The Rey-Osterrieth Complex Figure Test (ROCFT) is a popular measure of visuoconstructive skills and visual memory. A recognition memory trial was recently developed by Meyers and Meyers (1995) and attached to the standard administration of the ROCFT. The addition of this recognition paradigm (comprised of 12 small designs from the original ROCFT stimulus interspersed among 12 foils) makes ROCFT a potentially useful instrument in capturing suspect effort because patients attempting to feign memory difficulties typically operate from the misconception that recognition memory is as impaired as free recall in brain injury and, as a result, suppress recognition performance. The ROCFT (copy, immediate recall [i.e., 3-min recall], and the recognition trial) was administered to four sets of participants: 58 patients with suspect effort; 23 neuropsychology clinic patients with verbal memory impairment, 17 clinic patients with visual memory impairment, and 30 clinic patients without memory impairment. Group comparisons revealed significant group differences in direct copy, immediate recall, and recognition scores of the ROCFT (p<.0001), with the suspect effort group displaying significantly lower performance on the copy and immediate recall scores than the verbal memory impaired and nonmemory impaired clinic patient groups, and significantly lower recognition scores than all three clinical groups. Furthermore, qualitative examination of the recognition trial revealed the presence of "atypical recognition errors" that were endorsed with significantly higher frequency by the suspect effort patients. A combination score incorporating the copy, true positive recognition, and atypical recognition error scores yielded a sensitivity of 74% while misclassifying only approximately 4% of verbal memory impaired clinic patients, 12% of visual memory impaired clinic patients, and 3% of nonmemory impaired clinic patients. Thus, the ROCFT+recognition trial show considerable potential for detecting noncredible effort.
The demand for information by relatives and the success of family intervention programs with an initial didactic component has resulted in a proliferation of educational interventions in schizophrenia. The present study assesses the impact of a single educational session on relatives of recent-onset schizophrenic patients. Results suggest that relatives who participated in family education experience an increased sense of support from the treatment team and a nearly significant tendency toward a decrease in self-blame regarding the schizophrenic illness. Despite findings in previous studies suggesting information acquisition immediately after education and retention after 6 months, the present study found no information retention after a 2-month period. After family education, relatives rated as high in expressed emotion (EE) reported a significantly increased sense of understanding of the illness and expressed increased feelings of support from the treatment team, whereas low EE relatives did not change significantly in these attitudes as a function of the educational session. Low EE relatives demonstrated more actual information about the illness and were less likely to perceive the symptoms as being done intentionally to bother them.
This chapter is an introduction to how the learning process changes the brain, with special attention to the facilitative role of the adult educator/mentor.Recent work on brain development and learning suggests that the most effective adult educators may be unwitting neuroscientists who use their interpersonal skills to tailor enriched environments that enhance brain development. The brain is a social organ innately designed to learn through shared experiences. Throughout the life span, we all need others who show interest in us, help us feel safe, and encourage our understanding of the world around us. Brains grow best in this context of interactive discovery and through cocreation of stories that shape and support memories of what is being learned. Although many teachers consciously focus on what they are teaching, the evolution and structure of the brain suggests that who they are may be far more important to their students' learning.As teachers and therapists ourselves, we are especially interested in how relationships of all kinds initially shape the brain during childhood and reshape the brain later in life. As people move through the stages of life, the brain also passes through various ways of perceiving, organizing, and learning about the world. As a result, the topic of learning (that is, the "what") and the nature of the student-teacher relationship are transformed as the adult student and teacher/mentor join together in a process that changes both of their brains. Plasticity and LearningThe brain has been shaped by evolution to adapt and readapt to an everchanging world. The ability to learn is dependent on modification of the brain's chemistry and architecture, in a process called "neural plasticity." 11 2
This study integrated psychological and neuroscience research regarding the effects of childhood trauma in order to advance assessment with this population. Recently, researchers proposed new criteria for complex posttraumatic stress disorder (PTSD) on the basis of years of interdisciplinary research, identifying symptoms that have an empirical association with survivors of childhood trauma. The criteria reflect alterations in regulating affect, dissociation, executive functioning, somatization, and chronic characterological changes. These content areas are compatible with recent neuroscience research with this population and illustrate the interplay between mind-brain interactions, chronic stress, and neurodevelopment. Prior research suggested that Scale 8 of the Minnesota Multiphasic Personality Inventory (MMPI) was most sensitive to neurological dysfunction. Therefore, can complex PTSD be detected by the MMPI? Item analyses were performed comparing abused and nonabused participants. Stage 1 of the analysis identified 11 items that differentiated groups. In Stage 2, the study attempted to construct a preliminary scale that correctly classified 81% of participants and 89% of those with a history of abuse. The content of identified items reflects problems with impulsivity, affect regulation, and disrupted cognitive processes. A theoretical explanation is provided in the Discussion section.
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