The role of sex hormones, oral contraceptive use, and its parameters on visuospatial abilities, verbal fluency, and verbal memory

Sex hormones can cross the blood-brain barrier and access brain regions underlying higher-order cognition. Containing synthetic sex hormones, oral contraceptives (OC) have been found to modulate visuospatial and verbal abilities, though inconsistencies have been found in the literature. Among possible explanations, certain OC use parameters (progestin androgenicity, synthetic hormone levels, duration of use) have not received consistent consideration. Thus, the objectives were to (1) examine group differences between men, combined OC users, and naturally cycling women (NC women; not using OC) in visuospatial abilities, verbal fluency, and verbal memory and (2) investigate the contribution of endogenous and exogenous sex hormones on these effects. We also aimed to (3) identify OC use parameters relevant to cognitive outcomes. In total, 70 combined OC users, 53 early follicular (EF) women, 43 pre-ovulatory (PO) women, and 47 men underwent cognitive tests. Performance was compared based on hormonal milieus (OC, EF, PO, men) and OC users' contraceptive androgenicity (anti, low, high). Correlations between performance, hormone levels and OC use duration were also conducted. OC use dampened the sex difference that typically favors men in 3D visuospatial abilities, whereas its duration of use positively predicted verbal fluency. Androgenicity and hormone levels did not predict performance in any task. These results highlight the importance of considering OC use duration. Results also did not support a role for androgenicity in cognition. Importantly, combined OC use (including prolonged use) does not impair visuospatial, verbal, and memory functions in a healthy young sample.

Is numerical information always beneficial? Verbal and numerical cue-integration in additive and non-additive tasks

When people use rule-based integration of abstracted cues to make multiple-cue judgments they tend to default to linear additive integration of the cues, which may interfere with efficient learning in non-additive tasks. We hypothesize that this effect becomes especially pronounced when cues are presented numerically rather than verbally, because numbers elicit expectations about a task with a simple numerical solution that can be appropriately addressed by linear and additive integration. This predicts that, relative to a verbal format, a numerical format should be advantageous for learning in additive tasks, but detrimental for learning in non-additive tasks. In two experiments, we find support for the hypothesis that a verbal format can improve learning in non-additive tasks. The division-of-labor between cognitive processes observed in previous research (Juslin et al., 2008), with cue abstraction in additive tasks and exemplar memory in non-additive tasks, was only present in conditions with numeric information and may therefore in part be driven by the use of numeric formats. This illustrates how surface characteristic of stimuli can elicit different priors about the nature of the variables and the generative model that produced the cues and the criterion. We fitted cue-abstraction and exemplar algorithms by PNP-modeling (Sundh et al., 2021). At the end of training both cue abstraction and exemplar memory processes primarily involved exact analytic processes marred by occasional error, rather than the noisy and approximate intuitive processes typically assumed in previous studies - specifically, cue abstraction was primarily implemented by number crunching and exemplar memory by rote memorization.

The Effect of Combined Intervention on Improvement of Early Lexical Development in Minimally Verbal Children with Autism Spectrum Disorder

Background

Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by severe communication deficits and limited and repetitive behavioral tendencies. There are several treatment approaches and methods for minimally verbal children with ASD; nonetheless, there is inconclusive evidence about how early lexical development could be improved. The present study aimed to investigate the effect of combined intervention derived from the principles of different theories-including contemporary behaviorism, schemas, sociocultural, and event representation theories-to improve early lexical development in minimally verbal children with ASD.

Methods

In this single-group pretest-posttest study, 10 children with ASD (mean age, 47.9 ± 8.3 months), including 7 boys and 3 girls, participated. Participants received 16 intervention sessions in 8 weeks. The combined intervention consisted of various methods derived from contemporary behaviorism, schemas, sociocultural, and event representation approaches. The MacArthur-Bates Communicative Development Inventory 1 (Infant form) assessed early lexical development before and after intervention and after a 2-month follow-up. The Friedman test was used to analyze the data, and pairwise comparisons were performed with the Will-Coxon test. Cohen's d was used to investigate the effect sizes.

Results

Significant increases in expressive vocabulary (P < 0.001) and receptive language (P < 0.001) were seen after the end of the intervention and at the follow-up (P = 0.005). Large effect sizes were found for expressive vocabulary (d = 3.7) and receptive vocabulary (d = 2.17).

Conclusion

This study suggests that the combination of intervention based contemporary behaviorism, schemas, sociocultural, and event representation approaches improved receptive and expressive vocabulary in minimally verbal children with ASD.

Cognitive-adaptive Functioning Gap and Mediating Factors that Impact Adaptive Functioning in Chinese Preschool-aged Children with Autism Spectrum Disorder

This study aimed to investigate the gap between adaptive functioning and cognitive functioning, especially verbal and nonverbal intelligence quotient (IQ) in Chinese children with ASD. We systematically explored cognitive functioning, ASD severity, early signs of developmental abnormalities, and socioeconomic factors as mediating factors of adaptive functioning. We enrolled 151 children (age: 2.5?6 years) with ASD and categorized them into one group with IQ ≥ 70 and another with IQ < 70. The two groups were calibrated for age, age at diagnosis, and IQ, and the relationship of adaptive skills with vocabulary acquisition index (VAI) and nonverbal index (NVI) were separately analyzed. Results show that the gap between IQ and adaptive functioning was significant in children with ASD having IQ ≥ 70, with both VAI and NVI showing statistically significant differences (all P < 0.001). VAI correlated positively with scores for overall adaptive skills and specific domains, whereas NVI had no significant correlations with adaptive skill scores. Age of first walking unaided had an independent positive correlation (all P < 0.05) with scores of adaptive skills and specific domains. IQ-adaptive functioning gap is significant in children with ASD having IQ ≥ 70, suggesting that defining "high-functioning autism" merely on the basis of IQ is not appropriate. Verbal IQ and early signs of motor development are specific and possible predictors of adaptive functioning in children with ASD, respectively.

Workplace violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis

Workplace violence (WPV) is a prevalent phenomenon, especially in the healthcare setting. WPV against healthcare workers (HCWs) has increased during the COVID-19 epidemic. This meta-analysis determined the prevalence and risk factors of WPV. A database search was conducted across six databases in May 2022, which was updated in October 2022. WPV prevalence among HCWs was the main outcome. Data were stratified by WPV/HCW type, pandemic period (early, mid, late), and medical specialty. WPV risk factors were the secondary outcome. All analyses were conducted through STATA. Newcastle Ottawa Scale evaluated the quality. Sensitivity analysis identified effect estimate changes. A total of 38 studies (63,672 HCWs) were analyzed. The prevalence of WPV of any kind (43%), physical (9%), verbal (48%), and emotional (26%) was high. From mid-pandemic to late-pandemic, WPV (40-47%), physical violence (12-23%), and verbal violence (45-58%) increased. Nurses had more than double the rate of physical violence (13% vs. 5%) than physicians, while WPV and verbal violence were equal. Gender, profession, and COVID-19 timing did not affect WPV, physical, or verbal violence risk. COVID-19 HCWs were more likely to be physically assaulted (logOR = 0.54; 95% CI: 0.10: 0.97). Most healthcare employees suffer verbal violence, followed by emotional, bullying, sexual harassment, and physical assault. Pandemic-related workplace violence increased. Nurses were twice as violent as doctors. COVID-19 healthcare employees had a higher risk of physical and workplace violence.

Superior verbal but not nonverbal memory in congenital blindness

Previous studies suggest that people who are congenitally blind outperform sighted people on some memory tasks. Whether blindness-associated memory advantages are specific to verbal materials or are also observed with nonverbal sounds has not been determined. Congenitally blind individuals (n = 20) and age and education matched blindfolded sighted controls (n = 22) performed a series of auditory memory tasks. These included: verbal forward and backward letter spans, a complex letter span with intervening equations, as well as two matched recognition tasks: one with verbal stimuli (i.e., letters) and one with nonverbal complex meaningless sounds. Replicating previously observed findings, blind participants outperformed sighted people on forward and backward letter span tasks. Blind participants also recalled more letters on the complex letter span task despite the interference of intervening equations. Critically, the same blind participants showed larger advantages on the verbal as compared to the nonverbal recognition task. These results suggest that blindness selectively enhances memory for verbal material. Possible explanations for blindness-related verbal memory advantages include blindness-induced memory practice and 'visual' cortex recruitment for verbal processing.

Neutral and negative mood induction in executive tasks of working memory

The mood induction paradigm has been an important tool for investigating the effects of negative emotional states on working memory (WM) executive functions. Though some evidence showed that negative mood has a differential effect on verbal and visuospatial WM, other findings did not report a similar effect. To explore this issue, we examined the negative mood's impact on verbal and visuospatial WM executive tasks based on grammatical reasoning and visuospatial rotation. Participants with no anxiety or depression disorders performed the tasks before and after negative (n = 14) or neutral (n = 13) mood induction. Participants' mood at the beginning and the end of the session was assessed by the Present Mood States List (LEAP) and word valence rating. The analyses showed changes in the emotional state of the negative group (ps < .03) but not of the neutral group (ps > .83) in the LEAP instrument. No significant differences between groups were observed in the WM tasks (ps > .33). Performance in the visuospatial WM task improved after mood induction for both groups (p < .05), possibly due to a practice effect. In sum, our findings challenge the view that negative mood modulates WM executive functions; thus, they were discussed considering the similarities and differences between studies that found negative mood effects on WM and those that did not find. Different WM tasks tap distinct processes and components, which may underlie behavioral effects of negative mood on WM tasks.

Dump the "dimorphism": Comprehensive synthesis of human brain studies reveals few male-female differences beyond size

With the explosion of neuroimaging, differences between male and female brains have been exhaustively analyzed. Here we synthesize three decades of human MRI and postmortem data, emphasizing meta-analyses and other large studies, which collectively reveal few reliable sex/gender differences and a history of unreplicated claims. Males' brains are larger than females' from birth, stabilizing around 11 % in adults. This size difference accounts for other reproducible findings: higher white/gray matter ratio, intra- versus interhemispheric connectivity, and regional cortical and subcortical volumes in males. But when structural and lateralization differences are present independent of size, sex/gender explains only about 1% of total variance. Connectome differences and multivariate sex/gender prediction are largely based on brain size, and perform poorly across diverse populations. Task-based fMRI has especially failed to find reproducible activation differences between men and women in verbal, spatial or emotion processing due to high rates of false discovery. Overall, male/female brain differences appear trivial and population-specific. The human brain is not "sexually dimorphic."

Simulated patient and role play methodologies for communication skills and empathy training of undergraduate medical students

BACKGROUND

Verbal and non-verbal communication, as well as empathy are central to patient-doctor interactions and have been associated with patients' satisfaction. Non-verbal communication tends to override verbal messages. The aim of this study was to analyze how medical students use verbal and non-verbal communication using two different educational approaches, student role play (SRP) and actor simulated patient (ASP), and whether the non-verbal behaviour is different in the two different poses.

METHODS

Three raters evaluated 20 students playing the doctor role, 10 in the SRP group and 10 in the ASP group. The videos were analyzed with the Calgary-Cambridge Referenced Observation Guide (CCG) and, for a more accurate evaluation of non-verbal communication, we also evaluated signs of nervousness, and posture. Empathy was rated with the CARE questionnaire. Independent Mann Whitney U tests and Qhi square tests were performed for statistical analysis.

RESULTS

From the 6 main tasks of the CCG score, we obtained higher scores in the ASP group for the task 'Gathering information' (p = 0.0008). Concerning the 17 descriptors of the CCG, the ASP group obtained significantly better scores for 'Exploration of the patients' problems to discover the biomedical perspective' (p = 0.007), 'Exploration of the patients' problems to discover background information and context' (p = 0.0004) and for 'Closing the session - Forward planning' (p = 0.02). With respect to non-verbal behaviour items, nervousness was significantly higher in the ASP group compared to the SRP group (p < 0.0001). Concerning empathy, no differences were found between the SRP and ASP groups.

CONCLUSIONS

Medical students displayed differentiated verbal and non-verbal communication behaviour during the two communication skills training methodologies. These results show that both methodologies have certain advantages and that more explicit non-verbal communication training might be necessary in order to raise students' awareness for this type of communication and increase doctor-patient interaction effectiveness.

Neural correlates of verbal working memory in children with epilepsy with centro-temporal spikes

BACKGROUND

Previous functional magnetic resonance imaging (fMRI) studies have identified brain systems underlying different components of working memory (WM) in healthy subjects. The aim of this study was to compare the functional integrity of these neural networks in children with self-limited childhood epilepsy with centro-temporal spikes (ECTS) as compared to healthy controls, using a verbal working memory task (WMT).

METHODS

Functional MRI of WM in seventeen 6-to-13 year-old children, diagnosed with ECTS, and 17 sex- and age-matched healthy controls were conducted at 3 T. To estimate BOLD responses during the maintenance of low, medium, and high WMT loads, we used a Sternberg verbal WMT. Neuropsychological testing prior to scanning and behavioral data during scanning were also acquired.

RESULTS

Behavioral performances during WMT, in particular accuracy and response time, were poorer in children with ECTS than in controls. Increased WM load was associated with increased BOLD signal in all subjects, with significant clusters detected in frontal and parietal regions, predominantly in the left hemisphere. However, under the high load condition, patients showed reduced activation in the frontal, temporal and parietal regions as compared to controls. In brain regions where WM-triggered BOLD activation differed between groups, this activation correlated with neuropsychological performances in healthy controls but not in patients with ECTS, further suggesting WM network dysfunction in the latter.

CONCLUSION

Children with ECTS differ from healthy controls in how they control WM processes during tasks with increasing difficulty level, notably for high WM load where patients demonstrate both reduced BOLD activation and behavioral performances.

Insulin resistance is associated with verbal memory impairment in bipolar disorders

BACKGROUND

Cognitive impairment contributes to deterioration in social, family and work functioning in Bipolar Disorder (BD). Cognitive deficits are present not only during, but also outside of mood episodes. Insulin resistance (IR) impairs cognitive functioning and is frequent in participants with BD. Thus, we hypothesized that IR might contribute to cognitive deficits in remitted BD participants.

METHODS

We acquired biochemical (fasting insulin, glucose, lipids) cognitive (California Verbal Learning Test, Digit Span) measures from 100 euthymic participants with BD type I or II. IR was diagnosed using HOMA-IR.

RESULTS

BD participants with IR displayed worse composite verbal memory score (-0.38 vs 0.17; F(1, 8.23)=17.90; p = 0.003), while composite working memory scores were comparable in patients with or without IR (-0.20 vs 0.07; F(1, 6.05)=1.64; p = 0.25). Insulin resistance remained significantly associated with composite verbal memory scores (F(1, 47.99)=9.82, p = 0.003) even when we controlled for levels of lipids. The association between IR and verbal memory was not confounded by exposure to antipsychotics, which were not associated with worse cognitive performance (F(1, 2.07)=5.95, p = 0.13).

LIMITATIONS

The main limitation is the cross-sectional design, which does not allow us to rule out reverse causation.

CONCLUSIONS

We demonstrated that among remitted BD participants without diabetes mellitus, IR was significantly associated with verbal memory performance, even when we controlled for other relevant metabolic or treatment variables. These findings raise the possibility that early detection and treatment of IR, which is reversible, could possibly improve cognitive functioning in at least some BD participants.

Sexual Orientation and Cognitive Ability: A Multivariate Meta-Analytic Follow-Up

A cross-sex shift model of human sexual orientation differences predicts that homosexual men should perform or score in the direction of heterosexual women, and homosexual women in the direction of heterosexual men, in behavioral domains such as cognition and personality. In order to test whether homosexual men and women's cognitive performance was closer to that of heterosexual men or that of heterosexual women (i.e., sex-atypical for their sex and closer to that of the opposite-sex), we conducted a multivariate meta-analysis based on data from our previous meta-analysis (Xu, Norton, & Rahman, 2017). A subset of this data was used and comprised 30 articles (and 2 unpublished datasets) and 244,434 participants. The multivariate meta-analysis revealed that homosexual men were sex-atypical in mental rotation (Hedges' g = -0.36) and the water level test (Hedges' g = -0.55). In mental rotation, homosexual men were in-between heterosexual men and women. There was no significant group difference on spatial location memory. Homosexual men were also sex-atypical on male-favoring spatial-related tasks (Hedges' g = -0.54), and female-favoring spatial-related tasks (Hedges' g = 0.38). Homosexual women tended to be sex-typical (similar to heterosexual women). There were no significant group differences on male-favoring "other" tasks or female-favoring verbal-related tasks. Heterosexual men and women differed significantly on female-favoring "other" tasks. These results support the cross-sex shift hypothesis which predicts that homosexual men perform in the direction of heterosexual women in sex differentiated cognitive domains. However, the type of task and cognitive domain tested is critical.

Working memory predictors of written mathematics in 7- to 8-year-old children

There is extensive evidence for the involvement of working memory in mathematical attainment. This study aims to identify the relative contributions of verbal, spatial-simultaneous, and spatial-sequential working memory measures in written mathematics. Year 3 children (7-8 years of age, n = 214) in the United Kingdom were administered a battery of working memory tasks alongside a standardised test of mathematics. Confirmatory factor analyses and variance partitioning were then performed on the data to identify the unique variance accounted for by verbal, spatial-simultaneous, and spatial-sequential measures. Results revealed the largest individual contribution was that of verbal working memory, followed by spatial-simultaneous factors. This suggests the components of working memory underpinning mathematical performance at this age are those concerning verbal-numeric and spatial-simultaneous working memory. Implications for educators and further research are discussed.

Mindfulness improves verbal learning and memory through enhanced encoding

Recent research has begun to demonstrate the effectiveness of mindfulness in improving certain cognitive abilities, including verbal learning and memory. However, no research has investigated the potential mechanism by which mindfulness may improve verbal learning and memory. We examined encoding, consolidation, and retrieval as potential mechanisms by which learning and memory may be increased on a list learning test (Rey Auditory Verbal Learning Task; RAVLT). After dividing participants into either a mindfulness or a control condition, in which they listened to a 10-min audio tape, results found that the mindfulness condition significantly outperformed the control condition on every RAVLT trial. Using the Item-Specific Deficit Approach, we discovered that this enhanced verbal learning and memory was specifically due to a significantly enhanced encoding process for the mindfulness group, which fully mediated the relationship between the mindfulness condition and performance on the RAVLT. There were no differences between the conditions on consolidation or retrieval. Furthermore, these improvements were not accompanied by improvements in verbal fluency or attention. In a second study, we presented a mindfulness or control audio before the first RAVLT delayed free-recall trial and another one before the second RAVLT delayed free-recall trial in order to better determine the effect of mindfulness on consolidation and retrieval. The results replicated Study 1, in that neither consolidation nor retrieval were significantly affected by mindfulness. This research indicates that mindfulness may primarily improve verbal learning and memory through improved encoding processes.

How would you describe a familiar route or put in order the landmarks along it? It depends on your cognitive style!

Cognitive style refers to the preference in perceiving, organizing and remembering information. Different cognitive styles have been identified across the years. Amongst others, field-dependence/independence cognitive style is the extent to which the person perceives part of a field as discrete from the surrounding environment as a whole, rather than embedded in the field. Instead, visualizer/verbalizer cognitive style involves the preference in processing visual versus verbal information. Both cognitive styles can influence navigational behaviour. The present study aimed at clarifying the extent to which field-dependence/independence and visualizer/verbalizer cognitive styles affect route-based navigational tasks. Therefore, 44 healthy participants from L'Aquila City were assessed for their cognitive styles and were asked to perform two different navigational tasks: reorder paths using a series of photos depicting landmarks from L'Aquila (visually presented task, visual path task-VisPT); orally describe specific paths of L'Aquila (verbally presented task, verbal path task-VerPT). Results showed that the field-independence cognitive style predicted response times of VisPT, whereas the visualizer/verbalizer cognitive style predicted the instructions given when performing the VerPT, namely, the number of metrical distance indicators provided by participants. By investigating two different cognitive styles, the study clarifies that field-dependence/independence and visualizer/verbalizer cognitive styles can play a different role in spatial navigation and suggests that the material by which a navigational task is presented affects its performance.

Vowel-speech versus pure-tone processing in healthy subjects

To investigate the characteristics of speech perception, we evaluated the differences in mismatch negativity (MMN) between vowel change and frequency change. Additionally, we examined the effects of gender, age, and educational length on MMN. Forty healthy adults (21 females), who were native Japanese speakers, participated in the study. A Japanese vowel-speech pair (standard/a/vs. deviant/o/) and a pure-tone pair (standard 1000 Hz vs. deviant 1050 Hz) were constructed. MMN elicited by vowel-speech sounds was larger and earlier compared with pure-tone sounds. Larger and earlier MMNs for vowel-speech sounds than for pure-tone sounds suggest different processing of linguistically relevant information at the early stage in the auditory cortex. In conclusion, the factors influencing on MMN are different between vowel-speech sounds and pure-tone sounds.

The relationship between structural MRI, FDG-PET, and memory in temporal lobe epilepsy: Preliminary results

Structural and metabolic abnormalities of the temporal lobe are frequently found in temporal lobe epilepsy (TLE). In the present retrospective study, we investigated whether structural abnormalities evident in magnetic resonance imaging (MRI) and hypometabolism evident in [¹⁸F]fluorodeoxyglucose positron emission tomography (FDG-PET) independently influence verbal and nonverbal learning and delayed memory in patients with TLE. Sixty-eight patients with refractory unilateral TLE (35 left TLE, 33 right TLE) were divided into three groups: (1) no evidence of pathology in either MRI or FDG-PET studies (MRI-/PET-, n=15), (2) temporal FDG-PET determined hypometabolism with normal MRI findings (MRI-/PET+, n=21), and (3) evidence of temporal abnormalities in both MRI and FDG-PET studies (MRI+/PET+, n=32). A fourth group (MRI+/PET-, n=4) was too small for further statistical analysis and could not be included. Patients with MRI+/PET+ showed worse verbal memory than patients with MRI-/PET- (p<0.01), regardless of side of seizure focus. Verbal memory performance of patients with MRI-/PET+ was located between patients with MRI+/PET+ and MRI-/PET-, although group differences did not achieve statistical significance (ps>0.1). No group differences were found for nonverbal memory (p=0.27). Our results may suggest an interactive negative effect of metabolic and structural temporal lobe abnormalities on verbal memory. Still, our results are preliminary and need further validation by studies involving larger patient groups and up-to date quantitative imaging analysis methods.

Prospective randomised controlled trial of written supplement to verbal communication of results to patients at the time of flexible cystoscopy

PURPOSE

This trial assessed if written information on procedural findings and subsequent treatment improved understanding and reduced anxiety among patients undergoing day case flexible cystoscopy (FC).

METHODS

Participants completed pre- and post-procedure questionnaires self-rating anxiety and feeling well informed on 5-point Likert scales. Supplemental written information was provided after FC to half the patients on a standardized template, according to randomized allocation. Comparisons between the groups were undertaken using the Wilcoxon test.

RESULTS

Two hundred patients were recruited, with 171 evaluable questionnaires (83 from written group). The distribution of age, sex and prior FC, as well as the pre-procedure self-assessment of anxiety and understanding, was similar between the two groups. Patients receiving written information reported feeling better informed, with median (range) Likert score of 5 (4-5) compared to 4 (1-5) out of 5 (p < 0.0001) and less anxious (score 1 [1-4] compared to 2 [1-5] out of 5, p < 0.005), although all except four patients had an accurate understanding of the information provided (p = NS).

CONCLUSIONS

Written information at the time of FC leads to patients feeling better informed and less anxious, although verbal information alone appears to lead to an adequate understanding.

CLINICAL TRIAL REGISTRATION NUMBER

ACTRN12616000288426.

Concreteness of idiographic worry and anticipatory processing

BACKGROUND AND OBJECTIVES

Worry and anticipatory processing are forms of repetitive negative thinking (RNT) that are associated with maladaptive characteristics and negative consequences. One key maladaptive characteristic of worry is its abstract nature (Goldwin & Behar, 2012; Stöber & Borkovec, 2002). Several investigations have relied on inductions of worry that are social-evaluative in nature, which precludes distinctions between worry and RNT about social-evaluative situations. The present study examined similarities and distinctions between worry and anticipatory processing on potentially important maladaptive characteristics.

METHODS

Participants (N = 279) engaged in idiographic periods of uninstructed mentation, worry, and anticipatory processing and provided thought samples during each minute of each induction. Thought samples were assessed for concreteness, degree of verbal-linguistic activity, and degree of imagery-based activity.

RESULTS

Both worry and anticipatory processing were characterized by reduced concreteness, increased abstraction of thought over time, and a predominance of verbal-linguistic activity. However, worry was more abstract, more verbal-linguistic, and less imagery-based relative to anticipatory processing. Finally, worry demonstrated reductions in verbal-linguistic activity over time, whereas anticipatory processing demonstrated reductions in imagery-based activity over time.

LIMITATIONS

Worry was limited to non-social topics to distinguish worry from anticipatory processing, and may not represent worry that is social in nature. Generalizability may also be limited by use of an undergraduate sample.

CONCLUSIONS

Results from the present study provide support for Stöber's theory regarding the reduced concreteness of worry, and suggest that although worry and anticipatory processing share some features, they also contain characteristics unique to each process.

Leveling and abuse among patients with bipolar disorder at psychiatric outpatient departments in Ethiopia

INTRODUCTION

The World Health Organization (WHO) clearly states the importance of psychological well-being in the definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". However, in the community, the lives of people with bipolar disorders are often harsh and abusive. Till now, the rate and related information concerning verbal or physical abuse among patients with bipolar disorder at psychiatric outpatient clinics have not been well addressed in Ethiopian settings.

METHODS

Data were collected by interviewing 411 systematically selected participants at outpatient department of Amanuel Mental Specialized Hospital. For analysis, logistic regression and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used, and P  < 0.05 was considered statistically significant.

RESULTS

The prevalence of abuse (verbal/physical) was 37.7%. Having two or more episodes [AOR 1.70, 95% CI (1.06, 2.74)], a history of aggression [AOR 3.06, 95% CI (1.63, 5.75)] and comorbid illness [AOR 2.21, 95% CI (1.25, 3.90)] were significantly associated.

CONCLUSION

The prevalence of reported abuse is high among patients with bipolar disorder, and it is important to remember the rights of patients during treatment.

Modalities of Thinking: State and Trait Effects on Cross-Frequency Functional Independent Brain Networks

Functional states of the brain are constituted by the temporally attuned activity of spatially distributed neural networks. Such networks can be identified by independent component analysis (ICA) applied to frequency-dependent source-localized EEG data. This methodology allows the identification of networks at high temporal resolution in frequency bands of established location-specific physiological functions. EEG measurements are sensitive to neural activity changes in cortical areas of modality-specific processing. We tested effects of modality-specific processing on functional brain networks. Phasic modality-specific processing was induced via tasks (state effects) and tonic processing was assessed via modality-specific person parameters (trait effects). Modality-specific person parameters and 64-channel EEG were obtained from 70 male, right-handed students. Person parameters were obtained using cognitive style questionnaires, cognitive tests, and thinking modality self-reports. EEG was recorded during four conditions: spatial visualization, object visualization, verbalization, and resting. Twelve cross-frequency networks were extracted from source-localized EEG across six frequency bands using ICA. RMANOVAs, Pearson correlations, and path modelling examined effects of tasks and person parameters on networks. Results identified distinct state- and trait-dependent functional networks. State-dependent networks were characterized by decreased, trait-dependent networks by increased alpha activity in sub-regions of modality-specific pathways. Pathways of competing modalities showed opposing alpha changes. State- and trait-dependent alpha were associated with inhibitory and automated processing, respectively. Antagonistic alpha modulations in areas of competing modalities likely prevent intruding effects of modality-irrelevant processing. Considerable research suggested alpha modulations related to modality-specific states and traits. This study identified the distinct electrophysiological cortical frequency-dependent networks within which they operate.

The functional significance of EEG microstates--Associations with modalities of thinking

The momentary, global functional state of the brain is reflected by its electric field configuration. Cluster analytical approaches consistently extracted four head-surface brain electric field configurations that optimally explain the variance of their changes across time in spontaneous EEG recordings. These four configurations are referred to as EEG microstate classes A, B, C, and D and have been associated with verbal/phonological, visual, subjective interoceptive-autonomic processing, and attention reorientation, respectively. The present study tested these associations via an intra-individual and inter-individual analysis approach. The intra-individual approach tested the effect of task-induced increased modality-specific processing on EEG microstate parameters. The inter-individual approach tested the effect of personal modality-specific parameters on EEG microstate parameters. We obtained multichannel EEG from 61 healthy, right-handed, male students during four eyes-closed conditions: object-visualization, spatial-visualization, verbalization (6 runs each), and resting (7 runs). After each run, we assessed participants' degrees of object-visual, spatial-visual, and verbal thinking using subjective reports. Before and after the recording, we assessed modality-specific cognitive abilities and styles using nine cognitive tests and two questionnaires. The EEG of all participants, conditions, and runs was clustered into four classes of EEG microstates (A, B, C, and D). RMANOVAs, ANOVAs and post-hoc paired t-tests compared microstate parameters between conditions. TANOVAs compared microstate class topographies between conditions. Differences were localized using eLORETA. Pearson correlations assessed interrelationships between personal modality-specific parameters and EEG microstate parameters during no-task resting. As hypothesized, verbal as opposed to visual conditions consistently affected the duration, occurrence, and coverage of microstate classes A and B. Contrary to associations suggested by previous reports, parameters were increased for class A during visualization, and class B during verbalization. In line with previous reports, microstate D parameters were increased during no-task resting compared to the three internal, goal-directed tasks. Topographic differences between conditions included particular sub-regions of components of the metabolic default mode network. Modality-specific personal parameters did not consistently correlate with microstate parameters except verbal cognitive style which correlated negatively with microstate class A duration and positively with class C occurrence. This is the first study that aimed to induce EEG microstate class parameter changes based on their hypothesized functional significance. Beyond the associations of microstate classes A and B with visual and verbal processing, respectively, our results suggest that a finely-tuned interplay between all four EEG microstate classes is necessary for the continuous formation of visual and verbal thoughts. Our results point to the possibility that the EEG microstate classes may represent the head-surface measured activity of intra-cortical sources primarily exhibiting inhibitory functions. However, additional studies are needed to verify and elaborate on this hypothesis.

Precision of working memory for speech sounds

Memory for speech sounds is a key component of models of verbal working memory (WM). But how good is verbal WM? Most investigations assess this using binary report measures to derive a fixed number of items that can be stored. However, recent findings in visual WM have challenged such "quantized" views by employing measures of recall precision with an analogue response scale. WM for speech sounds might rely on both continuous and categorical storage mechanisms. Using a novel speech matching paradigm, we measured WM recall precision for phonemes. Vowel qualities were sampled from a formant space continuum. A probe vowel had to be adjusted to match the vowel quality of a target on a continuous, analogue response scale. Crucially, this provided an index of the variability of a memory representation around its true value and thus allowed us to estimate how memories were distorted from the original sounds. Memory load affected the quality of speech sound recall in two ways. First, there was a gradual decline in recall precision with increasing number of items, consistent with the view that WM representations of speech sounds become noisier with an increase in the number of items held in memory, just as for vision. Based on multidimensional scaling (MDS), the level of noise appeared to be reflected in distortions of the formant space. Second, as memory load increased, there was evidence of greater clustering of participants' responses around particular vowels. A mixture model captured both continuous and categorical responses, demonstrating a shift from continuous to categorical memory with increasing WM load. This suggests that direct acoustic storage can be used for single items, but when more items must be stored, categorical representations must be used.

Conceptual control across modalities: graded specialisation for pictures and words in inferior frontal and posterior temporal cortex

Controlled semantic retrieval to words elicits co-activation of inferior frontal (IFG) and left posterior temporal cortex (pMTG), but research has not yet established (i) the distinct contributions of these regions or (ii) whether the same processes are recruited for non-verbal stimuli. Words have relatively flexible meanings - as a consequence, identifying the context that links two specific words is relatively demanding. In contrast, pictures are richer stimuli and their precise meaning is better specified by their visible features - however, not all of these features will be relevant to uncovering a given association, tapping selection/inhibition processes. To explore potential differences across modalities, we took a commonly-used manipulation of controlled retrieval demands, namely the identification of weak vs. strong associations, and compared word and picture versions. There were 4 key findings: (1) Regions of interest (ROIs) in posterior IFG (BA44) showed graded effects of modality (e.g., words>pictures in left BA44; pictures>words in right BA44). (2) An equivalent response was observed in left mid-IFG (BA45) across modalities, consistent with the multimodal semantic control deficits that typically follow LIFG lesions. (3) The anterior IFG (BA47) ROI showed a stronger response to verbal than pictorial associations, potentially reflecting a role for this region in establishing a meaningful context that can be used to direct semantic retrieval. (4) The left pMTG ROI also responded to difficulty across modalities yet showed a stronger response overall to verbal stimuli, helping to reconcile two distinct literatures that have implicated this site in semantic control and lexical-semantic access respectively. We propose that left anterior IFG and pMTG work together to maintain a meaningful context that shapes ongoing semantic processing, and that this process is more strongly taxed by word than picture associations.

The interaction of process and domain in prefrontal cortex during inductive reasoning

Inductive reasoning is an everyday process that allows us to make sense of the world by creating rules from a series of instances. Consistent with accounts of process-based fractionations of the prefrontal cortex (PFC) along the left-right axis, inductive reasoning has been reliably localized to left PFC. However, these results may be confounded by the task domain, which is typically verbal. Indeed, some studies show that right PFC activation is seen with spatial tasks. This study used fMRI to examine the effects of process and domain on the brain regions recruited during a novel pattern discovery task. Twenty healthy young adult participants were asked to discover the rule underlying the presentation of a series of letters in varied spatial locations. The rules were either verbal (pertaining to a single semantic category) or spatial (geometric figures). Bilateral ventrolateral PFC activations were seen for the spatial domain, while the verbal domain showed only left ventrolateral PFC. A conjunction analysis revealed that the two domains recruited a common region of left ventrolateral PFC. The data support a central role of left PFC in inductive reasoning. Importantly, they also suggest that both process and domain shape the localization of reasoning in the brain.

Grouping, semantic relation and imagery effects in individuals with Down syndrome

Down syndrome (DS) is associated with a specific verbal short-term memory (STM) deficit. This study explored the effects of grouping, semantic relations and visual presentation upon verbal STM recall performance in a group of 15 individuals with DS and 15 vocabulary-matched typically developing (TD) children. Participants were presented with memoranda in either a temporally grouped schedule, such that items were grouped as pairs, or in an equally spaced presentation schedule. The two items constituting each pair were either semantically related or unrelated. Performance across these conditions was compared in verbal or verbal plus visual presentation modes. Significant memory recall benefits were observed across populations as a result of temporal grouping, semantic relations and verbal and visual combined presentation. However, a reduced benefit of semantic relation in the DS group compared to the TD group indicated that those with DS were less influenced by LTM relational knowledge. In addition, those with DS only experienced a grouping benefit during verbal and visual combined presentation, in contrast to the TD group who experienced grouping benefits throughout. This indicates that individuals with DS are poorer at encoding temporal context for purely verbal memoranda. These findings were replicated in a follow-up experiment, aimed at aligning baseline performance in the two populations. This study provides encouraging evidence that, despite their difficulties in some areas, individuals with DS can benefit from the use of grouping and LTM knowledge to assist their verbal STM performance under certain circumstances.

The effect of written material and verbal method education on anxiety and depression in patients with myocardial infarction in selected hospitals in Iran

INTRODUCTION

Myocardial infarction (MI) is the damage to the heart muscle, or myocardium, resulting from the lack of blood flow to the heart. MI patients experience mental and emotional problems such as depression and anxiety. These complications could cause delay in resuming work, decreased quality of life and increased risk of death. The role of education in facilitating adaptation is very important in these patients. The purpose of this study was to determine the effect of written material and verbal method education on anxiety and depression in patients with myocardial infarction in Urmia hospital in 2009.

METHODS

This study was a quasi-experimental study, comparing the effect of education on anxiety and depression in patients with myocardial infarction in hospitals affiliated to Urmia University of Medical Science. 124 patients were selected randomly and divided into two groups. The experimental group was educated through face to face training and an educational booklet (Written Material and Verbal Method). The control group did not receive any intervention. The level of anxiety and depression was evaluated, using HADS questionnaire at 3 intervals: after 48 hours of admission, the discharge day and 2 months after discharge.

RESULTS

The findings suggested that MI patients were worried about their social role, interpersonal relations and personal health. Such problems can aggravate symptoms and complicate the future care. There was no significant difference between the control and experimental groups before the intervention, but after the intervention, anxiety and depression in the experimental group was significantly less than that in the control group (p<0.05).

CONCLUSION

Considering the beneficial results obtained from written materials and verbal method education on reducing anxiety and depression in cases with myocardial infarction, this may be one of the health care goals. More research on more patients is required to achieve more conclusive results.