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OBJECTIVE: Patients and partners both cope individually and as a dyad with challenges related to a breast cancer diagnosis. The objective of this study was to evaluate the effect of a psychological attachment-oriented couple intervention for breast cancer patients and partners in the early treatment phase.METHODS: A randomised controlled trial including 198 recently diagnosed breast cancer patients and their partners. Couples were randomised to the Hand in Hand (HiH) intervention in addition to usual care or to usual care only. Self-report assessments were conducted for both patients and partners at baseline, postintervention (5 months), and follow-up (10 months), assessing cancer-related distress, symptoms of anxiety and depression, and dyadic adjustment. Patients' cancer-related distress was the primary outcome.RESULTS: Cancer-related distress decreased over time in both patients and partners, but the intervention did not significantly affect this decrease at postintervention (P = .08) or follow-up (P = .71). A significant positive effect was found on dyadic adjustment at follow-up for both patients (P = .04) and partners (P = .02).CONCLUSIONS: There was no significant effect of the HiH intervention cancer-related distress. The results suggest that most couples can cope with cancer-related distress in the context of usual care. However, the positive effect on dyadic adjustment implies that the HiH intervention benefitted both patients and partners. Future studies should investigate how to integrate a couple focus in usual cancer care to improve dyadic coping in the early treatment phase.

Parents tend to modulate their movements when demonstrating actions to their infants. Thus far, these modulations have primarily been quantified by human raters and for entire interactions, thereby possibly overlooking the intricacy of such demonstrations. Using optical motion tracking, the precise modulations of parents’ infant‐directed actions were quantified and compared to adult‐directed actions and between action types. Parents demonstrated four novel objects to their 14‐month‐old infants and adult confederates. Each object required a specific action to produce a unique effect (e.g. rattling). Parents were asked to demonstrate an object at least once before passing it to their demonstration partner, and they were subsequently free to exchange the object as often as desired. Infants’ success at producing the objects’ action‐effects was coded during the demonstration session and their memory of the action‐effects was tested after a several‐minute delay. Indicating general modulations across actions, parents repeated demonstrations more often, performed the actions in closer proximity and demonstrated action‐effects for longer when interacting with their infant compared to the adults. Meanwhile, modulations of movement size and velocity were specific to certain action‐effect pairs. Furthermore, a ‘just right’ modulation of proximity was detected, since infants’ learning, memory, and parents’ prior evaluations of their infants’ motor abilities, were related to demonstrations that were performed neither too far from nor too close to the infants. Together, these findings indicate that infant‐directed action modulations are not solely overall exaggerations but are dependent upon the characteristics of the to‐be learned actions, their effects, and the infant learners., Parents’ infant‐ and adult‐directed demonstrations of four novel objects with opaque action‐effects were recorded using optical motion tracking. For all objects, parents demonstrated actions closer (i.e. higher proximity) and showed effects longer when interacting with their infants compared to adult partners. Additionally, auditory‐effect actions were performed more slowly, and for two of the actions parents made larger movements for their infants than for adults.

Background: Loss of insight is a core diagnostic criterion for frontotemporal dementia (FTD), whereas failure to recognise cognitive deficits and unawareness of disease (anosognosia) are well established findings in Alzheimer’s disease (AD). However, self awareness of personality has not been quantified in these patient groups. Methods: Twenty two patients (12 with frontal variant FTD; 10 with early AD) and 11 older adult normal controls completed self report questionnaires (the Interpersonal Adjectives Scales) describing their current personality. First degree relative informants completed two questionnaires, one describing the subject’s current personality, the other retrospectively describing the subject’s personality before disease onset. Differences between subject and informant reports of current personality were used to measure the accuracy of self awareness. Results: Discriminant function analysis showed significant differences in self awareness among the three groups, with those in the FTD group showing the greatest magnitude of error in the largest number of personality dimensions (dominance, submissiveness, cold heartedness, introversion, and ingenuousness). Despite personality changes over time, patients with AD showed accurate self awareness in all personality dimensions except submissiveness and extraversion. Normal controls showed a pattern of underestimating positive qualities, whereas patients with FTD exaggerated positive qualities and minimised negative qualities. For the personality facets showing impaired insight, the self reports of patients with FTD and AD most closely matched their premorbid personalities, suggesting a failure to update their self image after disease onset. Conclusions: This study operationalises research criteria for loss of insight in FTD.

Objectives: Our social cognition model posits that social knowledge and executive resources guide interpersonal decision making. We investigated this model by examining the resolution of standardised social dilemmas in patients with a social and executive disorder (SOC/EXEC) caused by frontotemporal dementia (FTD). Methods: Patients with SOC/EXEC (n = 12) and those with progressive aphasia (APH, n = 14) completed measures requiring resolution of social dilemmas (Guilford’s Cartoon Predictions Test), social cognition (theory of mind false belief vignettes and a behavioural rating measure of empathy) and executive measures of cognitive flexibility (Visual Verbal Test). Regression analysis related judgments of social dilemmas to cortical volume using voxel based morphometry of high resolution structural MRI. Results: Patients with SOC/EXEC were impaired in judgments of social dilemmas as well as theory of mind, self-awareness of empathy and cognitive flexibility. Patients with APH were much less impaired in the social and cognitive measures. There were strong correlations among social dilemma, theory of mind and mental flexibility measures in patients with SOC/EXEC, and stepwise regression showed that mental flexibility was most predictive of social dilemma judgments. Social dilemma impairments in the SOC/EXEC sample correlated with cortical atrophy in the orbital frontal, superior temporal, visual association and posterior cingulate regions of the right hemisphere. Conclusions: Deficits in patients with SOC/EXEC in resolving social dilemmas are related to depleted executive resources and social knowledge that appear to arise from disease that interrupts a right frontal–temporal neural network crucial for mediating social cognition.

During the academic year 1958/59, a survey was made of interlibrary loan requests originating at Columbia University Medical Library. A high percentage of requests came from a relatively few requesters. However, analysis based on “one-time” and “repeat” categories for the patron and his requests indicated a situation less extreme than “monopoly use by an elite group.” Requests were classed by type, age, language, title, etc., and were also correlated with such variables as citation source, requester's academic status and experience, and estimated importance of material. The analysis aims to uncover patterns significant for cooperative planning. Did the repeat and one-time requester show distinctive characteristics and habits? Which materials attracted more repeat requests? Findings generally favored cooperation, at least for a library servicing nonstudent researchers. Unpredictability of researchers' needs was noted. Apart from specific findings, this paper offers methods for statistical analysis of interlibrary loans.