Screening for anxiety, depression and suicidality by epilepsy specialists in adult services in Scotland.

OBJECTIVE: Clinical guidelines recommend screening people with epilepsy (PWE) regularly for mental distress, but it is unclear how guidelines are implemented. We surveyed epilepsy specialists in adult Scottish services to determine approaches used to screen for anxiety, depression, and suicidality; the perceived difficulty of screening; factors associated with intention to screen; and treatment decisions made following positive screens. METHODS: An anonymous email-based questionnaire survey of epilepsy nurses and epilepsy neurology specialists (n = 38) was conducted. RESULTS: Two in every three specialists used a systematic screening approach; a third did not. Clinical interview was employed more often than standardized questionnaire. Clinicians reported positive attitudes towards screening but found screening difficult to implement. Intention to screen was associated with favorable attitude, perceived control, and social norm. Pharmacological and non-pharmacological interventions were proposed equally often for those screening positive for anxiety or depression. CONCLUSION: Routine screening for mental distress is carried out in Scottish epilepsy treatment settings but is not universal. Attention should be paid to clinician factors associated with screening, such as intention to screen and resulting treatment decisions. These factors are potentially modifiable, offering a means of closing the gap between guideline recommendations and clinical practice.

Questionnaire-based screening for mental distress in epilepsy: Outline and feasibility of an outpatient screening and intervention pathway.

OBJECTIVE: Mental distress is present in a significant proportion of people with epilepsy (PWE), with a negative impact across life domains. It is underdiagnosed and under-treated despite guidelines recommending screening for its presence (e.g., SIGN, 2015). We describe a tertiary-care epilepsy mental distress screening and treatment pathway, with a preliminary investigation of its feasibility. METHODS: We selected psychometric screening instruments for depression, anxiety, quality of life (QOL), and suicidality, establishing treatment options matched to instrument scores on the Patient Health Questionnaire 9 (PHQ-9), along 'traffic light' lines. We determined feasibility outcomes including recruitment and retention rates, resources required to run the pathway, and level of psychological need. We undertook a preliminary investigation of change in distress scores over a 9-month interval and determined PWE engagement and the perceived usefulness of pathway treatment options. RESULTS: Two-thirds of eligible PWE were included in the pathway with an 88% retention rate. At the initial screen, 45.8% of PWE required either an 'Amber-2' intervention (for moderate distress) or a 'Red' one (for severe distress). The equivalent figure at the 9-month re-screen was 36.8%, reflective of an improvement in depression and QOL scores. Online charity-delivered well-being sessions and neuropsychology were rated highly for engagement and perceived usefulness, but computerized cognitive behavioral therapy was not. The resources required to run the pathway were modest. CONCLUSION: Outpatient mental distress screening and intervention are feasible in PWE. The challenge is to optimize methods for screening in busy clinics and to determine the best (and most acceptable) interventions for screening positive PWE.

Forgetting Rates of Prose Memory in Mild Cognitive Impairment.

BACKGROUND: Some authors report steeper slopes of forgetting in early Alzheimer's disease (AD), while others do not. Contrasting findings are thought to be due to methodological inconsistencies or variety of testing methods, yet they also emerge when people are assessed on the same testing procedure. OBJECTIVE: We aimed to assess if forgetting slopes of people with mild cognitive impairment due to AD (MCI-AD) are different from age-matched healthy controls (HC) by using a prose paradigm. METHODS: Twenty-nine people with MCI-AD and twenty-six HC listened to a short prose passage and were asked to freely recall it after delays of 1 h and 24 h. RESULTS: Generalized linear mixed modelling revealed that, compared to HC, people with MCI-AD showed poorer encoding at immediate recall and steeper forgetting up to 1 h in prose memory as assessed by free recall and with repeated testing of the same material. Forgetting rates between groups did not differ from 1 h to 24 h. CONCLUSION: The differences observed in MCI-AD could be due to a post-encoding deficit. These findings could be accounted either by a differential benefit from retrieval practice, whereby people with MCI-AD benefit less than HC, or by a working memory deficit in people with MCI-AD, which fails to support their memory performance from immediate recall to 1 h.

Long-term memory for spatial frequency: a non-replication.

Reports on stability of spatial frequency in short-term memory span have confirmed low-level perceptual memory mechanism in early visual processing. However, some studies have also claimed evidence for high-fidelity perceptual long-term storage of spatial frequency. We report an attempted replication of Magnussen et al. (Psychol Sci 14:74-76, 2003) where participants were asked to discriminate the spatial frequency of a reference grating from a test stimulus after intervals of 5 s or 24 h. Group thresholds after 24 h were significantly higher than after 5 s, therefore failing to support long-term storage of spatial frequency.

Long-term learning and forgetting of feature binding in verbal free recall.

Temporary feature bindings can be learned under specific experimental conditions. However, how this learning occurs and how it is forgotten over long intervals is unclear. We addressed this question with repeated presentation of an array of coloured shapes followed by verbal free recall after delays of 1 day, 1 week, and 1 month. A total of 120 participants viewed 24 repetitions of the same study array of six objects each with two features (shape and colour). After 24 trials, 61 participants reported becoming aware of the repetition while 59 reported being unaware. Memory performance improved across trials, with aware participants showing faster learning than unaware participants whose performance appeared to reflect the capacity of short-term visual memory across all repetitions. Both aware and unaware participants recalled some of the array after their allocated delay, showing that learning had occurred during repetition trials, even for unaware participants who showed little or no improvement across 24 repetition trials. Memory for binding showed no change after 1 day compared with performance on the 24th repetition trial, was significantly lower for participants tested after 1 week, and was lower still for those tested after 1 month. Findings are interpreted as consistent with both a short-term, limited capacity visual cache that supports performance during early repetition trials, before learning can have occurred, and gradual strengthening across trials of an episodic long-term memory trace that supports learning. If the episodic trace exceeds the threshold of awareness, this accelerates learning.

Forgetting rates of gist and peripheral episodic details in prose recall.

In a seminal study, Slamecka and McElree showed that the degree of initial learning of verbal material affected the intercepts but not the slopes of forgetting curves. However, more recent work has reported that memories for central events (gist) and memory for secondary details (peripheral) were forgotten at different rates over periods of days, with gist memory retained more consistently over time than details. The present experiments aimed to investigate whether qualitatively different types of memory scoring (gist vs. peripheral) are forgotten at different rates in prose recall. In three experiments, 232 participants listened to two prose narratives and were subsequently asked to freely recall the stories. In the first two experiments participants were tested repeatedly after days and a month, while in the third experiment they were tested only after a month to control for repeated retrieval. Memory for gist was higher than for peripheral details, which were forgotten at a faster rate over a month, with or without the presence of intermediate recall. Moreover, repeated retrieval had a significant benefit on both memory for gist and peripheral details. We conclude that the different nature of gist and peripheral details leads to a differential forgetting in prose free recall, while repeated retrieval does not have a differential effect on the retention of these different episodic details.

Benefit of wakeful resting on gist and peripheral memory retrieval in healthy younger and older adults.

Retrieval is greater if new learning is followed by a period of wakeful rest, minimising the likelihood of retroactive interference. It is not known if this benefit extends to recollection of both gist and peripheral details, nor whether age affects the benefit of wakeful resting in either of these types of recollection. Forty-five younger and forty older adults were presented with prose passages for later recall followed by a period of either interference or wakeful resting. Younger participants outperformed older participants in remembering peripheral details, but not on gist memory. Wakeful resting led to higher overall recollection in both age groups, both for gist and for peripheral details. Also, wakeful resting was more beneficial for gist than peripheral memory in older but not younger adults. We discuss these novel findings and their theoretical implications for a memory consolidation account of the benefits of wakeful resting.

Food-Induced Emotional Resonance Improves Emotion Recognition.

The effect of food substances on emotional states has been widely investigated, showing, for example, that eating chocolate is able to reduce negative mood. Here, for the first time, we have shown that the consumption of specific food substances is not only able to induce particular emotional states, but more importantly, to facilitate recognition of corresponding emotional facial expressions in others. Participants were asked to perform an emotion recognition task before and after eating either a piece of chocolate or a small amount of fish sauce-which we expected to induce happiness or disgust, respectively. Our results showed that being in a specific emotional state improves recognition of the corresponding emotional facial expression. Indeed, eating chocolate improved recognition of happy faces, while disgusted expressions were more readily recognized after eating fish sauce. In line with the embodied account of emotion understanding, we suggest that people are better at inferring the emotional state of others when their own emotional state resonates with the observed one.