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PubMed2004

Pain catastrophizing mediates the relationship between worry and pain suffering in patients with irritable bowel syndrome.

Although separate lines of behaviorally oriented pain research have drawn attention to the importance of pain catastrophizing and trait worry, little is known about how they work together to influence aspects of chronic pain. Integrating pain research with the broader anxiety, cognitive science, and learning literature, we hypothesized that the process (vs. content) of worry influences pain through catastrophizing. One hundred and eighty-six consecutive patients diagnosed (Rome II) with irritable bowel syndrome completed measures of three dimensions of pain (sensory pain, affective pain, long-term suffering), pain intensity, trait anxiety, worry, catastrophizing, and somatization during baseline assessment of an NIH-funded clinical trial of two psychological treatments. Worry was most strongly associated with the emotionally unpleasant aspects of pain, particularly suffering. Multivariate mediational analyses showed that catastrophizing mediated the link between worry and suffering. Worry, catastrophizing and control variables accounted for 46% of the variance in suffering. Chronic pain patients who worry excessively engage in more catastrophic thinking and through this cognitive process experience more intensely the suffering component of pain. Data are consistent with the notion that worry functions as an "experiential avoidance" strategy for aversive features of pain. Findings are discussed with respect to their relevance to behavioral models for understanding and treating anxiety-related chronic pain disorders.

Adult↗
PubMed1992

Psychoanalysis and its neighboring sciences: paradigms and opportunities.

Breuer and Freud's prepsychoanalytic cathartic treatment proved to be generally ineffective. Consequently, both the treatment and the theory adduced to support it were revised to accommodate the issue of wishes and their expression. But the new treatment, too, had only limited success, which resulted in a further revision of the supporting theory to emphasize the "resistances," or the control and modulation of drives. There is an irony in these progressive shifts: as the therapy's limitations became more apparent, the theory became more expansive, and extended itself beyond its beginnings in neurotic symptoms, and into slips, dreams, character formation, and sociology. In short, it encompassed more of normal behavior as its expectations for the therapy of pathological behavior were increasingly called into question. The paper explores some implications of this historical turn for a scientific data base with opportunities to test and revise the various psychoanalytic hypotheses. One view would have it that psychoanalysis has been lamed by the physicalistic language of its metapsychology, by its isolation from the neurosciences and the cognitive sciences, and by a compartmentalization of practice and knowledge that has kept its practitioners focused on the worried well and unimpressed by the knowledge at its borders. Another view would propose that the restiveness of some current and past theorists to claim the mantle of "science" continues to lead to premature and awkward attempts to couple psychoanalysis with putative neighbors rather than stick to its last of shaping its own findings into a language reflecting a coherent theory capable of validation.

Europe↗
PubMed2005

Neuropsychologic theory and findings in attention-deficit/hyperactivity disorder: the state of the field and salient challenges for the coming decade.

The past decade has witnessed the establishment of several now well-replicated findings in the neuropsychology of attention-deficit/hyperactivity disorder (ADHD), which have been confirmed by meta-analyses. Progress has been notable from the importing of cognitive science and neuroscience paradigms. Yet these findings point to many neural networks being involved in the syndrome and to modest effect sizes suggesting that any one neuropsychologic deficit will not be able to explain the disorder. In this article, leading theories and key findings are briefly reviewed in four key domains: attention, executive functions, state regulation and motivation, and temporal information processing. Key issues facing the field of neuropsychologic research and theory in ADHD include 1) the need for more integrative developmental accounts that address both multiple neural systems and the socialization processes that assure their development; 2) consideration of multiple models/measures in the same study so as to examine relative contributions, within-group heterogeneity, and differential deficit; and 3) better integration of cognitive process models with affective and temperament theories so that early precursors to ADHD can be better understood. Overall, the field has witnessed notable progress as it converges on an understanding of ADHD in relation to disruption of a multicomponent self-regulatory system. The next era must articulate multipathway, multilevel developmental accounts of ADHD that incorporate neuropsychologic effects.

Animals↗
PubMedDate not supplied

Collaborative problem-solving in telemedicine and evidence interpretation in a complex clinical case.

This study examined clinical problem-solving processes in the context of a telemedical consultation, in order to verify to what extent the technological environment preserves the characteristics of medical reasoning that are known to occur in more traditional clinical settings. This study also provided an opportunity for examining certain fundamental aspects of medical reasoning about complex cases. Within a case-study design, we used a theoretical framework and qualitative methods originating from cognitive science. Expert physicians used reasoning strategies commensurate with the complexity of the case. The technological context of the telemedical consultation did not overly contrive the interaction, allowing them to use real-time problem-solving processes characterizing medical reasoning in naturalistic settings. The results also suggest that high levels of expertise in the presence of very complex cases may elicit a particular configuration of problem-solving processes, associating certain reasoning patterns that are usually related to non-expert problem-solving with others that are typical of expertise. We believe that the evaluation of image transmission and diagnostic performance in telemedicine, as well as the determination of its indications and technological configurations, may benefit from taking into account, with the help of cognitive methodologies, the interacting problem-solving modalities that may be encountered in this context.

Adult↗
PubMed2004

Assessing the informational value of parameter estimates in cognitive models.

Mathematical models of cognition often contain unknown parameters whose values are estimated from the data. A question that generally receives little attention is how informative such estimates are. In a maximum likelihood framework, standard errors provide a measure of informativeness. Here, a standard error is interpreted as the standard deviation of the distribution of parameter estimates over multiple samples. A drawback to this interpretation is that the assumptions that are required for the maximum likelihood framework are very difficult to test and are not always met. However, at least in the cognitive science community, it appears to be not well known that standard error calculation also yields interpretable intervals outside the typical maximum likelihood framework. We describe and motivate this procedure and, in combination with graphical methods, apply it to two recent models of categorization: ALCOVE (Kruschke, 1992) and the exemplar-based random walk model (Nosofsky & Palmeri, 1997). The applications reveal aspects of these models that were not hitherto known and bring a mix of bad and good news concerning estimation of these models.

Algorithms↗
PubMed1996

Cognitive evaluation of the user interface and vocabulary of an outpatient information system.

This paper describes an innovative approach to the evaluation of the user interface and vocabulary of a medical information system. The use of video recording for collecting usability data is detailed. The technique employed involves the collection of data consisting of transcripts of physicians as they "think aloud" while interacting with the system, along with a video record of the complete user-computer interaction. Using methods of analysis from cognitive science, the study was able to distinguish the source of physician problems in using the system's interface and in interacting with its controlled medical vocabulary. Analysis of the protocols indicated that all subjects encountered several generic problems, the most common ones indicative of a need for greater consistency in the interface design. Based on this evaluation, parts of the user interface have been re-implemented in an ongoing process of iterative system development.

Ambulatory Care Facilities↗
PubMed2000

The cognitive imperative: thinking about how we think.

There are three domains of expertise required for consistently effective performance in emergency medicine (EM): procedural, affective, and cognitive. Most of the activity is performed in the cognitive domain. Studies in the cognitive sciences have focused on a number of common and predictable biases in the thinking process, many of which are relevant to the practice of EM. It is important to understand these biases and how they might influence clinical decision-making behavior. Among the specialities, EM provides a unique clinical milieu of inconstancy, uncertainty, variety, and complexity. Injury and illness are seen within narrow time windows, often under pressured ambient conditions. These operating characteristics force practitioners to adopt a distinctive blend of thinking strategies. Principal among them is the use of heuristics, a form of abbreviated thinking that often leads to successful outcomes but that occasionally may result in error. A number of opportunities exist to overcome interdisciplinary, linguistic, and other historical obstacles to develop a sound approach to understanding how we think in EM. This will lead to a better awareness of our cognitive processes, an improved capacity to teach effectively about cognitive strategies, and, ultimately, the minimization or avoidance of clinical error.

Attitude of Health Personnel↗
PubMed1989

Diagnostic reasoning.

Research in cognitive science, decision sciences, and artificial intelligence has yielded substantial insights into the nature of diagnostic reasoning. Many elements of the diagnostic process have been identified, and many principles of effective clinical reasoning have been formulated. Three reasoning strategies are considered here: probabilistic, causal, and deterministic. Probabilistic reasoning relies on the statistical relations between clinical variables and is frequently used in formal calculations of disease likelihoods. Probabilistic reasoning is especially useful in evoking diagnostic hypotheses and in assessing the significance of clinical findings and test results. Causal reasoning builds a physiologic model and assesses a patient's findings for coherency and completeness against the model; it functions especially effectively in verification of diagnostic hypotheses. Deterministic reasoning consists of sets of compiled rules generated from routine, well-defined practices. Much human problem solving may derive from activation and implementation of such rules. A deeper understanding of clinical cognition should enhance clinical teaching and patient care.

Cognition↗
PubMedDate not supplied

Development of visual diagnostic expertise in pathology -- an information-processing study.

OBJECTIVE: To identify key features contributing to trainees' development of expertise in microscopic pathology diagnosis, a complex visual task, and to provide new insights to help create computer-based training systems in pathology. DESIGN: Standard methods of information-processing and cognitive science were used to study diagnostic processes (search, perception, reasoning) of 28 novices, intermediates, and experts. Participants examined cases in breast pathology; each case had a previously established gold standard diagnosis. Videotapes correlated the actual visual data examined by participants with their verbal "think-aloud" protocols. MEASUREMENTS: Investigators measured accuracy, difficulty, certainty, protocol process frequencies, error frequencies, and times to key diagnostic events for each case and subject. Analyses of variance, chi-square tests and post-hoc comparisons were performed with subject as the unit of analysis. RESULTS: Level of expertise corresponded with differences in search, perception, and reasoning components of the tasks. Several discrete steps occur on the path to competence, including development of adequate search strategies, rapid and accurate recognition of anatomic location, acquisition of visual data interpretation skills, and transitory reliance on explicit feature identification. CONCLUSION: Results provide the basis for an empirical cognitive model of competence for the complex tasks of microscopic pathology diagnosis. Results will inform the development of computer-based pedagogy tools in this domain

Analysis of Variance↗
PubMed2005

The challenge of characterizing operations in the mechanisms underlying behavior.

Neuroscience and cognitive science seek to explain behavioral regularities in terms of underlying mechanisms. An important element of a mechanistic explanation is a characterization of the operations of the parts of the mechanism. The challenge in characterizing such operations is illustrated by an example from the history of physiological chemistry in which some investigators tried to characterize the internal operations in the same terms as the overall physiological system while others appealed to elemental chemistry. In order for biochemistry to become successful, researchers had to identify a new level of operations involving operations over molecular groups. Existing attempts at mechanistic explanation of behavior are in a situation comparable to earlier approaches to physiological chemistry, drawing their inspiration either from overall psychology activities or from low-level neural processes. Successful mechanistic explanations of behavior require the discovery of the appropriate component operations. Such discovery is a daunting challenge but one on which success will be beneficial to both behavioral scientists and cognitive and neuroscientists.

Animals↗
PubMed2006

What developmental disorders can tell us about the nature and origins of language.

Few areas in the cognitive sciences evoke more controversy than language evolution, due in part to the difficulty in gathering relevant empirical data. The study of developmental disorders is well placed to provide important new clues, but has been hampered by a lack of consensus on the aims and interpretation of the research project. We suggest that the application of the Darwinian principle of 'descent with modification' can help to reconcile much apparently inconsistent data. We close by illustrating how systematic analyses within and between disorders, suitably informed by evolutionary theory-and ideally facilitated by the creation of an open-access database-could provide new insights into language evolution.

Biological Evolution↗
PubMed2006

Probabilistic models of language processing and acquisition.

Probabilistic methods are providing new explanatory approaches to fundamental cognitive science questions of how humans structure, process and acquire language. This review examines probabilistic models defined over traditional symbolic structures. Language comprehension and production involve probabilistic inference in such models; and acquisition involves choosing the best model, given innate constraints and linguistic and other input. Probabilistic models can account for the learning and processing of language, while maintaining the sophistication of symbolic models. A recent burgeoning of theoretical developments and online corpus creation has enabled large models to be tested, revealing probabilistic constraints in processing, undermining acquisition arguments based on a perceived poverty of the stimulus, and suggesting fruitful links with probabilistic theories of categorization and ambiguity resolution in perception.

Brain↗
PubMed1997

Internal objects--a theoretical analysis of Jungian and Kleinian models.

In this paper I discuss the ways in which experimental and objective research from cognitive science and developmental psychology can help analysts evaluate the theoretical models of mental objects which we use; I indicate the ways in which such evidence tends to support models of internal objects as mental representations or developmental capacities rather than as wish-fulfilling expressions of instinctual drives. This kind of empirical evidence is not just of academic interest but also has direct clinical relevance, particularly with borderline patients; such patients' sense of identity is totally dependent on the analyst's understanding of their internal world and for this to be misunderstood by the analyst can be catastrophic. An accurate theoretical model of mental objects can therefore help analysts to contain their patients more effectively.

Adult↗
PubMed2006

[Neuropsychology and forensic assessment in brain injured patients].

Neuropsychology, which deals with the relationships between upper mental functions and brain structures is directly involved with psychiatric and psychological disorders and thus constitutes one of the major domains of cognitive sciences. The impairment of upper mental functions is evident after severe brain injuries causing significant motor deficits. However, it is becoming increasingly evident that even mild or moderate brain injuries can cause sequelae which are difficult to analyze and quantify clinically. These sequelae constitute an "invisible handicap" which may greatly interfere with the patient's professional, relational and social life. The neuropsychological evaluation must be systematic and complete and has to be carried out with a sufficient hindsight (two to three years after the trauma) using neuropsychological and behavioural deficiency evaluation scales. Psychometric tests are also necessary. The data obtained from this evaluation must be correctly interpreted and constitutes the main exhibit in the forensic examination of the brain injured patient.

Adult↗
PubMed2001

Evolutionary internalized regularities.

Roger Shepard's proposals and supporting experiments concerning evolutionary internalized regularities have been very influential in the study of vision and in other areas of psychology and cognitive science. This paper examines issues concerning the need, nature, explanatory role, and justification for postulating such internalized constraints. In particular, I seek further clarification from Shepard on how best to understand his claim that principles of kinematic geometry underlie phenomena of motion perception. My primary focus is on the ecological validity of Shepard's kinematic constraint in the context of ordinary motion perception. First, I explore the analogy Shepard draws between internalized circadian rhythms and the supposed internalization of kinematic geometry. Next, questions are raised about how to interpret and justify applying results from his own and others' experimental studies of apparent motion to more everyday cases of motion perception in richer environments. Finally, some difficulties with Shepard's account of the evolutionary development of his kinematic constraint are considered.

Biological Evolution↗
PubMedDate not supplied

Beyond the flesh: some lessons from a mole cricket.

What do linguistic symbols do for minds like ours, and how (if at all) can basic embodied, dynamical, and situated approaches do justice to high-level human thought and reason? These two questions are best addressed together, since our answers to the first may inform the second. The key move in scaling up simple embodied cognitive science is, I argue, to take very seriously the potent role of human-built structures in transforming the spaces of human learning and reason. In particular, in this article I look at a range of cases involving what I dub surrogate situations. Here, we actively create restricted artificial environments that allow us to deploy basic perception-action-reason routines in the absence of their proper objects. Examples include the use of real-world models, diagrams, and other concrete external symbols to support dense looping interactions with a variety of stable external structures that stand in for the absent states of affairs. Language itself, I finally suggest, is the most potent and fundamental form of such surrogacy. Words are both cheap stand-ins for gross behavioral outcomes, and the concrete objects that structure new spaces for basic forms of learning and reason. A good hard look at surrogate situatedness thus turns the standard skeptical challenge on its head. But it raises important questions concerning what really matters about these new approaches, and it helps focus what I see as the major challenge for the future: how, in detail, to conceptualize the role of symbols (both internal and external) in dynamical cognitive processes.

Animals↗
PubMed1999

The future of philosophy.

There is no sharp dividing line between science and philosophy, but philosophical problems tend to have three special features. First, they tend to concern large frameworks rather than specific questions within the framework. Second, they are questions for which there is no generally accepted method of solution. And third they tend to involve conceptual issues. For these reasons a philosophical problem such as the nature of life can become a scientific problem if it is put into a shape where it admits of scientific resolution. Philosophy in the 20th century was characterized by a concern with logic and language, which is markedly different from the concerns of earlier centuries of philosophy. However, it shared with the European philosophical tradition since the 17th century an excessive concern with issues in the theory of knowledge and with scepticism. As the century ends, we can see that scepticism no longer occupies centre stage, and this enables us to have a more constructive approach to philosophical problems than was possible for earlier generations. This situation is somewhat analogous to the shift from the sceptical concerns of Socrates and Plato to the constructive philosophical enterprise of Aristotle. With that in mind, we can discuss the prospects for the following six philosophical areas: (1) the traditional mind-body problem; (ii) the philosophy of mind and cognitive science; (iii) the philosophy of language; (iv) the philosophy of society; (v) ethics and practical reasons; (vi) the philosophy of science. The general theme of these investigations, I believe, is that the appraisal of the true significance of issues in the philosophy of knowledge enables us to have a more constructive account of various other philosophical problems than has typically been possible for the past three centuries.

Language↗
PubMed2004

[Evolution of language: attempt at synthesis].

There are at least three traits that distinguish modern Homo sapiens from his closest relatives: bipedal locomotion, the unusual size of his brain and the ability to use symbolic language. To this day the emergence and evolution of these traits have not been explained sufficiently. New research in anthropology, linguistics, cognitive science and other disciplines shows, that the evolution of the human language faculty is a complex field that was influenced by a wide variety of factors. This paper tries to show the width of these factors and to work out the demands that are to be met by a theory of language evolution. After the introduction, in Section 2 the evolutionary principles and their role in the evolution of symbolic communication will be reviewed. Section 3 gives an overview of the results and controversies of brain evolution research, while Section 4 introduces our current knowledge of the neuronal basis of language. In Section 5 the controversies that had the greatest impact on the field and development of ways to solve them are reviewed before Section 6 summarizes the most important preadaptations for the evolving language faculty.

Animals↗