Examination of a case of "treatment failure" in long-term psychoanalytic psychotherapy for treatment-resistant depression.

Randomized controlled trials have reported psychoanalytic psychotherapy to improve longer-term post-treatment outcomes in patients with treatment-resistant depression. In this case study, we examine the therapy process of a female trial participant diagnosed with treatment-resistant depression. Structured clinical assessments indicated that the patient's level of depression remained unchanged during and after treatment. Over the course of the therapy, she repeatedly broke away from important others and finally also from the therapy itself, which we linked to the impact of earlier experiences of abandonment on her internal world. In the discussion, we present a variety of reflections that were put forward by the authors during a series of case discussion meetings. Some of these reflections relate to how the inner world of this patient might have triggered a negative therapeutic reaction and a destructive pattern of repetition. The interpretative stance, in which the therapist interpreted this reaction as indicative of a psychic conflict and linked this conflict to the therapeutic relationship, seemed to be experienced by the patient as unhelpful and persecutory. Other elements that were brought up include basic distrust, lack of symbolization and trauma in the patient, as well as the constraints of the research context.

Non-Word Repetition in Arabic-speaking children with and without Autism Spectrum Disorder (ASD): A closer look into accuracy and error patterns.

Non-Word Repetition (NWR) tasks effectively identify language impairments and assess phonological skills across diverse populations and languages, including Arabic. Prior research revealed heterogeneity of performance in children with Autism Spectrum Disorder (ASD) on NWR tasks. The current study is the first to evaluate phonological skills of Palestinian-Arabic-speaking children with and without ASD, employing a Palestinian-Arabic NWR task. A total of 142 Palestinian-Arabic-speaking children, aged 5-11 participated in the study, including 75 children with Typical Language Development (TLD) and 67 children with ASD. The NWR task included 18 non-words of varying length (1-4 syllables) and complexity (with and without consonant clusters). Quantitative analysis examined the effects of length and phonological complexity on the NWR accuracy scores in children with TLD and ASD. Error pattern analysis accounting for phoneme and syllable substitutions/deletions/additions and lexicalisations aimed to shed light on the phonological representations of children with and without ASD. Within the ASD group, two subgroups emerged: 72% exhibited age-appropriate NWR performance, while 28% showed performance at-risk for phonological impairment. Non-word length, rather than complexity, significantly influenced the children's performance. Consonant substitution was the most frequent error pattern across all groups. On the theoretical side, these findings extend cross-linguistic evidence of phonological skill heterogeneity in children with ASD to Arabic-speaking children. Additionally, they highlight an overall delayed but qualitatively similar pattern of phonological development in children with ASD. On the clinical side, results underscore the importance of comprehensive language assessment in children with ASD.

Effects of verbatim repetition of the headline message on the proceed button on click-through rates in online retail.

For online retailers, increasing click-through rates and reducing dropout rates are critical to success. In this study, we examine the effect of verbatim repetition of the website's headline message on the proceed button, based on research on processing fluency. In our field study involving 956 online platform visitors, we found that verbatim repetitions of the header message on the proceed button resulted in an increase in the conversion rate by more than 10 percentage points compared to gist repetitions and new messages. Our findings highlight the importance of simple verbatim features and demonstrate the successful application of processing fluency research to impact consumer behavior.

Five-Repetition Sit-to-Stand Test as Predictor of Mortality in High Risk COPD Patients.

OBJECTIVE: To determine if adding performance on the five-repetition sit-to-stand test (5-STS) to chronic obstructive pulmonary disease (COPD) high-risk criteria, proposed by the Spanish COPD guidelines (GesEPOC), affects mortality prognosis. METHODS: Observational study of COPD outpatients involved prospective follow-up for 5 years. Patients were classified based on 5-STS performance and risk criteria proposed by GesEPOC version 2021. Outcome measures were 5-year mortality timing and rate. Kaplan-Meier curves and univariate and multivariate Cox proportional-hazard analyses, analysis of variance, and univariate and multivariate linear and logistic regression models were used. RESULTS: One hundred and thirty-seven patients were included. Mean age was 66±8.3 years, and 87.6% were men. Of them, 115 (83.9%) were classified as high risk, 43 (34.4%) of whom had poor performance on the 5-STS. Overall mortality at 5 years was 27% and was significantly higher in the high-risk (29.6%) compared with the low-risk (13.6%) group. Among high-risk patients, mortality at 5 years was significantly worse with poor 5-STS performance (60.5%) compared with non-poor performance (11.1%). Poor performance on the 5-STS was independently associated with increased 5-year mortality risk (HR 4.70; 95% CI: 1.96-11.27) in a model adjusted for history of heart disease and dyspnea. CONCLUSION: Among high-risk COPD patients, those with poor performance on the 5-STS have a significantly higher mortality at 5 years than those with non-poor 5-STS performance.

Language Markers of Dementia and Their Role in Early Diagnosis of Alzheimer's Disease: Exploring Grammatical and Syntactic Competence via Sentence Repetition.

Background: Earlier research focuses primarily on the cognitive changes due to Alzheimer's disease (AD); however, little is known with regard to changes in language competence across the lifespan. Objective: The present study aims to investigate the decline of language skills at the grammatical and syntactic levels due to changes in cognitive function. Methods: We administered the Litmus Sentence Repetition Task (SRT) to 150 native speakers of Greek who fall into five groups: 1) young healthy speakers, 2) cognitively intact elder healthy speakers, 3) speakers with subjective cognitive impairment (SCI), 4) speakers with mild cognitive impairment (MCI); and 5) speakers with AD dementia at the mild/moderate stages. All participants underwent a physical and neurological examination and cognitive screening with a standardized neuropsychological battery to assess cognitive status comprehensively and evaluate aspects like working memory, executive function, attention and memory to appropriately classify them. Results: The data analysis revealed that the SRT had high discriminatory value in the development of AD; specifically, both accuracy and grammaticality indices were related to cognitive decline. Additionally, syntax significantly affected the performance of speakers with structures such as clitics being particularly challenging and in most structures the performance of speakers with MCI drops significantly compared to speakers with SCI. Conclusions: Linguistic indices revealed subtle early signs of cognitive decline that can be helpful in the early detection of AD, thus facilitating the clinical process offering support to language-based assessment tools such as sentence repetition, a non-invasive type of assessment to evaluate symptoms of AD.

Perceptual anchoring: Children with dyslexia benefit less than controls from contextual repetitions in speech processing.

OBJECTIVES: Individuals with dyslexia perceive and utilize statistical features in the auditory input deficiently. The present study investigates whether affected children also benefit less from repeating context tones as perceptual anchors for subsequent speech processing. METHODS: In an event-related potential study, eleven-year-old children with dyslexia (n = 21) and without dyslexia (n = 20) heard syllable pairs, with the first syllable either receiving a constant pitch (anchor) or variable pitch (no-anchor), while second syllables were identical across conditions. RESULTS: Children with and without dyslexia showed smaller auditory P2 responses to constant-pitch versus variable-pitch first syllables, while only control children additionally showed smaller N1 and faster P1 responses. This suggests less automatic processing of anchor repetitions in dyslexia. For the second syllables, both groups showed faster P2 responses following anchor than no-anchor first syllables, but only controls additionally showed smaller P2 responses. CONCLUSIONS: Children with and without dyslexia show differences in anchor effects. While both groups seem to allocate less attention to speech stimuli after contextual repetitions, children with dyslexia display less facilitation in speech processing from acoustic anchors. SIGNIFICANCE: Altered anchoring in the linguistic domain may contribute to the difficulties of individuals with dyslexia in establishing long-term representations of speech.

EXPRESS: The influence of familiarisation and item repetition on the name agreement effect in picture naming.

Name agreement (NA) refers to the degree to which speakers agree on a picture's name. A robust finding is that speakers are faster to name pictures with high agreement (HA) than those with low agreement (LA). This NA effect is thought to occur because LA pictures strongly activate several names, and so speakers need time to select one. HA pictures, in contrast, strongly activate a single name and so there is no need to select one name out of several alternatives. Recent models of lexical access suggest that the structure of the mental lexicon changes with experience. Thus, speakers should consider a range of names when naming LA pictures, but the extent to which they consider each of these names should change with experience. We tested these hypotheses in two picture-naming experiments. In Experiment 1, participants were faster to name LA than HA pictures when they named each picture once. Importantly, they were faster to produce modal names (provided by most participants) than alternative names for LA pictures, consistent with the view that speakers activate multiple names for LA pictures. In Experiment 2, participants were familiarised with the modal name before the experiment and named each picture three times. Although there was still an NA effect when participants named the pictures the first time, it was reduced in comparison to Experiment 1 and was further reduced with each picture repetition.Thus, familiarisation and repetition reduced the NA effect, but did not eliminate it, suggesting speakers activate a range of plausible names.

The temporal dynamics of familiar face recognition: Event-related brain potentials reveal the efficient activation of facial identity representations.

While it is widely known that humans are typically highly accurate at recognizing familiar faces, it is less clear how efficiently recognition is achieved. In a series of three experiments, we used event-related brain potentials (ERP) in a repetition priming paradigm to examine the efficiency of familiar face recognition. Specifically, we varied the presentation time of the prime stimulus between 500 ms and 33 ms (Experiments 1 and 2), and additionally used backward masks (Experiment 3) to prevent the potential occurrence of visual aftereffects. Crucially, to test for the recognition of facial identity rather than a specific picture, we used different images of the same facial identities in repetition conditions. We observed clear ERP repetition priming effects between 300 and 500 ms after target onset at all prime durations, which suggests that the prime stimulus was sufficiently well processed to allow for facilitated recognition of the target in all conditions. This finding held true even in severely restricted viewing conditions including very brief prime durations and backward masks. We conclude that the facial recognition system is both highly effective and efficient, thus allowing for our impressive ability to recognise the faces that we know.

Adaptation of the inferior temporal neurons and efficient visual processing.

Numerous studies examining the responses of individual neurons in the inferior temporal (IT) cortex have revealed their characteristics such as two-dimensional or three-dimensional shape tuning, objects, or category selectivity. While these basic selectivities have been studied assuming that their response to stimuli is relatively stable, physiological experiments have revealed that the responsiveness of IT neurons also depends on visual experience. The activity changes of IT neurons occur over various time ranges; among these, repetition suppression (RS), in particular, is robustly observed in IT neurons without any behavioral or task constraints. I observed a similar phenomenon in the ventral visual neurons in macaque monkeys while they engaged in free viewing and actively fixated on one consistent object multiple times. This observation indicates that the phenomenon also occurs in natural situations during which the subject actively views stimuli without forced fixation, suggesting that this phenomenon is an everyday occurrence and widespread across regions of the visual system, making it a default process for visual neurons. Such short-term activity modulation may be a key to understanding the visual system; however, the circuit mechanism and the biological significance of RS remain unclear. Thus, in this review, I summarize the observed modulation types in IT neurons and the known properties of RS. Subsequently, I discuss adaptation in vision, including concepts such as efficient and predictive coding, as well as the relationship between adaptation and psychophysical aftereffects. Finally, I discuss some conceptual implications of this phenomenon as well as the circuit mechanisms and the models that may explain adaptation as a fundamental aspect of visual processing.

On the role of the arcuate fasciculus in word production and repetition: a reply to Van den Hoven et al. (2024).

Van den Hoven et al. contested my interpretation of Wernicke regarding the role of the arcuate fasciculus (AF) in word production. Here, I clarify and defend my interpretation. They also questioned the assumption of AF subtracts in my modern account, stating that subtracts are difficult to distinguish anatomically due to overlapping terminations. Here, I make clear that overlap in terminations was actually part of my account, in which differentially damaged subtracts explained patients' differential naming and repetition performance as well as types of repetition performance.

A Platform for Ultra-Fast Proton Probing of Matter in Extreme Conditions.

Recent developments in ultrashort and intense laser systems have enabled the generation of short and brilliant proton sources, which are valuable for studying plasmas under extreme conditions in high-energy-density physics. However, developing sensors for the energy selection, focusing, transport, and detection of these sources remains challenging. This work presents a novel and simple design for an isochronous magnetic selector capable of angular and energy selection of proton sources, significantly reducing temporal spread compared to the current state of the art. The isochronous selector separates the beam based on ion energy, making it a potential component in new energy spectrum sensors for ions. Analytical estimations and Monte Carlo simulations validate the proposed configuration. Due to its low temporal spread, this selector is also useful for studying extreme states of matter, such as proton stopping power in warm dense matter, where short plasma stagnation time (<100 ps) is a critical factor. The proposed selector can also be employed at higher proton energies, achieving final time spreads of a few picoseconds. This has important implications for sensing technologies in the study of coherent energy deposition in biology and medical physics.

Semantic-to-autobiographical memory priming: the role of cue repetition.

It is now well established that general information processing causes the activation of memories in the autobiographical memory system, and these memories on occasion emerge as involuntary autobiographical memories. This priming phenomenon has been dubbed semantic-to-autobiographical memory priming, and our goal in the current study was to examine the effects of cue/prime repetition on the production of involuntary autobiographical memories that were primed with semantic stimuli. In three experiments, participants were primed with words (e.g., cat), and then they were given an involuntary memory task (the vigilance task), which contained cues related to the primed stimuli. In Experiment 1, the cues were phrases containing the primes (e.g., getting a cat), which were presented one or five times. In Experiment 2, the cues were also phrases containing the primes (e.g., getting a cat), but they changed their context (e.g., feeding a cat), every time they repeated in the five-presentation condition. Experiment 3 also presented the cues one or five times, but the cues were replicas of the primes (e.g., cat). Consistent with predictions, greater priming was found in the five-presentation cue conditions in all three experiments, and Experiment 3 failed to find priming in the one-presentation cue condition, also consistent with predictions. We explain the findings in terms of semantic-to-autobiographical memory priming theory, and also argue that the results help explain the production of involuntary memories in everyday life.

Factors associated with nonword repetition skills in 4-to 6-year-old deaf and hard-of-hearing and typically hearing children.

Children identified as deaf and hard of hearing (DHH) exhibit an increased risk of speech and language difficulties. Nonword repetition (NWR) is a potential tool for identifying language difficulties in children with limited experience with the target language. In this study, we explored associations between auditory, linguistic, demographic and cognitive factors and NWR performance in DHH children and their typically hearing (TH) peers. We also examined the effect of the group on NWR outcomes when different factors were statistically controlled for. Our study included 68 4- to 6-year-old children: 18 with bilateral hearing aids (BiHAs), 18 with bilateral cochlear implants (BiCIs) and 32 with TH. The participants completed the Finnish Nonword Repetition Test comprising 24 test items with varying syllable lengths. The assessment methods also included tests of phonological, lexical, language comprehension and sentence repetition skills, along with a measure of nonverbal intelligence. The results showed that none of the auditory, linguistic, demographic and cognitive factors examined in the present study were correlated with NWR performance in the BiHA group, while significant correlations between NWR skills and linguistic abilities were observed in the BiCI group. The DHH children showed extraordinary difficulties in NWR compared to their TH peers, and these group differences remained after controlling for linguistic and demographic variables. The NWR task may be a potential clinical tool for identifying DHH children at risk for poor language outcomes and in need of speech and language intervention.

The Progression of Lethality Across Multiple Suicide Attempts: A Systematic Review.

OBJECTIVE: Suicide is a major global public health concern. While some progress has been made in understanding risk factors for suicidal behavior, other relevant questions have received less attention. One such question relates to the longitudinal course of suicidal behavior amongst individuals with multiple suicide attempts. This systematic review investigated whether there is an increase in the lethality across multiple suicide attempts. METHOD: This systematic review followed PRISMA 2020 reporting guidelines. A literature search was conducted in MEDLINE, Embase and PsycINFO electronic databases from inception to August 2023 to identify studies with key terms related to multiple suicide attempts and lethality. The review included longitudinal studies with data on multiple suicide attempts, and any rating of their lethality. Covidence was used to guide the screening and extraction process. A narrative synthesis approach was used to descriptively summarize included studies. RESULTS: After identifying 828 unique abstracts for screening, 11 studies were included for narrative synthesis. Suicide attempt assessment methods and definitions were heterogenous, often indirectly inferring lethality based on suicide attempt method. Individuals with repeat attempts may be more likely to continue using the same method. CONCLUSIONS: There was no evidence to support increasing lethality across repeat suicide attempts. However, this should be interpreted along with the fact that the evidence base is scarce, heterogenous, and methodologically limited.

There was no strong evidence for an increasing pattern of lethality across repeat attempts.A higher proportion of individuals continue to use the same method across repeat attempts.The evidence base is scarce, heterogenous, and methodologically limited.

Effects of the Ketogenic Diet on Strength Performance in Trained Men and Women: A Systematic Review and Meta-Analysis.

Ketogenic diets (KDs) are an alternative to improve strength performance and body composition in resistance training participants. The objective of this review and meta-analysis is to verify whether a ketogenic diet produces an increase in the strength of resistance-trained participants. We have evaluated the effect of the ketogenic diet in conjunction with resistance training on the strength levels in trained participants. Boolean algorithms from various databases (PubMed, Scopus, and Web of Science) were used. Meta-analyses were carried out, one on the 1-RM squat (SQ), with 106 trained participants or athletes, and another on the 1-RM on the bench press (BP), evaluating 119 participants. We did not find significant differences between the groups in the variables of SQ or BP, although the size of the effect was slightly higher in the ketogenic group. Conclusions: KDs do not appear to impair 1-RM performance; however, this test does not appear to be the most optimal tool for assessing hypertrophy-based strength session performance in resistance-trained participants.

Trait Mindfulness Moderates Treatment Outcomes in a Randomized Controlled Trial of Mantram Repetition Program for Veterans with Post-Traumatic Stress Disorder.

Objectives: This secondary analysis examined five facets of mindful awareness as potential moderators of clinical outcomes using data from a randomized controlled trial (RCT) that compared Mantram Repetition Program (MRP) with present-centered therapy (PCT) in veterans with post-traumatic stress disorder (PTSD). Methods: Data were examined from 173 veterans with military-related PTSD randomly assigned to receive eight sessions of MRP (n = 89) or PCT (n = 84). Clinician-administered and self-report measures of mindfulness (Five Facet Mindfulness Questionnaire [FFMQ]), PTSD severity, insomnia symptoms, and depression symptoms, and were obtained pre- and post-intervention. Hierarchical regressions were used to test for FFMQ moderation on clinical outcomes within the two treatment groups. Results: For those with greater ability to "describe their internal experience" (+1 standard deviation [SD]), MRP was associated with lower PTSD hyperarousal symptoms post-intervention than PCT (p < 0.001). For those with lower "nonreactivity to internal stimuli" (-1 SD), MRP was associated with greater reductions in PTSD avoidance and numbing symptoms and insomnia compared with PCT (all ps < 0.002). Conclusions: Pre-intervention mindfulness domains of "describe" and "nonreactivity to inner experience" differentially predicted improvements in PTSD and insomnia symptoms for MRP as compared with PCT subjects. The FFMQ may be an important tool for predicting patient preparedness for mindfulness-based interventions, such as MRP.

Non-word repetition and vocabulary in Kuwaiti Arabic-speaking children with down syndrome and typically developing children.

OVERVIEW: Non-word repetition (NWR) is one of the most effective predictors of language impairments in children as it has been found to correlate with various language measures and the association between NWR and vocabulary is well documented in typically developing (TD) studies. However, there is a dire need for investigations of language skills in Kuwaiti Arabic individuals with Down Syndrome, and this study set out to fill a gap in this field. METHOD: In this paper, we compare the vocabulary and NWR skills of a group of 48 individuals with DS aged 6-20 years to a group of 44 TD children aged 3-10 years matched on nonverbal IQ. Furthermore, we investigate the correlations among these language measures in the two groups and examine whether NWR can predict receptive and expressive vocabulary in these two groups. RESULT: Results found DS participants performed significantly less than the TD group on the three language measures (receptive vocabulary t(90)= -3.17, p < .01, expressive vocabulary t(90)= -3.27, p < .01, and NWR t(90)= -8.32, p < .01). Moreover, there were strong correlations between NWR and vocabulary (receptive and expressive) in the TD group but not the DS group. CONCLUSION: Findings supported the working memory model and the phonological processing account for the TD group. On the other hand, the poor association between NWR and vocabulary in the DS group might be due to poor phonological discrimination difficulties and speech discrimination difficulties.

Repetition-Dependent Adaptation and Prediction Error Signalling in Schizophrenia Patients With Auditory Hallucinations: A Roving Mismatch Negativity Study.

BACKGROUND: Dysregulated prediction error-signalling may explain auditory hallucinations in schizophrenia (SZ-AH). Roving mismatch negativity (rMMN) is an event-related potential (ERP) index where the deviant tone becomes the new standard with repetitions. Longer repetitions of standard stimuli yield a more positive sensory-adaptation response (Repetition Positivity-RP), elicit a stronger deviance-detection when interrupted (deviant negativity-DN), and the difference waveform between them reflects the strength of prediction-error signalling (mismatch negativity-MMN). METHODS: Twenty-three SZ-AH patients and twenty-three healthy controls (HC) underwent rMMN assessment. Various standard stimuli were repeated in sets of 3, 8 and 33 yielding three components for RP (RP3, RP8, RP33), DN (DN3, DN8, DN33), and MMN (MMN3, MMN8, MMN33). Amplitudes and latencies were compared across groups. Correlation between (a) rMMN amplitudes and latencies, and clinical variables in SZ-AH, and (b) the RP-DN amplitude pair for all three repetition sets (3, 8, 33) were also examined. RESULTS: All DN and MMN33 amplitudes were significantly suppressed in SZ-AH, while RP amplitudes were not. MMN33 latency was significantly longer in SZ-AH than HC. A few amplitudes and latencies significantly correlated with the frequency of AH. HC showed a significant positive correlation between RP-DN amplitude pairs for sets of 3 and 8 but not for 33; SZ-AH group's correlation profile was opposite to this. DISCUSSION: The link between repetition-dependent sensory-adaptation and deviance-detection is perturbed in SZ-AH. The unimpaired RP profile in SZ-AH is due to potential interference of AH with auditory information processing, and does not indicate a preserved short-term plasticity of the echoic memory trace.

A Rapid, Efficient Method for Anodic Aluminum Oxide Membrane Room-Temperature Multi-Detachment from Commercial 1050 Aluminum Alloy.

For commercial processes, through-hole AAO membranes are fabricated from high-purity aluminum by chemical etching. However, this method has the disadvantages of using heavy-metal solutions, creating large amounts of material waste, and leading to an irregular pore structure. Through-hole porous alumina membrane fabrication has been widely investigated due to applications in filters, nanomaterial synthesis, and surface-enhanced Raman scattering. There are several means to obtain freestanding through-hole AAO membranes, but a fast, low-cost, and repetitive process to create complete, high-quality membranes has not yet been established. Here, we propose a rapid and efficient method for the multi-detachment of an AAO membrane at room temperature by integrating the one-time potentiostatic (OTP) method and two-step electrochemical polishing. Economical commercial AA1050 was used instead of traditional high-cost high-purity aluminum for AAO membrane fabrication at 25 °C. The OTP method, which is a single-step process, was applied to achieve a high-quality membrane with unimodal pore distribution and diameters between 35 and 40 nm, maintaining a high consistency over five repetitions. To repeatedly detach the AAO membrane, two-step electrochemical polishing was developed to minimize damage on the AA1050 substrate caused by membrane separation. The mechanism for creating AAO membranes using the OTP method can be divided into three major components, including the Joule heating effect, the dissolution of the barrier layer, and stress effects. The stress is attributed to two factors: bubble formation and the difference in the coefficient of thermal expansion between the AAO membrane and the Al substrate. This highly efficient AAO membrane detachment method will facilitate the rapid production and applications of AAO films.

Dynamics of visual attention in exploration and exploitation for reward-guided adjustment tasks.

The learning process encompasses exploration and exploitation phases. While reinforcement learning models have revealed functional and neuroscientific distinctions between these phases, knowledge regarding how they affect visual attention while observing the external environment is limited. This study sought to elucidate the interplay between these learning phases and visual attention allocation using visual adjustment tasks combined with a two-armed bandit problem tailored to detect serial effects only when attention is dispersed across both arms. Per our findings, human participants exhibited a distinct serial effect only during the exploration phase, suggesting enhanced attention to the visual stimulus associated with the non-target arm. Remarkably, although rewards did not motivate attention dispersion in our task, during the exploration phase, individuals engaged in active observation and searched for targets to observe. This behavior highlights a unique information-seeking process in exploration that is distinct from exploitation.