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The role of encoding in reality monitoring: a running memory test with Alzheimer's type dementia.

Reality monitoring refers to the discrimination between memories of internal and external events (e.g., Johnson & Raye, 1981). A total of 28 healthy older adults and 28 older adults with Alzheimer's type dementia (DAT) were asked to perform or to imagine performing simple action statements in a running memory test. This task required participants to tell whether the action statement had been carried out or imagined, or whether it was new at unpredictable intervals. The results indicated that older adults with DAT had greater difficulty in reality monitoring than did the healthy control group. The finding is discussed in terms of the role of working memory functions in reality monitoring.

Aged↗

Irrational beliefs as predictors of adolescent drug abuse and running away.

With a population of 78 residents from a residential drug program and 79 residents from a shelter for runaways, this study examined the Rational Behavior Inventory's ability to predict two forms of adolescent maladjustment--drug use and running away. Specific belief systems were found to be differentially associated with each disorder. In addition, gender differences along two belief dimensions of the RBI were found in the drug abuse population. The importance of belief systems as mediating cognitive factors in both running away and drug use also is discussed.

Adaptation, Psychological↗

The relationship between psychological differentiation and performance expectation in alcoholics and normals.

Sixty subjects (20 alcoholic inpatients, 20 outpatient alcoholics, and 20 surgical controls from two Veterans Administration hospitals) were tested on field independence-dependence (measured by the Rod-and-Frame Test), realistic/unrealistic self-expectations (on the Level of Aspiration Board), and degree of alcohol dependence (on the Alcohol Dependence Scale). Response bias and current intelligence were controlled. As predicted, alcoholic inpatients were more alcohol dependent than outpatients, both groups of alcoholics were found to be more field dependent and more unrealistic in their self-expectations than controls, and field dependence was related to unrealistic expectations. Patterns of differentiation and expectation were similar in both alcoholic groups. Results support the consistency of differentiation levels within clinical groups and the relationship between field dependence and unrealistic self-expectation.

Achievement↗

Transcending death during early adulthood: symbolic immortality, death anxiety, and purpose in life.

Robert Jay Lifton has originated a comprehensive theory of development based on the human psychobiological need to symbolize death and life continuity. He calls this condition the sense of symbolic immortality and argues that life is threatened whenever death is not transcended. A Sense of Symbolic Immortality Scale was built and administered to two groups of young adults (N = 136) in order to test the hypothesis that symbolic immortality develops with age (Drolet, 1986). Templer's Death Anxiety Scale and Crumbaugh and Maholick's Purpose in Life Test also were administered. Results show that established adults have a sense of symbolic immortality and a purpose in life significantly stronger than those of young adults. They show a negative relation between death anxiety and purpose in life, while purpose in life correlates highly with the sense of symbolic immortality. Finally, the premise that the sense of symbolic immortality helps cope with the fear of death is supported.

Adaptation, Psychological↗

Spontaneous confabulations, disorientation, and the processing of 'now'.

We have previously demonstrated that spontaneous confabulations and disorientation in amnesia emanate from temporal context confusion in memory characterised by intrusion of previously acquired information into ongoing thinking. This failure appears to be due to an inability to suppress previously activated memory traces of events dating back hours, weeks or even years. In the present study, the possibility was explored that spontaneous confabulators also have a problem in processing information in the very short-term range of the psychological present (the 'now'), which has been defined as the duration of an experiential process. Tasks assessing the processing of time within the psychological present were devised to test this possibility. In experiment 1, spontaneous confabulators, in comparison with other amnestic patients, failed to discriminate brief, visually presented intervals in the now. In experiment 2, they failed to make motion-associated time estimations within the now. These deficits also correlated with disorientation. Although these results do not prove a causal relationship, they indicate that spontaneously confabulating and disorientated patients typically do fail to process information within the 'now'.

Adolescent↗

Confirmation of the borderline personality within a psychodynamic framework.

Using a psychodynamic framework and an underlying structural configuration, the borderline patient is described. Statistical methods are then used to differentiate this group from both a schizophrenic and a character disorder group of patients. The borderline group emerges as a clear-cut entity characterized by (1) the lack of an integrated self concept, and (2) a particular ego structure consisting of a specific pattern of superficial ego strengths and underlying ego weaknesses.

Adaptation, Psychological↗

Good test--retest reliability for standard and advanced false-belief tasks across a wide range of abilities.

Although tests of young children's understanding of mind have had a remarkable impact upon developmental and clinical psychological research over the past 20 years, very little is known about their reliability. Indeed, the only existing study of test-retest reliability suggests unacceptably poor results for first-order false-belief tasks (Mayes, Klin, Tercyak, Cicchetti, & Cohen, 1996), although this may in part reflect the nonstandard (video-based) procedures adopted by these authors. The present study had four major aims. The first was to re-examine the reliability of false-belief tasks, using more standard (puppet and storybook) procedures. The second was to assess whether the test-retest reliability of false-belief task performance is equivalent for children of contrasting ability levels. The third aim was to explore whether adopting an aggregate approach improves the reliability with which children's early mental-state awareness can be measured. The fourth aim was to examine for the first time the test-retest reliability of children's performances on more advanced theory-of-mind tasks. Our results suggest that most standard and advanced false-belief tasks do in fact show good test-retest reliability and internal consistency, with very strong test-retest correlations between aggregate scores for children of all levels of ability.

Aptitude↗

Virtual reality applied to procedural testing: the next era.

OBJECTIVE: To establish the construct validity of a virtual reality-based upper gastrointestinal endoscopy simulator as a tool for the skills training of residents. SUMMARY BACKGROUND DATA: Previous studies have demonstrated the relevance of virtual reality training as an adjunct to traditional operating room learning for residents. The use of specific task trainers, which have the ability to objectively analyze and track user performance, has been shown to demonstrate improvements in performance over time. Using this off-line technology can lessen the financial and ethical concerns of using operative time to teach basic skills. METHODS: Thirty-five residents and fellows from General Surgery and Gastrointestinal Medicine were recruited for this study. Their performance on virtual reality upper endoscopy tasks was analyzed by computer. Assessments were made on parameters such as time needed to finish the examination, completeness of the examination, and number of wall collisions. Subjective experiences were queried through questionnaires. Users were grouped according to their prior level of experience performing endoscopy. RESULTS: Construct validation of this simulator was demonstrated. Performance on visualization and biopsy tasks varied directly with the subjects' prior experience level. Subjective responses indicated that novice and intermediate users felt the simulation to be a useful experience, and that they would use the equipment in their off time if it were available. CONCLUSIONS: Virtual reality simulation may be a useful adjunct to traditional operating room experiences. Construct validity testing demonstrates the efficacy of this device. Similar objective methods of skills evaluation may be useful as part of a residency skills curriculum and as a means of procedural skills testing.

Computer Simulation↗

[The programming of cardiac pacemakers--wish and reality].

To test the extent and quality of pacemaker programming, 340 programmable pacemakers were selected out of 1,204 impulse generators removed post-mortem. Their actual program was compared with the nominal parameters when first delivered. 177 (52.1%) of the 340 pacemakers still had the same parameters as on delivery. The multiply programmable impulse generators with telemetry were more frequently programmed (61.2%) than the simple programmable ones (43.0%) or the multiply programmable ones without telemetry (43.7%). Rate was the most frequently programmed parameter, followed by impulse amplitude, sensitivity and impulse duration. Refractory time and hysteresis were only rarely changed from the initial state. Apparently, programmability was not thought to be important enough. Programming without telemetry was seemingly too complicated. The reasons for this attitude should be investigated so that the discrepancy between wishes and reality can be overcome.

Equipment Design↗

Virtual reality pencil and paper tests for neglect: a protocol.

Hemispatial neglect is a common disorder that can occur after a lesion in the right hemisphere. Its main characterization is the difficulty in processing visual stimuli emanating from the space contralateral to the lesion. Pencil and paper tests (such as target cancellation, line bisection, or drawing copy) are used to diagnose neglect. We propose using virtual reality technology and haptic force feedback to enhance pencil and paper tests. Our system can track the patients' eye-gaze and their hand movements. Also, the efficiency of several techniques used to decrease the neglect in different sensory spaces are investigated.

Computer Simulation↗

Shape constancy and theory of mind: is there a link?

In three experiments, children aged between 4 and 7 years viewed a circular disc oriented at a slant. The disc was made of luminous material and situated in a darkened chamber. Children of all ages exaggerated the circularity of the disc when they knew that the object was really a circle (the circle task), and the effect was greatest in the younger members of the sample. Crucially, however, a group of children in Experiment 3 who viewed an identical shape that they knew emanated from an actual ellipse did not exaggerate circularity. In the second experiment, children tackled three standard theory of mind tasks in addition to the circle task mentioned above. A significant correlation emerged (even with age partialed) between the extent of exaggeration made by those who knew that the shape was a circle and ability to pass the theory of mind tests. It seems knowledge of reality contaminates judgements of appearance in the circle task. This might be the same bias that features in realist errors in theory of mind tasks.

Analysis of Variance↗

Origins of individual differences in episodic memory in the oldest-old: a population-based study of identical and same-sex fraternal twins aged 80 and older.

The relative importance of genetic and environmental influences on episodic memory in very late life was studied using a quantitative genetic approach. Identical (n = 125) and same-sex fraternal (n = 157) twin pairs, aged 80 and older (mean age = 83.3; SD = 3.1) and without a diagnosis of dementia were tested with seven memory measures: (1-2) Digit Span Forward and Backwards, (3) Prose Recall, (4) Thurstone's picture memory test, and the Memory in Reality (MIR) test, including the subtasks of (5) free recall, (6) recognition, and (7) relocation. Heritabilities, estimated by structural equation modeling, ranged from .04 to .49. The digit span backward test showed the highest heritability (h2 = .49), while heritabilities were typically lower for the long-term memory measures. The results demonstrate genetic influences on memory in the oldest-old, but suggest that the magnitude of these effects differs across memory measures.

Aged↗

Peduncular hallucinosis: a syndrome of impaired reality monitoring.

Peduncular hallucinosis (PH) is a syndrome of hallucinations and brainstem symptoms which has only been described in single case reports. A detailed analysis of five patients was undertaken to investigate the clincial characteristics, hallucinations and behavioural abnormalities of PH in greater detail. Frequent clinical symptoms were oculomotor disturbances, impaired arousal, dysarthria and ataxia. In the chronic stage, sleep-wake cycle disturbances were common. Hallucinations were naturalistic, complex, scenic, mostly visual, but also combined visual-acoustic or visual-tactile and recurred stereotypically over months. Patients experienced their hallucinations as genuine and were unable to discriminate their percepts from reality. Neuropsychological testing disclosed severe impairments of episodic memory, occasionally coupled with confabulatory behaviour. By contrast, memory for hallucinations remained intact. Deficits of attentional and executive functions were found in a subgroup of patients. Associated abnormal behaviours were common, comprising confusion, delusional misidentification for persons and places, and loss of disease awareness. PH appeared after focal lesions in various regions, such as the midbrain, thalamus and pons. These findings document that subcortical, brainstem-related hallucinations are vivid, recurring percepts that have a strong naturalistic character and are often associated with cognitive and behavioural abnormalities. It seems likely that brainstem hallucinosis is caused by damage to ascending reticular systems and thalamocortical circuits. Available observations suggest that PH compromises cognitive functions which enable us to differentiate between illusionary percepts and reality, a reality monitoring system.

Aged↗

Confabulation, memory deficits, and frontal dysfunction.

This paper explores potential cognitive deficits underlying confabulation of patient, G.S., following an anterior communication artery aneurysm. G.S.'s performance on tasks assessing memory for temporal duration, temporal order, and speaker identification is examined as is his recollection of autobiographical events. We compare G.S. with three nonconfabulating patients matched with him for age, education, and neuropsychological measures of memory and frontal deficits and with three age- and education-matched control subjects. Like frontal control patients, G.S. underestimated temporal durations and showed poor source monitoring (speaker identification). In addition, G.S. showed an even more pronounced deficit in recall of autobiographical memories and relatively more detailed reports of laboratory-induced memories for imagined events. We suggest that this configuration of deficits rather than any single factor accounts for G.S.'s tendency to confabulate.

Amnesia↗

The statistical analysis of matched data in psychiatric research.

Clinical studies in psychiatry frequently involve the analysis of matched pairs, in which each patient is matched with his or her psychiatric clinician. If the response variable of interest is dichotomous, then McNemar's chi 2 test for correlated proportions may be applied to the resulting data. However, this test assumes that the set of matched pairs are statistically independent, an assumption that is violated if some clinicians are matched with more than one patient. In this article we present alternatives to McNemar's test for dealing with this problem.

Humans↗