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1.
J Exp Child Psychol ; 243: 105923, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38593709

RESUMO

Typically, children and adolescents dislike peers who deviate from their peer group's norm, preferring normative peers who are loyal to the peer ingroup. Yet children and adolescents also consider whether the behavior displayed by a deviant peer aligns with generic societally valued norms when evaluating peers within intergroup contexts. In an age where misinformation is rampant online, seeking the truth exemplifies a generic norm that is widely valued but not always upheld given that individuals often show loyalty to the ingroup. The current research explored the conflict between ingroup loyalty and seeking the truth. In this study, participants (N = 266; 8-15 years old) read about their school participating in an inter-school competition where their ingroup peer either accidentally or deliberately shared misinformation about their outgroup competitor. Participants with a peer group norm of ingroup loyalty positively morally evaluated a norm deviant seeking the truth, whereas those with a peer group norm of seeking the truth negatively morally evaluated a norm deviant showing ingroup loyalty. Participants also took into account the intentions of the misinformer in their evaluations of a deviant who was either loyal or questioning toward the misinformer. Overall, this study suggests that the norm of truth-seeking is welcomed and regarded as an important value to uphold both generically and at a peer group level, even when it violates the norm of ingroup loyalty. This research provides a novel contribution to understanding how factors like norms and intentionality interact with children's and adolescents' navigation of information in an age of misinformation.


Assuntos
Comunicação , Grupo Associado , Humanos , Criança , Masculino , Adolescente , Feminino , Processos Grupais , Identificação Social , Percepção Social
2.
Neuropsychol Rehabil ; 33(6): 1090-1119, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35443860

RESUMO

Peer relationship difficulties in adolescents with acquired brain injury (ABI) are under-recognized and targets for intervention are unclear. From a social constructionist position, this study aimed to engage with stakeholders to develop a collaborative understanding of peer relationship difficulties in adolescents with ABI and seek consultation on what might be required to improve them. Focus groups and semi-structured interviews were conducted with four stakeholder groups: adolescents with ABI (n = 4); parents of adolescents with ABI (n = 7); adults who sustained an ABI in adolescence (n = 2); and specialist practitioners (n = 3). Qualitative data were analysed using thematic analysis. The analysis yielded 11 themes, grouped into two domains. The first, understanding peer relationship difficulties, included themes from "exclusion and a need to belong", to "loss of past self". The second, supporting peer relationships, comprised themes of "building understanding" and "meaningful social connection", amongst others. A logic model of stakeholder experiences of peer relationship difficulties was constructed. Difficulties with peers can increase vulnerability to feelings of loneliness, shame, and hopelessness for adolescents post-ABI. Stakeholders described that a meaningful intervention would be multi-layered, targeting change within the adolescent's environment and within the adolescent themselves. The presented logic model provides a framework for future intervention development.


Assuntos
Lesões Encefálicas , Participação dos Interessados , Adulto , Humanos , Adolescente , Grupo Associado , Pais , Autoimagem
3.
Front Hum Neurosci ; 16: 835897, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35754774

RESUMO

Purpose/Objective: Young people with paediatric acquired brain injury (pABI) are twice as likely to develop a mood disorder as their peers, frequently have significant unmet socio-emotional needs, and are at over double the risk of going on to use adult mental health services. Recent years have seen significant advances in the development of interventions for young people with mood disorders. However, evidence-based approaches to mood disorders in pABI are lacking and surprisingly little work has evaluated clinical and neuro-developmental models of mood disorders in this population. Method: We review the literature regarding key mechanisms hypothesised to account for the increased vulnerability to mood disorders in pABI: First, we summarise the direct neurocognitive consequences of pABI, considering the key areas of the brain implicated in vulnerability to mood disorders within a neurodevelopmental framework. Second, we outline five key factors that contribute to the heightened prevalence of mood disorders in young people following ABI. Finally, we synthesise these, integrating neuro-cognitive, developmental and systemic factors to guide clinical formulation. Results and Implications: We present a framework that synthesises the key mechanisms identified in our review, namely the direct effects of pABI, neurocognitive and neuroendocrine factors implicated in mood and anxiety disorders, maladaptive neuroplasticity and trauma, structural and systemic factors, and psychological adjustment and developmental context. This framework is the first attempt to provide integrated guidance on the multiple factors that contribute to elevated life-long risk of mood disorders following pABI.

4.
Front Psychol ; 13: 835695, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35496208

RESUMO

Previous developmental research shows that young children display a preference for ingroup members when it comes to who they accept information from - even when that information is false. However, it is not clear how this ingroup bias develops into adolescence, and how it affects responses about peers who misinform in intergroup contexts, which is important to explore with growing numbers of young people on online platforms. Given that the developmental span from childhood to adolescence is when social groups and group norms are particularly important, the present study took a Social Reasoning Developmental Approach. This study explored whether children and adolescents respond differently to a misinformer spreading false claims about a peer breaking COVID-19 rules, depending on (a) the group membership of the misinformer and their target and (b) whether the ingroup had a "critical" norm that values questioning information before believing it. 354 United Kingdom-based children (8-11 years old) and adolescents (12-16 years old) read about an intergroup scenario in which a peer spreads misinformation on WhatsApp about a competitor. Participants first made moral evaluations, which asked them to judge and decide whether or not to include the misinformer, with follow-up "Why?" questions to capture their reasoning. This was followed by asking them to attribute intentions to the misinformer. Results showed that ingroup preferences emerged both when participants morally evaluated the misinformer, and when they justified those responses. Participants were more likely to evaluate an ingroup compared to an outgroup misinformer positively, and more likely to accuse an outgroup misinformer of dishonesty. Adolescents attributed more positive intentions to the misinformer compared with children, with children more likely to believe an outgroup misinformer was deliberately misinforming. The critical norm condition resulted in children making more positive intentionality attributions toward an ingroup misinformer, but not an outgroup misinformer. This study's findings highlight the importance of shared group identity with a misinformer when morally evaluating and reasoning about their actions, and the key role age plays in intentionality attributions surrounding a misinformer when their intentions are ambiguous.

5.
Child Dev ; 93(3): 815-830, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34897651

RESUMO

Working memory training improves children's cognitive performance on untrained tasks; however, little is known about the underlying neural mechanisms. This was investigated in 32 typically developing children aged 10-14 years (19 girls and 13 boys) using a randomized controlled design and multi-modal magnetic resonance imaging (Devon, UK; 2015-2016). Training improved working memory performance and increased intrinsic functional connectivity between the bilateral intraparietal sulci. Furthermore, improvements in working memory were associated with greater recruitment of the left middle frontal gyrus on a complex span task. Repeated engagement of fronto-parietal regions during training may increase their activity and functional connectivity over time, affording greater working memory performance. The plausibility of generalizable cognitive benefits from a neurobiological perspective and implications for neurodevelopmental theory are discussed.


Assuntos
Aprendizagem , Memória de Curto Prazo , Mapeamento Encefálico , Criança , Feminino , Lobo Frontal/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Lobo Parietal/diagnóstico por imagem
6.
Rehabil Psychol ; 66(4): 356-365, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34871027

RESUMO

PURPOSE/OBJECTIVE: To describe the process of adapting the evidence-based Teen Online Problem Solving (TOPS) program, a telehealth problem-solving treatment addressing executive function and behavior regulation challenges in adolescents with traumatic brain injury, in Italy, New Zealand, and the United Kingdom. Research Method/Design: We describe the process of adapting and translating the TOPS program in 3 case studies with unique methods and samples. In Italy, 14 parents of adolescents with TBI participated in focus groups, and 2 adolescents with TBI and their parents and 2 physicians provided input on the resulting translation. In New Zealand, an independent Maori cultural advisor reviewed the content, and 6 adolescent-parent dyads and 2 health professionals completed the 10 modules independently over a five-week period to inform adaptation. In the United Kingdom, a team of neuropsychologists and a parent of an adolescent with ABI reviewed and adapted the content through successive iterations. RESULTS: In Italy, suggested changes included greater emphasis on nonverbal communication and clearer examples of inappropriate problem-solving responses. In New Zealand, parents and adolescents rated the program as acceptable and helpful. Suggestions included incorporating familiar Maori settings, integrating religion, and developing videos with New Zealand adolescents. In the United Kingdom, iterative refinements focused on adapting TOPS for other acquired brain injuries and reflecting cross-national differences (e.g., drinking age). CONCLUSIONS/IMPLICATIONS: These 3 case studies suggest that programs such as TOPS developed in 1 cultural context can be broadly acceptable in other contexts, with adaptations focusing on tailoring to reflect the unique cultural and linguistic setting. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Lesões Encefálicas Traumáticas , Lesões Encefálicas , Adolescente , Função Executiva , Humanos , Pais , Resolução de Problemas
7.
Behav Res Ther ; 142: 103871, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34004447

RESUMO

Repetitive negative thinking (RNT) is a proximal risk factor implicated in the onset and maintenance of common mental health problems such as depression and anxiety. Adolescence may be a key developmental window in which to target RNT and prevent the emergence of such disorders. Impairments in updating the contents of working memory are hypothesised to causally contribute to RNT, and some theorists have suggested these difficulties may be specific to the manipulation of negative information. The present study compared the effects of computerised adaptive working memory updating training (in which the task becomes more difficult as performance improves) to a non-adaptive control task in reducing levels of RNT. 124 healthy young people were randomised to 20 sessions of (i) working memory updating training using neutral stimuli, (ii) working memory updating training using negative stimuli, or (iii) non-adaptive working memory updating training. Adaptive working memory updating training using neutral, but not negative, stimuli resulted in significant improvements to working memory updating for negative material, as assessed using an unpractised task, and significant reductions in susceptibility to state RNT. These findings demonstrate proof-of-concept that working memory updating training has the potential to reduce susceptibility to episodes of state RNT.


Assuntos
Pessimismo , Adolescente , Ansiedade , Transtornos de Ansiedade , Cognição , Humanos , Memória de Curto Prazo
8.
J Psychother Integr ; 30(2): 332-347, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34295136

RESUMO

The novel coronavirus, COVID-19, has led to sweeping changes in psychological practice and the concomitant rapid uptake of telepsychotherapy. Although telepsychotherapy is new to many clinical psychologists, there is considerable research on telepsychotherapy treatments. Nearly 2 decades of clinical research on telepsychotherapy treatments with children with neurological conditions has the potential to inform emerging clinical practice in the age of COVID-19. Toward that end, we synthesized findings from 14 clinical trials of telepsychotherapy problem-solving and parent-training interventions involving more than 800 children and families with diverse diagnoses, including traumatic brain injury, epilepsy, brain tumors, congenital heart disease, and perinatal stroke. We summarize efficacy across studies and clinical populations and report feasibility and acceptability data from the perspectives of parents, children, and psychotherapists. We describe adaptation for international contexts and strategies for troubleshooting technological challenges and working with families of varying socioeconomic strata. The extensive research literature reviewed and synthesized provides considerable support for the utility of telepsychotherapy with children with neurological conditions and their families and underscores its high level of acceptability with both diverse clinical populations and providers. During this period of heightened vulnerability and stress and reduced access to usual supports and services, telepsychotherapy approaches such as online family problem-solving treatment and online parenting skills training may allow psychologists to deliver traditional evidence-based treatments virtually while preserving fidelity and efficacy.


El nuevo coronavirus, COVID-19, ha conducido a cambios radicales en la psicología. práctica y el rápido consumo concomitante de telepsicoterapia. A pesar de que la telepsicoterapia es nueva para muchos psicólogos clínicos, existe una investigación considerable sobre tratamientos de telepsicoterapia. Casi dos décadas de investigación clínica sobre los tratamientos de telepsicoterapia con niños con afecciones neurológicas tienen la potencial para informar la práctica clínica emergente en la edad de COVID-19. Hacia ese fin, sintetizamos los resultados de 14 ensayos clínicos de resolución de problemas de telepsicoterapia e intervenciones de capacitación para padres que involucran a más de 800 niños y familias con diagnósticos diversos que incluyen lesión cerebral traumática, epilepsia, tumores cerebrales, enfermedad cardíaca congénita y accidente cerebrovascular perinatal. Resumimos la eficacia entre los estudios y poblaciones clínicas e reportamos datos de viabilidad y aceptabilidad desde las perspectivas de padres, hijos y psicoterapeutas. Describimos adaptacion para contextos internacionales y estrategias para resolver problemas tecnológicos y trabajar con familias de estratos socioeconómicos variables. La extensa literatura de investigación revisada y sintetizado proporciona un apoyo considerable para la utilidad de la telepsicoterapia con niños con afecciones neurológicas y sus familias y subraya su alto nivel de aceptabilidad con diversas poblaciones clínicas y proveedores. Durante este período de mayor vulnerabilidad y estrés y menor acceso a los apoyos habituales y servicios, enfoques de telepsicoterapia como tratamiento em línea para resolución de problemas familiares y la capacitación en habilidades para padres en línea pueden permitir que los psicólogos brinden tratamientos tradicionales basados en evidencia virtualmente mientras se preserva la fidelidad y la eficacia.

9.
Dev Sci ; 23(4): e12870, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31134713

RESUMO

Working memory training has been shown to improve performance on untrained working memory tasks in typically developing children, at least when compared to non-adaptive training; however, there is little evidence that it improves academic outcomes. The lack of transfer to academic outcomes may be because children are only learning skills and strategies in a very narrow context, which they are unable to apply to other tasks. Metacognitive strategy interventions, which promote metacognitive awareness and teach children general strategies that can be used on a variety of tasks, may be a crucial missing link in this regard. In this double-blind randomized controlled trial, 95 typically developing children aged 9-14 years were allocated to three cognitive training programmes that were conducted daily after-school. One group received Cogmed working memory training, another group received concurrent Cogmed and metacognitive strategy training, and the control group received adaptive visual search training, which better controls for expectancy and motivation than non-adaptive training. Children were assessed on four working memory tasks, reading comprehension, and mathematical reasoning before, immediately after, and 3 months after training. Working memory training improved working memory and mathematical reasoning relative to the control group. The improvements in working memory were maintained 3 months later, and these were significantly greater for the group that received metacognitive strategy training, compared to working memory training alone. Working memory training is a potentially effective educational intervention when provided in addition to school; however, future research will need to investigate ways to maintain academic improvements long term and to optimize metacognitive strategy training to promote far-transfer. A video abstract of this article can be viewed at https://youtu.be/-7MML48ZFgw.


Assuntos
Sucesso Acadêmico , Aprendizagem , Memória de Curto Prazo , Metacognição , Adolescente , Criança , Compreensão , Método Duplo-Cego , Feminino , Humanos , Masculino , Matemática/educação , Leitura
10.
BMJ Open ; 9(8): e029349, 2019 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-31444185

RESUMO

INTRODUCTION: Paediatric acquired brain injury is a leading cause of mortality in children in the UK. Improved treatment during the acute phase has led to increased survival rates, although with life-long morbidity in terms of social and emotional functioning. This is the protocol for a feasibility randomised controlled trial with an embedded qualitative study and feasibility economic evaluation. If feasible, a later definitive trial will test the effectiveness and cost-effectiveness of an online intervention to enhance problem solving ability versus treatment as usual. METHODS AND ANALYSIS: Twenty-five adolescents and their families identified by primary or secondary care clinicians at participating UK National Health Service Trusts will be recruited and individually randomised in a 1:1 ratio to receive the online intervention or treatment as usual. Participants will be followed up by online questionnaires 17 weeks after randomisation to capture acceptability of the study and intervention and resource use data. Qualitative interviews will capture participants' and clinicians' experiences of the study. ETHICS AND DISSEMINATION: This study has been granted ethical approval by the South West-Exeter Research Ethics Committee (ref 17/SW/0083). Results will be disseminated via peer-reviewed publications and will inform the design of a larger trial. TRIAL REGISTRATION NUMBER: ISRCTN10906069.


Assuntos
Lesões Encefálicas/reabilitação , Análise Custo-Benefício , Sistemas On-Line , Resolução de Problemas , Adolescente , Estudos de Viabilidade , Humanos , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Medicina Estatal , Reino Unido
11.
J Neurosurg Sci ; 62(2): 187-202, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29154509

RESUMO

INTRODUCTION: Following traumatic brain injury (TBI), children experience a variety of physical, motor, speech, and cognitive deficits that can have a long-term detrimental impact. The emergence and popularity of new technologies has led to research into the development of various apps, gaming systems, websites, and robotics that might be applied to rehabilitation. The objective of this narrative review was to describe the current literature regarding technologically-assisted interventions for the rehabilitation of motor, neurocognitive, behavioral, and family impairments following pediatric TBI. EVIDENCE ACQUISITION: We conducted a series of searches for peer-reviewed manuscripts published between 2000 and 2017 that included a technology-assisted component in the domains of motor, language/communication, cognition, behavior, social competence/functioning, family, and academic/school-based functioning. EVIDENCE SYNTHESIS: Findings suggested several benefits of utilizing technology in TBI rehabilitation including facilitating engagement/adherence, increasing access to therapies, and improving generalizability across settings. There is fairly robust evidence regarding the efficacy of online family problem-solving therapy in improving behavior problems, executive functioning, and family functioning. There was less compelling, but still promising, evidence regarding the efficacy other technology for motor deficits, apps for social skills, and computerized programs for cognitive skills. Overall, many studies were limited in the rigor of their methodology due to small heterogeneous samples and lack of control groups. CONCLUSIONS: Technology-assisted interventions have the potential to enhance pediatric rehabilitation after TBI. Future research is needed to further support their efficacy with larger controlled trials and to identify characteristics of children who are most likely to benefit.


Assuntos
Tecnologia Biomédica , Lesões Encefálicas Traumáticas/reabilitação , Reabilitação Neurológica , Tecnologia Biomédica/instrumentação , Tecnologia Biomédica/métodos , Criança , Humanos , Reabilitação Neurológica/instrumentação , Reabilitação Neurológica/métodos
12.
Appl Physiol Nutr Metab ; 42(7): 773-779, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28249119

RESUMO

Blueberries are rich in flavonoids, which possess antioxidant and anti-inflammatory properties. High flavonoid intakes attenuate age-related cognitive decline, but data from human intervention studies are sparse. We investigated whether 12 weeks of blueberry concentrate supplementation improved brain perfusion, task-related activation, and cognitive function in healthy older adults. Participants were randomised to consume either 30 mL blueberry concentrate providing 387 mg anthocyanidins (5 female, 7 male; age 67.5 ± 3.0 y; body mass index, 25.9 ± 3.3 kg·m-2) or isoenergetic placebo (8 female, 6 male; age 69.0 ± 3.3 y; body mass index, 27.1 ± 4.0 kg·m-2). Pre- and postsupplementation, participants undertook a battery of cognitive function tests and a numerical Stroop test within a 1.5T magnetic resonance imaging scanner while functional magnetic resonance images were continuously acquired. Quantitative resting brain perfusion was determined using an arterial spin labelling technique, and blood biomarkers of inflammation and oxidative stress were measured. Significant increases in brain activity were observed in response to blueberry supplementation relative to the placebo group within Brodmann areas 4/6/10/21/40/44/45, precuneus, anterior cingulate, and insula/thalamus (p < 0.001) as well as significant improvements in grey matter perfusion in the parietal (5.0 ± 1.8 vs -2.9 ± 2.4%, p = 0.013) and occipital (8.0 ± 2.6 vs -0.7 ± 3.2%, p = 0.031) lobes. There was also evidence suggesting improvement in working memory (2-back test) after blueberry versus placebo supplementation (p = 0.05). Supplementation with an anthocyanin-rich blueberry concentrate improved brain perfusion and activation in brain areas associated with cognitive function in healthy older adults.


Assuntos
Antioxidantes/administração & dosagem , Mirtilos Azuis (Planta)/química , Encéfalo/efeitos dos fármacos , Flavonoides/administração & dosagem , Preparações de Plantas/administração & dosagem , Descanso/fisiologia , Adulto , Idoso , Antocianinas/administração & dosagem , Antocianinas/sangue , Biomarcadores/sangue , Índice de Massa Corporal , Encéfalo/metabolismo , Proteína C-Reativa/metabolismo , Cognição/efeitos dos fármacos , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Flavonoides/sangue , Frutas , Glutationa/sangue , Humanos , Inflamação/sangue , Inflamação/tratamento farmacológico , Imageamento por Ressonância Magnética , Masculino , Malondialdeído/sangue , Pessoa de Meia-Idade , Estresse Oxidativo/efeitos dos fármacos , Carbonilação Proteica , Marcadores de Spin
13.
J Int Neuropsychol Soc ; 23(3): 254-265, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28100291

RESUMO

Objectives: Prospective memory (PM) impairments are common following acquired brain injury (ABI). PM is the ability to keep a goal in mind for future action and interventions have the potential to increase independence. This review aimed to evaluate studies examining PM rehabilitation approaches in adults and children with ABI. Methods:Relevant literature was identified using PsycARTICLES (1894 to present), PsycINFO (1880 to present), the Cochrane Library (1972 to present), MEDLINE PubMed, reference lists from relevant journal articles, and searches of key journals. Literature searches were conducted using variants of the terms brain injury, stroke, encephalitis, meningitis, and tumor, combined with variants of the terms rehabilitation and prospective memory.Results: Of the 435 papers identified, 11 were included in the review. Findings demonstrated a variety of interventions to alleviate PM deficits, including compensatory strategies (e.g., external memory aids) that provide either content-specific or content-free cueing, and remediation strategies (e.g., meta-cognitive training programs) aimed at improving the self-monitoring of personal goals. Risk of bias for individual studies was considered and the strengths and limitations of each of the included studies and the review itself were discussed. Conclusions: Interventions used with adults can be effective; PM abilities can be improved by using simple reminder systems and performance can be generalized to facilitate everyday PM functioning. There is, however, a lack of research of PM interventions conducted with children with ABI, and pediatric interventions need to consider on-going cognitive maturation. (JINS, 2017, 23, 254-265).

14.
J Appl Res Intellect Disabil ; 30(2): 255-268, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26810828

RESUMO

BACKGROUND: The aims of the current study were to adapt a version of the MET for people with intellectual disabilities and assess its ecological and construct validity. MATERIAL AND METHODS: Using a correlational design, 40 participants with intellectual disabilities were invited to complete a battery of neuropsychological assessments and the modified Multiple Errands Test for Intellectual Disabilities (mMET-IDs). RESULTS: The ability to successfully complete tasks on the mMET-IDs correlated significantly with measures of the Supervisory Attentional System, namely, the Tower of London Test and the Six Parts Test. However, performance on the mMET-IDs and the Six Parts Test could be accounted for by Verbal IQ and receptive vocabulary. The mMET-IDs failed to correlate with the DEX-IR. CONCLUSIONS: The mMET-IDs can be successfully used to assess some aspects of the Supervisory Attentional System in people with intellectual disabilities. Further development is needed, however, to improve the ecological validity of the mMET-IDs.

16.
Artigo em Inglês | MEDLINE | ID: mdl-27965860

RESUMO

BACKGROUND: Increases in life expectancy have resulted in a global rise in dementia prevalence. Dementia is associated with poor wellbeing, low quality of life and increased incidence of mental health difficulties such as low mood or depression. However, currently, there is limited access to evidence-based psychological interventions for people with dementia experiencing low mood and poor wellbeing. Behavioural activation-based self-help, supported by informal carers and guided by mental health professionals, may represent an effective and acceptable solution. METHODS/DESIGN: The present study is a phase II (feasibility) single-arm trial informed by the Medical Research Council complex interventions research methods framework. Up to 50 dementia participant/informal carer dyads will be recruited from a variety of settings including primary care, dementia-specific health settings and community outreach. People living with dementia will receive behavioural activation-based self-help and be supported by their informal carer who has received training in the skills required to support the self-help approach. In turn, during the use of the intervention, the informal carer will be guided by mental health professionals to help them work through the materials and problem solve any difficulties. Consistent with the objectives of feasibility studies, outcomes relating to recruitment from different settings, employment of different recruitment methods, attrition, data collection procedures, clinical delivery and acceptability of the intervention will be examined. Clinical outcomes for people with dementia (symptoms of depression and quality of life) and informal carers (symptoms of depression and anxiety, carer burden and quality of life) will be measured pre-treatment and at 3 months post-treatment allocation. DISCUSSION: This study will examine the feasibility and acceptability of a novel behavioural activation-based self-help intervention designed to promote wellbeing and improve low mood in people living with dementia, alongside methodological and procedural uncertainties associated with research-related procedures. As determined by pre-specified progression criteria, if research procedures and the new intervention demonstrate feasibility and acceptability, results will then be used to inform the design of a pilot randomised controlled trial (RCT) to specifically examine remaining methodological uncertainties associated with recruitment into a randomised controlled design. TRIAL REGISTRATION: Current Controlled Trials ISRCTN42017211.

17.
Brain Cogn ; 108: 88-97, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27566002

RESUMO

The aims of this systematic review were to determine: (a) which brain areas are consistently more active when making (i) moral response decisions, defined as choosing a response to a moral dilemma, or deciding whether to accept a proposed solution, or (ii) moral evaluations, defined as judging the appropriateness of another's actions in a moral dilemma, rating moral statements as right or wrong, or identifying important moral issues; and (b) shared and significantly different activation patterns for these two types of moral judgements. A systematic search of the literature returned 28 experiments. Activation likelihood estimate analysis identified the brain areas commonly more active for moral response decisions and for moral evaluations. Conjunction analysis revealed shared activation for both types of moral judgement in the left middle temporal gyrus, cingulate gyrus, and medial frontal gyrus. Contrast analyses found no significant clusters of increased activation for the moral evaluations-moral response decisions contrast, but found that moral response decisions additionally activated the left and right middle temporal gyrus and the right precuneus. Making one's own moral decisions involves different brain areas compared to judging the moral actions of others, implying that these judgements may involve different processes.


Assuntos
Córtex Cerebral/fisiologia , Tomada de Decisões/fisiologia , Princípios Morais , Humanos
18.
Neuropsychology ; 30(7): 811-819, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27182710

RESUMO

OBJECTIVES: To establish the magnitude of deficits in working memory (WM) and short-term memory (STM) in those with moderate-to-severe traumatic brain injury (TBI) relative to age-matched, healthy controls and to explore the moderating effects of time since injury and age at injury on these impairments. METHOD: Twenty-one studies that compared the WM and/or STM abilities of individuals with at least a moderate TBI relative to healthy controls were included in a random effects meta-analysis. Measures used to examine memory performance were categorized by modality (visuospatial, verbal) and memory system (WM, STM). RESULTS: Individuals with TBI had significant deficits in verbal STM (Cohen's d = .41), visuospatial WM (Cohen's d = .69), and verbal WM (Cohen's d = .37) relative to controls. Greater decrements in verbal STM and verbal WM skills were associated with longer time postinjury. Larger deficits were observed in verbal WM abilities in individuals with older age at injury. CONCLUSION: Evidence for WM impairments following TBI is consistent with previous research. Larger verbal STM and verbal WM deficits were related to a longer time postinjury, suggesting that these aspects of memory do not "recover" over time and instead, individuals might show increased rates of cognitive decline. Age at injury was associated with the severity of verbal WM impairments, with larger deficits evident for injuries that occurred later in life. Further research needs to chart the long-term effects of TBI on WM and to compare the effects of injury on verbal relative to visuospatial memory. (PsycINFO Database Record


Assuntos
Dano Encefálico Crônico/diagnóstico , Dano Encefálico Crônico/psicologia , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/psicologia , Transtornos da Memória/diagnóstico , Transtornos da Memória/psicologia , Memória de Curto Prazo , Sobreviventes/psicologia , Adolescente , Adulto , Idade de Início , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Psicometria/estatística & dados numéricos , Valores de Referência , Adulto Jovem
19.
J Abnorm Psychol ; 123(2): 330-335, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24886007

RESUMO

This is the first study to examine attentional control capacities in generalized anxiety disorder (GAD). GAD is characterized by uncontrollable worry. Individuals diagnosed with GAD and healthy participants (HPs) performed a random key-pressing task while thinking about a worrisome or a positive future event, to assess the extent to which attentional control resources are used by worry. Attentional control was also assessed when participants were not instructed to think about a specific topic using the N-back task, which varies in task difficulty, and therefore is sensitive to subtle differences in ability to handle increasing demands on attentional control within the same paradigm. GAD participants (but not HPs) were less random while worrying than thinking about a positive event during the key-pressing task, suggesting that worry consumed more attentional control resources in this population. During the N-Back task, GAD participants performed worse than HPs during the high load conditions only, indicating greater difficulty in sustaining focus on conditions requiring a higher degree of attentional control, even without concurrent task activity. Poor attentional control might underpin the difficulty of GAD individuals to stop worrying and switch to thinking more benign information. Further research could investigate whether worry consumes attentional control resources in other psychological disorders with high rates of worry (e.g., panic disorder, psychosis), as well as the extent to which attentional control is used by other forms of repetitive thinking, such as depressive rumination.


Assuntos
Transtornos de Ansiedade/fisiopatologia , Atenção/fisiologia , Função Executiva/fisiologia , Memória de Curto Prazo/fisiologia , Desempenho Psicomotor/fisiologia , Adulto , Feminino , Humanos , Masculino
20.
Neuropsychologia ; 51(8): 1481-7, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23499723

RESUMO

Semantic dementia (SD) is associated with a progressive, relatively selective, degeneration of semantic memory (both verbal and nonverbal facts and knowledge). Episodic memory, however, is thought to be relatively preserved. This study aimed to further assess the nonverbal, incidental, episodic memory profile associated with SD using deferred imitation, which measures recall by the nonverbal imitation of novel action sequences after a 24-h delay. The performance of six individuals with SD was compared to that of 10 healthy age- and education-matched controls. After a baseline phase, where sets of objects were presented for manipulation to measure the spontaneous production of relevant action sequences, participants were shown eight novel three-step action sequences with the sets of objects. The component actions of the sequences were causally related in four of the eight series and arbitrarily related in the remaining four, to investigate the influence of sequence structure on memory performance. All participants produced more target actions and pairs in the arbitrary sequences 24-h after demonstration compared to baseline, indicating memory for the sequences, but only the control group showed significant memory for the order of the causal sequences (pairs). Furthermore, and perhaps more strikingly, only the control participants showed a recall advantage for the causal relative to the arbitrary sequences, indicating that they, but not the patients, could take advantage of the semantic nature of these sequences. Together these findings suggest that individuals with SD show some nonverbal episodic memory, even after a 24-h delay, and that new anterograde memory can to some extent be established without significant support from semantic memory.


Assuntos
Demência Frontotemporal/complicações , Transtornos da Memória/etiologia , Memória Episódica , Rememoração Mental/fisiologia , Idoso , Análise de Variância , Aprendizagem por Associação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de Tempo
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