The cognitive reality monitoring network and theories of consciousness

Theories of consciousness abound. However, it is difficult to arbitrate reliably among competing theories because they target different levels of neural and cognitive processing or anatomical loci, and only some were developed with computational models in mind. In particular, theories of consciousness need to fully address the three levels of understanding of the brain proposed by David Marr: computational theory, algorithms and hardware. Most major theories refer to only one or two levels, often indirectly. The cognitive reality monitoring network (CRMN) model is derived from computational theories of mixture-of-experts architecture, hierarchical reinforcement learning and generative/inference computing modules, addressing all three levels of understanding. A central feature of the CRMN is the mapping of a gating network onto the prefrontal cortex, making it a prime coding circuit involved in monitoring the accuracy of one's mental states and distinguishing them from external reality. Because the CRMN builds on the hierarchical and layer structure of the cerebral cortex, it may connect research and findings across species, further enabling concrete computational models of consciousness with new, explicitly testable hypotheses. In sum, we discuss how the CRMN model can help further our understanding of the nature and function of consciousness.

Internally displaced persons in Mali facing the COVID 19 pandemic: A qualitative study

Introduction

The COVID-19 pandemic has exacerbated an already existing security crisis leading to massive population displacements that have been taking place since 2012.

Purpose of research

This study aims to explore the representations of internally displaced persons (IDPs) about the existence of COVID-19 and their knowledge about its signs, symptoms, modes of transmission and prevention measures.

Methods

The study was qualitative and exploratory. Individual and group interviews were used to collect data from 52 IDPs in six sites in Bamako and Segou. All interviews were recorded and transcribed. Thematic content analysis and N-Vivo software were used.

Results

The majority of IDPs believed in the existence of COVID-19 and had good knowledge of the signs, symptoms, modes of transmission and prevention measures against the disease. However, this was not sufficient for the adoption of public health measures. Among those who believed in its existence, some thought that it was a disease of the white and rich. Finally, a group of participants believed in conspiracy theories and claimed that the government and humanitarian organizations were only trying to make money through these campaigns.

Conclusion

To our knowledge, this is the first study in Mali to explore IDPs’ beliefs and knowledge about COVID-19. These results could inform policies, strategies, and interventions to combat COVID-19 in IDP sites and in the general population.

Perceptions, Disease Representations, and Response Obstacles Regarding the Ebola Virus Disease Epidemic in the North Kivu and Ituri Provinces of the Democratic Republic of the Congo

We explored the perceptions and representations of diseases in the North Kivu and Ituri provinces of the Democratic Republic of Congo to identify perceived obstacles regarding responses to the country 's Ebola virus disease (EVD) outbreak using a mix-methods approach. We surveyed a representative sample including 800 adults aged 18 years and older, held in-depth interviews with 17 community leaders, and conducted 10 focus group discussions with community members (using same-sex interviewers/discussion leaders). The results revealed the existence of several health conditions among members of the two communities. Locals consider nearly 80 of these ailments as untreatable by orthodox medicines and methods, even when symptoms are similar to EVD. Creating awareness must be considered a critical goal of community education to further educate these populations about EVD and other health problems and their respective treatments.

Spatiotemporal Precision of Neuroimaging in Psychiatry

Aberrant patterns of cognition, perception, and behavior seen in psychiatric disorders are thought to be driven by a complex interplay of neural processes that evolve at a rapid temporal scale. Understanding these dynamic processes in vivo in humans has been hampered by a trade-off between spatial and temporal resolutions inherent to current neuroimaging technology. A recent trend in psychiatric research has been the use of high temporal resolution imaging, particularly magnetoencephalography, often in conjunction with sophisticated machine learning decoding techniques. Developments here promise novel insights into the spatiotemporal dynamics of cognitive phenomena, including domains relevant to psychiatric illnesses such as reward and avoidance learning, memory, and planning. This review considers recent advances afforded by exploiting this increased spatiotemporal precision, with specific reference to applications that seek to drive a mechanistic understanding of psychopathology and the realization of preclinical translation.

The FOR-AD study

PURPOSE

Adjuvant endocrine therapy (ET) for 5-10 years is the backbone of the therapeutic strategy in patients with hormone receptor positive (HR+) early breast cancer (BC). However, long-term adherence to adjuvant ET represents a major challenge for most patients. According to prior studies, side effects of adjuvant ET are an important reason for poor adherence. In contrast, better communication and relational bond between patients and healthcare providers (HCPs) may improve adherence. The FOR-AD (Focus on non-adherence) study aimed at better understanding the representation of adjuvant ET by patients and their HCPs, in order to improve the care process.

METHODS

Three focus groups of premenopausal women (receiving adjuvant ET for variable amount of time) and two focus groups of HCPs (including oncologists, pharmacists, and nurses) were conducted, each including around ten participants. Thematic analyses using a general inductive approach were constructed to report participants' representations.

RESULTS

Two main themes emerged across groups, and appeared of major importance. Representations on adjuvant ET were often homogenous within each group, but differed between patients and their HCPs. The relationship between both groups was considerably discussed, particularly its importance in facilitating adherence to adjuvant ET. Suggestions on improving the care process were also given, such as systematically including psychologists in follow-up care paths and having a nurse navigator follow patients under treatment with adjuvant ET.

CONCLUSION

The present qualitative exploration may help buildi future tailored interventions to improve adherence to adjuvant ET, in particular regarding the role of nurse navigators.

Representations of older adults in COVID-related newspaper articles: A comparison between the perspectives of older and younger adults

During the COVID-19 pandemic, media sources discussed diverse perspectives on aging and older adults, providing opportunities to examine representations of older adults during times of crisis. This study aims to explore representations of older adults during the first month of the pandemic in the U.S. by comparing the perspectives of older and younger adults in national newspapers. A systematic search identified 115 articles published in four major newspapers in the U.S. between March 11 and April 10, 2020, in which older and younger adults were quoted on topics related to the intersection of COVID-19 and aging. Quotes were inductively reviewed using content and thematic analytic strategies. A total of 265 quotes were identified from older adults (n = 104, 39%) and younger adults (n = 161, 61%). We identified three primary themes: impacts on "vulnerable" older adults, debates over the value of older adults' lives, and a counternarrative of resiliency. Older adults were represented as a vulnerable group during the pandemic, in need of protection and support, while debates over the value of their lives similarly evoke images of frailty and dependency. Such depictions frame older adults as a burden on society and reduce their agency and subjectivity. Ageist biases were not only present in quotes from public figures and professionals, but also evident in quotes from older adults themselves. However, older adults also spoke to their own resiliency, survival, and strengths, thereby positioning themselves as elders worthy of respect and able to share wisdom with younger generations. These findings highlight the importance of listening to older adults' voices in order to understand their experiences from their own perspectives through their own agentive positioning and promoting intentionally age-positive and nuanced representations of older adults in public discourse.

The mental representation of occupational stereotypes is driven as much by their affective as by their semantic content

BACKGROUND

Studies on person perception showed that stereotypes can be activated by presenting either characteristic traits of group members, or labels associated to these groups. However, it is not clear whether these pieces of semantic information activate negative and positive stereotypes directly, or via an indirect cognitive pathway leading through brain regions responsible for affective responses. Our main objective with this study was to disentangle the effects of semantic and affective contents. To this end, we intended to scrutinize whether the representation of occupational labels is independent of the emotions they evoke.

METHODS

Participants (N = 73, M = 27.0, SD = 9.1, 31 men 42 women,) were asked to complete two tasks presented online. In the first task they had to arrange 20 occupational labels-randomly chosen from a pool of 60 items-in a two-dimensional space, moving the mouse pointer along two undefined axes. In a second task the axes' names were defined a priori. Subjects were asked to arrange the labels according to valence, the extent to which the word evoked pleasant or unpleasant feelings, and arousal, the extent to which the word evoked excitement or calmness.

RESULTS

Based on the final coordinates of the labels, two cluster analyses were carried out separately in the two tasks. The two clusters were compared with Fisher's exact test, which revealed that the cluster structures overlap significantly.

CONCLUSIONS

The results suggest that the spontaneous categorization and the semantic representation of occupations rely largely on the affective state they evoke. We propose that affective content might have a primacy over detailed semantic information in many aspects of person perception, including social categorization.

Learning exact enumeration and approximate estimation in deep neural network models

A system for approximate number discrimination has been shown to arise in at least two types of hierarchical neural network models-a generative Deep Belief Network (DBN) and a Hierarchical Convolutional Neural Network (HCNN) trained to classify natural objects. Here, we investigate whether the same two network architectures can learn to recognise exact numerosity. A clear difference in performance could be traced to the specificity of the unit responses that emerged in the last hidden layer of each network. In the DBN, the emergence of a layer of monotonic 'summation units' was sufficient to produce classification behaviour consistent with the behavioural signature of the approximate number system. In the HCNN, a layer of units uniquely tuned to the transition between particular numerosities effectively encoded a thermometer-like 'numerosity code' that ensured near-perfect classification accuracy. The results support the notion that parallel pattern-recognition mechanisms may give rise to exact and approximate number concepts, both of which may contribute to the learning of symbolic numbers and arithmetic.

[Electroconvulsive therapy during the perinatal period: Representations of mental health professionals]

INTRODUCTION

Psychiatric disorders are common in peripartum and are associated with adverse outcomes for mother and fetus. Electroconvulsive therapy (ECT) is one of the most effective and safe options to treat severe mental illness, including during the perinatal period. Nevertheless, it remains underutilized during this period, possibly due to negative representations. Research has been carried out on the representations and attitudes of caregivers towards ECT, but the specificities of these attitudes during peripartum have not been explored.

OBJECTIVES

We aimed to assess the attitudes towards ECT during the peripartum among psychiatrists, nurses, social workers and psychologists. The primary objective was to compare the score of favorability for ECT during peripartum according to the profession. The secondary objective was to highlight other factors involved in the favorability for ECT in peripartum.

METHODS

We investigated mental health professionals' attitudes sending by e-mail an anonymous questionnaire in five hospitals in France. The questionnaire was composed of demographic details, one scale about the attitudes towards ECT (the Questionnaire on Attitudes and Knowledge of ECT (QuAKE)) used in several studies; in this questionnaire, a specific part for perinatal period has been added for our study, both using a Likert scale. The completion time for this online questionnaire was approximately 5 to 7minutes. A score of favorability for ECT in general and in peripartum was established for each participant. These scores represented the percentage of positive responses to favorable items and of negative responses to unfavorable items towards ECT. Comparison of the QuAKE answers with a sample of English caregivers in 2001 has been determined with χ² tests. A Bonferroni correction was applied due to the large number of tests performed. Factors involved in the favorability for ECT have been studied with Pearson correlation, Kruskall-Wallis and Wilcoxon tests.

RESULTS

Two hundred and twenty one professionals (80 psychiatrists, 78 nurses, 19 social workers and 44 psychologists) were included in the study. Their answers to the QuAKE questionnaire were comparable or more favorable to ECT than the English sample answered in 2001. The perinatal part of questionnaire had a good internal consistency (Cronbach coefficient: 0,91). Participants were less favorable to ECT in perinatal period (favorability score: 44.2) than in general (63.6). They more often responded « uncertain » to the perinatal questionnaire (44,9 % against 18.4 % for the ECT in general; W=19931,5; P<0,001). The favorability for ECT in general and during peripartum were statistically associated with profession (psychiatrists were more favorable), specific training and experience in ECT. Gender, perinatal specialization, age, and the number of years in professional service were not associated with favorability for ECT in general and during peripartum in this study.

CONCLUSIONS

In this study, we have found that profession, training and experience in ECT are linked to the attitudes towards ECT, including in the perinatal period. It is necessary to inform professionals about the possibility of prescribing ECT in the perinatal period by training them in the specificities of pregnancy.

Age-related dedifferentiation and hyperdifferentiation of perceptual and mnemonic representations

Preliminary evidence indicates that occipito-temporal activation patterns for different visual stimuli are less distinct in older (OAs) than younger (YAs) adults, suggesting a dedifferentiation of visual representations with aging. Yet, it is unclear if this deficit (1) affects only sensory or also categorical aspects of representations during visual perception (perceptual representations), and (2) affects only perceptual or also mnemonic representations. To investigate these issues, we fMRI-scanned YAs and OAs viewing and then remembering visual scenes. First, using representational similarity analyses, we distinguished sensory vs. categorical features of perceptual representations. We found that, compared to YAs, sensory features in early visual cortex were less differentiated in OAs (i.e., age-related dedifferentiation), replicating previous research, whereas categorical features in anterior temporal lobe (ATL) were more differentiated in OAs. This is, to our knowledge, the first report of an age-related hyperdifferentiation. Second, we assessed the quality of mnemonic representations by measuring encoding-retrieval similarity (ERS) in activation patterns. We found that aging impaired mnemonic representations in early visual cortex and hippocampus but enhanced mnemonic representations in ATL. Thus, both perceptual and mnemonic representations in ATL were enhanced by aging. In sum, our findings suggest that aging impairs visual and mnemonic representations in posterior brain regions but enhances them in anterior regions.

Virile Infertile Men, and Other Representations of In/Fertile Hegemonic Masculinity in Fiction Television Series

Fiction television series are one of the few cultural expressions in which men's infertility experiences are represented. Through a content analysis of twenty fiction series, this article describes and analyzes such representations. By drawing on Connell's concept of hegemonic masculinity and Ricoeur's understanding of paradoxical power structuring, four character types of infertile men are identified: (1) the virile in/fertile man, (2) the secretly non-/vasectomized man, (3) the intellectual eunuch, (4) the enslaving post-apocalyptic man. While these various dramatis persona outline different ways of how infertile men relate to normative hegemonic masculinity, they all represent infertile men as diverging from shared masculine norms. This non-normativity initially excludes many represented men from hegemonic positions. Eventually, however, these men generally aspire to and succeed in reaffirming their hegemonic masculinity through coercive force towards women and other men, through instigating the precondition for any power structure - the shared will to live together as a community -, and/or by seeking and finding explicit recognition for their normativity and dominance. At the end of this paper, I will reflect on the potential harmful effect of these outlined representations of infertile men and make a plea for diversifying representations of infertile men in our culture.

Conveying symbolic relations: Children's ability to evaluate and create informative legends

Two studies were conducted to examine 4- to 6-year-old children's understanding of how to convey symbol-referent relations using legends. Study 1 investigated children's ability to evaluate legends in terms of whether or not they clearly convey information (N = 74). In this study, 41% of children were successful, with performance uniquely differentiated by sensitivity to ambiguity and executive function. Study 2 investigated children's ability to create informative legends (N = 115), with 39% being successful. Nearly half of those who were unsuccessful improved after exposure to exemplars (relative to only 9% in the baseline group). Sensitivity to ambiguity uniquely differentiated their ability to create a legend and improve after exposure. These studies provide insight into children's developing understanding of how symbol meanings are effectively conveyed and the contributions of other cognitive factors.

[Representations of the SARS-CoV-2 pandemic and confinement in a liberal psychiatric patient base in Paris]

A brief description of attitudes and representations of SARS-Cov-2 pandemic among patients in a psychiatric Parisian office. Collected data suggest that the confinement's measure has been accepted. However the end of confinement has been a time of increased anxiety for many. The representations of Covid-19 and the one of the other's body tended to be assimilated. Some perplexity over preventive measures has been observed.

Editors' Review and Introduction: Levels of Explanation in Cognitive Science: From Molecules to Culture

Cognitive science began as a multidisciplinary endeavor to understand how the mind works. Since the beginning, cognitive scientists have been asking questions about the right methodologies and levels of explanation to pursue this goal, and make cognitive science a coherent science of the mind. Key questions include: Is there a privileged level of explanation in cognitive science? How do different levels of explanation fit together, or relate to one another? How should explanations at one level inform or constrain explanations at some other level? Can the different approaches to the mind, brain, and culture be unified? The aim of this issue of topiCS is to provide a platform for discussing different answers to such questions and to facilitate a better understanding between the different strands of thinking about the right levels of explanation in cognitive science.

Introduction to “Levels of Explanation in Cognitive Science: From Molecules to Culture”

This paper introduces the topic “Levels of Explanation in Cognitive Science: From Molecules to Culture”, puts into focus some key questions, and provides an overview of the contributions in this topic.

Social Representations of People with Gambling Problems: The Influence of Prevention Classes on Non-gamblers

In the present study, we examine the impact of prevention classes on non-gambling males. Specifically, we measure whether attending a prevention class influences how non-gambling participants perceive people who gamble problematically. Participants (N = 545) were all lifetime non-gamblers, and were all conscripts attending a two-day military recruitment program. On the first day participants either attended or did not attend a gambling prevention class. On the second day, they all completed a questionnaire that contained questions on how they perceived people who gamble problematically. Results showed that their representations were organized in terms of mental status (i.e. mentally disordered or not) and person-centeredness (i.e. self-centered or not). Results also showed that participants who attended the gambling prevention class saw problem-gambling individuals as more mentally disordered and self-centered than those who did not attend the class. The implications of these results are discussed in terms of social support and their applicability to problem gambling prevention programs.

[Representations of high blood pressure in France: An exploratory study]

AIM OF THE STUDY

Non-adherence to treatment is one of the problems practitioners face with regard to hypertension. This lack of compliance is often attributed to disease representations. Understanding their nature can therefore help to better target therapeutic education messages and thus, increase compliance.

METHOD

It is in this context that the « groupe infirmiers et acteurs de la SFHTA » initiated a qualitative exploratory study of the representations of arterial hypertension in France. The study covered three sites: Bordeaux, Lyon and Nancy. Interviews with patients were conducted by the members of the group. Questions included the disease definition, its causes and consequences. The interviews were recorded and transcribed verbatim; they were analyzed with Nvivo pro® 11 software.

RESULTS

HTA is discovered accidentally. Patients define the disease according to their experience of symptoms, their perceptions of risks and the disease's consequences. The thresholds of systolic and diastolic blood pressure are unknown; most of the patients ignore their levels of both systolic and diastolic blood pressure. Besides, the fluctuating levels of blood pressure and conflicting messages about "lifestyle" generate confusion. HTA remains associated with stress. Regarding the burden of the disease, having to take a daily medication engendered anxieties, before being integrated into daily routines. The study also showed that patients have the desire to "pay attention" to their diet primarily.

CONCLUSION

This study showed the need to strengthen the training of health professionals and harmonize educational messages, which would allow patients to integrate new recommendations without stress.

Social representations about the functions of deliberate self-harm: Adolescents and parents

INTRODUCTION

The understanding of the social representations about the functions of deliberate self-harm can be an important factor for the comprehension of this phenomenon. Nonetheless, only a few studies focused on this topic and specifically on the social representations from adolescents with and without a history of deliberate self-harm and their parents.

METHODS

This article presents two studies that analysed these representations. Study 1 compared the social representations from 411 Portuguese adolescents (219 females and 192 males, aged 12-19 years), from which 109 reported having a history of deliberate self-harm. Study 2 focused on the comparison of the social representations from 471 parents (265 mothers and 206 fathers, aged 33-62 years) of Portuguese adolescents. Of the parents in Study 2, 120 had children with a history of deliberate self-harm.

RESULTS

In Study 1, adolescents without a history of deliberate self-harm perceived most interpersonal functions as more relevant than adolescents with a history of these behaviours, while adolescents with a history of deliberate self-harm emphasized one intrapersonal function. In Study 2, no differences were found between parents of adolescents with and without a history of deliberate self-harm. However, results revealed differences between the representations of mothers and fathers in several intrapersonal functions.

CONCLUSIONS

This research provides important insight regarding the social representations about the functions of deliberate self-harm from adolescents with and without a reported history of these behaviours and their parents. The impact for clinical intervention and prevention programs is discussed.

Toddlers with Autism Spectrum Disorder Can Use Language to Update Their Expectations About the World

This study examined if two-year-olds with ASD can update mental representations on the basis of verbal input. In an eye-tracking study, toddlers with ASD and typically-developing nonverbal age-matched controls were exposed to visual or verbal information about a change in a recently encoded scene, followed by an outcome that was either congruent or incongruent with that information. Findings revealed that both groups looked longer at incongruent outcomes, regardless of information modality, and despite the fact that toddlers with ASD had significantly lower measured verbal abilities than TD toddlers. This demonstrates that, although there is heterogeneity on the individual level, young toddlers with ASD can succeed in updating their mental representations on the basis of verbal input in a low-demand task.

Shared right-hemispheric representations of sensorimotor goals in dynamic task environments

Functional behaviour affords that we form goals to integrate sensory information about the world around us with suitable motor actions, such as when we plan to grab an object with a hand. However, much research has tested grasping in static scenarios where goals are pursued with repetitive movements, whereas dynamic contexts require goals to be pursued even when changes in the environment require a change in the actions to attain them. To study grasp goals in dynamic environments here, we employed a task where the goal remained the same but the execution of the movement changed; we primed participants to grasp objects either with their right or left hand, and occasionally they had to switch to grasping with both. Switch costs should be minimal if grasp goal representations were used continuously, for example, within the left dominant hemisphere. But remapped or re-computed goal representations should delay movements. We found that switching from right-hand grasping to bimanual grasping delayed reaction times but switching from left-hand grasping to bimanual grasping did not. Further, control experiments showed that the lateralized switch costs were not caused by asymmetric inhibition between hemispheres or switches between usual and unusual tasks. Our results show that the left hemisphere does not serve a general role of sensorimotor grasp goal representation. Instead, sensorimotor grasp goals appear to be represented at intermediate levels of abstraction, downstream from cognitive task representations, yet upstream from the control of the grasping effectors.

The posterior cingulate cortex: Insights from structure and function

The posterior cingulate cortex (PCC) (Brodmann areas 23/31) is one of the least well-understood regions of the cortex. The PCC has very high levels of metabolic consumption, and network analyses of functional and structural data suggest it is a core hub in the human connectome; however, contemporary neuroscience lacks a clear account of its functional significance. Consequently, many studies over the last decade have focused on understanding the role this region plays in cognition, particularly given its apparent tendency to deactivate during demanding external tasks. Consistent with the cytoarchitecture, recent work, leveraging complex analytical approaches, highlight that the connections the PCC forms with other regions are heterogeneous, going beyond a single network, while recent studies of its function highlight a role in a wide range of complex forms of cognition including memory, navigation, and narrative comprehension. This constellation of observations highlights a role for PCC in a set of cognitive processes that are supported by internal representations but may lack a common type of representational content. Together, these structural and functional studies contribute to an emerging view of the PCC as contributing to how cognition unfolds rather than what it is focused on.

Crazy'App: A web survey on representations and attitudes toward mental disorders using video testimonies

In the international context of efforts to combat the stigmatization of people with mental health problems, representations and attitudes about these illnesses have not to date been widely investigated in France. However, new technologies offer an unprecedented opportunity to collect such information on a large scale and to deploy more efficient action against stigma.

OBJECTIVES

The Crazy'App survey was designed as an instrument for studying potentially stigmatizing representations and attitudes towards mental disorders. It asks respondents to react, rather than to standard diagnostic labels or case vignettes, to video testimonies by people with different mental disorders talking about their experiences.

METHODS

The web survey was made available on smartphone or computer and advertised on various media and during a French exhibition about mental disorders, mental health and well-being ("Mental Désordre", Cité des sciences, Paris, 2016). It consisted of short (<2min) video testimonials by four people presenting respectively anorexia, bipolar disorder, obsessive-compulsive disorder and addiction to alcohol. Each testimony was immediately followed by series of questions to which participants were to respond using visual analog scales. The questionnaires investigated different domains, such as the causes of each of these mental disorders, the possible treatments and the respondent's personal attitudes in hypothetical situations (e.g. working with the person seen in the video). After having completed the survey, respondents were offered an opportunity to compare their own responses to those of the other respondents, and watch expert psychiatrists interviews delivering clinical and scientific knowledge and sharing their own attitudes.

RESULTS

The respondents (n=2600) were young, mostly women, educated and concerned about the subject. They exhibited good knowledge of the disorders. They reported a multi-causal view of the etiologies, where psychological causes were rated higher than neurobiological causes (although less so for respondents reporting having had a mental disorder themselves), while other types of causes (environmental, spiritual, and nutritional) received much lower ratings. Respondents also expressed high potential social proximity, but this result varied according to the type of disorder, in particular, the social distance and the perception of dangerousness were greater for addiction and bipolar disorder.

CONCLUSIONS

Crazy'App operationalizes emerging strategies in the efforts to combat stigma, implementing what is known as a "contact based intervention" in English-speaking countries. While it does not erase the differences in attitudes observed from one pathology to another, this type of survey-intervention based on video testimonies could help to reduce the desire for social distancing from people with mental disorders, even in a particularly sensitized and informed population. Multimedia technologies are an efficient way to offer rich, potentially interactive content better able to embody people and their actual experiences than clinical descriptions or even life narratives. However the use of videos could put the focus on the individual characteristics (physical, gestural, verbal, nonverbal…), and this should be cautiously taken into account according to the anti-stigma objectives. Connected technologies also make it possible to enhance the more classic de-stigmatization actions focused on the deconstruction of preconceived ideas, making the action more participatory, while simultaneously assessing their efficacy. By mediating contact with individuals and behaviors perceived as deviant, the aim would be to develop psycho-social skills and concrete abilities for action in the general population, to include people with mental disorders in the community.

[Between "pragmatic" interpretation and "disturbing" understanding: Embryonic cryopreservation for IVF patients]

OBJECTIVES

The aim of this article is to question the feeling of IVF patients towards embryonic cryopreservation, in order to understand their potential reluctance to freeze embryos and their difficulties to consider the fate of their frozen embryos once their parental project completed.

METHODS

Twenty-seven semi-directive interviews with homologous IVF patients were conducted. These persons were followed in two fertility centres in Marseille.

RESULTS

If all the patients interviewed have accepted embryonic cryopreservation or have accepted on principle, a majority have an ambivalent attitude towards this technique. If some share the "pragmatic" vision of professionals (embryologists, technicians and gynaecologists), they are numerous to worry about a possible deterioration of embryonic quality, or again about a disrupted order of generation. Finally, it appears that patients do not anticipate the possible fate of their frozen embryos if they are uninscribed from their parental project.

CONCLUSIONS

Patients are mainly ambivalent towards embryonic cryopreservation. They prioritize different rationality depending on the situations and issues they are dealing with.

Associations among mothers' representations of their relationship with their toddlers, maternal parenting stress, and toddlers' internalizing and externalizing behaviors

This study examined the array of associations among the emotional valence and the coherence of mothers' representations of their relationship with their toddlers, mothers' reported parenting stress, and toddlers' internalizing and externalizing behaviors. To evaluate maternal representations, 55 mothers were interviewed using the Five Minute Speech Sample procedure (FMSS; Magaña et al., 1986), which was coded for criticism and positive comments (Magaňa-Amato, 1993), as well as coherence (Sher-Censor & Yates, 2015). Mothers also completed the Parenting Stress Index - Short Form (PSI; Abidin, 1997) to evaluate their parenting stress and the Child Behavior Checklist (CBCL/1.5-5; Achenbach & Rescorla, 2000) to assess their toddlers' internalizing and externalizing behaviors. Results indicated that parenting stress was associated with maternal criticism and fewer positive comments in the FMSS, but not with the coherence of mothers' FMSS. Parenting stress, criticism, and lower coherence in the FMSS were associated with maternal reports of externalizing behaviors. Only parenting stress and lower coherence in the FMSS were related to mothers' reports of internalizing behaviors of the child. Thus, the emotional valence and the coherence of mothers' representations of their relationship with their child and parenting stress may each constitute a distinct aspect of parenting and contribute to the understanding of individual differences in toddlers' internalizing and externalizing behaviors. Implications for research and practice with families of toddlers are discussed.

Gesture as representational action: A paper about function

A great deal of attention has recently been paid to gesture and its effects on thinking and learning. It is well established that the hand movements that accompany speech are an integral part of communication, ubiquitous across cultures, and a unique feature of human behavior. In an attempt to understand this intriguing phenomenon, researchers have focused on pinpointing the mechanisms that underlie gesture production. One proposal--that gesture arises from simulated action (Hostetter & Alibali Psychonomic Bulletin & Review, 15, 495-514, 2008)--has opened up discussions about action, gesture, and the relation between the two. However, there is another side to understanding a phenomenon and that is to understand its function. A phenomenon's function is its purpose rather than its precipitating cause--the why rather than the how. This paper sets forth a theoretical framework for exploring why gesture serves the functions that it does, and reviews where the current literature fits, and fails to fit, this proposal. Our framework proposes that whether or not gesture is simulated action in terms of its mechanism--it is clearly not reducible to action in terms of its function. Most notably, because gestures are abstracted representations and are not actions tied to particular events and objects, they can play a powerful role in thinking and learning beyond the particular, specifically, in supporting generalization and transfer of knowledge.

Representational Uncertainty in the Brain During Threat Conditioning and the Link With Psychopathic Traits

BACKGROUND

Psychopathy has repeatedly been linked to disturbed associative learning from aversive events (i.e., threat conditioning). Optimal threat conditioning requires the generation of internal representations of stimulus-outcome contingencies and the rate with which these may change. Because mental representations are imperfect, there will always be uncertainty about the accuracy of representations in the brain (i.e., representational uncertainty). However, it remains unclear 1) to what extent threat conditioning is susceptible to different types of uncertainty in representations about contingencies during the acquisition phase and 2) how representational uncertainty relates to psychopathic features.

METHODS

A computational model was applied to functional neuroimaging data to estimate uncertainty in representations of contingencies (CoUn) and the rate of change of contingencies (RUn), respectively, from brain activation during the acquisition phase of threat conditioning in 132 adolescents at risk of developing antisocial personality profiles. Next, the associations between these two types of representational uncertainty and psychopathy-related dimensions were examined.

RESULTS

The left and right amygdala activations were associated with CoUn, while the bilateral insula and the right amygdala were associated with RUn. Different patterns of relationships were found between psychopathic features and each type of uncertainty. Callous-unemotional traits and impulsive-irresponsible traits uniquely predicted increased CoUn, while only impulsive-irresponsible traits predicted increased RUn.

CONCLUSIONS

The findings suggest that 1) the insula and amygdala differ in how these regions are affected by different types of representational uncertainty during threat conditioning and 2) CoUn and RUn have different patterns of relationships with psychopathy-related dimensions.

Unplanned Returns to Hospital Care: A Linked Data Study

The linkage of data across facilities and settings of care provides a holistic view of the patient journey through the healthcare system. This study, through data linkage, reviews alternative approaches to the measurement of unplanned returns to care in NSW public hospital emergency departments and admitted patient care settings. The study shows that existing measures of unplanned returns do not identify the true extent of these events and highlight the need to develop new approaches to measurement using the increasing availability of integrated patient information.

Fornix and medial temporal lobe lesions lead to comparable deficits in complex visual perception

Recent research dealing with the structures of the medial temporal lobe (MTL) has shifted away from exclusively investigating memory-related processes and has repeatedly incorporated the investigation of complex visual perception. Several studies have demonstrated that higher level visual tasks can recruit structures like the hippocampus and perirhinal cortex in order to successfully perform complex visual discriminations, leading to a perceptual-mnemonic or representational view of the medial temporal lobe. The current study employed a complex visual discrimination paradigm in two patients suffering from brain lesions with differing locations and origin. Both patients, one with extensive medial temporal lobe lesions (VG) and one with a small lesion of the anterior fornix (HJK), were impaired in complex discriminations while showing otherwise mostly intact cognitive functions. The current data confirmed previous results while also extending the perceptual-mnemonic theory of the MTL to the main output structure of the hippocampus, the fornix.

Discursive constructions of youth cancer: findings from creative methods research with healthy young people

PURPOSE

As part of work to understand the experiences of young people who had cancer, we were keen to examine the perspectives of peers who share their social worlds. Our study aimed to examine how cancer in young people, young people with cancer and young cancer survivors are represented through language, metaphor and performance.

METHODS

We generated data using creative activities and focus group discussions with three high school drama classes and used Foucauldian discourse analysis to identify the discursive constructions of youth cancer.

RESULTS

Our analysis identified two prevailing discursive constructions: youth cancer as an inevitable decline towards death and as overwhelming personhood by reducing the young person with cancer to 'cancer victim'.

CONCLUSIONS

If we are to understand life after cancer treatment and how to support young people who have been treated for cancer, we need a sophisticated understanding of the social contexts they return to. Discourses shape the way young people talk and think about youth cancer; cancer as an inevitable decline towards death and as overwhelming personhood is a key discursive construction that young people draw on when a friend discloses cancer.

IMPLICATIONS FOR CANCER SURVIVORS

The way cancer is constructed shapes how friends react to and relate to a young person with cancer. These constructions are likely to shape challenging social dynamics, such as bullying, that many young cancer survivors experience. Awareness of these discursive constructions can better equip young cancer survivors, their family and health professionals negotiate life after cancer.

Behavior problems of children in foster care: Associations with foster mothers' representations, commitment, and the quality of mother-child interaction

This study investigated different environmental and contextual factors associated with maltreated children's adjustment in foster care. Participants included 83 children (52 boys), ages 1-7 years, and their foster caregivers. Quality of interaction with the foster caregiver was assessed from direct observation of a free-play situation; foster caregiver attachment state of mind and commitment toward the child were assessed using two interviews; disruptive behavior symptoms were reported by foster caregivers. Results showed that quality of interaction between foster caregivers and children were associated with behavior problems, such that higher-quality interactions were related to fewer externalizing and internalizing problems. Foster caregivers' state of mind and commitment were interrelated but not directly associated with behavior problems of foster children. Type of placement moderated the association between foster caregiver commitment and foster child behavior problems. Whereas greater foster caregiver commitment was associated with higher levels of adjustment for children in foster families (kin and non-kin), this was not the case in foster-to-adopt families. Finally, the associations between foster child behavior problems and history of maltreatment and placement related-risk conditions fell below significance after considering child age and quality of interaction with the foster caregiver. Findings underscore the crucial contribution of the foster caregiver-child relationship to fostering child adjustment and, thereby, have important implications for clinical services offered to this population.

Grounding cognitive-level processes in behavior: the view from dynamic systems theory

Marr's seminal work laid out a program of research by specifying key questions for cognitive science at different levels of analysis. Because dynamic systems theory (DST) focuses on time and interdependence of components, DST research programs come to very different conclusions regarding the nature of cognitive change. We review a specific DST approach to cognitive-level processes: dynamic field theory (DFT). We review research applying DFT to several cognitive-level processes: object permanence, naming hierarchical categories, and inferring intent, that demonstrate the difference in understanding of behavior and cognition that results from a DST perspective. These point to a central challenge for cognitive science research as defined by Marr-emergence. We argue that appreciating emergence raises questions about the utility of computational-level analyses and opens the door to insights concerning the origin of novel forms of behavior and thought (e.g., a new chess strategy). We contend this is one of the most fundamental questions about cognition and behavior.

From the father's point of view: how father's representations of the infant impact on father-infant interaction and infant development

Despite the knowledge that fathers uniquely contribute to the development of their infants, relatively few studies have focused on the father-infant relationship during early infancy. In the present longitudinal study we included 189 fathers and examined whether their early attachment representations of the infant predicted future quality of father-infant interaction. We also investigated whether these representations were related to the infant's development. Paternal attachment representations were assessed by the Working Model of Child Interview (WMCI) at 6 months post-partum and classified fathers' representations as 'balanced' or 'unbalanced' (disengaged or distorted). At 24 months, father-infant interaction was videotaped and analyzed by the NICHD coding scales. Further, the Peabody Picture Vocabulary Test (PPVT-III) was administered to evaluate the infant's verbal development. Results revealed that fathers' early attachment representations of the infant predict the quality of future father-infant interaction, with balanced representations more strongly associated with more favorable behaviors in fathers and infants. In addition, paternal interactive behavior appears an important mechanism through which paternal representations influence the development of the infant. These results underline the importance of early identification of fathers with unbalanced attachment representations, and we therefore recommend that more attention should be directed to the quality of the early father-infant relationship in clinical settings.

Minor injuries in older adults have different characteristics, injury patterns, and outcomes when compared with younger adults: an emergency department correlation study

AIM

To examine the injury patterns, characteristics, and outcomes of older adults presenting with minor injuries compared with younger adults.

BACKGROUND

Sustaining a minor injury is one of the most common reasons people present to an Emergency Department. Many presentations involve older Australians and greater than 50% of older adults are discharged from the Emergency Department. However, little is known about the characteristics, injury patterns, and outcomes of minor injuries in older adults compared to younger adults.

METHODS

A 12-month exploratory correlational study was conducted using Emergency Department electronic medical record data from a single metropolitan hospital located in Sydney, Australia. Older adults were defined as ≥65 years with younger adults defined as 18-64 years. Minor injuries were classified by diagnoses as fractures/dislocations, sprains/strains, wounds/burns/infections, minor head injuries, eye/ear/nose/oral injuries. Exclusion criteria included: triage category 1 or 2, major trauma, critical care admission, or injuries and fractures to the hip or neck of femur.

RESULTS

There were 36,671 Emergency Department presentations of which 7582 (21%) were for older adults and 19,234 (52%) were younger adults (aged 18-64). Injuries represented 21% (n = 7754) of all Emergency Department presentations with 1294 (17%) occurring in those aged 65 years and older and 3937 (20%) in younger adults. Of the minor injuries (n = 3594; 10%), the most common presentation in younger adults was sprains/strains (n = 1045; 36%) but in older adults it was fractures (n = 229; 32%). There was a statistical (Pearson's χ(2) test 63.4, df = 4, P < 0.001) difference with injury pattern when comparing age groups. Older adults were allocated proportionately higher triage categories when compared with younger adults (Pearson's χ(2) test 26.3, df = 2, P < 0.001). Older adults with minor injuries had a longer mean stay (315 min; SD 238.9 min; younger adults 198 min, SD 132.3 min) and this difference was statistically (P ≤ 0.001) and clinically significant. Fewer older adults were discharged home (n = 531, 73%; n = 2648, 92%; P < 0.001) and more were admitted for minor injuries (n = 179, 25%; n = 156, 5%; P < 0.001) when compared with younger adults.

CONCLUSION

Older adults with minor injuries have different injury patterns, higher acuity, longer length of stay, and lower discharge rates compared with younger adults. Clinicians may need to modify their approach and differential diagnoses when treating older adults with minor injuries. Further research is needed to explore the reasons for these differences and whether older adults have different service needs compared with younger adults with minor injuries.

Preschoolers can form abstract rule representations regardless of cognitive flexibility

The abstractness of rule representations in the pre-switch phase of the Dimensional Change Card Sorting (DCCS) task was studied by letting 3- and 4-year-old children perform a standard DCCS task and a separate generalization task. In the generalization task, children were asked to generalize their sorting rules to novel stimuli in one of three conditions. In the relevant change condition, values of the relevant dimension changed; in the irrelevant change condition, values of the irrelevant dimension changed; and in the total change condition, values of both dimensions changed. All children showed high performance on the generalization task in the relevant change condition, implying an abstract rule representation at the level of dimensions ("same colors go together"). Performance in the relevant change condition was significantly better (and faster) than performance in the other two conditions. Children with high cognitive flexibility (switchers on the DCCS task) more often switched their attention to the irrelevant dimension in the generalization task only if values of the irrelevant dimension changed. Children with low cognitive flexibility (perseverators) were more often inconsistent in their sorting on the generalization task if values of both dimensions changed. The difference in performance on the DCCS task between switchers and perseverators seems to result from the processes that operate on the learned sorting rules and not from the abstractness of the rule representations children have.

How embodied is action language? Neurological evidence from motor diseases

Although motor-language coupling is now being extensively studied, its underlying mechanisms are not fully understood. In this sense, a crucial opposition has emerged between the non-representational and the representational views of embodiment. The former posits that action language is grounded on the non-brain motor system directly engaged by musculoskeletal activity - i.e., peripheral involvement of ongoing actions. Conversely, the latter proposes that such grounding is afforded by the brain's motor system - i.e., activation of neural areas representing motor action. We addressed this controversy through the action-sentence compatibility effect (ACE) paradigm, which induces a contextual coupling of motor actions and verbal processing. ACEs were measured in three patient groups - early Parkinson's disease (EPD), neuromyelitis optica (NMO), and acute transverse myelitis (ATM) patients - as well as their respective healthy controls. NMO and ATM constitute models of injury to non-brain motor areas and the peripheral motor system, whereas EPD provides a model of brain motor system impairment. In our study, EPD patients exhibited impaired ACE and verbal processing relative to healthy participants, NMO, and ATM patients. These results indicate that the processing of action-related words is mainly subserved by a cortico-subcortical motor network system, thus supporting a brain-based embodied view on action language. More generally, our findings are consistent with contemporary perspectives for which action/verb processing depends on distributed brain networks supporting context-sensitive motor-language coupling.

The role of perceptual similarity of the task environments in children's perseverative responding

Perseverative responding is often seen in children's performance in a variety of contexts. One such context is symbolic comprehension in which 2- and 2½-year-olds demonstrate difficulty in appreciating the association of symbols (pictures and scale models) and their referents and show a high proportion of perseverative responding. Representational-level explanations of perseveration were explored in the current studies via examination of the impact of perceptual similarity of visual environments across trials. Across two experiments, children saw either a picture (Experiment 1) or a scale model (Experiment 2) of a hiding location of a room and were then encouraged to recover the toy from an identical room. Manipulating the perceptual similarity of the environments across successive trials affected performance and perseverative responding. These results highlight the critical role played by perceptual information not only in symbolic tasks but also in many other tasks and have important implications for theories of perseveration.

Tracking zebrafish larvae in group--status and perspectives

Video processing is increasingly becoming a standard procedure in zebrafish behavior investigations as it enables higher research throughput and new or better measures. This trend, fostered by the ever increasing performance-to-price ratio of the required recording and processing equipment, should be expected to continue in the foreseeable future, with video-processing based methods permeating more and more experiments and, as a result, expanding the very role of behavioral studies in zebrafish research. To assess whether the routine video tracking of zebrafish larvae directly in the Petri dish is a capability that can be expected in the near future, the key processing concepts are discussed and illustrated on published zebrafish studies when available or other animals when not.