available for generating age- and gender-corrected standardized scores. A tablet-based version of the BACS called the BAC App has been developed. This study compared performance on the BACS and the BAC App in patients with schizophrenia and healthy controls. Test equivalency was assessed, and the applicability of paper-based normative data was evaluated. Results demonstrated the distributions of standardized composite scores for the tablet-based BAC App and the pen-and-paper BACS were indistinguishable, and the between-methods mean differences were not statistically significant. The discrimination between patients and controls was similarly robust. The between-methods correlations for individual measures in patients were r>0.70 for most subtests. When data from the Token Motor Test was omitted, the between-methods correlation of composite scores was r=0.88 (df=48; p<0.001) in healthy controls and r=0.89 (df=46; p<0.001) in patients, consistent with the test-retest reliability of each measure. Taken together, results indicate that the tablet-based BAC App generates results consistent with the traditional pen-and-paper BACS, and support the notion that the BAC App is appropriate for use in clinical trials and clinical practice. [ABSTRACT FROM AUTHOR]

Study Objective: To examine the impact of visual stimulation (exciting red and tranquilizing green) on the score of the Numerical Rating Scale (NRS) questionnaire in patients with chronic pain.Design: Prospective randomized study.Setting: Outpatient pain clinic of a university hospital.Patients: Two hundred outpatients with chronic pain.Interventions: Patients were randomly assigned to receive the NRS questionnaire printed on either red paper (red group) or green paper (green group).Measurements: The questionnaire included 5 questions consisting of the NRS in the worst, in the least, and in the average pain during last week and the NRS at rest and on movement at present. Calculation of the sample size was based on power of 0.8 and α=.01.Main Results: The NRS scores were not different between the 2 groups. In patients on antidepressants (n=76) and with depression (n=49), the NRS scores, except the NRS in the worst pain during last week score in patients on antidepressants, were significantly higher in the red group than in the green group (all P≤.040). In the red group, the NRS scores were significantly higher in patients with than without depression (all P≤.003), whereas there was no difference in the scores between patients of the green group with and without depression.Conclusion: Our findings suggest that visual/emotional stimuli and treatment with antidepressants alter the NRS score in patients with chronic pain. [ABSTRACT FROM AUTHOR]

Background and Aim: Factors promoting family adaptation to child's disability are poorly studied together. The aim of the study was to describe the family adaptation to disability and to identify determinants associated with using a global theoretical model.Materials and Methods: 286 families of teenagers [13-17 years] with cerebral palsy (CP) from 4 European disability registers were included and visited at home. Face to face interviews were performed in order to measure parental distress, perceived impact in various dimensions of family life, family resources and stressors. Relationships were modelled with structural equations.Results: 31.8% of parents living with an adolescent with CP showed clinically significant high stress requiring professional assistance. The main stressors were the level of motor impairment and behavioural disorders in adolescent. A good family functioning was the best protective factor. Respite in care and a parents' positive attitude were significantly related to less parental distress. Material support, socioeconomical level, marital status or parental qualifications did not appear to be significant protector factors.Conclusions: Particular attention must be paid not only on physical condition but also on adolescent psychological problems to improve family adaptation. Families at risk of experiencing severe distress should be targeted early and proactive caregiver interventions on the whole family should be performed.What This Paper Adds: Family is a dynamic system: facing disability, it tries to recover its balance with available resources and its perception of the situation. Literature highlights potential stressors and protecting factors that could affect the disabled child's family adaptation but few papers study a global model including most of these factors. This study validated a global theoretical model of family adaptation to disability at adolescence. It identified behaviour disorders and motor impairment level as main stressors, family functioning as the largest protecting factors, and equipment and financial support as non significant protective factors. [ABSTRACT FROM AUTHOR]

The fundamental goal of perception is to aid in the achievement of behavioral objectives. This requires extracting and communicating useful information from noisy and uncertain sensory signals. At the same time, given the complexity of sensory information and the limitations of biological information processing, it is necessary that some information must be lost or discarded in the act of perception. Under these circumstances, what constitutes an 'optimal' perceptual system? This paper describes the mathematical framework of rate-distortion theory as the optimal solution to the problem of minimizing the costs of perceptual error subject to strong constraints on the ability to communicate or transmit information. Rate-distortion theory offers a general and principled theoretical framework for developing computational-level models of human perception (Marr, 1982). Models developed in this framework are capable of producing quantitatively precise explanations for human perceptual performance, while yielding new insights regarding the nature and goals of perception. This paper demonstrates the application of rate-distortion theory to two benchmark domains where capacity limits are especially salient in human perception: discrete categorization of stimuli (also known as absolute identification) and visual working memory. A software package written for the R statistical programming language is described that aids in the development of models based on rate-distortion theory. [ABSTRACT FROM AUTHOR]

Background: Mood regulation is a complex and poorly understood process. In this study, we aimed to analyze the underlying dynamics of mood regulation in unaffected first degree relatives of patients diagnosed with bipolar disorder using time-series analysis.Methods: We recruited 30 unaffected first-degree relatives of bipolar disorder patients. Participants rated their mood, anxiety and energy levels using a paper-based visual analog scale; they recorded their sleep and life events as well. Participants provided information on these variables over a three month period, twice per day. We compared their data using Box-Jenkins time series analysis with data from 30 healthy controls (HC) and 30 euthymic bipolar patients (BD) to obtain information on the autocorrelation and cross-correlation of the series, and calculated entropy for mood, anxiety and energy series.Results: We analyzed 14,980 data points: 5200 in the healthy control group; 4970 in the bipolar group and 4810 in the unaffected relatives group. There were no significant differences between groups in terms of age, sex or education levels. Using Kolmogorov-Smirnov test, we found that individual measures were normally distributed in the whole sample (D = 0.23, p > 0.1). Autocorrelation functions for mood in all groups are governed by the ARIMA (1,1,0) model, which means that current values in the series are related to one previous point only. In terms of entropy for the mood series, unaffected relatives and bipolar patients showed lower values [mean (SD) : 1.028 ± 0.679; 1.042 ± 0.680], respectively, compared to healthy controls [(1.476 ± 0.33); F (2,74) = 4.39, p < 0.01]. The same case was seen in the energy series, with lower values in the unaffected relatives and bipolar patient groups [mean (SD) : 1.644 ± 0.566; 1.511 ± 0.879], respectively, compared to healthy controls [2.230 ± 0.531; F(2, 75) = 7.89, p < 0.001].Limitations: Low resolution for the visual analog scale.Conclusions: Using nonlinear analyses, we found that the underlying structure of mood regulation in unaffected relatives is undistinguishable from the one found in bipolar patients. Compared to healthy controls, both bipolar patients and their unaffected relatives showed lower entropy levels, which is in keeping with a more rigid system, not as flexible to cope with the demands of a changing environment. [ABSTRACT FROM AUTHOR]

Background: The established relationship between vision impairment and depression is limited by the examination of depression only as a unidimensional construct. The present study explores the vision-depression relationship using a dimensional approach.Methods: 9036 participants aged 65 years and above enrolled in the Three-City study were included. Relationships between baseline near Vision Impairment (VI) or self-reported distance Visual Function (VF) loss with trajectory of four dimensions of depression - depressed affect, positive affect, somatic symptoms and interpersonal problems - over 12 years were examined using mixed-effects models. Depression dimensions were determined using the four-factor structure of the Centre for Epidemiology Studies-Depression Scale (CESD).Results: In the fully adjustment models, mild near VI predicted poorer depressed affect (b = 0.04, p = .002) and positive affect (b = -0.06, p < 0.001) over time, with evidence of longer term adjustment. Distance VF loss was associated with poorer depressed affect (b = 0.27, p ≤ .001), positive affect (b = -0.15, p = .002), and somatic symptoms (b = 0.18, p ≤ .001) at baseline, although only the association with depressed affect was significant longitudinally (b = 0.01, p = .001). Neither near VI nor distance VF loss was associated with interpersonal problems.Limitations: This paper uses a well-supported model of depression dimensions, however, there remains no definite depression dimension model. Distance VF loss was self-reported, which can be influenced by depression symptoms.Conclusions: Vision impairment in older adults is primarily associated with affective dimensions of depression. A reduction in social connectedness and ability to engage in pleasurable activities may underlie the depression-vision relationship. Older adults with vision impairment may benefit from targeted treatment of affective symptoms, and pleasant event scheduling. [ABSTRACT FROM AUTHOR]

This paper makes the case that a perspective called “Gradualism” could serve as a foundation for building a therapeutic continuum between the harm reduction and abstinence-oriented treatment worlds. In contrast to other integrationist writers (Denning, 2001; Marlatt, Blume, & Parks, 2001), this paper argues for the incorporation of abstinence into harm reduction approaches. The goal is to build on the strengths of both perspectives while reducing their weaknesses, and examples of each are provided. Lastly, with the frequent occurrence of relapse among addicted patients, building a continuum could also serve to provide a therapeutic “safety net” for those in need. [Copyright &y& Elsevier]

Cognitive impairment is a primary feature of schizophrenia, with alterations in several cognitive domains appearing in the pre-morbid phase of the disorder. White matter microstructure is also affected in schizophrenia and considered to be related to cognition, but the relationship of the two is unclear. As interaction between cognition and white matter structure involves the interplay of several brain structures and cognitive abilities, investigative methods which can examine the interaction of multiple variables are preferred. A multiple-groups structural equation model (SEM) was used to assess the relationship between diffusion tension imaging data (fractional anisotropy of selected white matter tracts) and cognitive abilities of 196 subjects - 135 healthy subjects and 61 patients with schizophrenia. It was found that multiple-indicators, multiple-causes model best fitted the data analysed. Schizophrenia moderated the relation of white matter function on cognition with a large effect size. This paper extends previous work on modelling intelligence within a SEM framework by incorporating neurological elements into the model, and shows that white matter microstructure in patients with schizophrenia interacts with cognitive abilities. [ABSTRACT FROM AUTHOR]

Background: This paper combines evidence from an ethnographic study of illicit drug use amongst tourists in Ibiza with Bryman's (2004) theoretical model of Disneyization. The principal aim was to construct a new conceptual framework that may help scholars, practitioners and policy makers make sense of dynamic patterns of illegal drug use across bounded play spaces such as tourist resorts, music festivals and nightclubs.Methods: Ethnographic fieldwork employing a grounded theory design was undertaken over three summers in tourist locations on the Balearic island of Ibiza, including nightclubs, bars, cafes, beaches, airports and hotels. Field notes from participant observation were supplemented with data from semi-structured interviews (n = 56) and secondary sources gathered from tourist marketing.Results: The framework of Disneyization has been discussed in terms of 5 constructs: theming, hybrid consumption, branding, performative labour and atmospheres; each having a specific role in relation to understanding illicit drug use in bounded play spaces. Thus: Theming sets the stage, by physically and symbolically demarcating space with indelible themes of hedonism that open up the possibility of illicit drug use. Hybrid-consumption blurs the distinction between legal and illegal forms of intoxication, making the trading and consumption of illegal drugs appear like a natural feature of the consumer space. Branding demonstrates how participants construct intricate hierarchies of taste and credibility related to drug of choice. Performative labour re-enforces hybrid consumption, with participants working in the bounded play spaces of Ibiza immersed within the illicit drug market. Atmospheres represents the alchemic synergy of bounded play space and is important to understanding illicit drug use as a sensorial, deeply immersive but transitory experience.Conclusion: This research offers Disneyization as a new conceptual framework for making sense of deeply complex spatial, socio-cultural, psychological and economic processes that underpin dynamic patterns of drug use in bounded play spaces. [ABSTRACT FROM AUTHOR]

Objective: Social inclusion and vocational activity are central to personal recovery for young people with psychosis. Studies with people experiencing long term psychosis suggest negative self-beliefs are important, but less is known about whether this association is present for young service users or about the potential influence of positive self-beliefs such as hopefulness. The aim of the current paper was to investigate the direct and indirect associations between dysfunctional attitudes, self-stigma, hopefulness, social inclusion and vocational activity for young people with psychosis.Method: A 5-month longitudinal study was conducted with young psychosis service users. Measures of dysfunctional attitudes and self-stigma and vocational activity were obtained at baseline. Measures of hopefulness, social inclusion and vocational activity were obtained at follow-up.Results: Hopefulness mediates the associations between self-stigma, social inclusion and vocational activity. Self-stigma may have a greater influence on social inclusion with age. Dysfunctional attitudes do not significantly predict social inclusion or change in vocational activity status.Conclusion: Findings suggest that the impact of self-stigma may extend beyond social and occupational withdrawal and undermine subjective community belonging. Findings encourage an increased emphasis on facilitating hopefulness for young people who experience psychosis. [ABSTRACT FROM AUTHOR]

This paper reports on inter-disciplinary research designed to investigate the stress-buffering effects of green exercise, and the importance of the context in which exercise takes place. This investigation of context effects examines both individual physiological responses (salivary cortisol) and the phenomenological interpretation of lived experiences of the intervention, reported by a subsample of participants in a randomized, controlled trial, in which healthy, physically inactive university students were randomly allocated to three activities: walking on a treadmill in a gym, walking in semi-natural recreational area, and sitting and watching nature-based videos on TV. The study found clear indications of context effects, notably in the connections between positive appraisals of perceived circumstances, enjoyment in the enacted context, and physiological stress-reduction. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To observe the effect of a rehabilitation intervention on the comprehensive health status of patients with hand burns.Background: Most studies of hand-burn patients have focused on functional recovery. There have been no studies involving a biological-psychological-social rehabilitation model of hand-burn patients.Design: A randomized controlled design was used.Methods: Patients with hand burns were recruited to the study, and sixty patients participated. Participants were separated into two groups: (1) The rehabilitation intervention model group (n=30) completed the rehabilitation intervention model, which included the following measures: enhanced social support, intensive health education, comprehensive psychological intervention, and graded exercise. (2) The control group (n=30) completed routine treatment. Intervention lasted 5 weeks. Analysis of variance (ANOVA) and Student's t test were conducted.Results: The rehabilitation intervention group had significantly better scores than the control group for comprehensive health, physical function, psychological function, social function, and general health. The differences between the index scores of the two groups were statistically significant.Conclusions: The rehabilitation intervention improved the comprehensive health status of patients with hand burns and has favorable clinical application.Relevance To Clinical Practice: The comprehensive rehabilitation intervention model used here provides scientific guidance for medical staff aiming to improve the integrated health status of hand-burn patients and accelerate their recovery. What does this paper contribute to the wider global clinical community? [ABSTRACT FROM AUTHOR]

Background: Levodopa/carbidopa intestinal gel therapy (LCIG) can efficiently improve several motor and non-motor symptoms of advanced Parkinson's disease (PD). The recently developed Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) improved the original UPDRS making it a more robust tool to evaluate therapeutic changes. However, previous studies have not used the MDS-UPDRS and the Unified Dyskinesia Rating Scale (UDysRS) to assess the efficacy of LCIG.Objectives: Our aim was to determine if the MDS-UPDRS and UDysRS could detect improvement in the experiences of daily living following 1-year LCIG treatment.Methods: In this prospective, multicenter, open-label study, 34 consecutive patients undergoing LCIG treatment were enrolled. Patients were examined twice: prior to LCIG initiation and 12 months later. Impact of PD-related symptoms and dyskinesia was assessed by the MDS-UPDRS and UDysRS.Results: Non-motor Experiences of Daily Living part of MDS-UPDRS improved from 20 (median, interquartile-range, IQR:14-23) to 16 points (median, IQR:12-20, p = 0.044) and the Motor Experiences of Daily Living ameliorated from 24 (median, IQR:20-29) to 18 points (median, IQR:13-25, p = 0.025). Health-related quality of life, measured by PDQ-39, also improved from 35.4 (median, IQR:26.9-50.3) to 27.0 (median, IQR:21.3-31.4) points (p = 0.003). The total score of UDysRS decreased from 47 (median, IQR:36-54) to 34 (median, IQR:21-45) points (p = 0.003).Conclusions: As far as the authors are aware of, our paper is the first to evaluate the impact of LCIG on dyskinesia by the means of UDysRS. Changes in MDS-UPDRS and UDysRS confirm that LCIG treatment can efficiently improve experiences of daily living in advanced PD. [ABSTRACT FROM AUTHOR]

Introduction: Physical injury is a leading cause of death and disability among children worldwide and the largest cause of paediatric hospital admission. Parents of critically injured children are at increased risk of developing mental and emotional distress in the aftermath of child injury. In the Australian context, there is limited evidence on parent experiences of child injury and hospitalisation, and minimal understanding of their support needs. The aim of this investigation was to explore parents' experiences of having a critically injured child during the acute hospitalisation phase of injury, and to determine their support needs during this time.Methods: This multi-centre study forms part of a larger longitudinal mixed methods study investigating the experiences, unmet needs and well-being of parents of critically injured children over the two-year period following injury. This paper describes parents' experiences of having a child 0-13 years hospitalised with critical injury in one of four Australian paediatric hospitals. Semi-structured interviews were conducted with forty parents and transcribed verbatim. The data were managed using NVIVO 10 software and thematically analysed.Findings: Forty parents (26 mothers and 14 fathers) of 30 children (14 girls and 16 boys aged 1-13 years) from three Australian States participated. The majority of children were Australian born. Three main themes with sub-themes were identified: navigating the crisis of child injury; coming to terms with the complexity of child injury; and finding ways to meet the family's needs.Conclusions: There is a need for targeted psychological care provision for parents of critically injured children in the acute hospital phase, including psychological first aid and addressing parental blame attribution. Parents and children would benefit from the implementation of anticipatory guidance frameworks informed by a family-centred social ecological approach to prepare them for the trauma journey and for discharge. This approach could inform care delivery throughout the child injury recovery trajectory. The development and implementation of a major trauma family support coordinator in paediatric trauma centres would make a tangible difference to the care of critically injured children and their families. [ABSTRACT FROM AUTHOR]

Background: Research has shown that people often need assistance from an established person who injects drugs (PWID) in order to initiate their own injection drug use. Yet, there is scant research on the injection initiation process from the perspective of established PWID who assists with initiation. In this paper, we examine the injection initiation process from the perspective of established PWID.Methods: From 2011 to 2013, we conducted qualitative life history interviews with 113 PWID in San Francisco and Los Angeles, California. Qualitative data were coded using an inductive analysis approach. Emergent themes are presented in a series of emblematic case studies that elucidate the injection initiation process from the point of view of the PWID who help people with their first injection.Results: Most participants (70%) said that they had never initiated another person into drug injection, citing negative health and social consequences of drug injection as their primary reasons. Among those PWID who had ever facilitated initiation (30%), most expressed moral ambivalence about the behaviour. Using case studies, we show how PWID engage in a complicated calculation that weighs the pros and cons of assisting someone with their first injection. Concerns about long term harms associated with injection drug use sometimes give way to short-term altruistic concerns related to self-initiation or instrumental needs on the part of the established PWID.Conclusions: Objections to facilitating initiation of injection naïve persons appear to be common among established PWID but are sometimes overridden by a need to reduce harms that can be associated with self-initiation and one's structural vulnerability. For established PWID, helping to initiate another person becomes a complex moral question with nuanced motivations. While further substantiation of this observation will require more research, it is worth considering how existing disinclination to initiating injection naïve persons can be integrated into new or existing approaches to preventing injection initiation. [ABSTRACT FROM AUTHOR]

Background: Hot flushes and night sweats (HFNS) - the main symptoms of the menopause transition - can reduce quality of life and are particularly difficult to manage at work. A cognitive behaviour therapy (CBT) intervention has been developed specifically for HFNS that is theoretically based and shown to reduce significantly the impact of HFNS in several randomised controlled trials (RCTs). Self-help CBT has been found to be as effective as group CBT for these symptoms, but these interventions are not widely available in the workplace. This paper describes the protocol of an RCT aiming to assess the efficacy of CBT for menopausal symptoms implemented in the workplace, with a nested qualitative study to examine acceptability and feasibility.Methods/design: One hundred menopausal working women, aged 45-60 years, experiencing bothersome HFNS for two months will be recruited from several (2-10) large organisations into a multicentre randomised controlled trial. Women will be randomly assigned to either treatment (a self-help CBT intervention lasting 4 weeks) or to a no treatment-wait control condition (NTWC), following a screening interview, consent, and completion of a baseline questionnaire. All participants will complete follow-up questionnaires at 6 weeks and 20 weeks post-randomisation. The primary outcome is the rating of HFNS; secondary measures include HFNS frequency, mood, quality of life, attitudes to menopause, HFNS beliefs and behaviours, work absence and presenteeism, job satisfaction, job stress, job performance, disclosure to managers and turnover intention. Adherence, acceptability and feasibility will be assessed at 20 weeks post-randomisation in questionnaires and qualitative interviews. Upon trial completion, the control group will also be offered the intervention.Discussion: This is the first randomised controlled trial of a self-management intervention tailored for working women who have troublesome menopausal symptoms.Trial Registration: Clin.Gov NCT02623374. [ABSTRACT FROM AUTHOR]

Objective: The main aim of this paper is to investigate the prediction that greater subjective identification with relevant groups and social categories (i.e. 'family' and 'transplantees') can be an outcome of post-traumatic growth (PTG). To date there are no studies that have explored these relationships.Methods: A longitudinal study was conducted with a group of 100 liver transplant patients from the outpatient populations of the participating centre. Data were collected by means of a self-report questionnaire, which was completed at two different time points (T1 and T2) that were 24months apart. PTG was assessed using the Post-Traumatic Growth Inventory, while both transplantee and family identification were assessed using group identification scales. A path model was tested, using a structural equation model (SEM) approach, to examine the reciprocal effects among family identification, transplantee identification, and PTG over time.Results: As predicted, we found that greater PTG T1 predicted both greater family identification T2 and marginally greater transplantee identification T2. However, the two identification variables did not predict PTG over time.Conclusions: The results show that family identification and transplantee identification may be outcomes of the PTG process, confirming the importance of adopting a thriving multidimensional model of adjustment to medical illness, whereby people facing adverse life events, such as transplantation, may flourish rather than deteriorate psychologically. [ABSTRACT FROM AUTHOR]

Unlabelled: Asian countries are currently witnessing unprecedented increase in physical inactivity and subsequent negative health outcomes; however, few cross-country studies documenting this trend exist. This paper presents the findings of a nationally representative sample, based on the East Asian Social Survey in 2011. The study sought to examine the association of social identity factors, such as objective socio-economic position, perceived social status and neighborhood quality with physical inactivity, while controlling for psychosocial and physical health. A sample of 5222 adults living in urban areas across China, Taiwan, and South Korea were surveyed.Methods: Multivariate nested logistic regressions were constructed.Results: Perceived social status was positively associated with physical activity. Gender difference in physical activity was significant, and this difference widened as educational levels increased. Class division in physical activity was also found. Perceived physical and social features of neighborhood such as suitability for walking and jogging, air quality, and help from neighbors were to different degrees associated with physical inactivity.Conclusion: Gender, marital status, education and perceived social status were common factors associated with physical inactivity in East Asian countries. Perceived urban neighborhood quality is particularly important for Chinese people to stay physically active. Cultural-behavioral norms for physical activity associated with gender and social status call for more studies on cultural perspective for health behaviors in cross-cultural contexts. [ABSTRACT FROM AUTHOR]

The Afghanistan conflict has resulted in a large number of service personnel sustaining amputations. Whilst obvious differences exist between military and civilian trauma-related amputations both settings result in life changing injuries. Comparisons offer the potential of advancement and protection of the knowledge gained during the last 12 years. This paper compares the military and civilian trauma-related amputee cohorts' demographics, management and rehabilitation outcomes measures. The UK military Joint Theatre Trauma Registry and a civilian major trauma centre database of trauma-related amputees were analysed. 255 military and 24 civilian amputees were identified. A significant difference (p>0.05) was seen in median age (24, range 18-43, vs. 48, range 24-87 years), mean number of amputations per casualty (1.6±SD 0.678 vs. 1±SD 0.0), mean ISS (22±SD 12.8 vs. 14.7±SD 15.7) and gender (99% males vs. 78%). Rehabilitation outcome measures recorded included the Special Interest Group in Amputee Medicine score where the military group demonstrated significantly better scores (91% Grade E+ compared to 19%). Differences in patients underlying physiology and psychology, the military trauma system and a huge sustained investment in rehabilitation are all contributing factors for these differing outcomes. However the authors also believe that the use of a consultant-led MDT and central rehabilitation have benefited the military cohort in the acute rehabilitation stage and is reflected in the good short-term outcomes. [ABSTRACT FROM AUTHOR]

The influence of statistical information on behavior (either through learning or adaptation) is quickly becoming foundational to many domains of cognitive psychology and cognitive neuroscience, from language comprehension to visual development. We investigate a central problem impacting these diverse fields: when encountering input with rich statistical information, are there any constraints on learning? This paper examines learning outcomes when adult learners are given statistical information across multiple levels of abstraction simultaneously: from abstract, semantic categories of everyday objects to individual viewpoints on these objects. After revealing statistical learning of abstract, semantic categories with scrambled individual exemplars (Exp. 1), participants viewed pictures where the categories as well as the individual objects predicted picture order (e.g., bird1-dog1, bird2-dog2). Our findings suggest that participants preferentially encode the relationships between the individual objects, even in the presence of statistical regularities linking semantic categories (Exps. 2 and 3). In a final experiment we investigate whether learners are biased towards learning object-level regularities or simply construct the most detailed model given the data (and therefore best able to predict the specifics of the upcoming stimulus) by investigating whether participants preferentially learn from the statistical regularities linking individual snapshots of objects or the relationship between the objects themselves (e.g., bird_picture1-dog_picture1, bird_picture2-dog_picture2). We find that participants fail to learn the relationships between individual snapshots, suggesting a bias towards object-level statistical regularities as opposed to merely constructing the most complete model of the input. This work moves beyond the previous existence proofs that statistical learning is possible at both very high and very low levels of abstraction (categories vs. individual objects) and suggests that, at least with the current categories and type of learner, there are biases to pick up on statistical regularities between individual objects even when robust statistical information is present at other levels of abstraction. These findings speak directly to emerging theories about how systems supporting statistical learning and prediction operate in our structure-rich environments. Moreover, the theoretical implications of the current work across multiple domains of study is already clear: statistical learning cannot be assumed to be unconstrained even if statistical learning has previously been established at a given level of abstraction when that information is presented in isolation. [ABSTRACT FROM AUTHOR]

Helmet safety benefits are reduced if the headgear is poorly fitted on the wearer's head. At present, there are no industry standards available to assess objectively how a specific protective helmet fits a particular person. A proper fit is typically defined as a small and uniform distance between the helmet liner and the wearer's head shape, with a broad coverage of the head area. This paper presents a novel method to investigate and compare fitting accuracy of helmets based on 3D anthropometry, reverse engineering techniques and computational analysis. The Helmet Fit Index (HFI) that provides a fit score on a scale from 0 (excessively poor fit) to 100 (perfect fit) was compared with subjective fit assessments of surveyed cyclists. Results in this study showed that quantitative (HFI) and qualitative (participants' feelings) data were related when comparing three commercially available bicycle helmets. Findings also demonstrated that females and Asian people have lower fit scores than males and Caucasians, respectively. The HFI could provide detailed understanding of helmet efficiency regarding fit and could be used during helmet design and development phases. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this paper is to study transitions between two states of gambling in adulthood (problem gambling and non-problem gambling) and to identify factors that might influence these transitions.Methods: Data for this 2-year long longitudinal study were collected in a French Outpatient Addiction Treatment Center, in gambling establishments and through the press. Both problem gamblers and non-problem gamblers were evaluated using a structured interview and self-report questionnaires. The statistical analysis was carried out using a Markovian approach.Results: The analyzed cohort consisted of 304 gamblers with 519 observed transitions. Participants with no past-year gambling problems (based on the DSM-IV) had a probability of about 90% of also having no past-year gambling problems at the following assessment, whereas the observed percentage of problem gamblers transitioning to non-problem gambling was of 48%. We reported (i) vulnerability factors of transitioning to problem gambling (such as an anxiety disorder or an Attention Deficit Hyperactivity Disorder (ADHD) during the childhood), (ii) protective factors for non-problem gamblers, (iii) recovery factors (such as ongoing treatment and younger age) and (iv) persistence factors of a gambling problem (such as a persistent ADHD).Conclusions: The status of problem gambler is unstable over time, whereas we found stability among non-problem gamblers. Our findings suggest the existence of vulnerability and protective factors in gambling. These results lead to think about preventive actions and adaptive care, such as cognitive-behavioral therapy or researching gambling problems in people with an anxiety disorder or ADHD. [ABSTRACT FROM AUTHOR]

Background: The outcomes of psychological therapies for anxiety and depression vary across individuals and symptom domains. Being able to predict treatment response from readily available patient data at presentation has potentially important benefits in aiding decisions about the most suitable interventions for a patient. This paper presents a method of identifying subgroups of patients using latent profile analysis, and comparing response to psychological treatments between these profiles.Methods: All outpatients taken into treatment at two psychological treatment services in London, UK and who provided basic demographic information and standardized symptom measures were included in the analysis (n=16636).Results: Latent Profile Analysis was performed on intake data to identify statistically different groups of patients, which were then examined in longitudinal analyses to determine their capacity to predict treatment outcomes. Comparison between profiles showed considerable variation in recovery (74-15%), deterioration rates (5-20%), and levels of attrition (17-40%). Further variation in outcomes was found within the profiles when different intensities of psychological intervention were delivered.Limitations: Latent profiles were identified using data from two services, so generalisability to other services should be considered. Routinely collected patient data was included, additional patient information may further enhance utility of the profiles.Conclusions: These results suggest that intake data can be used to reliably classify patients into profiles that are predictive of outcome to different intensities of psychological treatment in routine care. Algorithms based on these kinds of data could be used to optimize decision-making and aid the appropriate matching of patients to treatment. [ABSTRACT FROM AUTHOR]

Background: According to a recent position paper by the American Heart Association, it remains unclear whether depression is a risk factor for incident Coronary Heart Disease (CHD). We assessed whether a depressive disorder independently predicts 18-year incident CHD in women.Method: A prospective longitudinal study of 860 women enrolled in the Geelong Osteoporosis Study (1993-2011) was conducted. Participants were derived from an age-stratified, representative sample of women (20-94 years) randomly selected from electoral rolls in South-Eastern Australia. The exposure was a diagnosis of a depressive disorder using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. Outcomes data were collected from hospital medical records: (1) PRIMARY OUTCOME: a composite measure of cardiac death, non-fatal Myocardial Infarction or coronary intervention. (2) Secondary outcome: any cardiac event (un/stable angina, cardiac event not otherwise defined) occurring over the study period.Results: Seven participants were excluded based on CHD history. Eighty-three participants (9.6%) recorded ≥1 cardiac event over the study period; 47 had a diagnosis that met criteria for inclusion in the primary analysis. Baseline depression predicted 18-year incidence, adjusting for (1) anxiety (adj. OR:2.39; 95% CIs:1.19-4.82), plus (2) typical risk factors (adj. OR:3.22; 95% CIs:1.45-6.93), plus (3) atypical risk factors (adj. OR:3.28; 95% CIs:1.36-7.90). This relationship held when including all cardiac events. No relationship was observed between depression and recurrent cardiac events.Conclusion: The results of this study support the contention that depression is an independent risk factor for CHD incidence in women. Moreover, the strength of association between depression and CHD incidence was of a greater magnitude than any typical and atypical risk factor. [ABSTRACT FROM AUTHOR]

Background: The study aimed to elucidate previously observed associations between morningness-eveningness and depressive symptomatology in university students. Relations between components of depressive symptomatology and morningness-eveningness were analysed.Methods: Nine hundred and seventy-four university students completed Polish versions of the Centre for Epidemiological Studies - Depression scale (CES-D; Polish translation appended to this paper) and the Composite Scale of Morningness. Principal component analysis (PCA) was used to test the structure of depressive symptoms. Pearson and partial correlations (with age and sex controlled), along with regression analyses with morning affect (MA) and circadian preference as predictors, were used.Results: PCA revealed three components of depressive symptoms: depressed/somatic affect, positive affect, interpersonal relations. Greater MA was related to less depressive symptoms in three components. Morning circadian preference was related to less depressive symptoms in depressed/somatic and positive affects and unrelated to interpersonal relations. Both morningness-eveningness components exhibited stronger links with depressed/somatic and positive affects than with interpersonal relations. Three CES-D components exhibited stronger links with MA than with circadian preference. In regression analyses only MA was statistically significant for positive affect and better interpersonal relations, whereas more depressed/somatic affect was predicted by lower MA and morning circadian preference (relationship reversed compared to correlations).Limitations: Self-report assessment.Conclusions: There are three groups of depressive symptoms in Polish university students. Associations of MA with depressed/somatic and positive affects are primarily responsible for the observed links between morningness-eveningness and depressive symptoms in university students. People with evening circadian preference whose MA is not lowered have less depressed/somatic affect. [ABSTRACT FROM AUTHOR]

Background: Availability of the opioid antagonist naloxone for lay administration has grown substantially since first proposed in 1996. Gaps remain, though, in our understanding of how people who inject drugs (PWID) engage with naloxone programmes over time.Aims: This paper aimed to address three specific evidence gaps: the extent of naloxone supply to PWID; supply-source (community or prisons); and the carriage of naloxone among PWID.Materials and Methods: Analysis of Scotland's Needle Exchange Surveillance Initiative (NESI) responses in 2011-2012 and 2013-2014 was undertaken with a specific focus on the extent of Scotland's naloxone supply to PWID; including by source (community or prisons); and on the carriage of naloxone. Differences in responses between the two surveys were measured using Chi-square tests together with 95% confidence intervals for rate-differences over time.Results: The proportion of NESI participants who reported that they had been prescribed naloxone within the last year increased significantly from 8% (175/2146; 95% CI: 7-9%) in 2011-2012 to 32% (745/2331; 95% CI: 30% to 34%) in 2013-2014. In contrast, the proportion of NESI participants who carried naloxone with them on the day they were interviewed decreased significantly from 16% (27/169; 95% CI: 10% to 22%) in 2011-2012 to 5% (39/741; 95% CI: 4% to 7%) in 2013-2014.Conclusions: The supply of naloxone to PWID has increased significantly since the introduction of a National Naloxone Programme in Scotland in January 2011. In contrast, naloxone carriage is low and decreased between the two NESI surveys; this area requires further investigation. [ABSTRACT FROM AUTHOR]

Background: In recent years, an abstinence-focused, 'recovery' agenda has emerged in UK drug policy, largely in response to the perception that many opioid users had been 'parked indefinitely' on opioid substitution therapy (OST). The introduction of ten pilot 'Drug Recovery Wings' (DRWs) in 2011 represents the application of this recovery agenda to prisons. This paper describes the DRWs' operational models, the place of opiate dependent prisoners within them, and the challenges of delivering 'recovery' in prison.Methods: In 2013, the implementation and operational models of all ten pilot DRWs were rapidly assessed. Up to three days were spent in each DRW, undertaking semi-structured interviews with a sample of 94 DRW staff and 102 DRW residents. Interviews were fully transcribed, and coded using grounded theory. Findings from the nine adult prisons are presented here.Results: Four types of DRW were identified, distinguished by their size and selection criteria. Strikingly, no mid- or large-sized units regularly supported OST recipients through detoxification. Type A were large units whose residents were mostly on OST with long criminal records and few social or personal resources. Detoxification was rare, and medication reduction slow. Type B's mid-sized DRW was developed as a psychosocial support service for OST clients seeking detoxification. However, staff struggled to find such prisoners, and detoxification again proved rare. Type C DRWs focused on abstinence from all drugs, including OST. Though OST clients were not intentionally excluded, very few applied to these wings. Only Type D DRWs, offering intensive treatment on very small wings, regularly recruited OST recipients into abstinence-focused interventions.Conclusion: Prison units wishing to support OST recipients in making greater progress towards abstinence may need to be small, intensive and take a stepped approach based on preparatory motivational work and extensive preparation for release. However, concerns about post-release deaths will remain. [ABSTRACT FROM AUTHOR]

I read with great interest the innovative review paper recently published by Kudlow et al. (2015). The authors address an important topic, investigating the prevalence and odds of bipolar disorder (BD) among people with fibromyalgia (FM), which has received minimal attention in the literature to date. Whilst this paper was helpful and clearly advanced the field, the authors determined the 'pooled prevalence rate' based upon a calculation using the sum of the total number of people with BD across all studies divided by the total sample size and did not perform a meta-analysis. Therefore, utilising the author's data across the eight studies, I recalculated the prevalence of BD in FM with a random effects meta-analysis together with the 95% CI. Across all 8 studies, the pooled prevalence of BD was 15.2% (95% CI 5.3-36.3%) with high heterogeneity (I(2)=95%). Although the Egger test indicated no significant publication bias (=-6.70, p=0.12) the Duval and Tweedie trim and fill adjusted prevalence of BD in fibromyalgia was 17.9% (6.68-40.2%) with one study adjusted for publication bias. Sub group meta-analysis determined that the prevalence of BD was similar in case control (15.2%, 95% CI 2.9-54.0%, 4 studies) and cohort studies (14.2%, 95% CI 2.7-49.7%, P=0.94, 4 studies). Thus, the actual prevalence of BD in FM may be slightly lower than that the reported by the authors. Nonetheless, more should be done to accurately identify and manager people with FM and comorbid BD. Future research might also consider common neurobiological underpinnings. [ABSTRACT FROM AUTHOR]

Background: The prevalence of dental anxiety among a representative sample of children in the UK was determined in the Children's Dental Health survey of 2003. Aims: This paper is concerned with the extent to which children in the United Kingdom are judged by a parent or carer to be behaviourally affected by dental anxiety and the factors associated with this. Method: The information was gathered by self-completion questionnaire distributed to the parents of half of the sample of children who were also clinically examined in the dental survey. Results: Dental anxiety that was sufficient to disrupt dental attendance was reported for around 3-4% of the four age groups surveyed (5, 8, 12 and 15 years of age). Children's dental anxiety was associated with parental dental anxiety; a greater experience of invasive dental treatment and general anaesthetic; receipt of free school meals and social class. Conclusions: Whilst these findings do not necessarily indicate causal relationships, they do confirm a number of co-factors associated with dental anxiety perhaps most importantly that of anxiety with the experience of general anaesthetic for tooth extractions. [ABSTRACT FROM AUTHOR]

Objectives: Shorter duration of untreated psychosis (DUP) is often correlated with a poorer response to treatment. In this paper we test the hypothesis that the importance of DUP is moderated by early premorbid adjustment. Method: Three year prospective data were collected for 154 first episode patients. DUP, premorbid adjustment and symptoms were assessed at time of presentation for treatment and symptoms were reassessed after three years of treatment. Results: DUP was correlated with level of symptoms at three years only for patients with better premorbid adjustment in childhood and early adolescence. Conclusions: These results suggest that DUP may have more of an impact on treatment response for those with a less pernicious, more reversible form of illness. [ABSTRACT FROM AUTHOR]

Background: This paper examines the potential impact of recruitment source differences in schizophrenia research by comparing the neuropsychological performance of volunteers from the NISAD Schizophrenia Research Register with recently published schizophrenia normative data for the Repeatable Battery for Neuropsychological Status (RBANS). Methods: The Register sample comprised 285 volunteers with schizophrenia or schizoaffective disorder. Their RBANS performance was compared with US data from 575 predominantly outpatient-recruited schizophrenia patients. Results: The Register sample displayed impairments in immediate and delayed memory, but near-normal language, attention and visuospatial-constructional performance (mean RBANS total score=88.72, SD=16.35). By contrast, health service-recruited schizophrenia patients displayed impairments on all RBANS scales (mean RBANS total score=70.54, SD=14.80). Within the Register sample, volunteers with low levels of current functioning had immediate and delayed memory performance comparable to the US schizophrenia sample. Gender and school completion status were also associated with different RBANS profiles. Conclusions: These findings reinforce the notion that a severity/functioning gradient exists across schizophrenia recruitment sources, which has important implications for research design and generalizability. Memory impairments have emerged as a central feature of schizophrenia. [ABSTRACT FROM AUTHOR]

Abstract: Background: Despite a plethora of studies, controversies abound on whether the long-term traits of unipolar and bipolar patients could be differentiated by temperament and whether these traits, in turn, could be distinguished from subthreshold affective symptomatology. Methods: 98 bipolar I (BP-I), 64 bipolar II (BP-II), and 251 unipolar major depressive disorder (UP-MDD) patients all when recovered from discrete affective episodes) and 617 relatives, spouses or acquaintances without lifetime RDC diagnoses (the comparison group, CG) were administered a battery of 17 self-rated personality scales chosen for theoretical relevance to mood disorders. Subsamples of each of the four groups also received the General Behavior Inventory (GBI). Results: Of the 436 personality items, 103 that significantly distinguished the three patient groups were subjected to principal components analysis, yielding four factors which reflect the temperamental dimensions of “Mood Lability”, “Energy-Assertiveness,” “Sensitivity–Brooding,” and “Social Anxiety.” Most BP-I described themselves as near normal in emotional stability and extroversion; BP-II emerged as labile in mood, energetic and assertive, yet sensitive and brooding; MDD were socially timid, sensitive and brooding. Gender and age did not have marked influence on these overall profiles. Within the MDD group, those with baseline dysthymia were the most pathological (i.e., high in neuroticism, insecurity and introversion). Selected GBI items measuring hypomania and biphasic mood changes were endorsed significantly more often by BP-II. Finally, it is relevant to highlight a methodologic finding about the precision these derived temperament factors brought to the UP–BP differentiation. Unlike BP-I who were low on neuroticism, both BP-II and UP scored high on this measure: yet, in the case of BP-II high neuroticism was largely due to mood lability, in UP it reflected subdepressive traits. Limitation: We used self-rated personality measures, a possible limitation generic to the paper-and-pencil personality literature. It is therefore likely that BP-I may have over-rated their “sanguinity”; or should one consider such self-report as a reliable reflection of one''s temperament? One can raise similar unanswerable questions about “depressiveness” and “mood lability.” Conclusion: As contrasted to CG and published norms, the postmorbid self-described “usual” personality is 1) sanguine among many, but not all, BP-I; 2) labile or cyclothymic among BP-II; and 3) subanxious and subdepressive among UP. It is further noteworthy that with the exception of BP-II, the temperament scores of BP-I and MDD were within one SD from published norms. Rather than being pathological, these attributes are best conceived as subclinical temperamental variants of the normal, thereby supporting the notion of continuity between interepisodic and episodic phases of affective disorders. These findings overall are in line with Kraepelin''s views and contrary to the DSM-IV formulation of axis-II constructs as being pathological and sharply demarcated from affective episodes. [Copyright &y& Elsevier]

Mothers who are physically and/or psychologically dependent upon alcohol and illicit drugs are at risk for a wide range of parenting deficits beginning when their children are infants and continuing as their children move through school-age and adolescent years. Behavioral parent training programs for drug-dependent mothers have had limited success in improving parent-child relationships or children’s psychological adjustment. One reason behavioral parenting programs may have had limited success is the lack of attention to the emotional quality of the parent-child relationship. Research on attachment suggests that the emotional quality of mother-child relationships is an important predictor of children’s psychological development through school-age and adolescent years. In this paper, we present a rationale and approach for developing attachment-based parenting interventions for drug-dependent mothers and report preliminary data on the feasibility of offering an attachment-based parenting intervention in an outpatient drug treatment program for women. [Copyright &y& Elsevier]

Researchers working on children''s moral understanding maintain that the child''s capacity to distinguish morality from convention shows that children regard moral violations as objectively wrong (e.g. Nucci, L. (2001). Education in the moral domain. Cambridge: Cambridge University Press). However, one traditional way to cast the issue of objectivism is to focus not on conventionality, but on whether moral properties depend on our responses, as with properties like icky and fun. This paper argues that the moral/conventional task is inadequate for assessing whether children regard moral properties as response-dependent. Unfortunately, children''s understanding of response-dependent properties has been neglected in recent research. Two experiments are reported showing that children are more likely to treat properties like fun and icky as response-dependent than moral properties like good and bad. Hence, this helps support the claim that children are moral objectivists. [Copyright &y& Elsevier]

The ‘fast and frugal’ approach to reasoning (Gigerenzer, G., & Todd, P. M. (1999). Simple heuristics that make us smart. New York: Oxford University Press) claims that individuals use non-compensatory strategies in judgment – the idea that only one cue is taken into account in reasoning. The simplest and most important of these heuristics postulates that judgment sometimes relies solely on recognition. However, the studies that have investigated usage of the recognition heuristic have confounded recognition with other cues that could also lead to similar judgments. This paper tests whether mere recognition is actually driving the findings in support of the recognition heuristic. Two studies provide evidence that judgments do not conform to the recognition heuristic when these confounds are accounted for. Implications for the study of simple heuristics are discussed. [Copyright &y& Elsevier]

Consider the task of predicting which soccer team will win the next World Cup. The bookmakers may judge Brazil to be the team most likely to win, but also judge it most likely that a European rather than a Latin American team will win. This is an example of a non-aligned hierarchy structure: the most probable event at the subordinate level (Brazil wins) appears to be inconsistent with the most probable event at the superordinate level (a European team wins). In this paper we exploit such structures to investigate how people make predictions based on uncertain hierarchical knowledge. We distinguish between aligned and non-aligned environments, and conjecture that people assume alignment. Participants were exposed to a non-aligned training set in which the most probable superordinate category predicted one outcome, whereas the most probable subordinate category predicted a different outcome. In the test phase participants allowed their initial probability judgments about category membership to shift their final ratings of the probability of the outcome, even though all judgments were made on the basis of the same statistical data. In effect people were primed to focus on the most likely path in an inference tree, and neglect alternative paths. These results highlight the importance of the level at which statistical data are represented, and suggest that when faced with hierarchical inference problems people adopt a simplifying heuristic that assumes alignment. [Copyright &y& Elsevier]

Background: This paper investigates the durability of the effects of cognitive remediation therapy (CRT). In a randomised control trial, CRT was compared with a control therapy (intensive occupational therapy activities), matched for length of therapist contact. The main three cognitive outcomes, (i) number of categories achieved on the Wisconsin Card Sort Test, (ii) age-scaled score on the Digit Span subtest of the WAIS-R, and (iii) mean number of moves on the Tower of London test, were chosen because they are known to be problematic in schizophrenia. In addition, a wide variety of other outcomes (symptoms, social functioning, self-esteem and cognition) were assessed. At the end of treatment, CRT conferred a benefit to people with schizophrenia in cognition and self-esteem [Schizophr. Bull. 25 (1999) 291]. This study investigates these outcomes 6 months after the therapies were withdrawn. Method: Participants were assessed at baseline, posttreatment and 6-month follow-up (n=17 for the CRT group; n=16 for the control therapy group). In addition to the functioning measures, data on use of services and cost of therapy were collected. Results: The effects of CRT on cognition were still apparent at follow-up, particularly in the memory domain. When these cognitive improvements reached a criterion threshold, there were also improvements in social behaviour and symptoms. The gains made in self-esteem disappeared following the withdrawal of therapy. The economic analysis showed overall reductions in the care packages of both patient groups but there was a significant increase in day-care costs for patients who have received CRT. This additional use of day care may confer further advantages to the CRT group, such as improved social functioning and quality of life. Conclusions: The overall results of this first trial of a novel CRT approach have produced encouraging results which merit further investigation. [Copyright &y& Elsevier]

Monocular cues to depth derive their informativeness from a combination of perspective projection and prior constraints on the way scenes in the world are structured. For many cues, the appropriate priors are best described as mixture models, each of which characterizes a different category of objects, surfaces, or scenes. This paper provides a Bayesian analysis of the resulting model selection problem, showing how the mixed structure of priors creates the potential for non-linear, cooperative interactions between cues and how the information provided by a single cue can effectively determine the appropriate constraint to apply to a given image. The analysis also leads to a number of psychophysically testable predictions. We test these predictions by applying the framework to the problem of perceiving planar surface orientation from texture. A number of psychophysical experiments are described that show that the visual system is biased to interpret textures as isotropic, but that when sufficient image data is available, the system effectively turns off the isotropy constraint and interprets texture information using only a homogeneity assumption. Human performance is qualitatively similar to an optimal estimator that assumes a mixed prior on surface textures--some proportion being isotropic and homogeneous and some proportion being anisotropic and homogeneous. [ABSTRACT FROM AUTHOR]

Vulnerability–stress models suggest that training in specific stress management techniques should yield benefits to those suffering from schizophrenia and related disorders. In this paper, we describe an evaluation of the impact of adding a stress management program to other medical and psychosocial interventions for such patients. Outcomes were compared for 121 patients randomly assigned to receive either a 12-week stress management program with follow-up sessions or participation in a social activities group. The two treatment conditions did not differ in levels of symptoms, perceived stress or life skills immediately after completion of treatment or at 1-year follow-up. Patients who received the stress management program did have fewer hospital admissions in the year following treatment. This effect of stress management was most apparent for those who showed high levels of attendance for treatment sessions. It was concluded that training in stress management may provide patients with skills for coping with acute stressors and reduce the likelihood of subsequent acute exacerbation of symptoms with need for hospitalization. [Copyright &y& Elsevier]

Social desirability, while a recognized source of respondent bias among Mexican-Americans, has not been evaluated as an explanation for the lower rate of high expressed emotion (EE) found in the family members of Mexican-Americans versus Caucasians with schizophrenia. In this study, we tested the hypothesis that the lower rate of high EE (hostility and criticism) among Mexican-Americans was the result of cultural factors impacting on how information was reported by the Mexican-American relative of a patient with schizophrenia. We compared the ratings of EE between Caucasian (N=17) and Mexican-American (N=44) patients with schizophrenia or schizoaffective disorder and their key relatives using the level of expressed emotion (LEE) scale (paper and pencil instrument rated by the patient and relative separately) and the Five Minute Speech Sample (observational experimenter rated). The ability of the various measures to predict relapse over two years was also examined. Contrary to our hypothesis, there were no differences between patient and family measures within ethnic group. Mexican-American patients and relatives reported lower rates of high EE than Caucasians across all measures. High EE predicted relapse across measures for Caucasian participants, but did not predict relapse for Mexican-Americans on any of the measurement instruments. We discuss the implications of these findings on cross-cultural research and family interventions for individuals with psychotic disorders. [Copyright &y& Elsevier]

Many species rely on the three-dimensional surface layout of an environment to find a desired goal following disorientation. They generally do so to the exclusion of other important spatial cues. Two influential frameworks for explaining that phenomenon are provided by geometric-module theories and view-matching theories of reorientation respectively. The former posit a module that operates only on representations of the global geometry of three-dimensional surfaces to guide behavior. The latter place snapshots, stored representations of the subject's two-dimensional retinal stimulation at specific locations, at the heart of their accounts. In this paper, I take a fresh look at the debate between them. I begin by making a case that the empirical evidence we currently have does not clearly favor one framework over the other, and that the debate has reached something of an impasse. Then, I present a new explanatory problem-the representation selection problem-that offers the prospect of breaking the impasse by introducing a new type of explanatory consideration that both frameworks must address. The representation selection problem requires explaining how subjects can reliably select the relevant representation with which they initiate the reorientation process. I argue that the view-matching framework does not have the resources to address this problem, while a certain type of theory within the geometric-module framework can provide a natural response to it. In showing this, I develop a new geometric-module theory. [ABSTRACT FROM AUTHOR]