Optimal stimulation: A model of disordered activity and performance in normal and deviant children.

There is considerable evidence that organisms can moderate incoming sensory stimulation to more closely approach optimal levels of arousal. When normal individuals are exposed to unusually high or low sensory input, they tend to show "disordered" behavior similar to that of certain chronically disordered populations, for example, hyperactive and autistic children. The present authors propose that at least some of the deviant behavior displayed by such disordered children represents a functional set of homeostatic responses to conditions of abnormal sensory input. Attempts to correct chronic imbalances in arousal through antecedent manipulations of chemical and sensory stimulation have been relatively successful and may provide appropriate treatment as well as a better understanding of the mechanisms underlying many kinds of disordered behavior. (5 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cerebellar degeneration associated with human immunodeficiency virus infection

Cerebellar disorders associated with HIV infection are typically the result of discrete cerebellar lesions resulting from opportunistic infections such as toxoplasmosis and progressive multifocal leukoencephalopathy or primary CNS lymphoma. Clinical symptoms and pathologic abnormalities related to the cerebellum may also be observed with HIV dementia. A primary cerebellar degeneration with HIV has not previously been reported. Ten patients were identified over an 8-year period at five medical centers. All patients had clinical, laboratory, and radiologic evaluations, and three had neuropathologic examinations. Patients presented with progressively unsteady gait, slurred speech, and limb clumsiness. Examination revealed gait ataxia, impaired limb coordination, dysarthria, and abnormal eye movements. Cognition, strength, and sensory function remained normal. CD4 lymphocyte counts varied between 10 and 437 cells/mm3. Neuroimaging studies showed prominent cerebellar atrophy. Neuropathology showed focal degeneration of the cerebellar granular cell layer and unusual focal axonal swellings in the brainstem and spinal cord. Cultures, histopathology, and immunochemical studies showed no conclusive evidence of infection. We report a syndrome of unexplained degeneration of the cerebellum occurring in association with HIV infection.     

Atypical laterality and retardation.

Empirical evidence is reviewed to examine whether retarded groups are characterized by reduced cerebral lateralization as predicted by theoretical accounts. There is clear evidence for atypical hand preferences and also for less congruency across hand, foot, eye, and ear preferences for retarded groups. However, these observations cannot be interpreted as indicative of reduced asymmetry in cerebral representation of function. Dichotic-listening studies provide little support for a general association between reduced cerebral asymmetry and retardation, although they indicate that Down's syndrome children, as well as autistic children, are characterized by atypical specialization for language. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of defeat and entrapment in depression, anxiety, and suicide.

Defeat and entrapment are psychological constructs that have played a central role in evolutionary accounts of depression. These concepts have since been implicated in theoretical accounts of anxiety disorders and suicidality. The current article reports on a systematic review of the existing research investigating the links among defeat, entrapment, and psychopathology in the domains of depression, suicidality, posttraumatic stress disorder (PTSD), and other anxiety syndromes. Fifty-one original research articles were identified and critically reviewed. There was strong convergent evidence for a link with depressive symptoms, across a variety of clinical and nonclinical samples. Preliminary support for an association with suicidality was also observed, with effects not readily explainable in terms of comorbid depression. There was strong evidence for an association between defeat and PTSD, although this may have been partly accounted for by comorbid depression. The findings for other anxiety disorders were less consistent. There was, however, evidence that social anxiety in individuals with psychosis may be related to perceptions of entrapment. Overall, there was evidence that perceptions of defeat and entrapment were closely associated with various forms of human psychopathology. These effects were often in the moderate to large range and superseded the impact of other environmental and psychological stressors on psychopathology. We provide a unified theoretical model of how defeat and entrapment may contribute to these different psychopathological conditions. Clinical implications and avenues for future research are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Pretherapy dental decisions in patients with head and neck cancer. A proposed model for dental decision support

OBJECTIVE: Sensory and motor abnormalities are common among patients with complex regional pain syndrome (CRPS). The purpose of the present study was to define and characterize these abnormalities and to develop a hypothesis regarding the area of the central nervous system from which they derive. DESIGN: Data were acquired from study subjects using clinical examination and quantitative assessment of neurological function. Subjects were divided into four groups. CRPS patients were differentiated into two groups based on the presence or absence of sensory deficit on the face to clinical examination. The other two groups were composed of patients with other chronic pain syndromes and normal individuals without chronic pain or disability. Clinical and quantitative data were compared between groups. PATIENTS: One hundred forty-five CRPS patients, 69 patients with other pain conditions, and 26 normal individuals were studied. RESULTS: A high incidence of trigeminal hypoesthesia was observed in CRPS patients. CRPS patients with trigeminal hypoesthesia manifested bilateral deficits of sensory function, with a predominant hemilateral pattern. These patients also manifested bilateral motor weakness with a more prominent hemiparetic pattern. Both sensory and motor deficits were greatest ipsilateral to the painful side of the body. These features differed significantly from those of CRPS patients lacking clinical trigeminal deficit, other pain patients, and normals. A lower cranial nerve abnormality (sternocleidomastoid weakness) and a myelopathic feature (Hoffman's reflex) were more common in CRPS patients with trigeminal hypoesthesia. CONCLUSIONS: Nearly half of CRPS patients had abnormalities of spinothalamic, trigeminothalamic, and corticospinal function that may represent dysfunction of the medulla. One-third of the remaining CRPS patients had neuroimaging evidence of spinal cord or brain pathology. The majority of CRPS patients in this study have measurable abnormalities of the sensory and motor systems or neuroimaging evidence of spinal cord or brain dysfunction.     

Quantitative analysis and isolation of Escherichia coli O157:H7 in a food matrix using flow cytometry and cell sorting

Until recently, very little attention has been paid to male victims of sexual abuse in childhood and male victims of rape and sexual assault in adulthood. Increasingly, researchers and clinicians are turning their attention to the particular problems encountered by male victims of abuse and sexual assault. Recent changes in British Law have acknowledged the existence of rape of male victims and have highlighted the need to identify the number of male victims of sexual assault and plan appropriate clinical services. A review of the literature reveals very little British empirical research on the psychological impact of rape upon male victims, although the studies that have been carried out provide clear evidence of a wide range of psychological consequences, both in the immediate period following the assault and in the long-term. Differences and similarities with female victims of rape are discussed. The particular problems encountered by male victims mean that they are even less likely than female victims to report an assault; when they do seek help the most pervasive themes that emerge from the literature concern their problems in reconciling their masculine identity with their experience of being a sexual victim. Issues concerning treatment of male victims are also discussed.     

Inadequate cortical feature maps: a neural circuit theory of autism

The autistic syndromes are caused by neurological dysfunctions. The capacity of autistic individuals to form representations of previous sensory impressions, useful for the processing of present information, is impaired. Self-organizing feature maps are mathematical models of cortical feature maps and may be used to simulate cortical processing. Dysfunctional self-organization, resulting in disability to extract features from stimuli, is proposed as a neural circuit theory of autism. The nature and a possible cause of dysfunction self-organization are examined. It is shown that impaired feature detection is valid for explaining the memory function in autism, the lack of drive for central coherence according to Frith's theory of autism, and a number of impairments from the diagnostic criteria. Unequal levels of impairment of different cortical feature maps can account for the typically uneven intelligence profile of autistic individuals. Excessive inhibitory lateral feedback synaptic connection strengths are presented as one factor impairing the development of feature maps. Strong or excessive inhibitory lateral feedback synaptic connection strengths also cause high sensory discrimination and abnormal sensory responses, both documented in autism. A neural circuit theory for autism has been presented. For a proof of this neural circuit theory neurological investigations are required.     

Electrophysical evidence reveals affective evaluation deficits early in stimulus processing in patients with panic disorder.

Cognitive and neurobiological accounts of clinical anxiety and depression were examined via event-related brain potentials (ERPs) recorded from patients with panic disorder and healthy controls as they performed an old/new recognition memory task with emotionally negative and neutral words. The emotive connotation of words systematically influenced control subjects'--but not patients'--ERP effects at prefrontal sites in a latency range (–300-500 ms) generally assumed to reflect greater contribution of automatic than controlled memory processes. This provides evidence for dysfunctional inhibitory modulation of affective information processing in panic disorder. The ERP effects after 700 ms, however, suggest that some patients may adopt conscious strategies to minimize the impact of these early processing abnormalities on overt behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autism: the phenotype in relatives

There is broad agreement that genetic influences are central in the development of idiopathic autism. Whether relatives manifest genetically related milder phenotypes, and if so how these relate to autism proper, has proved a more contentious issue. A review of the relevant studies indicates that relatives are sometimes affected by difficulties that appear conceptually related to autistic behaviors. These range in severity from pervasive developmental disorders to abnormalities in only one area of functioning, and possibly extend to related personality traits. Issues involved in clarifying the components of milder phenotypes and their relationship to autism are outlined.     

Lessons from Katrina: Disaster mental health service in the Gulf Coast region.

In this article, 4 mental health professionals provide firsthand accounts of experiences as volunteers in the Gulf Coast region following Hurricanes Katrina and Rita in the fall of 2006. These accounts are provided with the goal of informing psychologists and other mental health providers about the role of volunteers from a frontline perspective. The authors offer these observations as a compliment to formal training in disaster preparedness that psychologists might receive for volunteer service in the wake of a devastating disaster. Specifically, the authors discuss the training they received, the settings in which they worked, and the client needs and mental health skills they used to meet those needs. Last, the lessons the authors learned about providing disaster mental health services are discussed. It is hoped that these observations might inspire others to lend their expertise and compassion in response to future catastrophic events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distress among young adults from divorced families.

Researchers find that most children from divorced families function normally, but some clinicians assert that young people are disturbed even many years after a divorce. These accounts may be less discrepant than they appear, because research typically focuses on notably problematic behavior (disorder), whereas case studies emphasize more subtle inner turmoil (distress). In Study 1 college students reported painful feelings, beliefs, and memories about their parents divorce on a reliable new measure, but they also reported accepting the divorce and having few psychological symptoms. Distress about family life was greater among students from divorced than from married families. Study 2 replicated these findings in a community sample of young people from low-income divorced families. In both studies, greater distress was associated with children's residence, frequency of contact with fathers, interparental conflict, and psychological symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lower extremity sensory nerve conduction studies

The need for routine recording of sensory potentials in the lower extremity was developed in efforts to better investigate peripheral neuropathy. Sensory nerve conduction studies (NCS) are more sensitive to many abnormalities in the peripheral nervous system than the motor NCS responses. This article provides a thorough review of sensory nerve conduction studies of the lower extremity, with special emphasis on electrodiagnostic issues.     

Sensory and mixed nerve conduction studies in the evaluation of ulnar neuropathy at the elbow

The relative sensitivities of sensory, mixed nerve, and motor conduction studies in assessing ulnar neuropathy at the elbow have not yet been established. Using surface electrodes, we performed conduction studies across the elbow segment in 43 patients with symptoms referable to the ulnar nerve and 40 control subjects. Segmental slowing of motor conduction localized the lesion to the elbow in 14 of 21 patients (67%) with clear evidence of ulnar neuropathy on physical examination but only in 2 of 22 (9%) with subtle or no physical examination abnormalities. The diagnostic yield was increased by the finding of segmental slowing of sensory or mixed nerve conduction across the elbow to 86% and 68%, respectively, for each of the groups. We conclude that surface-recorded sensory and mixed nerve conduction studies appear to be more sensitive than motor studies in the electrodiagnosis of ulnar neuropathy at the elbow and are especially valuable in patients with subtle clinical involvement.     

Consciousness and metacognition.

This article describes the interplay between psychological and philosophical approaches to consciousness. The role of empirical evidence from psychological research on metacognition is emphasized. The metacognitive approach to subjective reports is helpful for circumventing some fundamental shortcomings in early introspectionist approaches. A central claim of the article is that subjective reports can be useful for testing hypotheses if the way in which they are used is reformulated, and specific reformulations are offered. Illustrative findings about metacognitive monitoring and metacognitive control demonstrate how research on metacognition can produce synergy between the psychological and philosophical approaches to consciousness, by furnishing constraints on the range of acceptable theories and by producing clues to inspire new theories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some nondeprivation variables which influence the "effects" of experimental sensory deprivation.

48 university students similar to those used in experiments on sensory deprivation (SD) were surveyed to determine their knowledge about SD, their acknowledged reasons for volunteering to be in SD experiments, and their previous history of unusual appearing (SD-like) experiences. The responses indicated considerable knowledge of SD, very "active" reasons for volunteering, and a variety of previous unusual appearing experiences. The results are in accord with the hypothesis that some reported effects of SD, particularly self-reported, unusual appearing, subjective experiences, may be strongly influenced by extradeprivation variables which are part of the total experimental situation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When distress does not become depression: Emotion context sensitivity and adjustment to bereavement.

Recent evidence suggests that the sensitivity of emotion responses to changing context may be a key element of psychological adjustment and psychopathology (Bonanno et al., 2007; Rottenberg, Kasch, Gross, & Gotlib, 2002). However, there have been no previous investigations to examine emotion context sensitivity and adjustment following stressful life events. This investigation addressed this deficit in a sample of middle-aged bereaved adults (N = 48) whose emotion responses were measured as they described loss and non-loss-related events during a laboratory interview 4 months after the death of their spouse or child. Symptoms of depression were assessed using structured clinical interviews at 4 and 18 months postloss. Although positive emotions were beneficial regardless of context, context sensitivity for negative emotions at 4 months predicted fewer depression symptoms at 18 months. These findings suggest that the capacity to shift negative emotion responses according to changing context may differentiate those individuals who will show improvements in depression symptoms over time from those who will show chronic impairments. Implications for future research and clinical intervention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of clinical pharmacology in molecular genetics

PROBLEM: Discovering the causes of unusual phenotypes in human subjects is an important aspect of patient-oriented research. MATERIAL: The tools of clinical pharmacology are uniquely useful in addressing these problems. PATIENTS, SUBJECTS, OR CASE HISTORIES: We evaluated a 42-year-old patient with lifelong orthostatic hypotension and ptosis of the eyelids. He underwent a series of biochemical, physiological, and pharmacological tests outlined in this article. RESULTS: These studies indicated that sympathetic innervation was intact but that the sympathetic neurotransmitter was dopamine rather than norepinephrine. These results demonstrated that dopamine-beta-hydroxylase deficiency underlies the clinical abnormalities of this patient. CONCLUSION: In selected individuals with unusual phenotypes, the techniques of clinical chemistry and clinical pharmacology can define the nature of the defect at almost the resolution of the human genome.     

Cost effectiveness and medical cost-offset considerations in psychological service provision.

Suggests that empirical evidence has demonstrated that psychological interventions can effectively treat a wide range of child and adult health problems. The focus of this review is on costing issues associated with psychological interventions, including cost-effectiveness and cost offset (i.e., a reduction in health care costs attributable to effective intervention). Recent evidence has demonstrated that psychological interventions can be more cost-effective than optimal drug treatment. For example, although having comparable effectiveness, cognitive-behavioral treatments for panic disorder and for depression have been estimated to cost approximately one-third less than pharmacological treatment. Further, a recent meta-analysis of 91 research studies published between 1967 and 1997 found that average health care cost savings due to psychological intervention were in the range of 20-30% across studies, and 90% of the studies reported evidence of a medical cost offset. In conclusion, the evidence indicates that psychological treatments (1) can be cost-effective forms of treatment and (2) have the potential to reduce health care costs, as successfully treated patients typically reduce their utilization of other health care services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)