What are the essential cognitive requirements for prospection (thinking about the future)?

Crisis Response Model Preferences of Mental Health Care Clients With Prior Misdemeanor Arrests and of Their Family and Friends

The overrepresentation of people with serious mental illnesses in the criminal legal system has spurred the development of crisis response models to improve or reduce police response to a mental health crisis. However, limited research has explored preferences for crisis response, and no research in the United States has examined the responses desired by mental health care clients or their family members. This study aimed to understand the experiences of people with serious mental illnesses interacting with police and to learn about their preferences for crisis response models. The authors interviewed 50 clients with serious mental illnesses and a history of arrest who were enrolled in a randomized controlled trial of a police-mental health linkage system, as well as 18 of their family members and friends. Data were coded with deductive and inductive approaches and were grouped into larger themes. Clients and family or friends described needing a calm environment and empathy during a crisis. They selected a nonpolice response as their first choice and response from a crisis intervention team as their last choice among four options, highlighting the importance of trained responders and past negative interactions with police. However, they also noted concerns about safety and the shortcomings of a nonpolice response. These findings build understanding about clients' and family members' preferences for crisis response and highlight concerns that are relevant for policy makers.

Qualitative, grounded theory exploration of patients' experience of early mobilisation, rehabilitation and recovery after critical illness

RATIONALE

Physical rehabilitation (encompassing early mobilisation) of the critically ill patient is recognised best practice; however, further work is needed to explore the patients' experience of rehabilitation qualitatively; a better understanding may facilitate implementation of early rehabilitation and elucidate the journey of survivorship.

OBJECTIVES

To explore patient experience of physical rehabilitation from critical illness during and after a stay on intensive care unit (ICU).

DESIGN

Exploratory grounded theory study using semistructured interviews.

SETTING

Adult medical/surgical ICU of a London teaching hospital.

PARTICIPANTS

A purposive sample of ICU survivors with intensive care unit acquired weakness (ICUAW) and an ICU length of stay of >72 hours.

ANALYSIS

Data analysis followed a four-stage constant comparison technique: open coding, axial coding, selective coding and model development, with the aim of reaching thematic saturation. Peer debriefing and triangulation through a patient support group were carried out to ensure credibility.

MAIN RESULTS

Fifteen people were interviewed (with four relatives in attendance). The early rehabilitation period was characterised by episodic memory loss, hallucinations, weakness and fatigue, making early rehabilitation arduous and difficult to recall. Participants craved a paternalised approach to care in the early days of ICU.The central idea that emerged from this study was recalibration of the self. This is driven by a lost sense of self, with loss of autonomy and competence; dehumanised elements of care may contribute to this. Participants described a fractured life narrative due to episodic memory loss, meaning that patients were shocked on awakening from sedation by the discrepancy between their physical form and cognitive representation of themselves.

CONCLUSIONS

Recovery from ICUAW is a complex process that often begins with survivors exploring and adapting to a new body, followed by a period of recovering autonomy. Rehabilitation plays a key role in this recalibration period, helping survivors to reconstruct a desirable future.

The execution of planned detours by spider-eating predators

Many spiders from the salticid subfamily Spartaeinae specialize at preying on other spiders and they adopt complex strategies when targeting these dangerous prey. We tested 15 of these spider-eating spartaeine species for the capacity to plan detours ahead of time. Each trial began with the test subject on top of a tower from which it could view two boxes: one containing prey and the other not containing prey. The distance between the tower and the boxes was too far to reach by leaping and the tower sat on a platform surrounded by water. As the species studied are known to avoid water, the only way they could reach the prey without getting wet was by taking one of two circuitous walkways from the platform: one leading to the prey ('correct') and one not leading to the prey ('incorrect'). After leaving the tower, the test subject could not see the prey and sometimes it had to walk past the incorrect walkway before reaching the correct walkway. Yet all 15 species chose the correct walkway significantly more often than the incorrect walkway. We propose that these findings exemplify genuine cognition based on representation.

A taxonomy of prospection: introducing an organizational framework for future-oriented cognition

Prospection--the ability to represent what might happen in the future--is a broad concept that has been used to characterize a wide variety of future-oriented cognitions, including affective forecasting, prospective memory, temporal discounting, episodic simulation, and autobiographical planning. In this article, we propose a taxonomy of prospection to initiate the important and necessary process of teasing apart the various forms of future thinking that constitute the landscape of prospective cognition. The organizational framework that we propose delineates episodic and semantic forms of four modes of future thinking: simulation, prediction, intention, and planning. We show how this framework can be used to draw attention to the ways in which various modes of future thinking interact with one another, generate new questions about prospective cognition, and illuminate our understanding of disorders of future thinking. We conclude by considering basic cognitive processes that give rise to prospective cognitions, cognitive operations and emotional/motivational states relevant to future-oriented cognition, and the possible role of procedural or motor systems in future-oriented behavior.