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Predicting relapse and recovery in alcoholism and addiction: neuropsychology, personality, and cognitive style.

Neuropsychological studies of substance abuse treatment outcome have generally found successful recoverers to show intact functioning on most measures, whereas relapsers do poorly on tests of language, abstract reasoning, planning, and cognitive flexibility. These have been related to involvement of left hemisphere and frontal lobe functions. Personality profiles of successful remitters, with or without formal treatment, include future goal-orientation, frustration-tolerance, and self-efficacy, while relapsers are characterized by impulsivity, antisocial personality, and affective disorders. It is proposed that what these neuropsychological and personality indexes are actually describing in successful recoverers is the neuropsychodynamic trait variable of ego autonomy, which is related to a reflective, nonimpulsive, goal-directed cognitive style. Implications of the neuropsychodynamic model for the evaluation and treatment of substance abusers is discussed.

Alcoholism↗

Pattern learning and the control of behaviour by all-inhibitory neural network hierarchies.

An all-inhibitory network which learns by selective disconnection of synapses is described. This is similar to an 'associative net'; however, it is simpler in that its neurons do not need to perform arithmetical operations, and the net does not require additional threshold modulating neurons in order to cope with input patterns which are incomplete, or of differing sizes. This fundamental simplicity permits a greater variety and density of connections. These can multiply the capacity of the nets to learn complex sequences of patterns without being saturated. An "all-connected" net is described which has the holograph-like capacity to reconstruct the whole of an input pattern from part patterns without involving delays or threshold devices. All of these inhibitory nets can construct themselves by means of simple random growth processes, without incurring any loss of learning capacity of holographic properties. Similarly, synapses can be allowed to potentiate with use, so that reaction times are progressively reduced by practice, without any reduction in the quality of the performance. Inhibitory connections between arrays can give patterns in one array control over the allocation of channels in which lower arrays store learned information. A description is given of a model, decentralised, inhibitory hierarchy consisting of inter-connected arrays which can learn to execute goal-directed TOTE-type programs of behaviour by means of a simple 'putting-through' procedure.

Axons↗

Therapeutic antagonism between anticholinergics and neuroleptics: possible involvement of cholinergic mechanisms in schizophrenia.

We have answered technical criticisms of our work in which anticholinergic agents were added to ongoing neuroleptic treatment in an ABA' research design. The suggested analysis of variance for repeated measures of the three periods is inappropriate because of the expected carryover effects from continuous neuroleptic treatment. The multivariate analysis of various parameters seems unsuitable because homogeneity of covariance cannot be ensured due to the heterogeneity of schizophrenia and the diverse factors represented in the psychopathology measures. We have summarized the results of recent parametric and nonparametric analyses of combined data from our three studies to show that the significant effects clearly pointed to therapeutic antagonism between anticholinergic agents and neuroleptics. We suggest that cholinergic neurons may be part of some crucial discriminative control mechanisms in the brain organization that are ineffective in schizophrenia and lead to a relative overactivity of the opposing catecholaminergic neurons in the midbrain-limbic circuitry which promote repetition of behaviors in goal-directed activity.

Antipsychotic Agents↗

Reliability and validity of the Apathy Evaluation Scale.

This article presents evidence for the reliability and construct validity of the Apathy Evaluation Scale (AES). Conceptually, apathy is defined as lack of motivation not attributable to diminished level of consciousness, cognitive impairment, or emotional distress. Operationally, the AES treats apathy as a psychological dimension defined by simultaneous deficits in the overt behavioral, cognitive, and emotional concomitants of goal-directed behavior. Three versions of the AES (clinician, informant, and self-rated) were evaluated for 123 subjects, ages 53-85, meeting research criteria for right or left hemisphere stroke, probable Alzheimer's disease, major depression, or well elderly control. Multiple forms of reliability (internal consistency, test-retest, and interrater) were satisfactory. Several types of validity evidence are presented for each version of the scale, including the following: ability of the AES to discriminate between groups according to mean levels of apathy, discriminability of apathy ratings from standard measures of depression and anxiety, convergent validity between the three versions of the scale, and predictive validity measures derived from observing subjects' play with novelty toys and videogames. Guidelines for the administration of the AES are presented, along with suggestions for potential applications of the scale to clinical and research questions.

Aged↗

[Current problems in the reinforcement and regulation of goal-directed behavior].

Contemporary problems and arguable questions of reinforcement and self-regulation of animals behaviour and human activity are considered conformably to organization and analysis of results of conditioned experiments with probable reinforcement on the basis of semantic and pragmatic diagrams of conceptual space of decisions making. Situations are analyzed when the subject not simply "receives" the reinforcement but must actively "procure" (earn) the useful result. Scientific substantiation of conceptions of reinforcement and activity self-regulation is of considerable importance not only in the higher nervous activity physiology but also in psychology, economics and sociology for the decision of actual problems of organization of the processes of control in contemporary society of all mankind values and norms of behaviour.

Animals↗

The role of histamine in the anterior hypothalamus and its functional interaction with the hippocampus on exploratory behavior in adult male rats.

The possible effects of histamine (HA) locally applied into the preoptic area (POA) on hippocampus-mediated behaviors were studied in adult male rats. Animals were double-implanted unilaterally with microinjection cannulae into POA and hippocampus (HPC). In experiment 1, HA was injected into POA and pyrilamine (H1-HA antagonist) or ranitidine (H2-HA antagonist) were microinjected into the ipsilateral HPC in two different doses. In Experiment 2, HA was injected into POA and the histamine antagonists were microinjected into the contralateral HPC. Ten min later the animals were tested in an automatic monitor activity. Horizontal, ambulatory and vertical movements were measured as general motor exploratory behaviors. Contact time (in seconds) to a circular metal rack positioned in the center of the animal activity monitor was also recorded as goal-directed exploratory activity. Results of Experiment 1 showed that HA in POA exerted an inhibitory influence on general motor behaviors and also on goal-directed activity. Ipsilateral administration of HA-antagonists into HPC blocked the HA effect on behavior. Results of Experiment 2 showed that the administration of the HA-antagonists in any of the two doses used were not able to block the depressive actions on behavior caused by HA into POA. In conclusion, data suggest that POA is linked to the ipsilateral HPC through histaminergic influence to control behavioral patterns induced by novelty.

Animals↗

Cannabis intoxication: effects of monetary incentive on performance, a controlled investigation of behavioural tolerance in moderate users of cannabis.

The study examined the effect of monetary incentive on the performance of five tasks after two heterogeneous groups of experienced users of cannabis and previously naive subjects had smoked placebo material and two dose levels of cannabis. The performance of the motivated subjects was compared with that of two non-motivated matched groups. Dose-related impairment was found on four of the five tasks, supporting previous findings of cannabis-induced impairment of short-term memory, goal-directed behavior and choice reaction times. Results for three of the tasks suggested that the performance of the motivated subjects was less affected by the drug than was the performance of the non-motivated subjects. There was no difference between the performance of subjects naive and experienced with respect to drug use.

Adult↗

Understanding motor events: a neurophysiological study.

Neurons of the rostral part of inferior premotor cortex of the monkey discharge during goal-directed hand movements such as grasping, holding, and tearing. We report here that many of these neurons become active also when the monkey observes specific, meaningful hand movements performed by the experimenters. The effective experimenters' movements include among others placing or retrieving a piece of food from a table, grasping food from another experimenter's hand, and manipulating objects. There is always a clear link between the effective observed movement and that executed by the monkey and, often, only movements of the experimenter identical to those controlled by a given neuron are able to activate it. These findings indicate that premotor neurons can retrieve movements not only on the basis of stimulus characteristics, as previously described, but also on the basis of the meaning of the observed actions.

Animals↗

Behavior and the balance between norepinephrine and serotonin.

The functions of the central monoamines Norepinephrine (NE) and Serotonin (5HT) can be clarified by the study of behaviors of rats administered selective monoamine toxins. In his home environment the low NE rat has drive deficits and is lethargic, tending to remain in his burrow, but in novel environments this animal acts less frightened than Controls. The low 5HT rat is conversely active and exploratory in familiar environments but frightened in novel environments. These two animals model aspects of depression and anxiety, respectively. 5HT can be thought of as placing the brain into a state of consciousness appropriate for an animal in his nest (i.e., 5HT neurons act as relaxers), and as involved in a type of positive affect related to security, whereas NE neurons are dominant when an animal is vigilant, foraging out in the environment and are involved in a type of positive affect related to goal-directed approach arousal. Monoamine toxins may be produced when the behaviors elicited by these central neuronal systems are negatively reinforced (extinguished).

Affective Symptoms↗

[Prediction of goal-directed behavior: attitude, subjective behavioral competence and emotions].

Ajzen's (1985) theory of planned behavior explaining and predicting goal-directed behavior is extended by an emotional component. The extended theory of planned behavior is tested experimentally. N = 64 subjects play with two video games (a speed- and a problem-oriented game) under an achievement-motivational orientation. One half of the subjects plays both games in an easy version, the other half in a difficult version. The verbal emotional reactions to playing video games are grouped factor-analytically into an "activity emotion" and a "security emotion". Subjects playing video games in the difficult condition feel significantly more insecure, and perceive their behavioral control as significantly lower than subjects playing in the easy condition. Tests of the extended theory of planned behavior lead to significant squared multiple correlations for the dependent variables within the range of R2 = .20 to .58. The activity emotion accounts predominantly for a significant part of the variance of the attitude and the security emotion accounts for a significant part of the variance of the perceived behavioral control. No predictive power was found for the intention to play the games successfully.

Achievement↗

Using the OPTIMAL Theory to Optimize Aerodynamics in Respiratory Training for Healthy Adults and Individuals With Parkinson's Disease.

BACKGROUND: The OPTIMAL (Optimizing Performance Through Intrinsic Motivation and Attention for Learning) theory is a motor learning framework proposing that optimizing intrinsic motivation enhances motor performance and learning. The theory identifies three key components-Enhanced Expectancies (EE), Autonomy Support (AS) and External Focus of Attention (EF)-which facilitate more efficient, goal-directed movement. These components have been shown to improve motor outcomes in limb-based tasks; however, their application to respiratory training, particularly in clinical contexts such as voice and swallowing therapy in patients with Parkinson's disease (pwPD), has not yet been systematically explored. AIMS: This study aimed to investigate whether implementing OPTIMAL theory strategies during a respiratory muscle strength training (RMST) task improves immediate respiratory motor performance in healthy adults and pwPD. Additionally, we aimed to examine the effects of these strategies on motivation and cognitive engagement. METHODS: This quasi-randomized, single-session trial included 47 participants: Healthy CONTROL (n = 17), Healthy OPTIMAL (n = 16) and PD OPTIMAL (n = 14). Healthy participants were quasi-randomly assigned to either intervention or control conditions, whereas pwPD completed the intervention only. All participants completed a single respiratory session that included baseline, practice and retention phases. Outcome measures included peak expiratory flow, cough peak expiratory flow, cognitive engagement (EEG-based Cognitive Engagement Index) and self-administered motivation questionnaire. OUTCOMES AND RESULTS: Exhalation force improved from baseline to retention in the Healthy OPTIMAL group (baseline: M = 296 L/min; retention: M = 338 L/min; p < 0.001) and the PD OPTIMAL group (baseline: M = 315 L/min; retention: M = 370 L/min; p < 0.0001), but not in the Healthy CONTROL group (p > 0.05). No significant changes in cough strength were observed in any group. No correlations were found between cognitive engagement and exhalation force or motivation scores. However, motivation increased more in the Healthy OPTIMAL group (Questionnaire 1: M = 57.2; Questionnaire 2: M = 60.7) and the PD OPTIMAL group (Questionnaire 1: M = 60.1; Questionnaire 2: M = 62.8) than in the Healthy CONTROL group (Questionnaire 1: M = 61.1; Questionnaire 2: M = 62.5). CONCLUSIONS AND IMPLICATIONS: Implementing the OPTIMAL theory enhances immediate respiratory motor performance in both healthy participants and pwPD. OPTIMAL theory has clinical value in voice and swallowing therapy, although further research is needed to establish long-term efficacy and clinical impact. WHAT THIS PAPER ADDS: What is already known on the subject Motivation is a critical factor in rehabilitation. The OPTIMAL theory has been shown to improve both motivation and motor performance in limb-based tasks. Its impact on respiratory training, however, has not been previously examined. What this paper adds to the existing knowledge This study shows that applying OPTIMAL strategies during a respiratory muscle strength training task significantly improved peak expiratory flow in both healthy adults and people with Parkinson's disease. What are the potential or clinical implications of this work? Integrating the OPTIMAL theory principles into respiratory therapy may enhance motor outcomes, supporting voice, swallowing and cough rehabilitation.

Humans↗

A neural network model for the intersensory coordination involved in goal-directed movements.

A neural network model for a sensorimotor system, which was developed to simulate oriented movements in man, is presented. It is composed of a formal neural network comprising two layers: a sensory layer receiving and processing sensory inputs, and a motor layer driving a simulated arm. The sensory layer is an extension of the topological network previously proposed by Kohonen (1984). Two kinds of sensory modality, proprioceptive and exteroceptive, are used to define the arm position. Each sensory cell receives proprioceptive inputs provided by each arm-joint together with the exteroceptive inputs. This sensory layer is therefore a kind of associative layer which integrates two separate sensory signals relating to movement coding. It is connected to the motor layer by means of adaptive synapses which provide a physical link between a motor activity and its sensory consequences. After a learning period, the spatial map which emerges in the sensory layer clearly depends on the sensory inputs and an associative map of both the arm and the extra-personal space is built up if proprioceptive and exteroceptive signals are processed together. The sensorimotor transformations occurring in the junctions linking the sensory and motor layers are organized in such a manner that the simulated arm becomes able to reach towards and track a target in extra-personal space. Proprioception serves to determine the final arm posture adopted and to correct the ongoing movement in cases where changes in the target location occur. With a view of developing a sensorimotor control system with more realistic salient features, a robotic model was coupled with the formal neural network. This robotic implementation of our model shows the capacity of formal neural networks to control the displacement of mechanical devices.

Algorithms↗

Visuomotor performance of normal and clumsy children. I: Fast goal-directed arm-movements with and without visual feedback.

The mechanisms underlying accuracy in fast goal-directed arm-movements were investigated in normal and clumsy children in two age-groups, six to seven and 10 to 11 years. Clumsy children in both age-groups had a longer movement time than normal children; this difference increased slightly when there was visual feedback. For both normal and clumsy children, the relative variability of the total distance moved was smaller than that of the distance moved during acceleration, indicating a variability reduction mechanism in the course of a movement. In the six- to seven-year-old group, the relative variability of the distance moved during acceleration and of the total distance was larger for clumsy than for normal children; this did not reach significance in the 10- to 11-year-old group. It is suggested that motor difficulties are linked to inaccuracy in open-loop control processes and to less efficient use of visual feedback.

Age Factors↗

Effects of weak antagonist on fast elbow flexion movements in man.

By using a mathematical model and experiments involving electrical simulation of antagonistic muscles, we have formed the hypothesis (Wierzbicka et al. 1986) that in one-joint movements the antagonist muscle not only provides braking torque but also controls movement time. To get additional experimental support for this hypothesis, we studied elbow flexion movements performed by patients with spinal cord injury at the C5-6 level who had relatively normal strength in their biceps muscle and little or no voluntary control of the triceps. Seven quadriplegic patients and six control subjects performed elbow flexion movements of 10 degrees, 20 degrees, and 30 degrees "as fast and accurately as possible". Despite the lack of antagonist, patients used the same "pulse height" strategy as control subjects to scale their responses with movement amplitude. However, patients' movement time was on average twice that of control subjects, and durations of both accelerative and decelerative phases of movement were increased. Movement speed and acceleration were reduced to 20-50% of the corresponding values of control subjects. Patients tended to overshoot the target to a larger extent than control subjects, particularly 10 degrees targets, with nearly twice the error. We performed the same experiments using an external torque motor to assist the weak triceps. When a constant extensor torque of 2.5 or 5 Nm was provided by the motor, patients were able to move faster, and movement accuracy improved to within the normal range. These results provide direct evidence that the lack of an antagonist has an important effect on completion time and accuracy of fast goal-directed movements.

Adult↗

Intention and outcome: key components of causal structure facilitating mapping in children's analogical transfer.

The consequences of two key features of causal structure in source stories, intention and positive outcome, for analogical transfer were examined in kindergarten and second graders. In Experiment 1, children received either structure-complete, structure-incomplete, or irrelevant source stories. Structure-incomplete stories lacked either the intention to solve a problem (a goal-directed component), evidence of a successful consequence (an outcome-related component), or both as part of the solution activity described in source stories. Evidence for transfer was obtained for second graders when a goal-directed component, and to a lesser extent, an outcome-related component were connected to the solution action in source stories. Differences among conditions for kindergartners were less evident, although they revealed a pattern of performance similar to the second graders. A second experiment was conducted to determine whether memory and an orientation to use the source story information might account for these findings. Efforts to ensure memory for and hints to use information in the source stories, however, did not benefit solution transfer when intention and positive outcome were absent. These results suggest that a complete causal structure, including goal and outcome, in source stories augments transfer in young children by promoting mapping of the analogical relationship between source stories and the target problem.

Achievement↗

The effects of visuomotor training and tDCS stimulation on visuomotor integration and visual processing: an electrophysiological approach.

BACKGROUND: Visuomotor integration coordinates visual and motor cortical activity to produce goal-directed responses and can be indexed by Rolandic Mu-rhythm suppression and visual evoked potential (VEP) P100 parameters. Perceptual-motor training improves visuomotor performance, and transcranial direct current stimulation (tDCS) over primary motor cortex (M1) has been reported to enhance motor learning when paired with training. This study examined whether anodal M1 tDCS augments the effects of Senaptec visuomotor training in healthy adults. METHODS: Sixty participants were randomized to active anodal tDCS (five 10-minute sessions, 1&#xa0;mA; n&#xa0;=&#xa0;31) or sham (n&#xa0;=&#xa0;29) over M1 immediately before each Senaptec training session; 53 completed all sessions and post-testing. Outcomes were Mu-suppression ratios, VEP P100 latency and amplitude, and Senaptec measures of visual sensitivity and visuomotor control. RESULTS: Active tDCS produced no augmentation of any outcome, with no significant group&#xa0;&#xd7;&#xa0;time interaction for any measure, consistent across composite and task-level analyses. Training alone produced no change in Mu suppression or visuomotor control. By contrast, both groups showed significant training-related gains in visual sensitivity, including near-far quickness and stereopsis, accompanied by shorter P100 latencies and larger amplitudes, indicating more efficient early visual processing. CONCLUSIONS: A clear dissociation emerged: training produced robust improvements in early visual processing, whereas neither tDCS nor training altered sensorimotor (Mu) or visuomotor-control measures. The tDCS results should be interpreted cautiously given the modest dose and limited power to detect small effects, rather than as evidence of inefficacy. Tablet-based perceptual training enhanced visual processing independent of neuromodulation.

Humans↗

Goal-directed care: caring for aggressive nursing home residents with dementia.

1. Aggressive behavior in elders with dementia occurs most often during personal care. It is often a response to invasion of private space and may be prevented or reduced by interpersonal approaches that reflect a set of individualized goals for the resident. 2. Five resident goals for preventing or reducing aggressive behavior are to feel safe, to feel physically comfortable, to experience a sense of control, to experience optimal stress, and to experience pleasure. 3. These goals provide a framework for humane care that respects the personhood of the individual and minimizes the need for psychotropic medications and physical restraints.

Aged↗

The effects of task preference on performance during purposeful and nonpurposeful activities.

This study examined the number of repetitions, increase in heart rate, increase in blood pressure, and rating of perceived exertion of subjects performing the most-preferred and least-preferred tasks from a predetermined list under purposeful and nonpurposeful conditions. Twenty healthy women completed the four experimental tests in random order for a period of 10 min each. The results indicated that there was no significant interaction (p greater than .05) between task choice and condition, thus implying that the subjects' performance was not influenced by task preference regardless of whether the activity was purposeful or nonpurposeful. Comparisons between the purposeful and nonpurposeful conditions revealed that the increase in heart rate and rating of perceived exertion were significantly higher (p less than .05) during nonpurposeful activity for both the most-preferred and the least-preferred tasks. On the basis of these results, it is recommended that therapists use purposeful, or goal-directed, activities in their practice, even if they are unable to provide their patients with a choice of therapeutic tasks.

Adult↗