Faculty Bibliography

Electronic shared-decision making programs may provide an assistive technology to support physician-patient communication. This mixed methods study examined use of a web-based shared decision-making program (MyCHOIS-CommonGround) by individuals receiving specialty mental health services, and identified qualitative factors influencing adoption during the first 18 months of implementation in two Medicaid mental health clinics. T-tests and χ² analyses were conducted to assess differences in patient use between sites. Approximately 80% of patients in both clinics created a MyCHOIS-CommonGround user profile, but marked differences emerged between clinics in patients completing shared decision-making reports (79% vs. 28%, χ²₍₁₎ = 109.92, p < .01) and average number of reports (7.20 vs. 3.60, t = - 3.64, p < .01). Results suggest high penetration of computer-based programs in specialty mental health services is possible, but clinic implementation factors can influence patient use including leadership commitment, peer staff funding to support the program, and implementation strategy, most notably integration of the program within routine clinical workflow.

Motor development and psychological development are fundamentally related, but researchers typically consider them separately. In this review, we present four key features of infant motor development and show that motor skill acquisition both requires and reflects basic psychological functions. (a) Motor development is embodied: Opportunities for action depend on the current status of the body. (b) Motor development is embedded: Variations in the environment create and constrain possibilities for action. (c) Motor development is enculturated: Social and cultural influences shape motor behaviors. (d) Motor development is enabling: New motor skills create new opportunities for exploration and learning that instigate cascades of development across diverse psychological domains. For each of these key features, we show that changes in infants' bodies, environments, and experiences entail behavioral flexibility and are thus essential to psychology. Moreover, we suggest that motor development is an ideal model system for the study of psychological development. Expected final online publication date for the Annual Review of Psychology Volume 70 is January 4, 2019. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Post-stroke aphasia (PSA), which refers to the loss or impairment of language, is typically caused by left hemisphere lesions. Previous neuroimaging studies have indicated that the pathology of PSA may be related to abnormalities in functional integration. In this study, we used resting-state functional magnetic resonance imaging (rs-fMRI) to examine functional connectivity density (FCD) in PSA. We compared short- and long-range FCD between individuals with PSA (n = 17) and healthy controls (HC, n = 20). We then performed Pearson's correlation analysis on the FCD values from the affected brain regions and the speech scores in the PSA group. Compared with HCs, individuals with PSA showed increased short-range FCD in the contralesional temporal gyrus, the inferior frontal gyrus, the thalamus, the insula, and the mesial temporal gyrus [hippocampus/parahippocampus (HIP/ParaHIP)]. PSA demonstrated an increased long-range FCD in the contralesional mesial temporal gyrus (HIP/ParaHIP). PSA also displayed decreased short-range FCD in the ipsilesional part of the frontal gyrus, the caudate, the thalamus, the fusiform gyrus, and the mesial temporal gyrus (HIP/ParaHIP), and decreased long-range FCD in the ipsilesional superior temporal gyrus, the fusiform gyrus, and the mesial temporal gyrus (HIP/ParaHIP). The decreased long-range FCD in the left superior temporal gyrus in PSA subjects was positively correlated with the spontaneous speech score. The altered FCD observed due to disrupted functional connectivity after stroke may lead to language production, semantic processing, and cognitive impairments. Our findings expand previous functional studies on stroke and provide new evidence of the intraregional and interregional interactions at the voxel level in the pathophysiology of PSA.

Interactions between oxytocin and the basal ganglia are central in current overarching conceptualizations of its broad modulatory effects on behavior. Whereas evidence from animal models emphasizes the critical role of the ventral striatum in the behavioral effects of oxytocin, region-specific contributions of the basal ganglia have not been systematically explored in humans. The present study combined the randomized placebo-controlled administration of oxytocin versus placebo in healthy men (n = 144) with fMRI-based resting-state functional connectivity to determine the modulatory role of oxytocin on the major basal ganglia pathways. Oxytocin specifically increased connectivity between ventral striatal and pallidal nodes with up-stream frontal regions, whereas it decreased the strengths of downstream pathways between the dorsal striatum and posterior cerebellum. These pathways have previously been implicated in salience, reward and behavioral flexibility, thus shaping goal-directed behavior. Given the importance of aberrant striatal intrinsic organization in autism, addiction and schizophrenia the present findings may suggest new mechanistic perspectives for the therapeutic potential of oxytocin in these disorders.