A longitudinal, randomized, and prospective study of nocturnal monitoring in children and adolescents with epilepsy: Effects on quality of life and sleep.

OBJECTIVE: Most studies on seizure detection systems focus more on the effectiveness of devices than on their practicability in and impact on everyday life. Our study investigated the impact of a technical monitoring system on subjective quality of sleep and the lives of affected families. Furthermore, we evaluated the impact of anxiety levels on seizure monitoring and vice versa. METHODS: Forty-three patients with newly diagnosed epilepsy were included. Initially, the families decided whether they did (group 1, n=27) or did not (group 2, n=16) want to use a monitoring device. In group 1, patients were randomly assigned to using Epi-Care® (group 1A, n=14) or an audio baby monitor (group 1B, n=13). Quality of life was assessed at two points (t1, at the start of the study and t2, at 5-7months of follow-up) using the SF-12, Kindl-R, and "Familien-Belastungs-Fragebogen" (German version of the "Impact on Family Scale"). In addition, parental anxiety was measured using the State-Trait Anxiety-Inventory, and subjective quality of sleep was measured using the Pittsburgh Sleep Quality Index. Statistical analysis focused on the possible differences between groups 1 and 2 that may influence parents' decisions and the effects of the presence and types of technical monitoring over time. RESULTS: Anxiety levels were not significantly different between the groups with and without monitoring (group 1 vs. group 2). We also found no statistically significant, substantial baseline differences between the Epi-Care® and audio baby monitor groups, with at least medium effect sizes (group 1A vs. group 1B). Parents' health-related mental quality of life measured via the SF-12 increased significantly over time in all groups. By tendency, the fear of further seizures as well as the frequency of cosleeping arrangements in the monitoring group decreased during the study and approached the stable values of the control group. SIGNIFICANCE: Individual parental anxiety levels are not crucial in the decision regarding the use of a monitoring device. A monitoring system may help some families in certain aspects of daily life. During the first months following a diagnosis of epilepsy, quality of life increases independently of the use of a monitoring system.

Alice-in-Wonderland syndrome--a case-based update and long-term outcome in nine children.

PURPOSE: There are some reports of so-called Alice-in-Wonderland syndrome mostly concerning differential diagnosis, association with a variety of infectious diseases and even some case reports on functional imaging. Long-term data are rare. METHODS: Nine boys aged 6 to 11 years that had been diagnosed with Alice-in-Wonderland syndrome between 2003 and 2008 were contacted for a long-term follow-up study in summer, 2009, with a mean follow-up of 4.6 years. RESULTS: At the time of the follow-up study, all children were in good general and mental health. Symptoms of Alice-in-Wonderland syndrome had ceased within weeks or months. In two patients, episodes of metamorphopsia returned after a symptom-free latency of 3 years and 1 year, respectively. Five children had a family history of migraine or epilepsy. In one case, the father was reported to have experienced similar symptoms when he was a child. CONCLUSION: Our follow-up study shows that Alice-in-Wonderland is most likely a benign, self-terminating childhood condition, although occasional recurrences of symptoms are possible.

An evaluation of two commonly used tests of unfamiliar face recognition.

The Warrington Recognition Memory for Faces (RMF) and the Benton Facial Recognition Test (BFRT) are commercially available tests that are commonly used by clinicians and cognitive neuropsychologists to evaluate unfamiliar face recognition. Yet, it is not clear that a normal score on either instrument demonstrates normal unfamiliar face recognition. Because the RMFs stimuli contain abundant non-internal facial feature information, subjects may be able to score in the normal range without using internal facial features. On the BFRT, subjects commonly rely on feature matching strategies using the hairline and eyebrows rather than recognizing the facial configuration. To test whether these routes to recognition can support normal performance, normal subjects were tested with versions of the RMF and the BFRT in which the faces had been painted over in a way that prevented the operation of some of the procedures normally involved with face recognition. Even though these modifications removed all of the internal feature information in the RMF, many subjects scored in the normal range, and despite precluding the use of configural processing in the BFRT, many of the scores were in the normal range. As a result, it is apparent that normal scores on these tests do not demonstrate normal unfamiliar face recognition and so clinicians should be cautious in interpreting scores in the normal range. Finally, these results place in question models supported by dissociations involving normal performance on these tests.

Logical reasoning and probabilities: a comprehensive test of Oaksford And Chater (2001).

We report two experiments testing a central prediction of the probabilistic account of reasoning provided by Oaksford and Chater (2001): Acceptance of standard conditional inferences, card choices in the Wason selection task, and quantifiers chosen for conclusions from syllogisms should vary as a function of the frequency of the concepts involved. Frequency was manipulated by a probability-learning phase preceding the reasoning tasks to simulate natural sampling. The effects predicted by Oaksford and Chater (2001) were not obtained with any of the three paradigms.

Two meanings of "if"? Individual differences in the interpretation of conditionals.

This work investigates the nature of two distinct response patterns in a probabilistic truth table evaluation task, in which people estimate the probability of a conditional on the basis of frequencies of the truth table cases. The conditional-probability pattern reflects an interpretation of conditionals as expressing a conditional probability. The conjunctive pattern suggests that some people treat conditionals as conjunctions, in line with a prediction of the mental-model theory. Experiments 1 and 2 rule out two alternative explanations of the conjunctive pattern. It does not arise from people believing that at least one case matching the conjunction of antecedent and consequent must exist for a conditional to be true, and it does not arise from people adding the converse to the given conditional. Experiment 3 establishes that people's response patterns in the probabilistic truth table task are very consistent across different conditionals, and that the two response patterns generalize to conditionals with negated antecedents and consequents. Individual differences in rating the probability of a conditional were loosely correlated with corresponding response patterns in a classical truth table evaluation task, but there was little association with people's evaluation of deductive inferences from conditionals as premises. A theoretical framework is proposed that integrates elements from the conditional-probability view with the theory of mental models.

Between reasoning.

In two experiments we investigated three-term reasoning with spatial relational assertions using the preposition between as compared to projective prepositions (such as to the left of). For each kind of assertion we distinguish the referent expression (i.e., the grammatical subject) from the relatum expression (i.e., the internal argument of the preposition; e.g., [The hedgehog]referent_expressionis to the left of [the frog]relatum_expression; [the snake]referent_expressionis between [the donkey and the deer]relatum_expression). Previous research has shown that integrating premises with projective prepositions is easier (a) when the relatum expression of the second premise denotes an element already given by the first premise (relatum = given), and (b) when the term denoting a given element precedes the term denoting a new element (given-new). Experiment 1 extended this finding to second premises with the preposition between. In Experiment 2, between figured in the first premise. In this case, participants built an initial preferred model already from the first premise, although such a premise is indeterminate with respect to the array that it describes. Since there is no need left for integrating the second premise, this premise is instead used to verify the initial model and to modify it when necessary. A further investigation of conclusion evaluation times showed that conclusions were evaluated faster when they first mentioned the element that was included most recently into the mental model of the premises. The use of premises with between permitted the separation of recency of model inclusion from recency of appearance of an element in a premise.

Working memory capacity and the construction of spatial mental models in comprehension and deductive reasoning.

We asked 149 high-school students who were pretested for their working memory capacity (WMC) to read spatial descriptions relating to five objects and to evaluate conclusions asserting an unmentioned relationship between two of the objects. Unambiguous descriptions were compatible with a single spatial arrangement, whereas ambiguous descriptions permitted two arrangements; a subset of the ambiguous descriptions still determined the relation asserted in the conclusion, whereas another subset did not. Two groups of participants received different instructions: The deduction group should accept conclusions only if they followed with logical necessity from the description, whereas the comprehension group should accept a conclusion if it agreed with their representation of the arrangement. Self-paced reading times increased on sentences that introduced an ambiguity, replicating previous findings in deductive reasoning experiments. This effect was also found in the comprehension group, casting doubt on the interpretation that people consider multiple possible arrangements online. Responses to conclusions could be modelled by a multinomial processing model with four parameters: the probability of constructing a correct mental model, the probability of detecting an ambiguity, and two guessing parameters. Participants with high and with low WMC differed mainly in the probability of successfully constructing a mental model.

Causal and noncausal conditionals: an integrated model of interpretation and reasoning.

We present an integrated model for the understanding of and the reasoning from conditional statements. Central assumptions from several approaches are integrated into a causal path model. According to the model, the cognitive availability of exceptions to a conditional reduces the subjective conditional probability of the consequent, given the antecedent. This conditional probability determines people's degree of belief in the conditional, which in turn affects their willingness to accept logically valid inferences. In addition to this indirect pathway, the model contains a direct pathway: Availability of exceptional situations directly reduces the endorsement of valid inferences. We tested the integrated model with three experiments using conditional statements embedded in pseudonaturalistic cover stories. An explicitly mentioned causal link between antecedent and consequent was either present (causal conditionals) or absent (arbitrary conditionals). The model was supported for the causal but not for the arbitrary conditional statements.

Two principles of premise integration in spatial reasoning.

We propose two principles that facilitate integration of two relational premises in spatial reasoning. Integration is easier if the anaphor in the second premise, P2, bears the role of the relatum (relatum = given). Moreover, integration is easier if, in P2, the anaphor is mentioned before the new element (given-new). In premises with canonical word order (grammatical subjects mentioned first), these principles always conflict with one another. In topicalized statements mentioning the prepositional phrase first, the two principles work in tandem. By varying word order, we tested the two principles by measuring P2 comprehension times. Comprehension times indicated that integration was easiest when P2 obeyed both principles and most difficult when both principles were violated. Canonical premises were of intermediate difficulty. This pattern emerged regardless of whether the anaphor was a definite description or a pronoun.

Effects of directionality in deductive reasoning: II. Premise integration and conclusion evaluation.

Previous research (Oberauer & Wilhelm, 2000) has shown an inherent directionality between the two terms linked in premises of typical deductive reasoning tasks. With three experiments we investigated the effect of inherent directionality on the time to integrate two premises and for the derivation of a conclusion. We varied figure (i.e., order of terms in the premises) and direction of inference (i.e., order of terms in the conclusion) in deduction tasks from various domains (propositional reasoning, syllogisms, spatial, temporal, and linear order reasoning). Effects of figure on premise reading times varied with the directionality of the relations. Effects of direction of inference reflected the same directionality for a subset of relations. We propose that two factors are jointly responsible for a large part of observed directionality effects in premise integration: the inherent directionality of relational statements and a general advantage for a given-new order of terms in the second premise. Difficulty of deriving a conclusion is affected by the directionality or relations if and only if the relation is semantically asymmetric, so that the directionality must be preserved in the integrated mental model.