Bosco Andrea, Lancioni Giulio E, Belardinelli Marta Olivetti, Singh Nirbhay N, O'Reilly Mark F, Sigafoos Jeff
Department of Psychology, University of Bari, Via Quintino Sella 268, 70100, Bari, Italy.
Cogn Process. 2009 Nov;10(4):355-9. doi: 10.1007/s10339-009-0334-3. Epub 2009 Aug 20.
A diagnosis of vegetative state represents a serious predicament, which basically precludes/minimizes rehabilitation perspectives. Reliability of the assessment approach in these situations is of paramount importance, but not easy to achieve. In recent studies, a learning assessment procedure has been suggested as a supplement in the diagnostic process and assessed with eight patients. The procedure involves an ABABCB sequence in which A represents baseline phases with no stimulation available, B intervention phases with stimuli delivered contingently on target responses, and C a control condition. This condition involves stimulation presented non-contingently. The patients' ability to associate responding with environmental stimuli and thus increase such responding during the B phases, and reduce it during the A and C phases, may be considered a sign of learning. Learning might be viewed as representative of forms of concrete knowledge and presumably basic levels of consciousness. Preliminary results indicate that (a) signs of learning may appear in patients with a previous diagnosis of vegetative state and (b) the presence of those signs may require a revision of their diagnostic label and a reappraisal of their rehabilitation perspectives.
植物状态的诊断意味着一种严重的困境，这基本上排除了/将康复前景最小化。在这些情况下，评估方法的可靠性至关重要，但却不易实现。在最近的研究中，一种学习评估程序被建议作为诊断过程中的补充，并对八名患者进行了评估。该程序涉及ABABCB序列，其中A代表无刺激可用的基线阶段，B代表根据目标反应随机给予刺激的干预阶段，C代表一种对照条件。这种条件涉及非随机呈现刺激。患者将反应与环境刺激联系起来并因此在B阶段增加这种反应，而在A和C阶段减少这种反应的能力，可能被视为学习的标志。学习可能被视为具体知识形式和大概基本意识水平的代表。初步结果表明：（a）学习迹象可能出现在先前被诊断为植物状态的患者中；（b）这些迹象的存在可能需要对其诊断标签进行修订，并重新评估其康复前景。
